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Eagle D, Holleman A, Olvera BB, Blackwood E. Prevalence of obesity in religious clergy in the United States: A systematic review and meta-analysis. Obes Rev 2024; 25:e13741. [PMID: 38572610 DOI: 10.1111/obr.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/05/2024] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This systematic review aims to summarize the current body of evidence concerning the prevalence of obesity among clergy (i.e., the officially designated leaders of a religious group) in the United States. METHOD From November 2022 to February 2023, five databases, one data repository, and gray matter were searched for articles and data sources. The search was restricted to articles published or raw data collected from 2001 to 2021. Study quality was assessed with a template, and heterogeneity was assessed using the I 2 statistic. The protocol for this review was registered with PROSPERO (CRD42022376592). RESULTS Forty-seven studies of clergy obesity involving 35,064 individuals were eligible. The pooled prevalence estimate of obesity across studies was 34.8% (95% confidence interval [CI]: 32.5-37.2). Obesity prevalence was found to be increasing over time and to vary considerably between clergy from different religious traditions. Compared to national estimates, from 2005 onwards, obesity prevalence was higher than in the US adult population.
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Affiliation(s)
- David Eagle
- Duke University Global Health Institute and Department of Sociology, Duke University, Durham, NC, USA
| | - Anna Holleman
- Duke University Global Health Institute and Department of Sociology, Duke University, Durham, NC, USA
| | - Brianda Barrera Olvera
- Duke University Global Health Institute and Department of Sociology, Duke University, Durham, NC, USA
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Yao J, Steinberg D, Turner EL, Cai GY, Cameron JR, Hybels CF, Eagle DE, Milstein G, Rash JA, Proeschold-Bell RJ. When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for US Christian Clergy. JOURNAL OF RELIGION AND HEALTH 2024; 63:1849-1866. [PMID: 37709979 PMCID: PMC11061022 DOI: 10.1007/s10943-023-01910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.
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Affiliation(s)
- Jia Yao
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA.
| | - Dori Steinberg
- School of Nursing and Global Health Institute, Duke University, Durham, NC, USA
| | - Elizabeth L Turner
- Department of Biostatistics and Bioinformatics and Global Health Institute, Duke University, Durham, NC, USA
| | - Grace Y Cai
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Jacqueline R Cameron
- Department of Internal Medicine, Section of Palliative Medicine, Department of Preventive Medicine, Department of Religion, Health and Human Values, Rush University, Chicago, IL, USA
| | - Celia F Hybels
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - David E Eagle
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Glen Milstein
- Department of Psychology, The City College of New York, New York, NY, USA
| | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Rae Jean Proeschold-Bell
- Global Health Institute and Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
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Powell LH, Daniels BT, Drees BM, Karavolos K, Lohse B, Masters KS, Nicklas JM, Ruder EH, Suzuki S, Trabold N, Zimmermann LJ. Enhancing Lifestyles in the Metabolic syndrome (ELM) multisite behavioral efficacy trial. Design and baseline cohort. Am Heart J 2024; 270:136-155. [PMID: 38215918 DOI: 10.1016/j.ahj.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Prevalence of metabolic syndrome (MetS) increased from one-quarter to one-third of the U.S. adult population over 8 years and is spreading to young adults and Asian and Hispanic Americans. Diagnosed when >3 out of 5 cardiometabolic risk factors are present, there is widespread agreement that its fundamental roots are in a lifestyle characterized by poor dietary quality and physical inactivity. Past lifestyle trials for MetS produce benefits that have limited sustainability, suggesting the need for new treatment approaches. METHODS This is the design and baseline cohort of the Enhancing Lifestyles in the Metabolic Syndrome (ELM) multi-site trial. The trial tests the hypothesis that a habit-based lifestyle treatment offered over 6 months, followed by 18 monthly maintenance contacts, can produce 4 new diet, physical activity, and mindfulness habits and, if so, sustained MetS remission. The design is an individually randomized, partially clustered group treatment trial of 618 participants with the MetS recruited from 5 sites in the U.S. and randomized to a small group lifestyle treatment or an enhanced standard of care education comparator. The primary outcome is MetS remission at 24 months. Secondary outcomes compare arms at 6, 15, and 24 months on MetS components, lifestyle targets, weight, body mass index, hemoglobin A1c, LDL cholesterol, medications, quality of life, psychosocial factors, and cost-effectiveness. RESULTS The cohort of 618 participants was recruited by screening 14,817 over 2.5 years (screening to enrollment ratio 24:1). Recruitment exceeded the target of 600 despite 2 COVID-19 pauses. The mean age was 55.5 years, 24.3% were male, 25.5% were a racial minority, 9.7% identified as Hispanic, and 83.0% were classified as obese (body mass index >30). The most common MetS components were abdominal obesity (97.7%) and elevated blood pressure or antihypertensive medication (86.2%). CONCLUSIONS The geographic, sociodemographic, and clinical diversity of the cohort, combined with rigorous behavioral efficacy trial methods, will provide a conclusive answer to the question of whether this habit-based lifestyle program can produce sustained 24-month remission of the MetS and thereby help to curb a significant and growing public health problem.
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West NT, Harmon BE, Case T, Huey M, Webb BL, Nelson J, Webster KH, Webster TA, Leach CH. A Scoping Review of Self-Care Within the Context of Obesity-Related Outcomes Among Faith Leaders. Am J Health Promot 2024; 38:112-123. [PMID: 37828763 DOI: 10.1177/08901171231204669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVE Faith leaders often serve as health-related role models yet many struggle with obesity and self-care engagement. The purpose of this scoping review was to examine how the faith leader literature has defined self-care and examined obesity and obesity-related chronic disease. DATA SOURCE Studies were identified through database (eg, PubMed, CINAHL, PsycINFO), backward, and grey literature (eg, dissertations) searches. INCLUSION/EXCLUSION CRITERIA Studies published in English with participants who were 18 years or older and examined leaders across all faiths. Studies also included an examination of self-care behaviors among faith leaders within the context of obesity or obesity-related chronic diseases. DATA EXTRACTION/SYNTHESIS Data synthesis was qualitative and informed by the six-step framework developed by Arksey and O'Malley (2005) as well as updated recommendations by Daudt et al (2013). Of the 418 studies identified and screened, 20 met the eligibility criteria. RESULTS Studies were primarily cross-sectional and participants Christian faith-leaders in the US. Most studies did not define self-care or incorporate theory, but focused on vegetarian diets and physical activity engagement. Other self-care related behaviors (eg, sleep, days off), some unique to faith leaders (eg, sabbatical), were included but not systematically. CONCLUSIONS Research with more diverse faith leaders and that uses theory is needed to guide development of strategies for engaging this population in self-care to reduce obesity and related chronic diseases.
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Affiliation(s)
- Nathan T West
- Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, AK, USA
| | - Brook E Harmon
- Associate Professor, Department of Nutrition and Health Management, Appalachian State University, Boone, NC, USA
| | - Talsi Case
- Department of Nutrition and Health Management, Appalachian State University, Boone, NC, USA
| | - Madelyn Huey
- Department of Nutrition and Health Management, Appalachian State University, Boone, NC, USA
| | - Benjamin L Webb
- Associate Professor, Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - John Nelson
- President & CEO, Healthcare Environment, New Brighton, MN, USA
| | - Karen H Webster
- Co-Founder/Executive Director, Healthy Seminarians - Healthy Church, Murrysville, PA, USA
| | - Travis A Webster
- Co-Founder/Secretary, Healthy Seminarians - Healthy Church, Murrysville, PA, USA
| | - Charolette H Leach
- Community Health Coordinator, FaithHealth Division, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
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Proeschold-Bell RJ, Eagle DE, Tice LC, Yao J, Rash JA, Choi JY, Stringfield B, Labrecque SM. The Selah Pilot Study of Spiritual, Mindfulness, and Stress Inoculation Practices on Stress-Related Outcomes Among United Methodist Clergy in the United States. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01848-x. [PMID: 37365439 PMCID: PMC10366291 DOI: 10.1007/s10943-023-01848-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
The job-demand-control-support model indicates that clergy are at high risk for chronic stress and adverse health outcomes. A multi-group pre-test-post-test design was used to evaluate the feasibility, acceptability, and range of outcome effect sizes for four potentially stress-reducing interventions: stress inoculation training, mindfulness-based stress reduction (MBSR), the Daily Examen, and Centering Prayer. All United Methodist clergy in North Carolina were eligible and recruited via email to attend their preferred intervention. Surveys at 0, 3, and 12 weeks assessed symptoms of stress, anxiety, and perceived stress reactivity. Heart rate variability (HRV) was assessed at baseline and 12 weeks using 24 h ambulatory heart rate monitoring data. A subset of participants completed in-depth interviews and reported skill practice using daily text messages. Standardized mean differences with 95% and 75% confidence intervals were calculated for the change observed in each intervention from baseline to 3 and 12 weeks post-baseline to determine the range of effect sizes likely to be observed in a definitive trial. 71 clergy participated in an intervention. The daily percentage of participants engaging in stress management practices ranged from 47% (MBSR) to 69% (Examen). Results suggest that participation in Daily Examen, stress inoculation, or MBSR interventions could plausibly result in improvement in stress and anxiety at 12 weeks with small-to-large effect sizes. Small effect sizes on change in HRV were plausible for MBSR and Centering Prayer from baseline to 12 weeks. All four interventions were feasible and acceptable, although Centering Prayer had lower enrollment and mixed results.
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Affiliation(s)
- Rae Jean Proeschold-Bell
- Duke Global Health Institute, Duke University, Durham, USA.
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA.
| | - David E Eagle
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
| | - Logan C Tice
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
| | - Jia Yao
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
| | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NF, Canada
| | - Jessica Y Choi
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
| | - Beth Stringfield
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
| | - Sofia M Labrecque
- Duke Global Health Institute, Duke University, Durham, USA
- Duke Center for Health Policies and Inequalities Research, Duke University, Durham, USA
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Kalita K, Leszczak J, Czenczek-Lewandowska E, Mazur A. Assessment of Health Behaviours and Satisfaction with Life among Catholic Priests in Poland. JOURNAL OF RELIGION AND HEALTH 2023; 62:1676-1694. [PMID: 36645611 PMCID: PMC9842205 DOI: 10.1007/s10943-023-01736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
The aim of the study was to assess the relationship between the health behaviours of diocesan priests in Poland and their level of life satisfaction. The specific goal was to determine the factors that most affect their quality of health (internal health control, the influence of others or coincidence) and life satisfaction (positive mental attitude, preventive behaviour, eating habits, health practices). The study involved 250 diocesan priests from the Podkarpackie region who took part in the research by completing an anonymous questionnaire. The questions were mainly based on tools for assessing health behaviours, namely the HBI-health behaviour inventory, MHLC-multidimensional scale of health locus of control and the SWLS-satisfaction with life scale. The general index of health behaviour of clergymen on the HBI scale was 77.12 ± 16.20 (Me = 78), showing a moderate level on the sten scale. On the MHLC health locus of control scale, the respondents believed that their health depended most on internal control: 25.27 ± 5.10 and the influence of others: 23.13 ± 5.57, are of utmost importance for their health. To a lesser extent they believed that health was dependent on chance: 17.60 ± 5.95. The SWLS satisfaction with life index was 22.51 ± 5.43 (Me = 23), also within the moderate range of the sten scale. The factors most closely related to the assessment of life satisfaction were positive mental attitudes and the overall HBI index. The health behaviours of priests measured by the HBI scale and the level of satisfaction with the life of SWLS clergymen are within a moderate range. On the MHLC scale, priests likewise believe that their health depends on themselves and then on others. They are clearly less likely to indicate accidental causes.
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Affiliation(s)
- Krzysztof Kalita
- BBIAS Office for Statistical Research and Analysis Rzeszów, Ul. Malownicza 36, 35-304, Rzeszów, Poland
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. Rejtana 16C, 35-959, Rzeszów, Poland.
| | | | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. Rejtana 16C, 35-959, Rzeszów, Poland
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Harmon BE, West NT, Webb BL, Johnson BM, Smith S. Fit with Faith: An Exploratory Study Examining a Behavior Change Intervention for African-American Clergy and Their Spouses. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01820-9. [PMID: 37097411 DOI: 10.1007/s10943-023-01820-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
Fit with Faith is a 10-week, diet, physical activity, and stress reduction intervention for African-American clergy and spouses, which included: meetings, phone calls, a behavior tracking app. Survey, 24-h recall, accelerometer, anthropometric, and blood pressure data were collected. Wilcoxon signed ranked tests were used for analyses. In this one-arm study, clergy and spouses (n = 20) attended most meetings and calls, but only half posted daily goals or tracked behaviors using the app. Spouses' body mass index (BMI) decreased and physical activity self-regulation cognitive scores increased pre-post intervention. Statistically significant changes in BMI, systolic blood pressure, and self-regulations scores also were seen among younger (< 51 years) participants (n = 8). As positive changes were seen mostly among women and younger participants, more research is needed on how to engage all clergy in behavior change programs.
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Affiliation(s)
- Brook E Harmon
- Department of Nutrition and Health Care Management, Beaver College of Health Sciences, Leon Levine Hall of Health Sciences, Appalachian State University, Room 575, 1179 State Farm Road, Boone, NC, 28608, USA.
| | - Nathan T West
- Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, AK, USA
| | - Benjamin L Webb
- Department of Applied Health, School of Education, Health, and Human Behavior, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - Brandi M Johnson
- Clinical Nutrition Program, College of Health Sciences, University of Memphis, Memphis, TN, USA
| | - Stacy Smith
- The Center of Excellence in Faith and Health Equity, Methodist Le Bonheur Healthcare, Memphis, TN, USA
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Pandya SP. Pastors in Prisons and Correctional Settings, Resilience, and the Propensity for Social Entrepreneurship: Comparing two Continuing Education Programs. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2022; 76:254-269. [PMID: 35929124 DOI: 10.1177/15423050221117465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article reports a study on the impact of two continuing education programs for pastors working in prisons and correctional settings. Pastors who did the spirituality refresher training sessions reported greater resilience and social entrepreneurship inclinations posttest compared to those who did the expressive writing sessions. Male pastors, with a postgraduate degree and chaplaincy-focused training, prison pastors, ever-singles, pastors living in religious institutions/seminaries, and with higher intervention compliance, reported higher benefits from spirituality refresher training.
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Affiliation(s)
- Samta P Pandya
- 29411Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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Johnston EF, Eagle DE, Corneli A, Perry B, Proeschold-Bell RJ. Seminary Students and Physical Health: Beliefs, Behaviors, and Barriers. JOURNAL OF RELIGION AND HEALTH 2022; 61:1207-1225. [PMID: 35034253 PMCID: PMC8761106 DOI: 10.1007/s10943-021-01480-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2021] [Indexed: 05/11/2023]
Abstract
As an occupational group, clergy exhibit numerous physical health problems. Given the physical health problems faced by clergy, understanding where physical health falls within the priorities of seminary students, the ways students conceptualize physical health, and how seminary students do or do not attend to their physical health in the years immediately prior to becoming clergy, can inform intervention development for both seminary students and clergy. Moreover, understanding and shaping the health practices of aspiring clergy may be particularly impactful, with cascading effects, as clergy serve as important role models for their congregants. Drawing on 36 in-depth, qualitative interviews with first-year seminary students, this study examines the complex dynamics between religious frameworks related to physical health, explicit intentions to maintain healthy practices, and reported physical health behaviors. Our findings suggest that even students who deploy religious frameworks in relation to their physical health-and who, as a result, possess positive intentions to implement and maintain healthy behaviors-often report being unable to live up to their aspirations, especially in the face of barriers to health practices posed by the seminary program itself. After reviewing these findings, we offer suggestions for physical health focused interventions, including action and coping planning, which could be implemented at seminaries to reduce the intention-behavior gap and improve clergy health.
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Affiliation(s)
- Erin F Johnston
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27708, USA.
| | - David E Eagle
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27708, USA
| | - Amy Corneli
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Brian Perry
- Department of Population Health Sciences, Duke University, Durham, NC, USA
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Age differences in trajectories of depressive, anxiety, and burnout symptoms in a population with a high likelihood of persistent occupational distress. Int Psychogeriatr 2022; 34:21-32. [PMID: 32985393 DOI: 10.1017/s1041610220001751] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Work in occupations with higher levels of occupational stress can bring mental health costs. Many older adults worldwide are continuing to work past traditional retirement age, raising the question whether older adults experience depression, anxiety, or burnout at the same or greater levels as younger workers, and whether there are differences by age in these levels over time. DESIGN/SETTING/PARTICIPANTS Longitudinal survey of 1161 currently employed US clergy followed every 6-12 months for up to 66 months. MEASUREMENTS Depression was measured with the 8-item Patient Health Questionnaire (PHQ-8). Anxiety was measured using the anxiety component of the Hospital Anxiety and Depression Scale (HADS). Burnout symptoms were assessed using the three components of the Maslach Burnout Inventory: emotional exhaustion (EE), depersonalization (DP), and sense of personal accomplishment (PA). RESULTS Older participants had lower scores of depression, anxiety, EE, and DP and higher levels of PA over time compared to younger adults. Levels of EE decreased for older working adults, while not significantly changing over time for those younger. DP symptoms decreased over time among those 55 years or older but increased among those 25-54 years. CONCLUSIONS Older working adults may have higher levels of resilience and be able to balance personal life with their occupation as well as may engage in certain behaviors that increase social support and, for clergy, spiritual well-being that may decrease stress in a way that allows these older adults to appear to tolerate working longer without poorer mental health outcomes.
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Gea Cabrera A, Caballero P, Wanden-Berghe C, Sanz-Lorente M, López-Pintor E. Effectiveness of Workplace-Based Diet and Lifestyle Interventions on Risk Factors in Workers with Metabolic Syndrome: A Systematic Review, Meta-Analysis and Meta-Regression. Nutrients 2021; 13:nu13124560. [PMID: 34960112 PMCID: PMC8704618 DOI: 10.3390/nu13124560] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.
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Affiliation(s)
- Alicia Gea Cabrera
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technology, Universidad Miguel Hernández, 03550 Alicante, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science (Spain), University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - Carmina Wanden-Berghe
- Grupo de Nutrición Clínica y HAD del Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-Fundación FISABIO), Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health and History of Science, Universidad Miguel Hernández, 03550 Alicante, Spain;
| | - Elsa López-Pintor
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technology, Universidad Miguel Hernández, 03550 Alicante, Spain;
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
- Correspondence:
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Terry JD, Cunningham CJL. Some Rest for the Weary? A Qualitative Analysis of Clergy Methods for Managing Demands. JOURNAL OF RELIGION AND HEALTH 2021; 60:1230-1247. [PMID: 32944893 DOI: 10.1007/s10943-020-01086-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 05/25/2023]
Abstract
In many ways, clergy (i.e., religious leaders including pastors, ministers) are a high-risk population. In their efforts to ensure the spiritual well-being of their congregations, clergy may neglect their own well-being and be unaware of the potentially detrimental effects that their work has on their health. The purpose of this study was to add to the growing knowledge base about how clergy perceive the relationship between their work and their well-being, the strategies they use to recover from their work, and the ways they balance work and nonwork areas of their lives. This qualitative study explores these areas to further understand the nature of clergy work and recovery from work. Clergy (N = 332) were asked to respond to a set of open-ended prompts related to their perceptions of work interference with health, and strategies at and outside of work they use to manage work and nonwork demands. The present study sheds light on recovery strategies (i.e., self-care practices) and practices clergy may use to successfully manage demands in the work and nonwork areas of their lives. Specifically, prioritizing, personal time (e.g., time spent in hobbies), and physical activities emerged as common strategies and practices. Our results have the potential to guide researchers in how to design interventions aimed at assisting individuals in this at-risk population.
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Affiliation(s)
- J Drake Terry
- Department of Psychology, The University of Tennessee at Chattanooga, Chattanooga, TN, USA.
- Department of Psychology, Old Dominion University, 250 Mills Godwin Life Sciences Building, Norfolk, VA, 23529, USA.
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Harmon BE, Strayhorn SM, West NT, Schmidt M, Webb BL, Grant L, Smith S. Strategies for Designing Clergy and Spouse Obesity-Related Programs. Am J Health Promot 2020; 35:399-408. [PMID: 32985232 DOI: 10.1177/0890117120960574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Qualitative methods were used to identify opportunities and resources for the development of an effective obesity-related program for clergy. APPROACH Ninety-minute focus groups were held with clergy (3 groups) and spouses (3 separate groups). Discussion explored: Program target(s); Opportunities and barriers that influence diet, physical activity, and stress-reduction practices; Empowering and culturally relevant health promotion strategies. SETTING All study activities took place in Memphis, TN. PARTICIPANTS Eighteen clergy and fourteen spouses participated. All clergy were male, all spouses were female. METHOD Previous research with clergy informed the interview guide and the PEN-3 framework aided in organizing the coding of clergy and spouse focus groups. Focus groups were audio recorded and transcripts analyzed using NVivo® 12. RESULTS Themes included: 1) Intervention targets-clergy, spouses, congregations; 2) Opportunities and barriers-making time, establishing boundaries, church traditions, individuals who support and hinder behavior change; 3) Intervention strategies-tools for healthy eating, goal setting, camaraderie, combining face-to-face with eHealth modalities. CONCLUSION The relationship between clergy, spouse, and congregation make it important for obesity-related programs to target the unique needs of both clergy and spouses. Strategies should focus on healthy eating and personal connections no matter the modality used.
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Affiliation(s)
- Brook E Harmon
- Nutrition and Health Care Management, Appalachian State University, Boone, NC, USA.,School of Public Health, 5415University of Memphis, Memphis, TN, USA
| | - Shaila M Strayhorn
- Institute for Health Research and Policy, 14681University of Illinois at Chicago, Chicago, IL, USA
| | - Nathan T West
- School of Public Health, 5415University of Memphis, Memphis, TN, USA
| | - Michael Schmidt
- Department of Art, 5415University of Memphis, Memphis, TN, USA
| | - Benjamin L Webb
- Department of Applied Health, 33140Southern Illinois University at Edwardsville, Edwardsville, TN, USA
| | - Lindsey Grant
- School of Public Health, 5415University of Memphis, Memphis, TN, USA
| | - Stacy Smith
- The Center of Excellence in Faith and Health Equity, 5416Methodist Le Bonheur Healthcare, Memphis, TN, USA
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14
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Proeschold-Bell RJ, Steinberg DM, Yao J, Eagle DE, Smith TW, Cai GY, Turner EL. Using a holistic health approach to achieve weight-loss maintenance: results from the Spirited Life intervention. Transl Behav Med 2020; 10:223-233. [PMID: 30544179 DOI: 10.1093/tbm/iby117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Weight-loss maintenance is essential to sustain the health benefits of weight loss. Studies with lower intensity intervention supports under real-world conditions are lacking. This study examined changes in weight and cardiometabolic biomarkers among Spirited Life participants following initial 12-month weight loss at 12-24 months and 24-42 months. A total of 719 clergy received a wellness intervention, including a 10-week online weight-loss program in the first 12 months and monthly health coaching throughout 24 months. Mean changes in weight, blood pressure, high-density lipoproteins, and triglycerides were estimated using random effects linear models, accounting for repeated measures. Weight was additionally analyzed in subsamples stratified by body mass index (BMI). At baseline, 17.1% of participants had BMI < 25 kg/m2 and 11.8% had BMI ≥ 40 kg/m2. Mean 12-month weight loss was -2.4 kg (95% CI: -2.8 kg, -2.1 kg). On average, at 42 months, participants regained weight but did not exceed baseline (-0.5 kg, 95% CI: -1.2 kg, 0.2 kg), improvements in triglycerides were completely sustained (-13.9 mg/dL, 95% CI: -18.6 mg/dL, -9.2 mg/dL), and systolic blood pressure improvements remained significant (-1.9 mmHg, 95% CI: -3.0 mmHg, -0.9 mmHg). Participants with a BMI ≥ 40 kg/m2 lost significantly more weight that was sustained at 42 months (-5.8 kg, 95% CI: -8.9 kg, -2.7 kg). The Spirited Life wellness intervention produced weight loss and, for participants with higher levels of obesity, sustained weight-loss maintenance. The intervention was effective for long-term prevention of weight gain among participants with BMI of 25 to ≤40 kg/m2, through 42 months. Wellness interventions such as Spirited Life should be considered for adoption.
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Affiliation(s)
- Rae Jean Proeschold-Bell
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Dori M Steinberg
- Duke School of Nursing, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jia Yao
- Duke Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - David E Eagle
- Duke Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Timothy W Smith
- Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - Grace Y Cai
- Trinity College of Arts & Sciences, Duke University, Durham, NC, USA
| | - Elizabeth L Turner
- Department of Biostatistics and Bioinformatics, Duke Global Health Institute, Duke University, Durham, NC, USA
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Persistent Depressive Symptoms in a Population With High Levels of Occupational Stress: Trajectories Offer Insights Into Both Chronicity and Resilience. J Psychiatr Pract 2018; 24:399-409. [PMID: 30395547 DOI: 10.1097/pra.0000000000000337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Religious participation and spirituality are linked to good mental health. However, clergy may experience more depression than is observed in the general population, which may be due in part to high job strain. The objectives of this study were to identify distinct longitudinal trajectories of depressive symptoms in clergy and to identify variables associated with each course. The sample was 1172 clergy who were followed for up to 66 months. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-8), which was administered approximately every 6 months. Latent class trajectory analysis was conducted for group identification, and a 3-class trajectory model fit the data best. Class 1 (38% of the sample) had minimal or no depressive symptoms over time, class 2 (47%) had chronic mild symptoms, and class 3 (15%) had persistent moderate/severe symptoms. Occupational distress was significantly associated with trajectory class. The odds of being in either the chronic mild or the persistent moderate/severe depressive symptom class were significantly higher for those who were female, for those with fair/poor self-rated health, for those with more perceived financial or occupational stress, for those with lower levels of perceived emotional support, and/or for those with lower levels of spiritual well-being. The class exhibiting resilience to depressive symptoms had higher levels of perceived support and spiritual well-being as well as lower levels of perceived financial and occupational stress. A substantial percentage of clergy, and possibly people in similar helping occupations, may experience significant levels of depressive symptoms that do not remit over time. These individuals may benefit from treatments that address work-related coping.
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Harmon BE, Strayhorn S, Webb BL, Hébert JR. Leading God's People: Perceptions of Influence Among African-American Pastors. JOURNAL OF RELIGION AND HEALTH 2018; 57:1509-1523. [PMID: 29388002 PMCID: PMC6026478 DOI: 10.1007/s10943-018-0563-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Religious leaders, particularly African-American pastors, are believed to play a key role in addressing health disparities. Despite the role African-American pastors may play in improving health, there is limited research on pastoral influence. The purpose of this study was to examine African-American pastors' perceptions of their influence in their churches and communities. In-depth interviews were conducted with 30 African-American pastors and analyzed using a grounded theory approach. Three themes emerged: the historical role of the church; influence as contextual, with pastors using comparisons with other pastors to describe their ability to be influential; and a reciprocal relationship existing such that pastors are influenced by factors such as God and their community while these factors also aid them in influencing others. A conceptual model of pastoral influence was created using data from this study and others to highlight factors that influence pastors, potential outcomes and moderators as well as the reciprocal nature of pastoral influence.
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Affiliation(s)
- Brook E Harmon
- Division of Social and Behavioral Sciences, University of Memphis School of Public Health, 200 Robison Hall, Memphis, TN, 38152, USA.
| | - Shaila Strayhorn
- Division of Social and Behavioral Sciences, University of Memphis School of Public Health, 200 Robison Hall, Memphis, TN, 38152, USA
| | - Benjamin L Webb
- School of Education, Health and Human Behavior, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - James R Hébert
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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