O-94 Barriers, facilitators, and perceived benefits for noncommunicable diseases prevention, of church-based gardening with the Kalinago community: qualitative insights from a non-randomised implement

Methods: Using the Medical Research Council process evaluation framework, we conducted semi-structured interviews with 26 participants at baseline and three months post-intervention. Reflexive thematic analysis examined implementation, mechanisms of impact, and perceived benefits.

Results: Three interrelated themes emerged. (i) Implementation challenges reflected legitimacy concerns regarding lay health advocates, resource and transportation constraints, environmental conditions, and COVID-19 disruptions. (ii) Enabling mechanisms operated at individual, organisational, and system levels; faith-based framing motivated participation, church authority facilitated trust and access, culturally centred delivery enhanced acceptability, and partnerships between advocates, nurses, and churches supported adaptive delivery. (iii) Perceived benefits extended beyond individual behaviour change to community and system effects, including improved screening access, early detection, reduced clinic demand, increased vegetable consumption and physical activity, and community diffusion through spillover effects through produce sharing and household garden replication.

Conclusion: Culturally centred, church-based gardening interventions can enhance healthcare access, support healthier lifestyles, and generate community diffusion in resource-limited Indigenous settings. Successful implementation depends on legitimacy-building, adaptive partnerships, and alignment with local sociocultural contexts and equity goals.