Church Leaders' Health Behaviors and Program Implementation in the Faith, Activity, and Nutrition Program in the United States.

Objectives: Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders' health-related behaviors, differences in health behaviors by socio-demographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention.

Methods: Pastors (n=93) and church coordinators (n=92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the intervention. Church coordinators reported program implementation for their church. Socio-demographic differences and associations between changes in health behaviors and program implementation were tested with regression models. Changes in health-related variables were examined using paired t-tests and McNemar's test.

Results: Pastors (40.9% women, 41.9% Black/African American) had a mean BMI of 30.0 kg/m2; 23.7% met F&V guidelines and 45.2% met PA guidelines. Black/African American pastors were less likely to meet F&V guidelines and had lower self-rated health than their counterparts. Pastor PA improved over time, but pastor health behaviors were not associated with program implementation. Church coordinators' (94.6% women, 39.1% Black/African American) mean BMI was 27.8 kg/m2; 27.2% met F&V guidelines and 62.0% met PA guidelines. Black/African American church coordinators had higher BMIs and lower self-rated health than their counterparts. Church coordinator F&V intake improved over time; self-rated health was positively associated with PA program implementation.

Conclusions: This study underscores the need for preventive interventions for church leaders.