Establishing health ministries: leaders' perceptions of process and effectiveness

Church-based health interventions are one mechanism to address health issues of African Americans. This study determines the perceptions of health leaders regarding the development process for and the effectiveness of church health ministries, using the Precede/Proceed model. Ten health leaders from six medium-sized churches in a North Florida county participated in a 10-month breast health intervention. Data were collected using two methods. A brief questionnaire was administered that included items related to knowledge about breast health, perceptions of and processes for health ministry development, and perceptions of resources used during the intervention. In addition, a focus group was conducted with the health leaders, using a trained moderator, which included questions about their health behaviors prior to and after the project, biggest successes and challenges in establishing their health ministries, and plans for sustaining the health ministry after the project. Questionnaire data were analyzed using descriptive statistics and paired t-tests. Focus group data and open-ended questionnaire responses were transcribed and analyzed using code-based analytic procedures where data were organized into thinking units, categories, and then broader themes. Findings indicate that health leaders perceived that health ministry development focused on a series of steps, including: a) predisposing: health leaders background (personal characteristics, education/profession, health behaviors); b) enabling: support and participation from the pastor; and c) reinforcing: start-up processes (personal contact, public relations, materials and church member involvement) and outputs (activities and partnerships). This study demonstrates that health ministry development involves a sequential process that fits within a broad organizational framework for health behavior change.