Challenges and Lessons Learned While Conducting a Diabetes Prevention Program Among Black Churches During the COVID-19 Pandemic

We share our experiences conducting a 5-year randomized controlled diabetes prevention project among 20 Black churches in central Kentucky during the COVID-19 pandemic and offer strategies to inform future church-based interventions. Researchers have long recognized the potential to reach Black adults in church settings for health promotion interventions and have implemented trials within this socially rich setting. However, there is a dearth of literature that describes the challenges and lessons learned while conducting these trials. We describe the challenges we experienced and the strategies we used to overcome them to successfully conduct the trial. During the study, we maintained detailed field notes and research team meetings. Three team members independently reviewed these documents and compiled a list of the challenges and strategies and categorized them by themes. We then met to reach consensus on the major themes. Three major themes emerged: (1) protocol adaptations, (2) recruitment and communication, and (3) intervention delivery. Solutions included timeline extension, flexibility in training, and codification of team scripts. Our experiences will inform future researchers on the implementation of faith-based interventions.