Community health advisors’ participation in a dissemination and implementation study of an evidence-based physical activity and healthy eating program in a faith-based setting

Community health advisors (CHAs) have been widely involved in health promotion, but few details on role expectations, retention, and evaluation have been reported. In a dissemination and implementation (DI observers’ ratings of CHAs’ church training delivery; church committee members’ ratings of the training experience, including CHAs’ performance; and data from the TA database to assess CHAs’ adherence to the protocol. The main challenge was the early dropout of one CHA and the reduced role of another. CHAs trained 142 intervention and 60 control church committee members in nine sessions; they covered 99% (intervention) and 90% (control) of training content, indicating high fidelity. Observers’ scored CHAs’ teaching and facilitation skills at 96.7% (intervention) and 80% (control) of the possible score. CHAs completed 92% of intervention and 93% of control TA calls. The great majority of church participants’ comments regarding CHAs were positive. This study demonstrates that with training and support, CHAs demonstrate high levels of intervention fidelity, confidence, and competence.