Despite many efforts to address chronic conditions within the African American (AA) population, the rates of disease, disability and death, still remain disproportionate in AAs compared to other racial/ethnic groups. Historically, AAs have been exploited in health care which has garnered a mistrust of the health care system. To effectively improve health outcomes, it is necessary to implement culturally-tailored programming within a trusted institute. Such an institute within the AA community has historically been the church. While churches have the potential to play an important role in impacting health among AAs, it is unclear what attributes within churches are necessary for health promotion. The purpose of this study was to create a survey to predict the readiness of the AA church to engage in health promotion programming by examining the relationship between church infrastructure (physical structure, personnel, funding, and social/cultural support) and readiness to engage in health promotion programming. To accomplish this goal, 36 key informant interviews were conducted with pastors, health leaders and congregants to identify key infrastructure attributes necessary for health programming. Data collected from the interviews were used to develop a survey that was administered to 108 churches to identify the presence or absence of infrastructure and church readiness. Readiness was assessed by the amount of infrastructure present within churches along with the frequency of health activities. The study findings revealed that infrastructure, namely, physical structure, personnel, funding and cultural/social support were all associated with and able to predict the readiness of churches to engage in health programming. Churches with more infrastructure tended to engage in more health promotion programming. Churches with less infrastructure tended to engage in less health promotion programming. Overall, the infrastructure components of the African American church were noted to be very instrumental in the implementation and success of church-based health promotion programming. Hence, the AA church has the potential to help improve the health of the AA community and become a leading change agent for health. In turn, this can prove effective for health program planners and researchers, in partnership with churches, for developing, implementing and evaluating health promotion programming within the AA community
