Abstract:
Collaboration with African religious congregations can promote psychosocial well-being with
greater accessibility. Effective collaboration requires studying congregations as unique inter-
vention contexts. This study explored how an intervention in western Kenya fit within and
altered congregational discussion patterns. We conducted a cluster-randomized trial of a
church-based intervention to improve family relationships, mental health and sexual health.
For each intervention topic covered, we describe baseline and post-intervention changes in
church leaders’ beliefs and communication as well as discussion frequency between leaders and
members and among members. Mixed-effects logistic regression assessed pre-post change in
member-reported discussion frequency. At baseline, members and leaders reported already
discussing family, parenting, and emotions frequently and sexuality and finances less frequently.
Leaders generally felt they should discuss all topics but were less comfortable and knowledgeable
about sexuality and finances than other topics. After the intervention, leader comfort and
knowledge increased and discussion frequency increased for nearly all topics, especially those
discussed less initially. Good fit between the desires and activities of church members and leaders
suggests the potential for further collaboration, especially on mental health and family well-
being. Increased discussion of sensitive topics underscores the potential of community-level
interventions to affect social norms.