Are religiosity and spirituality associated with obesity among African Americans in the Southeastern United States (the Jackson Heart Study)?

Religiosity in adolescence and body satisfaction and disordered eating in adolescence and young adulthood: cross-sectional and longitudinal findings from project EAT

PURPOSE

This research identified whether adolescent religiosity was associated with body satisfaction and disordered eating in adolescence and early adulthood and explored gender/sex differences in these associations.

METHODS

Project EAT (Eating and Activity in Teens and Young Adults) is a longitudinal cohort study following participants from adolescence into young adulthood. For this analysis (N = 1620), religiosity (importance of religion and frequency of religious service participation) during adolescence was examined as a correlate of body satisfaction and disordered eating (binge eating, maladaptive behaviors intended to lose or maintain weight, eating to cope, and dieting) at the same life stage (EAT-II, 2003-2004, Mage = 19.4 years) and during young adulthood (EAT-IV, 2015-2016, Mage = 31.5 years). Analyses used linear and logistic regression models adjusted for demographics and adolescent body mass index.

RESULTS

During adolescence, females who placed greater importance on religion had higher body satisfaction, 22% higher odds of binge eating, and 19% greater odds of dieting in the past year, while more frequent attendance of religious services was associated with higher body satisfaction and 37% greater odds of dieting past year. Among males, only frequent attendance of religious services was associated with higher adolescent body satisfaction. Longitudinally, among females, only frequent attendance of religious services in adolescence predicted higher levels of body satisfaction in young adulthood. No significant longitudinal associations were observed among males.

CONCLUSIONS

Our findings contribute to understanding the complex interplay between religiosity, gender, and body satisfaction. Further research should explore cultural factors influencing these associations and qualitative aspects of religious experiences to inform nuanced interventions.

LEVEL OF EVIDENCE

Level III, cohort study.

Religion and Pandemic Weight Gain: A Refuge from the Storm?

The COVID-19 pandemic was an inherently stressful global crisis that was associated with weight gain for over 40% of the American public. Building on previous research, we draw on recently collected national survey data from the United States to examine the effects of religious attendance (both in-person and virtual), the sense of divine control, and religious/spiritual (R/S) struggles on pandemic weight gain. A series of logistic regression models were conducted. Our findings suggest that divine control and monthly in-person religious attendance were associated with a lower risk of pandemic weight gain, while R/S struggles were associated with a higher risk of weight gain. Our results reveal the complex role that religiosity can play with respect to pandemic weight gain.

The Association Between Individualised Religiosity and Health Behaviour in Denmark: Are Social Networks a Mediating Factor?

The present study investigates whether social networks mediate the well-established positive association between religiosity and health behaviour. Most research has focused on traditional public religiosity (e.g. regular church attendance). This study, however, focuses on the Danish population in which non-traditional and private religiosity is common. We utilise data from the Danish population-based project, Early Detection and Prevention. Our results suggest that religiosity is linked to health behaviour; however, this association is not mediated by social network.

Religiosity/Spirituality and Cardiovascular Health: The American Heart Association Life's Simple 7 in African Americans of the Jackson Heart Study

Background

Religiosity/spirituality is a major coping mechanism for African Americans, but no prior studies have analyzed its association with the American Heart Association Life's Simple 7 (LS7) indicators in this group.

Methods and Results

This cross‐sectional study using Jackson Heart Study (JHS) data examined relationships between religiosity (religious attendance, private prayer, religious coping) and spirituality (theistic, nontheistic, total) with LS7 individual components (eg, physical activity, diet, smoking, blood pressure) and composite score among African Americans. Multivariable logistic regression assessed the odds of achieving intermediate/ideal (versus poor) LS7 levels adjusted for sociodemographic, behavioral, and biomedical factors. Among the 2967 participants (mean [SD] age=54.0 [12.3] years; 65.7% women), higher religious attendance was associated with increased likelihood (reported as odds ratio [95% CI]) of achieving intermediate/ideal levels of physical activity (1.16 [1.06–1.26]), diet (1.10 [1.01–1.20]), smoking (1.50 [1.34–1.68]), blood pressure (1.12 [1.01–1.24]), and LS7 composite score (1.15 [1.06–1.26]). Private prayer was associated with increased odds of achieving intermediate/ideal levels for diet (1.12 [1.03–1.22]) and smoking (1.24 [1.12–1.39]). Religious coping was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.18 [1.08–1.28]), diet (1.10 [1.01–1.20]), smoking (1.32 [1.18–1.48]), and LS7 composite score (1.14 [1.04–1.24]). Total spirituality was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.11 [1.02–1.21]) and smoking (1.36 [1.21–1.53]).

Conclusions

Higher levels of religiosity/spirituality were associated with intermediate/ideal cardiovascular health across multiple LS7 indicators. Reinforcement of religiosity/spirituality in lifestyle interventions may decrease overall cardiovascular disease risk among African Americans.

Psychometric Testing of the Daily Spiritual Experiences Scale (DSES) Among Black Gay, Bisexual, and Other Sexual Minority Men (SMM) and Black Transwomen in the Deep South: The MARI Study

Spirituality is a well-established protective psychosocial determinant of health. The current study examined the psychometric properties of the Daily Spiritual Experiences Scale (DSES) among Black gay, bisexual and other sexual minority men (SMM) and Black transwomen (TW) in the Deep South. Data were collected via self-interview technology and analyzed using factor analyses and correlation coefficients. We demonstrated a single-factor structure of the DSES with high internal consistency (Cronbach's α = 0.96). DSES was positively and significantly associated with multiple dimensions of religion, resilience, optimism and social support and not significantly associated with cynicism and anger expressions. Spirituality should be included in HIV prevention, treatment and care strategies focused on Black SMM and Black TW, especially those residing in the Deep South, USA.

Denominational Differences in Obesity Among Black Christian Adults: Why Gender and Life Stage Matter

Religiosity is a potential social determinant of obesity risk among black Americans, a group that tends to be highly religious and disproportionately suffers from this disease. Although religious engagement differs within this group, researchers often classify black Protestants into broad categories, making it challenging to determine which subgroups experience the worst outcomes. Using data from the National Survey of American Life, this study investigated whether black adults from various Christian denominations had comparable odds of having obesity and if these findings were consistent across life stage (i.e., young, middle, and late adulthood). Results suggest that for middle-aged Pentecostal women, and men and women who attend church most frequently, the odds of having obesity were comparably higher than their respective counterparts. These findings indicate that, even when denominational consolidation is appropriate in other religious research contexts, researchers should consider diaggregating black Christians by denomination when examining the relationship between religion and health.

Identifying neighbourhood and individual resilience profiles for cardiovascular health: a cross-sectional study of blacks living in the Atlanta metropolitan area

OBJECTIVE

To simultaneously examine multiple individual-level neighbourhood perceptions and psychosocial characteristics and their relationships with cardiovascular health (CVH) among blacks.

DESIGN

Cross-sectional study.

SETTING

Subjects were recruited between 2016 and 2018 via convenience sampling.

PARTICIPANTS

385 Black men and women, age 30-70 living in the Atlanta metropolitan area (Georgia, USA).

PRIMARY OUTCOME MEASURE

Individual's CVH was summarised as a composite score using American Heart Association's Life's Simple 7 (LS7) metrics.

METHODS

We implemented unsupervised learning (k-means) and supervised learning (Bayesian Dirichlet process clustering) to identify clusters based on 11 self-reported neighbourhood perception and psychosocial characteristics. We also performed principal component analysis to summarise neighbourhood perceptions and psychosocial variables and assess their associations with LS7 scores.

RESULTS

K-means and Bayesian clustering resulted in 4 and 5 clusters, respectively. Based on the posterior distributions, higher LS7 scores were associated with better neighbourhood perceptions and psychosocial characteristics, including neighbourhood safety, social cohesion, activities with neighbours, environmental mastery, purpose in life, resilient coping and no depression. Taken together, the first principal components of neighbourhood perceptions and psychosocial characteristics were associated with an increase of 0.07 (95% CI -0.17 to 0.31) and 0.31 (95% CI 0.06 to 0.55) in LS7 score, respectively, after accounting for age, sex, household income and education level.

CONCLUSION

Both neighbourhood perception and psychosocial domains were related to CVH, but individual psychosocial characteristics appeared to contribute to CVH most. Approaches that acknowledge the importance of factors in both domains may prove most beneficial for enhancing resilience and promoting CVH among black communities.

Impact of spiritual beliefs and faith-based interventions on diabetes management

Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.

Religiosity and Health-Related Risk Behaviours in a Secular Culture-Is there a Correlation?

In the present study, we examine the correlation between religiosity and health-related risk behaviours among citizens aged 29-60 based on a cross-sectional survey in Denmark, known for its more secular culture. Health-related risk behaviours such as smoking and alcohol intake are known to increase the risk of developing one or more chronic or life-threatening diseases. In this study religiosity, in a random sample of Danes, seems to be associated with healthier lifestyle, such as a healthier dietary pattern and less smoking, as is found in more religious cultures. Our study suggests that religious practice among Danish citizens seems to be correlated with health behaviours and that healthcare professionals should pay more attention to the connection between religiosity and health.

Cumulative psychosocial factors are associated with cardiovascular disease risk factors and management among African Americans in the Jackson Heart Study

BACKGROUND

Racial disparities in cardiovascular disease (CVD) have been attributed in part to negative psychosocial factors. Prior studies have demonstrated associations between individual psychosocial factors and CVD risk factors, but little is known about their cumulative effects.

METHODS

Using the Jackson Heart Study, we examined the cross-sectional associations of cumulative psychosocial factors with CVD risk factors among 5306 African Americans. We utilized multivariable Poisson regression to estimate sex-stratified prevalence ratios (PR 95% confidence interval-CI) of obesity, hypertension and diabetes prevalence and hypertension and diabetes control with negative affect (cynicism, anger-in, anger-out, depressive symptoms and cumulative negative affect) and stress (global stress, weekly stress, major life events-MLEs and cumulative stress), adjusting for demographics, socioeconomic status, and behaviors.

RESULTS

After full adjustment, high (vs. low) cumulative negative affect was associated with prevalent obesity among men (PR 1.36 95% CI 1.16-1.60), while high (vs. low) cumulative stress was similarly associated with obesity among men and women (PR 1.24 95% CI 1.01-1.52 and PR 1.13 95% CI 1.03-1.23, respectively). Psychosocial factors were more strongly associated with prevalent hypertension and diabetes among men than women. For example, men who reported high cynicism had a 12% increased prevalence of hypertension (PR 1.12, 95% CI 1.03-1.23). Psychosocial factors were more strongly associated with lower hypertension and diabetes control for women than men. Women who reported high (vs. low) cynicism had a 38% lower prevalence of hypertension control (PR 0.62, 95% CI 0.46-0.84).

CONCLUSIONS

Cumulative psychosocial factors were associated with CVD risk factors and disease management among African Americans. The joint accumulation of psychosocial factors was more associated with risk factors for men than women.

Religiosity/Spirituality and Physiological Markers of Health

The long-standing interest in the effects of religiosity and spirituality (R/S) on health outcomes has given rise to a large and diverse literature. We conducted a meta-analysis on research involving R/S and physiological markers of health to elucidate both the scope and mechanism(s) of this phenomenon. A combined analysis found a significant, but small, beneficial effect. Subgroup analyses found that some measures of both extrinsic and intrinsic religiosity were significantly associated with health. Several outcome measures, including blood pressure, C-reactive protein, and cardiovascular health markers, were significantly associated with R/S. Our findings suggest that R/S benefits health, perhaps through minimizing the disruptive effects of stress/depression on inflammation. We hope that researchers can use these results to guide efforts aimed at elucidating the true mechanism(s) linking religious/spiritual beliefs and physical health.

Destroying God's Temple? Physical Inactivity, Poor Diet, Obesity, and Other "Sin" Behaviors

On average, our participants (N = 112), who self-proclaimed to be Christians, believed that physically inactive lifestyles, unhealthy eating, overeating, and being obese destroy the body, God's temple. However, these beliefs were less definitive, than those of other common "sin" behaviors, such as drug use, smoking, and excessive drinking of alcohol. In addition, destroying the body with physical inactivity or poor diet was not necessarily viewed as sinful. Subsequently, these beliefs did not relate to self-reported physical activity, dietary behavior, or body mass index. It is possible that inactivity, poor dietary habits, and obesity are not internalized into the spiritual perspective as destroying the body, God's temple, in the same way as other "sin" behaviors.

Efeitos da associação entre espiritualidade, religiosidade e atividade física na saúde/saúde mental: revisão sistemática

RESUMO Objetivo: Identificar na literatura evidências acerca dos efeitos da associação entre espiritualidade, religiosidade e atividade física na saúde física e mental. Método: Revisão sistemática realizada em janeiro de 2019 nas bases de dados MEDLINE/PubMed, SCOPUS, Web Of Science, CINAHL, PsycINFO, LILACS e SciELO, com os descritores “spirituality”, “religion”, “physical activity” e “physical exercise”. Incluíram-se estudos primários realizados com adultos, publicados até 2018 em português, inglês ou espanhol. Resultados: Foram selecionados nove estudos, publicados entre 2011 e 2017, todos internacionais, com desenho transversal (55%) e nível de evidência quatro (78%). Oito estudos abordaram efeitos na saúde física e um abordou efeitos na saúde mental. Conclusão: A Associação entre espiritualidade, religiosidade e atividade física promove efeitos na saúde física e mental, porém as evidências disponíveis não são suficientes para que esta associação seja aplicada na prática clínica.

Religious Attendance and Body Mass: An Examination of Variations by Race and Gender

Studies of the association between religious attendance and body mass have yielded mixed results. In this paper, we consider intersectional variations by race and gender to advance our understanding of these inconsistencies. We use data from the 2006-2008 Health and Retirement Study to examine the association between religious attendance and three indicators of body mass: overall body mass index, waist circumference, and waist-to-height ratio (n = 11,457). For White women, attendance is either protective or unrelated to body mass. For Black women, attendance is consistently associated with increased body mass. We find that religious attendance is not associated with body mass among the men.

Different dimensions of religiousness/spirituality are associated with health behaviors in breast cancer survivors

OBJECTIVE

Religiousness/spirituality (R/S) may influence cancer survivors' health through multiple pathways. We aimed to examine one potentially key pathway that has seldom been examined: relationships between survivors' R/S and their health behaviors.

METHODS

The present study investigated links between four core dimensions of R/S (beliefs, behaviors, identity, and coping) and three health behaviors (fruit/vegetable consumption, physical activity, and maintenance of a healthy weight) in 172 breast cancer survivors.

RESULTS

Both spiritual identity and use of religious coping were positively related to fruit and vegetable intake, while private prayer was marginally positively related. Both service attendance and religious identity (marginally) were related to engaging in less physical activity, while private prayer was positively related. Afterlife beliefs and private prayer were positively associated with BMI.

CONCLUSIONS

R/S has complex but meaningful associations with health behaviors in breast cancer survivors. More research is needed to understand these relationships and to determine whether different dimensions of R/S may play useful roles in lifestyle change interventions.

The Impact of Religiosity on Substance Abuse and Obesity in African Americans

Among the African American community, there exist many health disparities which warrant greater examination through the practice of social work. The aim of the present research was to explore the impact of religiosity on substance abuse and obesity among African American populations by employing a systematic review of the current body of literature on this subject. While many of the studies reviewed found at least a weak relationship between religiosity and obesity, such results were not consistent across all materials examined. Among those studies that found a correlation between these factors, many demonstrated that religiosity had a positive impact on substance abuse and obesity. A discussion of the implications of these findings is submitted as a means of illuminating the significance of all research findings that were examined. Limitations such as more standardized criteria for inclusion of research material are identified and discussed. Implications for future research are presented to promote the advancement of future efforts in this area research.

Sex-Specific Impact of Spiritual Beliefs and Sleep Quality on Degree of Psychological Distress

The purpose of this study was to test a set of hypotheses suggesting sleep quality and spiritual beliefs differed according to degree of psychological distress and biological sex. The Pittsburgh Sleep Quality Index measured sleep quality, the Beliefs and Values Scale measured spiritual beliefs, and the Kessler-6 Psychological Distress Scale measured distress. A factorial MANOVA tested the model. Higher sleep quality and greater spiritual beliefs were associated with lower levels of distress. Women exhibited lower sleep quality than men, whereas spiritual beliefs were equivalent between sexes. To decrease psychological distress, interventions should improve sleep quality and increase spiritual engagement.

Reducing depressive symptoms through behavioral activation in churches: A Hybrid-2 randomized effectiveness-implementation design

Rural African Americans are disproportionately exposed to numerous stressors such as poverty that place them at risk for experiencing elevated levels of depressive symptoms. Effective treatments for decreasing depressive symptoms exist, but rural African Americans often fail to receive adequate and timely care. Churches have been used to address physical health outcomes in rural African American communities, but few have focused primarily on addressing mental health outcomes. Our partnership, consisting of faith community leaders and academic researchers, adapted an evidence-based behavioral activation intervention for use with rural African American churches. This 8-session intervention was adapted to include faith-based themes, Scripture, and other aspects of the rural African American faith culture (e.g. bible studies) This manuscript describes a Hybrid-II implementation trial that seeks to test the effectiveness of the culturally adapted evidence-based intervention (Renewed and Empowered for the Journey to Overcome in Christ: REJOICE) and gather preliminary data on the strategies necessary to support the successful implementation of this intervention in 24 rural African American churches. This study employs a randomized one-way crossover cluster design to assess effectiveness in reducing depressive symptoms and gather preliminary data regarding implementation outcomes, specifically fidelity, associated with 2 implementation strategies: training only and training+coaching calls. This project has the potential to generate knowledge that will lead to improvements in the provision of mental health interventions within the rural African American community. Further, the use of the Hybrid-II design has the potential to advance our understanding of strategies that will support the implementation of and sustainability of mental health interventions within rural African American faith communities.

TRIAL REGISTRATION

NCT02860741. Registered August 5, 2016.

Spiritual well-being, religious activity, and the metabolic syndrome: results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Sociocultural risk and protective factors for developing the metabolic syndrome (MetS), a risk factor for cardiovascular disease (CVD), have not been well studied in Hispanics/Latinos residing in the United States (U.S.). Religiosity and/or spirituality (R/S), important aspects of Hispanic/Latino culture, have been inversely associated with CVD and multiple CVD risk factors. Cross-sectional associations between dimensions of R/S and prevalent MetS, and its five individual components were examined using multiple logistic and linear regression, among 3278 U.S., middle-aged and older Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Dimensions of R/S were not associated with presence of the MetS. Certain dimensions of Spiritual Well-being (Meaning, Peace, Faith), and frequency of non-organizational religious activity were weakly but significantly associated with one or more MetS components including waist circumference, diastolic blood pressure, and systolic blood pressure. R/S variables were not associated with triglycerides, fasting glucose or HDL cholesterol levels. Prospective, longitudinal studies are needed to gain a deeper understanding of the nature of the relationship between R/S and health risk factors in U.S. Hispanics/Latinos.

Aspects of quality of life affected in morbidly obese patients who decided to undergo bariatric surgery: A qualitative study to design a native questionnaire

BACKGROUND

Obesity is a known prevalent major health issue. The aim of this study is to assay Iranian patients' problems with obesity and their expectations of bariatric surgery.

MATERIALS AND METHODS

In this study, we included patients who have used different medical noninvasive treatments and were unsuccessful in losing weight from the obesity clinic in Al Zahra Hospital, Isfahan, from 2014 to 2015. Morbidly obese patients were interviewed using some open-ended questions, and then, directional content analysis of data was done.

RESULTS

Analysis of data showed five main categories including (1) physical health, (2) psychological health, (3) social relationships, (4) environment, and (5) "about the causes of obesity" with some subcategories for each category.

CONCLUSION

This study is the first step of designing a quality of life questionnaire while we focused on spiritual and cultural states of Iranian people.

Influence of Holy Month Ramadan on Alcohol Consumption in Turkey

This study utilizes a balanced panel data set covering 50 monthly observations regarding the brewery products to examine the impact of holy month Ramadan on alcohol consumption in Turkey. In addition to the Ramadan, temperature, prices of the products and disposable income are other demand factors which are taken into account in this study. As expected, the Ramadan has been found to be associated with lower alcohol usage. As price of alcoholic drinks increases, the alcohol consumption decreases significantly. In addition, alcohol consumption rises with the enhancements in the disposable income. However, surprisingly, the temperature has not any significant effect on alcohol consumption in Turkey.

True Believers? Religion, Physiology, and Perceived Body Weight in Texas

This paper examines relationships between body weight, religion, and gender while controlling for relevant covariates and body mass index (BMI), a measure of physical/biological body type. Using data from the 2004 Survey of Texas Adults (n = 1,504), we present results of ordered logistic regression models which indicate that religious factors work distinctly for men and women when controlling for BMI. While church attendance is associated with lower odds of overweight perceptions among women, it is religious salience that is associated with lower odds of self-reported excess weight in men. Implications for research which associates religious and physiological factors are discussed.

The relationship between religiosity and cardiovascular risk factors in Japan: a large-scale cohort study

The goal of this study was to examine the relationship between religiosity and cardiovascular risk factors in a Japanese population. A retrospective cohort study was conducted involving individuals who underwent annual health check-ups at St. Luke's International Hospital from 2005 to 2010. Data collected included self-reported demographics, clinical information, and health habits, as well as religiosity, baseline examination, and laboratory measures. We conducted multivariable regression analyses to examine the associations between religiosity and cardiovascular risk factors at baseline and longitudinally. The analyses were performed in 2012. A total of 36,965 participants were enrolled, and 13,846 (37.8%) reported being at least somewhat religious. Compared with those who were not religious at baseline, religious participants (n = 3685) were less likely to be current smokers (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.53-0.67) and to report excessive alcohol consumption (OR, 0.74; 95% CI, 0.67-0.82), and more likely to exercise at least three times a week (OR, 1.27; 95% CI,1.16-1.39) and to be obese (OR, 1.32; 95% CI, 1.19-1.47). There were no significant differences in the rate of hypertension, diabetes mellitus, or dyslipidemia prevalence. In longitudinal data analyses, religiosity was associated with a lower likelihood of smoking and excessive alcohol consumption, and a higher likelihood of regular exercise and a lower incidence of diabetes over time. Individuals who were more religious were significantly more likely to have favorable health habits and fewer cardiovascular risk factors, except for a higher prevalence of overweight/obesity at baseline. Religiosity was also associated with better health habits over time and less likely to be associated with future diabetes but not with blood pressure or lipid levels.

Spirituality moderates the relationship of psychosocial stress to metabolic risk factors among Afro-Caribbean immigrants in the US Virgin Islands

OBJECTIVE

Spirituality may contribute to the health advantage of foreign-born blacks compared to United States (US)-born blacks. The objective of this study was to test the hypothesis that spirituality attenuates the association of psychosocial stress to stress-associated metabolic risk factors among foreign-born Caribbean blacks living in a US jurisdiction.

METHODS

Data on demographic factors, anthropometric measurements (height, weight and waist), fasting glucose and insulin, lifestyle behaviors (smoking and alcohol use), psychosocial stress and spirituality were collected from a population-based sample of 319 Afro-Caribbean immigrants, ages 20 and older, who were recruited between 1995 and 2000 in the Virgin Islands of the United States (USVI). Glucose and insulin measurements were used to estimate insulin resistance by the homeostasis model assessment (HOMA-IR) method. Participants were classified into three levels of spirituality, "low", "medium" and "high" based on the distribution of spirituality scores. Stepwise regression analyses were used to identify the significant predictors of waist circumference and HOMA-IR within each level of spirituality.

RESULTS

The predictors of waist circumference and HOMA-IR varied across the levels of spirituality. Psychosocial stress was an independent predictor of waist and HOMA-IR only among participants with a low level of spirituality.

CONCLUSION

Spirituality appears to attenuate the association of psychosocial stress to waist circumference and insulin resistance among Afro-Caribbean immigrants in the USVI.

The role of religion and spirituality in coping with type 2 diabetes: a qualitative study among Black men

Religion and spirituality are instrumental to coping with health; however, there is limited literature on the use of religion and spirituality among Black men with type 2 diabetes. The purpose of this study is to explore how Black men use religion or spirituality to cope with diabetes management. We conducted in-depth interviews with 30 Black men recruited from a diabetes clinic in Atlanta, Georgia as part of a larger study. This article reports on data from 12 of the 30 Black men who reported the use of religion and spirituality as a coping strategy for diabetes management. The following coping strategies were reported: prayer and belief in God, keeping me alive, turning things over to God, changing my unhealthy behaviors, supplying my needs, reading the Bible, and religious or spiritual individuals helping me. Healthcare professionals and researchers involved in diabetes management among Black men should consider these findings in their efforts.

Utility of a congregational health assessment to identify and direct health promotion opportunities in churches

PURPOSE

The church is a focal point for health education efforts in minority communities due to its status as one of the most prominent and stable institutions. This paper highlights an approach for identifying health programming targets in minority churches.

METHODS

Twenty-four churches participated in a one-year Health Ministry Institute (HMI), designed to help churches develop sustainable ministries for health promotion. HMI attendees were instructed on conducting a Congregational Health Assessment (CHA) to identify prevalent health conditions and related behaviors in their churches. Churches collected CHAs over a one-month period. Data were analyzed and results were discussed during a HMI session and used to prioritize health-related issues that could be addressed at individual churches.

RESULTS

Seventeen churches (71%) returned surveys (n=887; 70% female; 73% African American). Prevalent health conditions, participation in health-promoting behaviors, interest in learning to live healthy, and interest in health ministry activities were identified using the CHA.

CONCLUSIONS

The CHA shows promise for health assessment, and can be used to identify health issues that are of interest and relevance to church congregants and leaders. The CHA may assist churches with implementing effective and sustainable programs to address the identified health issues.

The psychological well-being of people living with HIV/AIDS and the role of religious coping and social support

OBJECTIVE

This study examined correlates of depressive symptoms, particularly the role of religious coping (RCOPE), among people living with HIV/AIDS (PLWHA). The study also examined social support as a possible mediator of the proposed association between religious coping and depressive symptoms and the impact of depressive symptomatology on health outcomes such as HIV medication adherence, immune function, and health-related quality of life (HRQOL) among PLWHA.

METHOD

A convenience sample of 292 PLWHA were recruited from an out-patient infectious disease clinic and AIDS-service organizations in the Southeastern United States.

RESULTS

56.7% reported depressive symptoms. PLWHA with depressive symptomatology reported significantly poorer health outcomes, including poorer HIV medication adherence, lower CD4 cell count, and poorer HRQOL. The odds of being depressed was significantly associated with birth sex (female: OR = 0.43, 95% CI = .23-.80), sexual orientation (gay/bisexual: OR = 1.95, 95% CI = 1.04-3.65), marital status (single: OR = .52, 95% CI = .27-.99), social support satisfaction (OR = 0.65, 95% CI = .49-.86), and negative RCOPE (OR = 1.22, 95% CI = 1.14-1.31). Social support partially mediated the relationship between religious coping and depressive symptoms.

CONCLUSIONS

High rates of depressive symptoms are present in PLWHA, which negatively impact health outcomes. Religious coping, perceived stress, and social support satisfaction serve an important role in depressive symptomatology among PLWHA. These findings underscore the need for healthcare providers to regularly screen PLWHA for and adequately treat depression and collaborate with mental health providers, social workers, and pastoral care counselors to address PLWHA's mental, social, and spiritual needs and optimize their HIV-related outcomes.

Social epidemiology of diabetes and associated conditions

Research focusing on the social determinants of diabetes has focused on individual-level factors such as health behaviors, socioeconomic status, and depression. Fewer studies that incorporate a broader consideration of the multiple contexts or organizational levels (eg, family, health care setting, neighborhood) within which individuals are embedded exist in the mainstream diabetes literature. Such an approach would enhance our understanding of this complex disease, and thus, future avenues of research should consider the following: (1) a life-course approach, which examines the influence of early life exposures on the development of diabetes; (2) aiming to understand the biological mechanisms of social determinants of diabetes; and (3) implementing interventions on multiple levels. Integrating this multilevel and life-course approach will require transdisciplinary science that brings together highly specialized expertise from multiple disciplines. Broadening the study of social determinants is a necessary step toward improving the prevention and treatment of type 2 diabetes.

Religiosity and spirituality and the intake of fruit, vegetable, and fat: a systematic review

Objectives. To systematically review articles investigating the relationship between religion and spirituality (R/S) and fruit, vegetable, and fat intake. Methods. PubMed, CINAHL, and PsycInfo were searched for studies published in English prior to March 2013. The studies were divided into two categories: denominational studies and degree of R/S studies. The degree of R/S studies was further analyzed to (1) determine the categories of R/S measures and their relationship with fruit, vegetable, and fat intake, (2) evaluate the quality of the R/S measures and the research design, and (3) determine the categories of reported relationship. Results. Thirty-nine studies were identified. There were 14 denominational studies and 21 degree of R/S studies, and 4 studies were a combination of both. Only 20% of the studies reported validity and 52% reported reliability of the R/S measures used. All studies were cross-sectional, and only one attempted mediation analysis. Most studies showed a positive association with fruit and vegetable intake and a mixed association with fat intake. Conclusion. The positive association between R/S and fruit and vegetable intake may be one possible link between R/S and positive health outcome. However, the association with fat intake was mixed, and recommendations for future research are made.

Predictors of change in fruit and vegetable consumption in a faith-based intervention with African American adults

A majority of African American adults do not eat the recommended daily amount of fruit and vegetables. This study examined baseline demographic, health-related, and psychosocial variables as predictors of change in fruit and vegetable consumption from baseline to postprogram in a sample of church members taking part in a 15-month intervention. Participants who had a greater waist circumference, greater baseline fruit and vegetable consumption, greater leisure time physical activity, higher levels of social support, greater attendance at worship service, were obese, and did not have diabetes at baseline showed higher posttest fruit and vegetable consumption.

Spiritual and religious beliefs and practices and social support's relationship to diabetes self-care activities in African Americans

PURPOSE

The purpose of this study is to investigate the relationship among spiritual and religious beliefs and practices, social support, and diabetes self-care activities in African Americans with type 2 diabetes, hypothesizing that there would be a positive association.

METHOD

This cohort study used a cross-sectional design that focused on baseline data from a larger randomized control trial. Diabetes self-care activities (summary of diabetes self-care activities) and sociodemographic characteristics were assessed, in addition to spiritual and religious beliefs and practices and social support based on the systems of belief inventory subscales I (beliefs and practices) and II (social support).

RESULTS

There were 132 participants: most were women, middle-aged, obese, single, high school educated, and not employed. Based on Pearson correlation matrices, there were significant relationships between spiritual and religious beliefs and practices and general diet. Additional significant relationships were found for social support with general diet, specific diet, and foot care. Based on multiple linear regression, social support was a significant predictor for general diet, specific diet, and foot care. Sex was a significant predictor for specific diet, and income was a significant predictor for blood glucose testing.

CONCLUSIONS

The findings of this study highlight the importance of spiritual and religious beliefs and practices and social support in diabetes self-care activities. Future research should focus on determining how providers integrate patients' beliefs and practices and social support into clinical practice and include those in behavior change interventions.

Association of church-sponsored activity participation and prevalence of overweight and obesity in African American Protestants, National Survey of American Life, 2001-2003

OBJECTIVE

This study examines the relationships between participation in the African American church and overweight/obesity (body mass index (BMI) > or = 25 kg/m2).

DESIGN

This cross-sectional analysis was based on the National Survey of American Life 2001-2003 and included 2,689 African American Protestant (AAP) adults. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for overweight/obesity. Two practices were examined--frequency of participation in church activities (excluding services) and frequency of church service attendance. Each practice was analyzed in separate models. Each model included the following covariates: age, marital status, education, poverty, smoking, and region of country. We also adjusted models for sex.

RESULTS

After adjustment, African American Protestant men (AAPM) who participated in church activities at least weekly were more likely to be overweight/obese (aOR=2.17; 95% CI = 1.25, 3.77) compared to AAPM who did not participate in church activities. There was no statistically significant association between overweight/obesity and participation in church activities for AAPW. There was no association between overweight/obesity and attendance of church services for AAP men and women combined.

CONCLUSIONS

For AAPM, participation in church activities was significantly associated with overweight/obesity. Further studies are required to determine why this association occurs in AAPM but not AAPW. Studies looking at the wider application of the several successful health initiatives targeting the AAP community should also be considered.