Heart, Body, and Soul: a Church-based Smoking-cessation Program for Urban African Americans

Background: This article provides a descriptive overview of the implementation process of the Heart, Body, and Soul program. The program objective was to test strategies to reduce the prevalence of cigarette smoking among urban African Americans in East Baltimore.

Method: This study constitutes a prospective randomized trial among inner-city African Americans designed to improve quit rates among church attenders. A random-digit-dialing survey was conducted to establish baseline levels of self-reported cigarette smoking, examine attendant attitudes, and determine the presence of known cardiovascular risk factors among community residents of the catchment area. A similar survey was conducted among churchgoers to establish a baseline. Twenty-two churches were recruited and randomly assigned to either intensive or minimal (self-help) intervention strategies. Baseline health screenings were held in all participating churches. Innovative culturally specific smoking cessation strategies mediated through lay volunteers from participating churches were implemented in the intensive intervention churches.

Results: Pastors of all churches were directly involved in all aspects of the planning and implementation process. A total of 29 volunteer lay smoking-cessation specialists were trained and successfully implemented the intensive interventions in churches. An additional 272 church members were trained to conduct their church's health screenings.

Conclusion: The essential component of this successful implementation process were building trust and acceptance and providing the technical support to encourage smoking-cessation strategies. This description of the project is presented to assist others involved in church-based trials in urban African American communities.