Eat, Pray, Move: A Faith Community-level Intervention to Prevent Obesity among Black and Latino Adults

About This Grant

Obesity disproportionately affects Black and Latino populations in California, placing them at higher risk of poor mental and physical health. Addressing obesity disparities requires approaches that engage and empower trusted community institutions such as churches, which have a long history of supporting the health and well-being of Black and Latino congregants. Faith-based interventions have been shown to improve health behaviors, but few have a) included both Black and Latino populations, b) targeted factors beyond the individual, c) examined causal mechanisms, or d) studied factors that influence effective implementation. Through an NIH-funded pilot, we developed and tested a faith community-level intervention called Eat, Pray, Move (EPM), which engaged both Black and Latino churches in South Los Angeles (LA) and resulted in improved obesity outcomes among adults (e.g., less weight gain and greater weight loss). The study’s pilot nature limited our ability to examine longer-term effects and sustainability and analyze mediators. Specific Aims: We propose to conduct a fully powered, cluster randomized controlled trial (RCT) of EPM to 1) Determine the efficacy of a faith community-level intervention on obesity-related outcomes among Black and Latino adult congregants (n=1120); 2) Examine mechanisms by which the intervention affects intermediate and obesity outcomes; and 3) Evaluate facilitators and barriers of intervention implementation and sustainment. Design and Methods: We will conduct a cluster RCT involving 28 churches (14 predominantly Black and 14 predominantly Latino) in South LA to test the impacts of EPM on body mass index and weight among adult participants at 6-, 12-, and 24-months follow-up. Churches will be pair-matched on race/ethnicity, church size, and denominational grouping and randomly assigned to intervention or control. The intervention will target the physical and social environments at the faith community-level as well as interpersonal- and individual-levels. In addition to examining effects on obesity outcomes, we will examine potential mediators such as faith community-level access to healthy eating and physical activity and social norms and support. The Consolidated Framework for Implementation Research will guide evaluation of implementation barriers and facilitators across multiple domains (e.g., inner/outer setting) from the perspective of faith community leaders and collect process evaluation data to explore community-level impacts and sustainability. Innovation and Impact: This is the first full-scale cluster RCT of a faith community-level intervention to engage both Black and Latino congregations. Findings from the proposed work will fill a critical gap in knowledge regarding the causal mechanisms by which faith-based interventions impact obesity outcomes and will enhance understanding of determinants that influence successful implementation and sustainability. The intervention has the potential to address obesity disparities in two high-risk population groups while empowering trusted institutions to deliver effective obesity prevention strategies, which may serve as a sustainable model to improve health outcomes in congregations and more broadly in their communities.