Learning Session 8

Working with Faith-based Entities to Increase Hypertension Awareness and Control

Speaker: Sunita Dodani, MBBS (MD), MS, PhD, FAHA
Adjunct Associate Professor,
Department of Epidemiology
College of Public Health & Health Professions, and College of Medicine
University of Florida, &
Senior Consultant & Research Affiliate
Mayo Clinic, Jacksonville, FL

Brief Bio: (download)
Dr Sunita Dodani MD, MSc, FCPS, PhD, FAHA is a Physician with specialization in cardiology. She received her undergraduate degree from the Aga Khan University, one of the premier private universities in Pakistan. In addition, she also received Masters in epidemiology and community health from the Dalhousie University, Halifax, Canada, and PhD in epidemiology (majors in cardiovascular disease epidemiology) from the University of Pittsburg. Her research interests are focused on health disparities related to cardiovascular diseases and type 2 diabetes in African Americans, Hispanics and South Asians. Dr Dodani’s future goal is to reduce health disparities and develop national level registries for cardiovascular diseases and type 2 diabetes for ethnic minorities.

Dr Dodani is NIH funded and recipients of several extramural funding including NIH. Dr. Dodani has successfully completed several research projects in Pakistan as well as in the US that focused on the distribution and determinants of cardiovascular diseases in ethnic minorities. Her current focus involves profiling non-traditional and genetic cardiovascular and metabolic risk factors in south Asian immigrants. She has worked with many ethnic minorities helping to reduce health disparities. For example Fit Body and Soul, Diabetes prevention program for African American churches was funded by NIH. Similarly HEALS-Healthy eating and Living spiritually is hypertension control program for African American. In addition CHHIL study (Children’s Healthy habits Integrated for Life) is a childhood obesity control program for African American kids. Dr Dodani received a National Gold Medal as Best Young Researcher of Pakistan in 2002, in addition to several awards for her achievements in this area. She also received the “Community Service Award” from the International Society on Hypertension in Blacks (ISHIB).” She has been recognized and honored as “Fellow” American Heart Association (FAHA). Dr. Dodani has published more than 40 multi-disciplinary articles in peer-reviewed journals.

Listen to the presentation (20 min)

Resources:

  • Transcript

Objectives of the presentation:

  • Increase the knowledge and ability of state and local health department to impact uncontrollable hypertension by collaborating with faith-based organizations to implement programs to increase hypertension awareness, prevention and control in their congregations and community.
  • Increase the knowledge and ability of state and local health department participants to implement a local faith-based program on hypertension awareness and control.

Main points to be covered:

  • Successful strategies for reaching out to faith-based entities as a means to promote hypertension awareness and control.
  • Implementation of the Healthy Eating and Living Spiritual (HEALS) program to increase awareness and action among African Americans in a faith-based setting to control hypertension.

Main points presented:

  • Development of the Healthy Eating and Living Spiritual (HEALS) program based off of the DASH, DASH+sodium and PREMIER research trials. DASH trials were nutrition based and PREMIER trial added behavioral approaches (physical activity, reduced alcohol consumption) to control high blood pressure. DASH trial successful in African Americans. PREMIER not as successful in African Americans. Fresh fruits and vegetables may be cost prohibitive for participants to purchase on their own.
  • Using the work of previous trials, HEALS program incorporated a modified culturally appropriate approach of spirituality, which focused on 3 levels: 1) Pastor endorsement of the program in their weekly message, 2) Group Activities conducted by Church Health Advisors (CHAs) who were lay persons of the church, and 3) Individual Activities conducted by the CHAs who identified barriers and resources for participants.
  • The sustainability factor has been successful because of the integration of the program and messages within the church culture and administration by individuals of the congregation.
  • Academic staff served as back bench supporters and county health department provided nutritionists for group presentations and technical advice.
  • A Community Advisory Board has been formed and has representation from churches, county health department, and local institutions to receive advice from African Americans on how academic, governmental and local institutions can assist in the program. The county health department was involved in the program at the beginning and remains deeply involved in the collaboration.
  • Connections with a Farmer’s Market was made to bring fresh produce to churches on Sunday for the congregation to purchase after church.
  • This program was tested in 2 churches and has now expanded to 36 churches.

Main take-away points:

  • African Americans practice a strong spirituality that should be incorporated into programs attempting to reach them.
  • African Americans tend to have a diet higher in fatty foods, and diet menus should be adjusted to reduce sodium, fat and include more fresh fruits and vegetables.
  • Key success factors to the HEALS program includes the buy-in of the Pastor, the participation of the lay leaders as CHAs to run and maintain the program, the inclusion of spirituality within the program components and the availability of low cost fresh fruits and vegetables.
  • High retention and adherence by participants to the program also included having the social needs of the community addressed and the building of trust with the academic and county health department institutions that they are there to participate with the community.