Paper Session 3: Community Engagement

Clergy currently experience a high prevalence of obesity, certain chronic health conditions as well as mental health concerns (e.g, depression, anxiety, burnout). Research shows many clergy experience unique barriers (e.g., 24/7 on-the-go vocation) to engaging in healthy behaviors (e.g., physical activity [PA]). Findings from PA interventions aimed at reducing these barriers and encouraging PA engagement have been mixed. This qualitative study aimed to gain an understanding of what clergy need to participate in physical activity (PA) programs. Virtual, in-depth interviews were conducted with clergy lasting approximately 45 min-1 hour. NVivo was used for thematic analysis of qualitative data and SPSS for analysis of demographic data. On average, participants (N = 27) spent 17.3 (SD=11.0) years in ministry and were 44.3 (SD=11.6) years old. Most participants were white (93%), female (52%), and affiliated with the Presbyterian denomination (89%). As themes emerged, the Socio-Ecological Model was used to organize findings. At the Individual level, clergy spoke of programs needing to have a Holistic Health Focus, provide Bite-Sized Tips and Tools, and provide internal and external forms of Motivation (e.g., help making PA a priority, motivational stories, incentives). At the Interpersonal level, creating Community with Other Clergy along with acknowledging their roles as Spiritual Leaders and Parents were discussed. At the Institutional level, clergy spoke of needing supportive cultures and policies at the Congregational and Denominational levels. At the Community level, themes related to Accessing Resources (e.g., gyms, equipment) and Using Technology (e.g., online components, social media) emerged. Data from this study indicate multi-level interventions are needed to account for the various factors impacting clergy engagement in PA and other health-related behaviors. Helping their social networks, congregations, and denomination leadership understand the importance of clergy health may be necessary for long-term, sustainable individual-level change.

Co-Author - Nathan T. West, PhD, PhD,
University of Alaska Anchorage

Co-Author - Adam Hege, PhD,
Appalachian State University

Co-Author - Brook E. Harmon, PhD, RDN, PhD, RDN,
Appalachian State University

Background: Urban parks are important locations for physical activity (PA) for people of all ages, yet their utilization varies dramatically. Improving these sites is critical to increase PA levels, particularly in racial/ethnic minority and lower-income neighborhoods with the least greenspace. Little attention has been paid to how Latino/a residents of such communities perceive local parks—including barriers to and facilitators of using them for PA—nor how perceptions may differ between English and Spanish speakers. To fill this gap and better understand resident needs, we conducted a pilot study using geo-tagged, multidimensional data collected with a citizen science mobile app within one such urban park in a primarily Latino/a, lower-income Los Angeles (LA) neighborhood.
Methods: A group of Latino/a youth and parents took part in a walk audit at Hazard Park in LA using the Our Voice Discovery Tool. They captured photos and recorded comments in their preferred language about park attributes that facilitated or hindered PA. Researchers utilized content analysis to identify the main topic for each entry. Two coders blindly coded each entry (percent agreement: 75.7%), and discrepancies were resolved verbally. The proportion of comments on each topic was compared between the English- and Spanish-speaking groups using a Fisher’s exact test.
Results: All 32 participants—including 20 adults and 12 youth—identified as Latino/a and 15 (55.6%) as female. Participants captured 416 photos and comments: 319 in English and 97 in Spanish. Across both language groups, participants had the most comments about sidewalks and other surfaces (n=61;14.7%), children’s play areas (61;14.7%), and landscaping (55;13.2%). Marginally significant differences were observed in the topics identified by the English- and Spanish-speaking groups (p=0.066). Among other differences, more English-speaking participants emphasized vandalism (6.0% vs. 1.0% in Spanish) and other concerns such as fencing (3.4% vs. 0%), whereas more Spanish speakers mentioned social spaces (4.2% vs. 1.6% in English) and security (4.2% vs. 0%).
Discussion: Given that preferred language is a sign of acculturation, our finding that the themes identified in comments in English and Spanish marginally differ suggests that cultural beliefs may influence perceptions of and visions for parks. Future research encompassing more parks across LA will explore the influence of acculturation on park utilization and changes in PA.

Author - Arjan Walia, MS,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Victoria Bermudez,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Diana M. Chavez,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Vignesh Kumar,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Tatyana Sgaraglino,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Gillian Gresham, PhD, MS,
Cedars-Sinai Medical Center Division of Population Sciences

Co-Author - Nima Nikravesh, BA,
Cedars-Sinai Cancer Center Cancer Research Center for Health Equity

Co-Author - Hannah Reynolds, MPH,
San Diego State University Division of Health Promotion and Behavioral Sciences

Co-Author - Lourdes Barajas, MBA,
Cedars-Sinai Cancer Center Cancer Research Center for Health Equity

Co-Author - Maria Campero, BA,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Zakaria Doueiri, BS,
Stanford School of Medicine Department of Epidemiology and Population Health

Co-Author - Michael Fine, BS,
Cedars-Sinai Cancer Center Cancer Research Center for Health Equity

Co-Author - Laurel Finster, MPH,
Cedars-Sinai Cancer Center Cancer Research Center for Health Equity

Co-Author - Ghecemy Lopez, DSW, MEd,
Cedars-Sinai Cancer Center Cancer Research Center for Health Equity

Co-Author - Celina Shirazipour, PhD,
Cedars-Sinai Medical Center Division of Population Sciences

Co-Author - Michael Sobolev, PhD,
Cedars-Sinai Medical Center

Co-Author - Zulfikarali Surani, EdD,
Cedars-Sinai Medical Center Community Outreach and Engagement

Co-Author - Robert Haile, DrPH,
Cedars-Sinai Division of Population Sciences

Co-Author - Abby King, PhD,
Stanford School of Medicine Department of Epidemiology and Population Health

Background: Children from sociodemographically marginalized backgrounds are disproportionately affected by water inequities. We partnered with our Community Advisory Board (CAB) and a public school district to develop and pilot a community-participatory intervention to improve water access and intake in school. Intervention feasibility and preliminary efficacy were examined.
Methods: Two Title I schools (N=510 students, 50% Black) were randomly assigned to Intervention or Control. A 12-week intervention engaged teacher and student ambassadors and included: a Kick-Off; education and outreach; behavioral reinforcement; and student-developed marketing. Assessments of water bottles and beverage selection at lunch (via observations), hydration station use (via flowmeters), beverage intake (BEVQ), and hydration practices and perceptions (via student and staff surveys) were conducted at baseline and post. Process evaluation assessed intervention feasibility. Preliminary efficacy was determined by exploring group differences in outcomes over time.
Results: Student (n=3) and teacher ambassadors (n=2) were successfully recruited and trained. Teachers taught 14 hydration lessons; 320 students received and personalized water bottles; 1298 incentives were provided to students for drinking water; 203 students submitted hydration trivia responses. Most school personnel felt prepared (93%) and were satisfied (91%) with the intervention. Student hydration knowledge increased (+10%) in the Intervention school and decreased (-6%) in Controls. Teacher adherence to hydration promotion practices increased (+12%) in the Intervention school and decreased (-17%) in Controls. Challenges included faulty hydration stations, broken water bottles, and limited wall space (33% of teachers posted water policy signs). Objective hydration station use (~25oz/student/day at post) and student-reported water intake (~23oz/day at post) increased in both schools. Daily sugar-sweetened beverage (SSB) intake decreased (-4.9oz) in the Intervention school and increased (+6.4oz) in Controls. At post, Intervention students (n=232) were 10x more likely to have water bottles at lunch compared with baseline (p<.001), with no change in Controls (n=207).
Discussion: Partnering with schools and our CAB to implement a hydration intervention is feasible, with preliminary findings suggesting reduced SSB intake and increased water bottle use and hydration knowledge. Findings are informing a fully powered trial.

Presenter - Melanie K. Bean, PhD, FSBM,
Virginia Commonwealth University

Co-Author - Katlyn Garr, PhD,
Virginia Commonwealth University

Co-Author - Jessica Gokee LaRose, PhD, FSBM,
Virginia Commonwealth University School of Population Health

Co-Author - Hsin-Ling Hung, PhD,
Virginia Commonwealth University

Co-Author - Alisa Brewer, MSPH,
Virginia Commonwealth University

Co-Author - Ashley Mendoza, RD,
Virginia Commonwealth University

Co-Author - Justine Blincoe, MSW,
Greater Richmond Fit4Kids

Co-Author - Kristina L. Tatum, PsyD,
Virginia Commonwealth University

Co-Author - Danyel I. Smith, PhD,
Georgetown University

Co-Author - Amanda Robinson, MS,
Virginia Commonwealth University

Co-Author - Roy Sabo, PhD,
Virginia Commonwealth University

Co-Author - Tegwyn Brickhouse, DDS PhD,
Virginia Commonwealth University

Community Health Workers (CHWs) are trusted community members capable of addressing the opioid epidemic at the frontlines through education, stigma reduction, and connection to culturally-competent care. This study evaluated changes in CHW knowledge and attitudes toward opioid use following a standardized Opioid Overdose Prevention and Response (OOPR) training.
CHWs (N=78) 18 years of age or older who were employed, volunteering, or in CHW training in Arizona between January and February 2024 participated in a 60-minute evidence-based OOPR training and online surveys at baseline, post-training, and 2-month follow-up. Elements of training and assessment mirrored the Opioid Overdose Awareness and Reversal training (OOART) by Bascou and colleagues (Bascou et al., 2022).
Data was analyzed in SPSS (Version 28). Descriptive statistics characterized demographic characteristics; a chi-square test evaluated for differences in gender, race/ethnicity, and education among respondents post-training. Paired Sample T-Tests assessed changes from baseline to post-training related to 1) Narcan-related risk compensation beliefs, 2) attitudes towards individuals with OUD, 3) opioid overdose knowledge, 4) and training effectiveness.
Participants were predominantly female (72.8%), with nearly half identifying as Hispanic/Latinx/Spanish (46.2%). The mean age was 37.69 (SD 13.4) years, and most (96.2%) were employed full-time, with (60.2%) reporting at least six or more years of CHW experience. Findings revealed baseline uncertainty regarding Narcan-related risk compensation beliefs, with attitudes toward Narcan usage and overdose reversal remaining consistent post-training. However, participants' attitudes towards individuals with opioid use disorder (OUD) shifted post-training, indicating greater acceptance of persons with OUD and the importance of a harm reduction approach. Despite the initial fear of handling overdose situations, nearly 45% of participants felt confident they would not panic during an overdose event.
This research underscores the critical role of CHWs in opioid response initiatives and highlights the importance of standardized training to enhance their effectiveness in mitigating stigma and improving overdose response outcomes.

Presenter - Madeline Hooten, MS,
Arizona State University - Phoenix, AZ

Co-Author - Mindy L. McEntee, PhD,
Arizona State University