Exploring the Readiness of African American Churches to Engage in a Community-Engaged Blood Pressure Reduction Research Study: Lessons Learned From the Church Challenge

The Transtheoretical Model (TTM) has been used to assess individual readiness for health behavior change. We describe our use of the TTM to assess African American churches’ organizational readiness to participate in the Church Challenge (CC) in Flint, Michigan; the processes that moved churches toward readiness for change; and lessons learned. The CC was a faith-based, multilevel intervention intended to reduce chronic disease risk. A community-based participatory approach was used to engage and recruit 70 churches. We used the TTM to capture each church’s readiness for change and to track church progress through the model’s five stages. By the end of the CC, 35 remained in Stage 1 (precontemplation), 10 remained in Stage 2 (contemplation), three remained in Stage 3 (preparation), five made it to Stage 4 (action), and 17 finished within Stage 5 (maintenance). Churches engaged in several processes of change as they moved through the various stages. Utilizing processes of change, establishing rapport, and having previous participants share success stories helped move churches from stage to stage. However, certain barriers prevented progression, such as scheduling conflicts and burnout/trauma from the Flint water crisis. Faith-based organizational readiness greatly impacted participation in the CC. Researchers should utilize established social capital, build rapport, and remain flexible when working with African American churches. Although traditionally used at the individual level, the TTM works well at the organizational level to assess and monitor church readiness to participate in community-engaged research and health programming to improve health in an African American faith community.