Faith community nursing

Faith community nurses (FCNs) are registered nurses positioned within a faith community or working in a health care system and serving as a liaison to congregations. FCNs focus largely on health promotion, managing chronic disease, and injury prevention, but also often function as health counselors, patient navigators, and advocates (Gotwals 2018*, Zahnd 2018*, Coenen 1999*). FCNs support the physical, psychological, and spiritual wellbeing of their patients (ANA HMA-FCN 2017*). FCNs, also known as parish or congregational nurses, are usually members of the faith communities they serve (Zahnd 2018*); FCNs may also provide care to patients from the boarder community (Hixson 2018*). Faith community nursing is common in Christian denominations, though FCNs also support temples, synagogues, mosques, and faith-based community agencies (ANA HMA-FCN 2017*).

Expected Beneficial Outcomes (Rated)

  • Increased healthy behaviors

  • Improved health outcomes

Other Potential Beneficial Outcomes

  • Reduced hospital readmissions

Evidence of Effectiveness

Faith community nursing is a suggested strategy to improve health outcomes (Cooper 2017*, Dyess 2010*, Buijs 2001*) and health behaviors (Cooper 2017*, Shackelford 2014*, Dyess 2010*, McGinnis 2008*, Buijs 2001*), especially among minorities (Shackelford 2014*, Mendelson 2008, Hughes 2001*) and populations with low incomes (Monay 2010*). However, additional evidence is needed to confirm effects.

Available evidence suggests that, overall, health programs in faith-based organizations may be effective in primary prevention, health maintenance, cardiovascular health, and cancer-related efforts (DeHaven 2004). Simple interventions provided through faith community nurses (FCNs), including health coaching or short education sessions, may result in improved health promoting behaviors (Cooper 2017*, Mendelson 2008), such as one where black women and women in rural areas in Illinois increased breast self-exams after education sessions with FCNs (Shackelford 2014*). One study suggests health coaching by FCNs may decrease blood pressure readings short-term (Cooper 2017*), however another study indicates referrals to FCNs are less effective than setting up appointments with physicians for controlling blood pressure (Baig 2010). A pilot study suggests FCNs following a transitional care plan may reduce 30-day hospital readmissions among their patients (Strait 2019*).

Experts recommend the use of FCNs to increase cancer screening in rural areas (Zahnd 2018*) and provide support and education to older adults and their families, such as transitional support following hospital discharge (Ziebarth 2015) or outreach to family members caring for those with dementia (Kazmer 2017*). Additional training for FCNs on providing general health education (Devido 2018*) and counseling on specific topics may prepare FCNs to better serve the needs of their patients and faith communities (Devido 2017*).

FCN may enable limited domain partnerships, allowing churches and medical centers to temporarily work together on common goals (Brudenell 2003*).

Impact on Disparities

Likely to decrease disparities

Implementation Examples

Health care organizations or systems which identify as faith-based, non-profit organizations, often employ faith community nurses (FCNs) to provide care in their affiliated religious institutions. For example, the FCNs of the Wesley Nurse program at Methodist Healthcare Ministries of South Texas, Inc., provide free health education, resources, and health promotion to community members at more than 80 churches across southern Texas (Wesley Nurse, Wesley Nurse-20 years). Another example, QueensCare Health and Faith Partnership in Los Angeles, CA, partners with faith-based institutions, employing FCNs to offer free immunizations and screenings, health education, and counseling to families and individuals with low income or without insurance (QHFP, AHRQ HCIE-Soper).

Implementation Resources

AHRQ HCIE-Soper - Soper S. Faith community nurses work with local, trusted organizations to enhance access to primary and preventive care for low-income individuals in Los Angeles. Rockville: AHRQ Health Care Innovations Exchange.

AHRQ-Stewart 2014 - Stewart EE, Taylor-Post N, Nichols L, Staton EW, Schleuning A. Linking primary care patients to local resources for better management of obesity. Rockville: Agency for Healthcare Research and Quality (AHRQ); 2014.

Citations - Evidence

* Journal subscription may be required for access.

Cooper 2017* - Cooper J, Zimmerman W. The effect of a faith community nurse network and public health collaboration on hypertension prevention and control. Public Health Nursing. 2017;34(5):444-453.

Dyess 2010* - Dyess S, Chase SK, Newlin K. State of research for faith community nursing 2009. Journal of Religion and Health. 2010;49(2):188-99.

Buijs 2001* - Buijs R, Olson J. Parish nurses influencing determinants of health. Journal of Community Health Nursing. 2001;18(1):13-23.

Shackelford 2014* - Shackelford JA, Weyhenmeyer DP, Mabus LK. Fostering early breast cancer detection. Clinical Journal of Oncology Nursing. 2014;18(6):E113-E117.

McGinnis 2008* - McGinnis SL, Zoske FM. The emerging role of faith community nurses in prevention and management of chronic disease. Policy, Politics & Nursing Practice. 2008;9(3):173-80.

Mendelson 2008 - Mendelson SG, McNeese-Smith D, Koniak-Griffin D, Nyamathi A, Lu MC. A community-based parish nurse intervention program for Mexican American women with gestational diabetes. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2008;37(4):415-25.

Hughes 2001* - Hughes CB, Trofino J, O’Brien BL, Mack J, Marrinan M. Primary care parish nursing: Outcomes and implications. Nursing Administration Quarterly. 2001;26(1):45-59.

Monay 2010* - Monay V, Mangione CM, Sorrell-Thompson A, Baig AA. Services delivered by faith-community nurses to individuals with elevated blood pressure. Public Health Nursing. 2010;27(6):537-543.

DeHaven 2004 - DeHaven MJ, Hunter IB, Wilder L, Walton JW, Berry J. Health programs in faith-based organizations: Are they effective? American Journal of Public Health. 2004;94(6):1030-6.

Baig 2010 - Baig AA, Mangione CM, Sorrell-Thompson AL, Miranda JM. A randomized community-based intervention trial comparing faith community nurse referrals to telephone-assisted physician appointments for health fair participants with elevated blood pressure. Journal of General Internal Medicine. 2010;25(7):701-9.

Strait 2019* - Strait LA, Fitzgerald E, Zurmehly J, Overcash J. A congregation transition of care program using faith community nurses and volunteer faith-based nurses. Journal of Christian Nursing. 2019;36(3):158-165.

Zahnd 2018* - Zahnd WE, Jenkins WD, Shackelford J, et al. Rural cancer screening and faith community nursing in the era of the Affordable Care Act. Journal of Health Care for the Poor and Underserved. 2018;29(1):71-80.

Ziebarth 2015 - Ziebarth D. Factors that lead to hospital readmissions and interventions that reduce them: Moving toward a faith community nursing intervention. International Journal of Faith Community Nursing. 2015;1(1).

Kazmer 2017* - Kazmer MM, Glueckauf RL, Schettini G, Ma J, Silva M. Qualitative analysis of faith community nurse–led cognitive-behavioral and spiritual counseling for dementia caregivers. Qualitative Health Research. 2017;28(4):633-647.

Devido 2018* - Devido JA, Doswell WM, Braxter BJ, Terry MA, Charron-Prochownik D. Exploring the experiences, challenges, and approaches of parish nurses in their community practice. Journal of Holistic Nursing. 2018;37(2):121-129.

Devido 2017* - Devido JA, Doswell WM, Braxter BJ, et al. Experiences of parish nurses in providing diabetes education and preconception counseling to women with diabetes. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2017;46(2):248-257.

Brudenell 2003* - Brudenell I. Parish nursing: Nurturing body, mind, spirit, and community. Public Health Nursing. 2003;20(2):85-94.

Citations - Implementation Examples

* Journal subscription may be required for access.

Wesley Nurse - Methodist Healthcare Ministries of South Texas, Inc. Wesley Nurse program.

Wesley Nurse-20 years - Methodist Healthcare Ministries of South Texas, Inc. Wesley Nurse program celebrates 20 years of faith community nursing.

QHFP - QueensCare. QueensCare Health & Faith Partnership (QHFP). Los Angeles, California.

AHRQ HCIE-Soper - Soper S. Faith community nurses work with local, trusted organizations to enhance access to primary and preventive care for low-income individuals in Los Angeles. Rockville: AHRQ Health Care Innovations Exchange.

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