HEALS: A Faith-Based Hypertension Control and Prevention Program for African American Churches: Training of Church Leaders as Program Interventionists

Background. A 12-session church-based HEALS program (healthy eating and living spiritually) was developed for hypertension control and prevention program in African Americans (AAs). This study presents specifics of training lay health educators to effectively deliver HEALS to high-risk AAs. Methods. A one-day workshop was conducted by the research experts in an AA church. Five church members were recruited to be program interventionists called church health counselors (CHCs). Results. Using principles of adult education, a training protocol was developed with the intention of recognizing and supporting CHCs skills. CHCs received training on delivering HEALS program. The process of training emphasized action methods including role playing and hands-on experience with diet portion measurements. Conclusion. With adequate training, the community lay health educator can be an essential partner in a community-based hypertension control programs. This may motivate program participants more and encourages the individual to make the behavior modifications on a permanent basis. 1. Introduction Hypertension (known as the “silent killer”) prevalence is highly variable among populations worldwide. In the US, there is a disproportionate burden of hypertension and its complications in African Americans (AAs) [1]. Not only are AAs more likely to suffer from hypertension than are whites, but they also experience a higher complication rate, greater severity, and earlier disease onset. From 1988–1994 to 1999–2002, the prevalence of hypertension in adults increased from 35.8% to 41.4% among AAs, and it was particularly high among AA women, at 44.0% compared to 28.1% in whites [2]. Hypertension is more common in middle-aged or older, less-educated, overweight or obese, and physically inactive AAs [3]. As a result, compared with whites, AAs have a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of heart disease death, and a 4.2-times greater rate of end-stage kidney disease [4, 5]. Many AAs, however, remain unaware of their blood pressure status [5]. It is common, asymptomatic, readily detectable, and easily treatable. Yet it burdens our economy substantially. Hypertension is the most common primary diagnosis in the US and accounts for over 38 million office visits per year [6]. Most patients will require two or more antihypertensive medications to achieve the goal of blood pressure less than 140/90 or 130/80 for patients with diabetes or kidney disease [7, 8]. Poor adherence to medication regimens is a common