title: Facilitators and Barriers to Implementing Church-Based Adolescent Sexual Health Programs in Baltimore City.
abstract: OBJECTIVE
  Black churches are an important community resource and a potentially powerful actor in adolescent health promotion. However, limited research exists describing the factors that may influence the successful implementation of evidence-based adolescent sexual health programs in churches. In the present study, a multi-informant approach was used to identify facilitators and barriers to implementing adolescent sexual health programs in black churches.
  
  
  METHODS
  Nine Black churches located in Baltimore, MD, were recruited to participate in this study. The senior pastor and youth minster from each congregation participated in an in-depth interview (N = 18). A total of 45 youth (ages 13-19 years) and 38 parents participated in 15 focus groups. Qualitative data were transcribed verbatim and analyzed using a qualitative content analytic approach.
  
  
  RESULTS
  Participants agreed that comprehensive adolescent sexual health education should be available for youth in black churches. They also believed that abstaining from sex should be discussed in all adolescent sexual health programs. Three facilitators were discussed: widespread endorsement of church-based adolescent sexual health education, positive influence of youth ministers on youth, and life lessons as teaching tools. Four barriers are described: perceived resistance from congregants, discomfort among youth, lack of financial resources, and competing messages at home about sexual health.
  
  
  CONCLUSIONS
  Our findings suggest that churches are a preferred place for adolescent sexual health education among some parents and youth. Study findings also reinforce the feasibility and desirably of church-based adolescent sexual health programs.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: terri.powell@jhu.edu.
authors.forename: Terrinieka W
authors.initials: TW
authors.lastname: Powell
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Fiona H
authors.initials: FH
authors.lastname: Weeks
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Samantha
authors.initials: S
authors.lastname: Illangasekare
authors.affiliation: Johns Hopkins School of Education, Baltimore, Maryland.
authors.forename: Eric
authors.initials: E
authors.lastname: Rice
authors.affiliation: Sisters Together and Reaching (STAR), Baltimore, Maryland.
authors.forename: James
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Sisters Together and Reaching (STAR), Baltimore, Maryland.
authors.forename: Debra
authors.initials: D
authors.lastname: Hickman
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Blum
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D000328:Adult; D001741:Black or African American; D015142:Baltimore; D002977:Clergy / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D016730:Program Development; D036301:Qualitative Research; D012736:Sex Education / Q000458:organization & administration*; D000074384:Sexual Health / Q000193:education*
keywords: Adolescents; Church based; Qualitative; Sexual health