• Sara Wilcox, Ruth P Saunders, Andrew T Kaczynski, Melinda Forthofer, Patricia A Sharpe, Cheryl Goodwin, Margaret Condrasky, Vernon L Kennedy, Danielle E Jake-Schoffman, Deborah Kinnard, and Brent Hutto.
• Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. Electronic address: wilcoxs@mailbox.sc.edu.
• Am J Prev Med. 2018 Jun 1; 54 (6): 776785776-785.

IntroductionFaith-based organizations can contribute to improving population health, but few dissemination and implementation studies exist. This paper reports countywide adoption, reach, and effectiveness from the Faith, Activity, and Nutrition dissemination and implementation study.DesignThis was a group-randomized trial. Data were collected in 2016. Statistical analyses were conducted in 2017.Setting/ParticipantsChurches in a rural, medically underserved county in South Carolina were invited to enroll, and attendees of enrolled churches were invited to complete questionnaires (n=1,308 participated).InterventionChurches (n=59) were randomized to an intervention or control (delayed intervention) condition. Church committees attended training focused on creating opportunities, setting guidelines/policies, sharing messages, and engaging pastors for physical activity (PA) and healthy eating (HE). Churches also received 12 months of telephone-based technical assistance. Community health advisors provided the training and technical assistance.Main Outcomes MeasuresThe Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided measurement of adoption and reach. To assess effectiveness, church attendees completed post-test only questionnaires of perceptions of church environment, PA and fruit and vegetable (FV) self-efficacy, FV intake, and PA. Regression models controlled for church clustering and predominant race of congregation, as well as member age, gender, education, and self-reported cancer diagnosis.ResultsChurch adoption was 42% (55/132). Estimated reach was 3,527, representing 42% of regular church attendees and 15% of county residents. Intervention church attendees reported greater church-level PA opportunities, PA and HE messages, and PA and HE pastor support (p<0.0001), but not FV opportunities (p=0.07). PA self-efficacy (p=0.07) and FV self-efficacy (p=0.21) were not significantly higher in attendees of intervention versus control churches. The proportion of inactive attendees was lower in intervention versus control churches (p=0.02). The proportion meeting FV (p=0.27) and PA guidelines (p=0.32) did not differ by group.ConclusionsThis innovative dissemination and implementation study had high adoption and reach with favorable environmental impacts, positioning it for broader dissemination.Trial RegistrationThis study is registered at www.clinicaltrials.gov NCT02868866.Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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