Development, feasibility, acceptability and potential effectiveness of a healthy lifestyle programme delivered in churches in urban and rural South Africa

Draper, C. E., Tomaz, S. A., Zihindula, G., Bunn, C. , Gray, C. M. , Hunt, K. , Micklesfield, L. K. and Wyke, S. (2019) Development, feasibility, acceptability and potential effectiveness of a healthy lifestyle programme delivered in churches in urban and rural South Africa. PLoS ONE, 14(7), e0219787. (doi: 10.1371/journal.pone.0219787) (PMID:31365557) (PMCID:PMC6668772)

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Abstract

Rising levels of obesity in South Africa require innovation in community-level lifestyle change programmes. Our aim was to co-develop Impilo neZenkolo (‘Health through Faith’), a healthy lifestyle programme for low-income, black South Africans delivered through churches, and evaluate its feasibility, acceptability and potential effectiveness. In the first phase we developed programme materials with church members. In the second phase we trained lay leaders to deliver the programme and assessed feasibility, acceptability (observation, focus groups and interviews) and potential effectiveness (pre and post measurement of weight, hip and waist circumferences, blood pressure, self-reported physical activity, dietary habits, health status, self-esteem, psychological distress). The study was conducted in four churches in urban and rural South Africa. The development workshops led to increased focus on positive benefits of participation, widening inclusion criteria to all adults and greater emphasis on Christian ethos. Challenges to feasibility included: recruitment of churches; scheduling of programme sessions (leading to one church not delivering the programme); attendance at the programme (63% attended more than half of the 12 weekly sessions); and poor programme fidelity (in particular in teaching behaviour change techniques). Aspects of the programme were acceptable, particularly the way in which the programme was aligned with a Christian ethos. There was some indication that amongst the 42/68 (62%) for whom we were obtained pre- and post-programme measurements the programme has potential to support weight loss. We conclude that a healthy lifestyle programme for low-income, black South Africans, delivered through churches, may be viable with extensive re-development of delivery strategies. These include finding external funding for the programme, endorsement from national level denominational organisations and the professionalization of programme leadership, including paid rather than volunteer leaders to ensure sufficient time can be spent in training.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and Gray, Professor Cindy and Hunt, Professor Kate and Bunn, Dr Christopher
Creator Roles:
Bunn, C.Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Software, Supervision, Writing – review and editing
Gray, C. M.Conceptualization, Funding acquisition, Methodology, Resources, Writing – review and editing
Hunt, K.Conceptualization, Funding acquisition, Methodology, Resources, Writing – review and editing
Wyke, S.Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review and editing
Authors: Draper, C. E., Tomaz, S. A., Zihindula, G., Bunn, C., Gray, C. M., Hunt, K., Micklesfield, L. K., and Wyke, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2019 Draper et al.
First Published:First published in PLoS ONE 14(7): e0219787
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5525/gla.researchdata.736

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
721111Health and Faith: can faith-based organisations support weight management and reduce risk of NCDs in South Africa?Sally WykeMedical Research Council (MRC)MR/N028260/1SPS - INST. OF HEALTH & WELLBEING