Peer Reviewed Articles by Tyler J Fuller
Journal of Racial and Ethnic Health Disparities, 2024
Black communities in the Southeast United States experience a disproportionate burden of illness ... more Black communities in the Southeast United States experience a disproportionate burden of illness and disease. To address this inequity, public health practitioners are partnering with Black Protestant churches to deliver health promotion interventions. Yet, the reach of these programs beyond the organizational level of the Social Ecological Model (SEM) is not well defined. Thus, the aim of this study is to understand Black Protestant church leaders’ and members’ perceptions about the capacity of their ministries to reach into their communities, beyond their congregations, as providers or hosts of health education or promotion interventions. From 20 Black Protestant churches in Atlanta, GA, 92 church leaders and members participated in semi-structured interviews. Grounded theory guided data analysis and a diverse team coded the interviews. Most participating churches had health ministries. Participants saw the boundaries between their churches at the organizational level of the SEM and the broader Black community to be porous. Those who described their “community” as being broader than their congregation also tended to describe community-wide health promotion their church engaged in. They described church-based health fairs as a strategy to promote engagement in their communities. Some participants, particularly those in a health-related profession, discussed visions of how to utilize their church as a site for community-wide health promotion. We suggest these participants may be boundary leaders who can build relationships between public health professionals, pastors, and congregants. Based on the findings, we suggest that church-based health fairs may be effective sites of community-wide health promotion.
Culture, Health & Sexuality, 2022
This analysis of 84 interviews with female Black Church leaders
and members from Atlanta, GA, ex... more This analysis of 84 interviews with female Black Church leaders
and members from Atlanta, GA, examined how women in Black
churches construct definitions of, and identities in relation to, HIV
narratives about men on the down low. We analyse these narratives
as collective memories, through the theoretical lens of memory
and trauma studies, by identifying how women understand
themselves as the victims of men on the down low transmitting
HIV; describe this as a painful experience; make public claims
about this experience; and draw on theological understandings to
make these claims. The narratives articulate how Black communal
modes of meaning making have been disrupted by the HIV epidemic
and assign responsibility for HIV transmission to men on
the down low, who are perceived to be engaged in risky sexual
behaviour. We discuss these results in relation to HIV education
and prevention and suggest health educators can engage Black
church leaders by understanding these narratives as forms of
countermemory.
Religion and Popular Culture in North America, 2023
In March 2020, many parts of the United States issued stay-at-home orders in response to the COVI... more In March 2020, many parts of the United States issued stay-at-home orders in response to the COVID-19 pandemic. These orders required religious organizations to cease in-person events. This included worship services and administration of sacramental rituals. This essay analyzes interviews to examine how Catholics created sacred space in their homes while watching Mass in a digital format during the COVID-19 pandemic. I argue that Catholics embodied authority and engaged in adapting their practices and spaces to creating experiences of sacramental rituals during a time when they were not able to participate in the rituals in person.
Sexuality & Culture, 2022
Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted... more Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted diseases, especially in the southern United States. This study investigates how multiple dimensions of current religiosity as well as religious upbringing influence the sexual behaviors, including contraceptive usage, of individuals 18–25 years old (n = 211) in the South. Based on regression analyses, results suggest that emerging adults with higher levels of current religiosity are more likely to remain abstinent, but less likely to use pregnancy prevention methods, such as birth controls pills and long-acting reversible contraceptives. Having a religious upbringing is also associated with lower contraceptive usage. Through the assessment of multiple dimensions of religiosity and various sexual behaviors, this study presents a nuanced picture of the complex associations between religion and sexual health, specifically among emerging adults in the southern United States.
Sex Roles, 2020
Human immunodeficiency virus (HIV) continues to be a prominent health and social justice issue, e... more Human immunodeficiency virus (HIV) continues to be a prominent health and social justice issue, especially for African American communities in the Southern United States. Gender role norms, specifically within faith-based communities in the South, pose challenges to empowering women to make safer sexual health decisions. To explore perceptions of gender norms and sexual health, 42 qualitative interviews were gathered from female members of 16 predominantly African American churches in Atlanta, GA. Constructs from the theory of gender and power and the social ecological model were used to guide coding and analysis. Participants discussed their experiences with gender norms and gender-based power differentials at the institutional (i.e., church), familial, and interpersonal (i.e., intimate relationship) levels. Because of the attitudes and beliefs held by their religious communities and families, many participants recalled struggling to assert themselves in sexual relationships and recalled engaging in risky and unwanted sexual behavior, especially during their young adult years. However, as the participants matured, they worked to overturn traditional gender norms, empowering both their children and women in their religious communities to make healthy, autonomous sexual decisions. Moving forward, participants want their churches and members of their faith communities to play an active role in the empowerment of African American women and provide them with the confidence and education necessary to negotiate sexual decisions with their partners.
BMC Public Health, 2022
Background: Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among work... more Background: Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa’s mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia.
Methods: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB.
Results: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%).
Conclusion: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.
Keywords: Miners, Mining, Healthcare, Africa, KAPs, Policy, TB, HIV
Health Promotion Practice, 2021
Many refugee and immigrant women in the United States experience cultural and language barriers w... more Many refugee and immigrant women in the United States experience cultural and language barriers when seeking pregnancy-related medical care. Such barriers may delay needed care and adversely impact birth outcomes. Embrace Refugee Birth Support (Embrace) in Clarkston, Georgia, supports pregnant refugee women by offering birth education classes in the women’s primary languages. Our academic–practice partnership designed and implemented a series of birth education videos for Embrace participants. Based on input from former participants, the partnership team created video scenarios that could be embedded into Embrace’s existing didactic curriculum. The videos addressed common challenges and learning needs identified by previous participants. All videos were filmed in the participant’s primary languages (Swahili and Kinyarwanda) and featured actual Embrace graduates who spoke the languages. Then, Embrace trainers used the video scenarios to augment teaching on birth preparedness and fost...
Teaching Theology & Religion, 2020
This case study leverages existing library assets and curated educational resources for students,... more This case study leverages existing library assets and curated educational resources for students, pastors, and health ministers by seeking to increase their understandings of how religion intersects with, and informs, health education and promotion, and public health more broadly, while equipping them with tools to engage in important conversations about health ministry. This article describes and evaluates a library-based research guide that is a replicable model for collaborative ministerial training about engaging, evaluating, and participating in health education and promotion, which is a vital component of theological education. Much of the pedagogical conversation around religion and health within theological and religious studies has focused on the ways that religion assists in the socio-cultural construction of health and healing. This case study expands on this conversation by detailing how seminary students, pastors, and health ministers can also use public health knowledge to better provide services to their congregations and communities. This model provides long-term, publicly-available, asynchronous access to these materials, making it a valuable resource for theology schools.
Pedagogy in Health Promotion, 2021
Writing well is an important skill for graduate students to learn. We contend that viewing the wr... more Writing well is an important skill for graduate students to learn. We contend that viewing the writing process through the lens of storytelling and narrative helps graduate students make clearer, more compelling cases in their academic writing. Mapping the movements of the classic narrative arc onto the Introduction, Methods, Results, and Discussion (IMRAD) format of health promotion writing can help authors engage in the writing process more thoroughly because we are socially trained to organize information in narrative forms. This commentary examines the narrative framework in relation to writing, reading, and synthesizing academic literature. We conclude that graduate students will benefit from seeing themselves as health promotion storytellers.
Graduate Student Journal Articles by Tyler J Fuller
Theological and Religious Studies: A Graduate Student Journal, 2020
HIV and AIDS continue to be important issues in the gay community 38 years after AIDS was first r... more HIV and AIDS continue to be important issues in the gay community 38 years after AIDS was first reported within the public health community. Over the course of the HIV and AIDS epidemics Christian churches and gay communities have often been in conflict about the nature of HIV and AIDS, as well as how to respond to them. Understanding how gay men make meaning of the HIV and AIDS epidemics and the role Christian churches play in the epidemics can inform how to implement effective public health programming for gay men. Halbwachs’ theory of collective memory posits that individual memories and interpretations of them are shaped by social location and that these in turn inform social identity and contribute to collective memory within social groups. Thus, this study seeks to understand white, gay, Christian men’s collective memory of the AIDS crisis and social identity in relation to Christian churches. This qualitative study utilized a case study with a white, gay, Christian man who lived in New York City during the 1980s – 1990s. Results suggest that white, gay, Christian men’s understanding of the AIDS epidemic is informed by their experiences of individual religious faith and with organized religion. White, gay men were deeply affected by the AIDS epidemic because they often watched their friends and community members suffer and die, and were often rejected by their families and churches. This was exacerbated by a lack of funding for research and social programs to address the AIDS epidemic, which caused gay men in New York to come together to advocate their needs to the public. Christian theologies that identified homosexuality as sinful informed public perceptions of AIDS, and churches were often dehumanizing, rejecting gay men because of their sexuality or blaming them for AIDS because they perceived them as immoral. Because of these experiences during the epidemic, churches are still not seen as places where white, gay, Christian men can receive care and support for living with HIV or AIDS in the present. Christian churches need to welcome lesbian, gay, and bisexual individuals if they are going to play an effective part in addressing the current HIV epidemic that gay men in the United States face. Countermemory in the white, gay, Christian community resists forms of forgetting that are concerning, including the loss of intergenerational memory, which teaches young gay men about HIV and AIDS. Yet, individual faith also emerged as a prominent theme in this work, suggesting that while organized religion may not have resources to address the HIV epidemic, individual faith may be an important source of perseverance and compassion. This study points towards a need for public health professionals who work with gay communities to be open to hearing narratives of faith and integrating them into their work addressing the HIV epidemic.
Papers by Tyler J Fuller
American journal of public health, Feb 1, 2024
American journal of public health, Feb 1, 2024
Bloomsbury Religion in North America, Dec 31, 2022
Journal of racial and ethnic health disparities, Feb 6, 2024
Black communities in the Southeast United States experience a disproportionate burden of illness ... more Black communities in the Southeast United States experience a disproportionate burden of illness and disease. To address this inequity, public health practitioners are partnering with Black Protestant churches to deliver health promotion interventions. Yet, the reach of these programs beyond the organizational level of the Social Ecological Model (SEM) is not well defined. Thus, the aim of this study is to understand Black Protestant church leaders’ and members’ perceptions about the capacity of their ministries to reach into their communities, beyond their congregations, as providers or hosts of health education or promotion interventions. From 20 Black Protestant churches in Atlanta, GA, 92 church leaders and members participated in semi-structured interviews. Grounded theory guided data analysis and a diverse team coded the interviews. Most participating churches had health ministries. Participants saw the boundaries between their churches at the organizational level of the SEM and the broader Black community to be porous. Those who described their “community” as being broader than their congregation also tended to describe community-wide health promotion their church engaged in. They described church-based health fairs as a strategy to promote engagement in their communities. Some participants, particularly those in a health-related profession, discussed visions of how to utilize their church as a site for community-wide health promotion. We suggest these participants may be boundary leaders who can build relationships between public health professionals, pastors, and congregants. Based on the findings, we suggest that church-based health fairs may be effective sites of community-wide health promotion.
Pedagogy in health promotion, Feb 25, 2021
Writing well is an important skill for graduate students to learn. We contend that viewing the wr... more Writing well is an important skill for graduate students to learn. We contend that viewing the writing process through the lens of storytelling and narrative helps graduate students make clearer, more compelling cases in their academic writing. Mapping the movements of the classic narrative arc onto the Introduction, Methods, Results, and Discussion (IMRAD) format of health promotion writing can help authors engage in the writing process more thoroughly because we are socially trained to organize information in narrative forms. This commentary examines the narrative framework in relation to writing, reading, and synthesizing academic literature. We conclude that graduate students will benefit from seeing themselves as health promotion storytellers.
Teaching Theology and Religion, Nov 25, 2020
BMC Public Health, Apr 20, 2022
Sexuality and Culture, Apr 16, 2022
Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted... more Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted diseases, especially in the southern United States. This study investigates how multiple dimensions of current religiosity as well as religious upbringing influence the sexual behaviors, including contraceptive usage, of individuals 18–25 years old (n = 211) in the South. Based on regression analyses, results suggest that emerging adults with higher levels of current religiosity are more likely to remain abstinent, but less likely to use pregnancy prevention methods, such as birth controls pills and long-acting reversible contraceptives. Having a religious upbringing is also associated with lower contraceptive usage. Through the assessment of multiple dimensions of religiosity and various sexual behaviors, this study presents a nuanced picture of the complex associations between religion and sexual health, specifically among emerging adults in the southern United States.
Culture, Health & Sexuality, Mar 2, 2021
Abstract This analysis of 84 interviews with female Black Church leaders and members from Atlanta... more Abstract This analysis of 84 interviews with female Black Church leaders and members from Atlanta, GA, examined how women in Black churches construct definitions of, and identities in relation to, HIV narratives about men on the down low. We analyse these narratives as collective memories, through the theoretical lens of memory and trauma studies, by identifying how women understand themselves as the victims of men on the down low transmitting HIV; describe this as a painful experience; make public claims about this experience; and draw on theological understandings to make these claims. The narratives articulate how Black communal modes of meaning making have been disrupted by the HIV epidemic and assign responsibility for HIV transmission to men on the down low, who are perceived to be engaged in risky sexual behaviour. We discuss these results in relation to HIV education and prevention and suggest health educators can engage Black church leaders by understanding these narratives as forms of countermemory.
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Peer Reviewed Articles by Tyler J Fuller
and members from Atlanta, GA, examined how women in Black
churches construct definitions of, and identities in relation to, HIV
narratives about men on the down low. We analyse these narratives
as collective memories, through the theoretical lens of memory
and trauma studies, by identifying how women understand
themselves as the victims of men on the down low transmitting
HIV; describe this as a painful experience; make public claims
about this experience; and draw on theological understandings to
make these claims. The narratives articulate how Black communal
modes of meaning making have been disrupted by the HIV epidemic
and assign responsibility for HIV transmission to men on
the down low, who are perceived to be engaged in risky sexual
behaviour. We discuss these results in relation to HIV education
and prevention and suggest health educators can engage Black
church leaders by understanding these narratives as forms of
countermemory.
Methods: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB.
Results: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%).
Conclusion: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.
Keywords: Miners, Mining, Healthcare, Africa, KAPs, Policy, TB, HIV
Graduate Student Journal Articles by Tyler J Fuller
Papers by Tyler J Fuller
and members from Atlanta, GA, examined how women in Black
churches construct definitions of, and identities in relation to, HIV
narratives about men on the down low. We analyse these narratives
as collective memories, through the theoretical lens of memory
and trauma studies, by identifying how women understand
themselves as the victims of men on the down low transmitting
HIV; describe this as a painful experience; make public claims
about this experience; and draw on theological understandings to
make these claims. The narratives articulate how Black communal
modes of meaning making have been disrupted by the HIV epidemic
and assign responsibility for HIV transmission to men on
the down low, who are perceived to be engaged in risky sexual
behaviour. We discuss these results in relation to HIV education
and prevention and suggest health educators can engage Black
church leaders by understanding these narratives as forms of
countermemory.
Methods: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB.
Results: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%).
Conclusion: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.
Keywords: Miners, Mining, Healthcare, Africa, KAPs, Policy, TB, HIV