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October 31, 2018The church plays a significant role in the African-American community, and has been used before to promote health information on cancer screening, vaccinations, HIV awareness, and weight reduction. And now research shows the church can also help African-American parishioners manage hypertension, a condition that affects 40 percent of this minority population in the United States.In a study published in October in the journal Circulation: Cardiovascular Quality and Outcomes, a team including Gbenga Ogedegbe, MD, MPH, a professor in the departments of medicine and population health at New York University’s Langone Medical Center, found that lifestyle interventions administered in churches by lay health advisers significantly reduced blood pressure among African-Americans compared with health education alone.”African-Americans have a significantly greater burden of hypertension and heart disease, and our findings prove that people with uncontrolled hypertension can, indeed, better manage their blood pressure through programs administered in places of worship.” Dr. Ogedegbe said in a press release.Researchers enrolled 373 men and women from 32 New York City churches who identified as black and had a self-reported diagnosis of hypertension with uncontrolled blood pressure. Half the group received 11 weekly 90-minute group sessions focused on healthy lifestyle behaviors and three monthly motivational interviewing sessions from community-based or lay health advisers.Each weekly session targeted a particular healthy behavior and incorporated a passage from the Bible and prayer into faith-based discussions.“It was something they could relate to, it was in sync with their values, so they received it well,” Ogedegbe said.The participants were also given three one-on-one counseling sessions over the phone after the 12-week group meetings ended. The same lay health workers talked to them about the issues they faced in changing lifestyle habits, and helped them understand how their behavior affects their health.For example, if they had difficulty going for daily walks, the counselor encouraged them to walk a little longer when they could go. The focus was on incremental progress, to help them stay on track without giving up.The other half of the group received one session on lifestyle and hypertension management and 10 weekly informational sessions on health topics that were led by health experts.When measurements were taken at the end of three months, the group that had the church-based intervention had a 5.8 millimeters of mercury (mmHg) greater reduction in systolic blood pressure compared with the group that received only health education. This showed that this faith-based intervention was effective.But the difference between the two groups reduced after nine months. Ogedegbe suggested that having the intervention delivered over a longer period of time, with periodic maintenance sessions, would help. He added that the next step would be to forge church-clinic partnerships, so the results are more effective in future studies.“If you can have a health ministry within your church, it will help improve community health,” he says.The Importance of Combining Church and Medicine for African-AmericansHypertension (high blood pressure) is a public health concern in today’s fast-paced, stressful world, with higher rates of obesity, sedentary lifestyles, and high-sodium foods. But it’s much more of an issue among African-Americans, with 40 percent experiencing high blood pressure compared with 28 percent of whites and Hispanics and 25 percent of Asians, according to the National Health and Nutrition Examination Survey (NHANES) data.Importantly, lifestyle choices and environment play an important role in the development of hypertension.“Your zip code is more important than your genetic code for hypertension,” says Ogedegbe. “Where you live matters. People in low-income neighborhoods tend to have higher stress, and therefore higher blood pressure.”Ogedegbe pointed out that African-Americans had a higher likelihood of dying from stroke, cardiac arrest, and kidney failure — hypertension is a leading cause for all three diseases.He found that programs that help people exercise more and reduce weight show results, but blacks don’t often come in for help until they have really high blood pressure.“Most low-income minorities have a lot of competing priorities, and can’t come into the clinic every week for 12 weeks to improve their blood pressure,” he pointed out. But they do find time to attend church and church group meetings.
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