Research Question: How can engagement with faith-based groups impact health and health inequalities?
British society is made up of people from a range of faiths; mainly Christian, Muslim, Hindu, Sikh, Jewish or Buddhist. Faith institutions are community hubs which have long been involved in advocacy for social change, including addressing health inequalities. Faith-based groups and faith leaders are an integral part of many communities and are known to be powerful agents for both positive and negative health behaviour change. Increasingly, faith-based groups are being called on to serve as key players in health promotion and disease prevention efforts. Therefore, strategic engagement of faith-based groups has the potential to be central in the public health agenda. Although partnerships with the health sector can be complex and contentious, faith and medical organisations have intersected successfully to deliver health-related programmes for a wide range of health-related outcomes.
Some faith-based group members are from populations facing higher risks from health inequalities or have difficulties in accessing healthcare. Therefore, faith group leaders may be well placed to take an active role in helping to tackle health problems in the communities they serve. Faith leaders can often reach those who are marginalised, such as migrants; those who cannot readily access health information though conventional routes, because of language barriers; and older people. Faith leaders have a pivotal role as ‘gatekeepers’ – they can disseminate health information, and allow health professionals to come into places of worship to deliver health information and activities. However, faith groups and their leaders may also have the potential to act as sources of disinformation and barriers to health improvement activities.
The assets of faith communities include physical and human resources, as well as communication and social networks. Particularly in rural areas, the range of locations means more people can be reached. Likewise, faith communities are recognised to have well-established local and national communication networks, such as newsletters and committee networks at multiple levels, central display points, bulletin boards and word-of-mouth.
Studies from the UK and US have found faith based-group interventions effective in improving healthy eating and physical activity behaviour, and religious settings were found to have a relatively high reach. However, less is known about promoting mental health in faith communities and the research on life-style behaviour changes has mostly been of low quality – meaning there is a need for more robust evidence. Moreover, little is known of any potential negative effects or unintended harms that faith-based group interventions may have.
Health inequalities
The PHR Programme is predominantly interested in interventions operating at a population level rather than at an individual level, and that address health inequalities and the wider determinants of health. Applicants are asked to specify which faith-based group(s) their work will focus on and justify this decision. It should be noted this call is not aimed at establishing the effects of faith or belonging to a faith group itself. This call is aimed at understanding health interventions which engage with faith-based group assets. The PHR Programme recognises that interventions are likely to impact different (sub)populations in different ways, and encourages researchers to explore such inequalities of impact in their study design.
Suggested areas of research
The PHR Programme recognises that this call is broad in its nature, but encourages researchers to be targeted in their chosen research area. Examples include:
- Evaluation of faith-based group interventions aimed at improving people’s social, mental and/or physical wellbeing. This may include exploration of how these may differ from other community-based interventions.
- Exploration of ‘conventional’ interventions delivered in faith-based group settings, particularly in rural settings.
- Exploration of using faith-based group assets for health promotion activities, and how may these differ between population (for example gender, sexuality and age).
- Exploration of how faith-based group health interventions are being, or can be linked, to other similar interventions with other community anchors.
- Evaluation of health communication programmes which engage with faith-based groups.
- Exploration of how to engage with faith-based groups where there is evidence of health (and health protection messaging) being misinterpreted or inaccurately conveyed.
Study designs
A range of study designs and outcome measures can be used. Researchers will need to clearly describe and justify their choice of health outcomes and target population group, as well as the rationale for their methodological approach. Researchers are encouraged to consider additional outcome measures, including those relating to the broader determinants of health and health inequalities, which should be specified and justified. Researchers will also need to specify key outcomes and how these will be measured in the short, medium and long term.
Providing value to the economy and community
Understanding the value of public health interventions – whether outcomes justify their use of resources – is integral to the PHR Programme, where resources relating to different economic sectors and budgets are potentially relevant. The main outcomes for economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include an economic component should provide appropriate justification.
Researchers are strongly encouraged to ensure that service users, including people with lived experience from the target audience, are involved in the design and planning of the intervention and/or as potential, suitably rewarded members of the research team. Researchers should demonstrate the relevance of their proposed research to decision-makers and people with lived experiences, and they might do this through involving them as costed/rewarded members of the research team. Researchers are encouraged to explain how they will share their findings with policy makers, public health officers, special interest groups, charities, community audiences and other relevant stakeholders. Researchers are expected to be aware of other studies in this area, development in practice and ensure their proposed research is complementary.
Further information
To find out more on how to submit an application to the PHR Programme, please refer to the Stage 1 guidance notes and PHR supporting information.