Key Social Norms Take-aways This study demonstrates how faith-based interventions influence social norms in congregational settings through increasing discussions around stigmatized or sensitive topics such as sexual health and condom use. The intervention helped normalize these conversations among both leaders and members, revealing that religious settings, when engaged thoughtfully, can become important spaces for addressing topics often considered taboo. The increase in frequency and comfort discussing sensitive issues suggests that church-based initiatives can play a significant role in shifting harmful norms and reducing stigma related to sexuality and health.
Objectives The study aimed to evaluate how a church-based family strengthening, mental health promotion, and HIV prevention intervention altered the discussion dynamics within religious congregations in rural Kenya, particularly focusing on how leaders and members communicated about key health topics.
Methods The study was part of a stepped-wedge cluster-randomized trial involving four churches. Surveys were administered to 17 church leaders and 440 congregation members (including caregivers and youth) at multiple timepoints. The surveys assessed frequency, comfort, and content of discussions on seven topics: family, parenting, emotional problems, finances, sexuality, HIV, and condom use. Mixed-effects logistic regression was used to analyze changes in discussion frequency.
Intervention Details The READY intervention was a culturally adapted, nine-week church-based program aimed at improving family relationships to reduce youth HIV risk. It included weekly two-hour workshops split between youth and caregivers for communication and skill-building around emotional support, economic empowerment, and sexual health. Simultaneously, church leaders participated in facilitated discussion groups to explore their roles in supporting families and continuing these conversations beyond the intervention period.
Results Prior to the intervention, family and emotional issues were already discussed frequently, while finances, sexuality, HIV, and condoms were less commonly addressed. After the intervention, both leaders and members reported increased discussion of all topics, with the most notable increases in the previously less-discussed areas. Leader comfort and knowledge on these sensitive issues improved significantly, and members—especially caregivers—reported more frequent discussions with both peers and leaders. Youth also increased their discussions, though to a lesser extent.
Conclusions Religious congregations, already trusted and active in community life, can serve as powerful partners in promoting open dialogue and reducing stigma around sexual and mental health. The intervention fostered broader and more inclusive discussions, indicating a shift in social norms and greater openness to sensitive health topics in faith settings. This suggests that sustained collaboration with faith communities could play a pivotal role in public health efforts.