How networking Black ministers created new regional capacity for improving community health.
| TIMEFRAME | 2019-2021 |
| COMMUNITY | Rural, Black faith-based communities |
| GEOGRAPHY | North Carolina |
| FOCUS | Promoting health equity in North Carolina communities |
| CORE PRINCIPLES | Culturally-centered, Co-created, Inclusive |
| COMMUNITY ENGAGEMENT OUTCOMES | Strengthened Partnerships + Alliances Expanded Knowledge Improved Health + Health Care Programs + Policies Thriving Communities |
PROJECT BACKGROUND
It is increasingly clear that building relationships and engagement capacity with communities before conducting research is essential for health improvement initiatives. This practice-to-research—as opposed to the traditional research-to-practice—framework for engaging communities was embraced by Dr. Lori Carter-Edwards, PhD, MPH, then Associate Professor at the UNC Gillings School of Global Public Health, in her work. In 2014, Dr. Carter-Edwards, prior to securing any research funding, launched a series of meetings with North Carolina pastoral leaders and local health department staff with a twofold goal: learn about health-related priorities within their faith-based organizations (FBOs), and brainstorm what a network of faith-based leaders might accomplish. Together they conceptualized the Faith-Based Organization Network (FBON), a regional network of Black ministries that would function as cross-county infrastructure for connecting health efforts to local communities through churches. A specific goal was to establish collaborations that could more effectively address the social determinants of health in North Carolina’s rural counties, where over 40% of its population lives.
FBON was launched in 2018 with a regional workshop for FBOs that focused on leadership capacity-building. It was conducted in partnership with the North Carolina Institute for Public Health, the Area L Area Health Education Center (AHEC), and interested FBOs in the AHEC’s five-county area.
KEY ENGAGEMENT ACTIVITIES
From conceptualization to funding to launch, FBON engagement activities spanned the Eastern North Carolina region and several years. Activities include:
Conducted a series of exploratory meetings. In her 2014 meetings, Dr. Carter-Edwards worked with eight pastoral leaders from three regions of the state (each representing different Black faith-based networks), three to four community health staff from a health department, and a community-engaged researcher. The pastors constructed three priorities for FBON: first, identify data and success measures that could inform how they provided and improved health programs in their churches; second, develop a network-wide competency in resource sharing and information dissemination; and third, strengthen the network’s capacity by inventorying each member’s unique role in their communities. In 2018, when a grant opportunity emerged, Dr. Carter-Edwards translated the group’s work into a funding proposal. The grant was awarded in 2018.
Built a pastoral steering committee. A full year before FBON activation, Dr. Carter-Edwards assembled a five-member pastoral steering committee to flesh out the priorities and develop a mission statement for the FBON. As FBON kicked off, the steering committee continued to be informed and engaged; one member joined the FBON workshop.
Activated the FBON network with a regional workshop. Each FBO sent a three-person team: a pastor or assistant pastor, a health minister or designated leader, and a food or culinary minister or designated leader. A total of 17 teams comprising 51 participants attended from four counties, all from predominantly Black faith-based communities.
Developed workshop activities to promote self-determinism and FBO capacity-building at three levels: 1) at the FBO level to identify health wishes, assets, and needs; 2) at the community level to identify county-level health priorities and resources; and 3) at the leadership role level to discuss the assets, needs, and action steps of each person’s role (pastors, health ministers, and food/culinary leaders). To promote action back in the community, FBON participants were trained in a system-mapping exercise that helped them identify their local health priorities, expand their thinking about how to address those priorities, and identify what was needed to implement potential solutions. Teams then drafted a 60-day action plan for the priority of their choice and received a $300 start-up fund to promote implementation.
Provided community communication tools. FBON participants were given a newsletter template and encouraged to share their health promotion work with their community, local officials, and other FBON members.
Conducted follow-up assessment and support. Each three-member FBO team engaged in an hour-long structured interview to assess progress and measure post-workshop networking. Additionally, all 17 FBOs attended a joint meeting held 60 days after the workshop.
Listen as Dr. Lori Carter-Edwards advocates for a simple change in practice among researchers when partnering with community members.
Listen to Pastor James Gailliard describe how Dr. Carter-Edward’s community-centered research approach created sustained value for his ministry.
PROJECT OUTCOMES
FBON jump-started action at multiple levels:
Expanded ministry priorities to include community health. At 60 days post-workshop, over 90% of FBOs reported successfully initiating or completing their goals. Projects included establishing a walking track around a church, inspiring walking challenges within and between FBOs, establishing coupon clubs and recipe sharing, initiating food giveaways, and installing vegetable garden beds. Pastor James Gailliard, an FBON member and continuing collaborator with Dr. Carter-Edwards, highlights the growth in his ministry’s capacity to address the health of his community: “Out of FBON we got this broader and even deeper community organization and framework. Our scope has expanded from health to housing, education, criminal justice reform, employment. It has broadened so that we literally cover every aspect of people’s lives. We have become flexible and fluid as an organization so that we can respond to a current crisis. Or if we don’t have a current crisis, we can proactively begin to address social determinants of health or social determinants around education.” He posits that FBON also encouraged the capacity-building of churches by “forcing them to take a look at health as a valid center of their ministry and to develop a group of lay people who could function as community engagement people. It forced churches to say, ‘we probably need to add this to who we are.’”
Created professional visibility for participants. Many participants reported increased professional visibility: Five FBO leaders generated newsletters to communicate activities back to their membership, community, and local officials about their health promotion work. Several FBO leaders received invitations to present the framework at local and national meetings. When the COVID-19 pandemic occurred, all 17 FBOs were offered COVID-19 education webinars to help them provide leadership to their communities.
Built sustained partnerships for continued action. Follow-up interviews indicated increased connectivity between FBOs. One FBO connected with all participating FBOs; three made connections with six others across the five-county region. Notably, FBO pastors used the FBON governance structure to create a second, more comprehensive network: a 110+ member Eastern North Carolina Ministerial Alliance that extends across all five counties.
FBON also promoted sustained partnerships between faith-based leaders and researchers. Dr. Carter-Edwards notes that “taking this practice-to-research approach led us beyond what we had anticipated the relationship to be. We’ve written multiple grants together. We’ve received funding for COVID-related projects. [FBON member] Word Tabernacle Church has been able to write its own grants based on the research that we’ve done together. The initial FBON effort has served as a springboard for other researchers, who can now work with the network.”
ASSESSING COMMUNITY ENGAGEMENT OUTCOMES
Below, the Assessing Community Engagement Conceptual Model is mapped to the Impact Story. This mapping illustrates how CORE PRINCIPLES of engagement lead to impact across the four OUTCOME domains, and to specific measurable indices within those domains
FBON used CORE PRINCIPLES in its engagement that were culturally-centered and co-created (the concept, mission, and workshop were built around the power and practices of Black ministries), as well as inclusive (engaging faith organizations across five counties).
Engagement activities resulted in STRENGTHENED PARTNERSHIPS + ALLIANCES, including diversity + inclusivity (17 FBOs from five counties participated, many of which had not been engaged in this type of capacity-building before), partnerships + opportunities (numerous connections between FBOs and an invitation to co-lead a grant), and acknowledgment, visibility, recognition (invitations to present locally and statewide). Members reported sustained relationships, shared power, and structural supports for community engagement (FBO leaders forming the Eastern North Carolina Ministerial Alliance).
Working collectively, faith-based leaders EXPANDED KNOWLEDGE in their communities by using community-ready information (at least five FBOs chose to disseminate their health-related efforts back to community and local audiences via newsletter).
Ministry-based partnerships led to IMPROVED HEALTH + HEALTH CARE PROGRAMS AND POLICIES, including community-aligned solutions and actionable, implemented, recognized solutions (all 17 FBOs meeting some part of their 60-day action plan, including completion of, or plans to move forward with, a health promotion project within or between FBOs).
Participating FBOs are succeeding in promoting THRIVING COMMUNITIES through improved community capacity + connectivity (adoption of health as a focus of ministry efforts, as well as the expanded mission of some ministries to address food, housing, education, criminal justice reform, and employment).
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