Enhancing organizational capacity to provide cancer control programs among Latino churches: design and baseline findings of the CRUZA Study

Abstract

BackgroundFaith-based organizations (FBOs) have been successful in delivering health promotion programs for African Americans, though few studies have been conducted among Latinos. Even fewer have focused on organizational change, which is required to sustain community-based initiatives. We hypothesized that FBOs serving Latinos would be more likely to offer evidence-based strategies (EBS) for cancer control after receiving a capacity enhancement intervention to implement health programs, and designed the CRUZA trial to test this hypothesis. This paper describes the CRUZA design and baseline findings.MethodsWe identified Catholic parishes in Massachusetts that provided Spanish-language mass (n = 65). A baseline survey assessed organizational characteristics relevant to adoption of health programs, including readiness for adoption, “fit” between innovation and organizational mission, implementation climate, and organizational culture. In the next study phase, parishes that completed the baseline assessment will be recruited to a randomized cluster trial, with the parish as the unit of analysis. Both groups will receive a Program Manual and Toolkit. Capacity Enhancement parishes will also be offered technical support, assistance forming health committees and building inter-institutional partnerships, and skills-based training.ResultsOf the 49 parishes surveyed at baseline (75%), one-third (33%) reported having provided at least one health program in the prior year. However, only two program offerings were cancer-specific. Nearly one-fifth (18%) had an active health ministry. There was a high level of organizational readiness to adopt cancer control programs, high congruence between parish missions and CRUZA objectives, moderately conducive implementation climates, and organizational cultures supportive of CRUZA programming. Having an existing health ministry was significantly associated with having offered health programs within the past year. Relationships between health program offerings and other organizational characteristics were not statistically significant.ConclusionsFindings suggest that many parishes do not offer cancer control programs, yet many may be ready to do so. However, the perceptions about existing organizational practices and policies may not be conducive to program initiation. A capacity enhancement intervention may hold promise as a means of increasing health programming. The efficacy of such an intervention will be tested in phase two of this study.

Recruiting and Surveying Catholic Parishes for Cancer Control Initiatives

“…The framework and its application is described in detail elsewhere (Allen et al, Under Review). Briefly, we sought to assess organizational characteristics specified in the Consolidated Framework for Implementation Research (CFIR) (Damschroder et al, 2009).…”

The impact of health and health insurance literacy on access to care for Hispanic/Latino communities

“…These cities are relatively far from each other and geographically distinct, but have a large concentration of uninsured, predominantly Spanish‐speaking Hispanics/Latinos from the Caribbean and Central America (Lawrence: 10.9%, Waltham: 19.4%, New Bedford: 11.7%), who continue to face challenges in accessing health insurance and health care (United States Census Bureau, ). Long‐standing, trusted partnerships have been established with faith‐based Hispanic/Latino ministries in these cities through several initiatives at the Gastón Institute (Allen et al., ). Faith‐based organizations serve as the primary source for culturally relevant communication and support around the promotion of health promotion activities in Hispanic/Latinos communities (Adamczyk, ; Cadge & Ecklund, ).…”

“…19.4%, New Bedford: 11.7%), who continue to face challenges in accessing health insurance and health care (United States Census Bureau, 2012). Long-standing, trusted partnerships have been established with faith-based Hispanic/Latino ministries in these cities through several initiatives at the Gastón Institute (Allen et al, 2015).…”

Heaven and Health: How Black, Latino, and Korean Christians View the Relationship between Faith and Health

“…Given that Latinos are three times more likely to be uninsured than non-Hispanic whites, health promotion has become a significant function of Latino churches (DeHaven et al 2004). In one study of predominantly Latino Catholic parishes, about one-third had at least one church-sponsored health program and one-fifth had an active health ministry (Allen et al 2015).…”