Health promotion perspectives on the COVID-19 pandemic: The importance of religion

Trust in COVID-19 information sources and vaccination status: Exploring social inequalities and differences within the four United Kingdom nations using a representative survey

OBJECTIVES

To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status.

METHODS

We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination.

RESULTS

Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65 years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust.

CONCLUSIONS

This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust.

Urban Churches Show an Increase in Attendance, Donations, and Finances During the COVID-19 Pandemic in the USA: Evidence from the United Methodist Church

The COVID-19 pandemic has had a significant impact on religion and its practice. This paper aims to examine how the pandemic affects religious activities, donations, and finances over time and across regions within the United Methodist Church (UMC) in the USA. To address this question, we analyze survey data collected during the pandemic from 2963 churches in the USA by United Methodist Communications. Our analysis utilizes several quantitative techniques, including Z-tests, one-way analysis of variance (ANOVA), and multinomial logistic regressions. The results indicate a decrease in church attendance over time, with a more pronounced effect observed in non-urban areas (suburban, small town, and rural). Similarly, while church donations and finances mitigate over time across churches, churches in urban areas experience a quicker rebound compared to those in non-urban areas. Lastly, we find that church attendance and donations positively affect finances. These findings hold important implications for churches in various regions, offering insights to develop strategies for navigating the challenges posed by the COVID-19 pandemic.

Outbreaks of COVID-19 in indoor places of worship: a systematic review

AIMS

This review aimed to describe what has been published on COVID-19 outbreaks originating from indoor places of worship.

METHODS

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus and Embase from 1 January 2020 to 29 March 2021. Citation chasing was also performed. Studies with information about COVID-19 outbreaks originating in indoor places of worship of any religion were included.

RESULTS

A total of 9729 records were identified and 36 were selected. The articles reported 119 descriptions of outbreaks linked to churches, mosques, synagogues, and temples, referring to approximately 52-74 unique outbreaks. The outbreaks were mostly located in three major areas: East and Southeast Asia (46%), the USA (27%), Europe (22%). All the outbreaks began in 2020. Mainly, there were no restrictive measures, or such measures were not followed at the time of the outbreak. Choir practices presented the highest attack rate (up to 0.867).

CONCLUSIONS

The lack of preventive measures and the role of singing practices were highlighted. Reports were often lacking contact tracing and sometimes did not report the date of outbreak extinction. Moreover, reports came from few geographical areas. Thus, the impact of transmission in places of worship may be largely underestimated.

What makes Indonesian government officials believe in and implement evidence-based policy: The mediating role of religion-science compatibility beliefs

This research is aimed at examining the relationship between religion-science compatibility belief (RSCB) and evidence-based policy (EBP) belief and implementation in Indonesia, a country with the biggest Muslim population in the world. A dataset containing responses to a questionnaire completed by 499 government officials in Indonesia was collected for the partial least square structural equation modeling (PLS-SEM). This study finds a relationship between RSCB and EBP belief and implementation. In addition, EBP belief also affected the implementation of EBP. The effect that RSCB has on EBP implementation was partially mediated by EBP belief. Studying how these beliefs relate to the attitude of policy makers toward science in a sociocultural context is important, considering that the focus of previous research is on different contexts pertaining to levels of education, industrialization, wealth, and democratization. This is important to encourage a more comprehensive understanding of the public about science globally. This study responds to the need for the literature to examine factors influencing EBP beliefs and implementation at the individual level in non-health contexts and developing countries.

Church leader's Interpretation of COVID-19 in Nigeria: Science, Conspiracies, and Spiritualization

The need for governments across the globe to collaborate with religious leaders in the fight against COVID-19 has been emphasized by international organizations including the World Health Organization (WHO). However, there has not been much discernible scholarly effort to know what religious leaders think of COVID-19. The present study, therefore, explored the interpretations church leaders have about COVID-19 in Nigeria. Semi-structured interviews were conducted with eighteen leaders from Catholic, Anglican and Pentecostal churches in Nigeria. Using a thematic analytical approach, the study found that only few church leaders interpreted COVID-19 as a medical problem in line with science (33%). The rest interpreted the virus as a tool of conspiracies/political manoeuvrings (27%) and as a spiritual event (39%). The study discussed the implications of the findings for policy and research as well as how to address some of the harmful interpretations.

The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia

BACKGROUND

SARS-COV-2 (COVID-19) has severely impacted people's health worldwide. Vaccines are one of the health measures taken to reduce the impact of COVID-19, but recent reports have revealed that some people are reluctant to be vaccinated against COVID-19. Understanding the factors underlying an individual's decision to take the COVID-19 vaccine is critical to designing an immunisation programme. This study examines factors that influence the intention to take a COVID-19 vaccine using the modified Health Belief Model (HBM) framework and analysing demographic factors.

METHOD

A cross-sectional online survey was conducted from 10 January to 20 January 2021. Five hundred thirty-seven respondents above 17 years old and residing in Indonesia voluntarily completed an online survey. Survey questions addressed sociodemographic factors; perception of susceptibility, severity, benefits and barriers; cues to action; and intention to take the COVID-19 vaccine. A Structural Equation Modelling (SEM) approach with SmartPLS software was used to analyse the measurements and model construct.

FINDINGS

The results showed that the perception of susceptibility, severity, benefits and barriers, as well as cues to action, predicted people's intention to take a COVID-19 vaccine. Model structure explained a large proportion of variance in people's intention to be vaccinated against COVID-19 (R2 = 66.8 %). Some demographic factors affected the key variables of the HBM. People with low and middle income negatively influence feeling severity, beneficial and barrier in intending to take vaccine. Other demographic factors such as sex, age, marriage and living areas did not affect the components of the HBM, except for females influencing severity and people living in urban areas associated with benefits variable. These findings imply that COVID-19 vaccination programmes should focus on providing accurate information about the severity of COVID-19 and the benefits of taking the vaccine. Building people's confidence in their ability to eliminate barriers to taking the vaccine and involving family members and community and religious leaders will increase COVID-19 vaccine uptake.

CONCLUSION

Despite limitations to the study, such as respondent demographics that are unrepresentative of the wider Indonesian population, inadequate survey timing and an exclusive focus on vaccine intention as the outcome variable, the present study contributes to explaining individuals' intentions to take a COVID-19 vaccine in a Eastern country context. This study is valuable to providing public health policy recommendations that focus on effectively designing immunisation programme interventions.

From fearful to hopeful: A thematic content analysis of COVID-19 survivors' YouTube videos

COVID-19 survivors experienced a spectrum of emotions as a result of surviving the said disease. Employing thematic content analysis, the researchers characterized the various emotional manifestations among recovered COVID-19 patients, which are crucial indicators of their mental well-being postinfection. From March 2020 to June 2021, data was collated from 31 Filipino COVID-19 Survivors' YouTube videos. 51.61% of the videos were posted in 2020 and 48.39% were posted in 2021 where 70.97% of the survivors were female while 29.03% were male. 579 primary codes emerged and were narrowed down into sixteen themes where Hope (18.83%) arose as the most predominant emotion followed by Gratitude (14.68%), Joy and Relief (14.16%), Faith (11.57%), Plight Response (10.88%), Sadness (10.88%), Fear (6.39%), and nine others (12.61%).

Who wears the face mask? Preventive measures against COVID-19 in Latin America before vaccination

OBJECTIVES

We analyze the profile of adults who used a mask in the context of the COVID-19 pandemic in Latin America, between October and November 2020, right before the mass vaccination campaigns.

STUDY DESIGN

Based on the Latinobarometer 2020 data, we assess the individual, regional, cultural and political factors of people who used a mask in the context of the COVID-19 pandemic in 18 countries of Latin America.

METHODS

We applied a logistic regression to model the probability of using the mask regularly to avoid being infected with the COVID-19 virus.

RESULTS

Women, older people, those with higher education, those being employed and not working in temporarily jobs, retirees, students, people with a centrist political ideology, and Catholics had a higher chance of using a face mask on a regular basis. People living in Venezuela, Chile, Costa Rica and Brazil were the most likely to use face masks.

CONCLUSION

These results highlight the need to understand the social forces behind the willingness to adopt non-pharmacological preventive measures to make them more effective in health crisis emergencies.

Fear God, Not COVID-19: Is Conservative Protestantism Associated with Risky Pandemic Lifestyles?

Previous research has established attitudinal and behavioral health variations in relation to the COVID-19 pandemic, but scholarship on the religious antecedents associated with these outcomes has only recently gained momentum. Rhetoric from some leading conservative Protestants in the U.S. has underplayed the threat of the pandemic and may have contributed to unhealthy pandemic behaviors within this faith tradition. Moreover, previous inquiries have revealed that conservative Protestantism's otherworldly focus can thwart personal and community health. We use nationally representative data to test the hypotheses that, compared with other religious groups and the non-religious, conservative Protestants will tend to (1) perceive the pandemic as less threatening and (2) engage in riskier pandemic lifestyles. These hypotheses are generally supported net of confounding factors. We conclude that affiliation with a conservative Protestant denomination can undermine public health among this faith tradition's adherents and may therefore compromise general health and well-being during a pandemic. We discuss the implications of these findings, offer recommendations for pandemic health promotion among conservative Protestants, and delineate promising avenues for future research on this important topic.

Face Mask Acceptability for Communal Religious Worship During the COVID-19 Pandemic in the United Kingdom: Results from the CONFESS Study

The COVID-19 pandemic has led to restrictions such as social distancing and mandatory wearing of face masks. Singing and religious gatherings have been linked to infection clusters, and between 2020 and 2021 indoor congregational singing and chanting were prohibited in the United Kingdom. We evaluated attitudes to face mask use and their acceptability as well as changes within places of worship since their reopening in July up to autumn 2020. In this cross-sectional study, participants were recruited using convenience sampling through selective targeting of religious organisations and social media. Participants self-enrolled and completed an online questionnaire, which included open and closed questions. We used multivariable logistic regression to identify factors associated with face mask acceptability. We performed thematic analysis to evaluate responses to open questions. A total of 939 participants were included in the analysis. Median age was 52.7 years and 66.1% were female, while 80.7% identified as Christian. A majority (672/861; 78.0%) of participants would find it acceptable to wear a face mask and reduce their singing or chanting volume if required, even though 428/681 (49.1%) found face masks to be uncomfortable. Multivariable regression found that younger age was associated with a higher acceptability of face masks (adjusted OR (aOR): 0.98 (95% confidence interval (95% CI) 0.96-1.00), p = 0.0218). The majority of respondents stated that religious services had become shorter, attended by fewer people and with reduced singing or chanting. Most (869/893, 97.3%) stated their place of worship complied with government guidelines, with 803/887 (90.5%) reported that their place of worship enforced face mask wearing and 793/887 (89.4%) at least moderately happy with precaution measures. Our study demonstrates the significant impact of COVID-19 in places of worship but a high degree of compliance with guidelines. Face masks, despite practical difficulties, appeared to be more acceptable if there was an incentive of being able to sing and chant.

The predictors of spiritual dryness among Iranian cancer patients during the COVID-19 pandemic

Background

Spiritual struggles affect the wellbeing of religious people. Among them are strugglers with God which is perceived as non-responsive and distant. These perceptions were so far analyzed predominantly in Western societies with a Christian background, but not in Muslims from Iran. The aim of this study was to determine the predictors of spiritual dryness among cancer patients in Iran during the COVID-19 pandemic.

Methods

Cross-sectional study with standardized questionnaires (i.e., Spiritual Dryness Scale, WHO-5, BMLSS-10, Awe/Gratitude Scale) among 490 cancer patients (mean age 49.50 ± 14.92 years) referring to the selected educational hospitals in Tehran (the capital of Iran), who were selected through convenience sampling and based on the inclusion criteria, enrolled between December 2020-May 2021. Data analysis was done using SPSS software version 26 and the statistical methods including calculating the mean and the standard deviation, correlation coefficients, as well as regression analysis.

Results

The overall experience of spiritual dryness was perceived regularly in 10.2% of Iranian cancer patients, sometimes in 22.9%, rarely in 22.9%, and never in 43.3%. The mean ± SD was 25.66 ± 5.04, and the scores ranged from 10 to 55. A higher score means greater spiritual dryness. The strongest predictors of spiritual dryness were praying activities Furthermore, the perception of burden due to the pandemic was positively correlated with spiritual dryness. Moreover, each 1 unit increase in its score changed the spiritual dryness score by 0.2 units. The regression of spirituality-related indicators, demographic-clinical variables, and health-related behaviors accounted for 21, 6, and 4% of the total SDS variance, respectively. These findings show that with an increase in praying, performing daily prayers, and the indicators related to spirituality, spiritual dryness will decrease. Most patients were able to cope with these phases often or even regularly, while 31.1% were never or rarely only able to cope.

Conclusion

The results of this study showed that in times of crisis, cancer patients' faith and confidence in God could be challenged. It is not the disease itself which seems to be associated with this form of crisis, but their religious practices. Therefore, it is necessary to support these patients during their struggle, especially as spirituality is one of the best approaches to cope with the disease.

Exploring the impact of shielding advice on the wellbeing of individuals identified as clinically extremely vulnerable amid the COVID-19 pandemic: a mixed-methods evaluation

BACKGROUND

The national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of "shielding" on the health and wellbeing of CEV individuals in Southwest England during the first COVID-19 lockdown.

METHODS

A two-stage mixed methods study, including a structured survey (7 August-23 October 2020) and semi-structured telephone interviews (26 August-30 September 2020) with a sample of individuals who had been identified as CEV and advised to "shield" by Bristol, North Somerset & South Gloucestershire (BNSSG) Clinical Commissioning Group (CCG).

RESULTS

The survey was completed by 203 people (57% female, 54% > 69 years, 94% White British, 64% retired) in Southwest England identified as CEV by BNSSG CCG. Thirteen survey respondents participated in follow-up interviews (53% female, 40% > 69 years, 100% White British, 61% retired). Receipt of 'official' communication from NHS England or General Practitioner (GP) was considered by participants as the legitimate start of shielding. 80% of survey responders felt they received all relevant advice needed to shield, yet interviewees criticised the timing of advice and often sought supplementary information. Shielding behaviours were nuanced, adapted to suit personal circumstances, and waned over time. Few interviewees received community support, although food boxes and informal social support were obtained by some. Worrying about COVID-19 was common for survey responders (90%). Since shielding had begun, physical and mental health reportedly worsened for 35% and 42% of survey responders respectively. 21% of survey responders scored ≥ 10 on the PHQ-9 questionnaire indicating possible depression and 15% scored ≥ 10 on the GAD-7 questionnaire indicating possible anxiety.

CONCLUSIONS

This research highlights the difficulties in providing generic messaging that is applicable and appropriate given the diversity of individuals identified as CEV and the importance of sharing tailored and timely advice to inform shielding decisions. Providing messages that reinforce self-determined action and assistance from support services could reduce the negative impact of shielding on mental health and feelings of social isolation.

Conflict, epidemic and faith communities: church-state relations during the fight against Covid-19 in north-eastern DR Congo

Background

Understanding and improving access to essential services in (post)-conflict settings requires paying particular attention to the actors who occupy the space left ‘empty’ by weak or deficient State institutions. Religious institutions often play a fundamental role among these actors and typically benefit from high trust capital, a rare resource in so-called ‘fragile’ states. While there is a literature looking at the role faith organisations play to mobilise and sensitise communities during emergencies, our focus is on a different dimension: the reconfiguration of the relationship between religion and health authorities impelled by health crises.

Methods

We analyse observations, interviews, and focus group discussions with 21 leaders from eight different religious groups in Ituri province in 2020–2021.

Results

Faith institutions handled the Covid-19 lockdown period by using and redeploying structures at the grassroots level but also by responding to health authorities’ call for support. New actors usually not associated with the health system, such as revivalist churches, became involved. The interviewed religious leaders, especially those whose congregations were not previously involved in healthcare provision, felt that they were doing a favour to the State and the health authorities by engaging in community-level awareness-raising, but also, crucially, by ‘depoliticising’ Covid-19 through their public commitment against Covid-19 and work with the authorities in a context where the public response to epidemics has been highly contentious in recent years (particularly during the Ebola outbreak). The closure of places of worship during the lockdown shocked all faith leaders but, ultimately, most were inclined to follow and support health authorities. Such experience was, however, often one of frustration and of feeling unheard.

Conclusion

In the short run, depoliticization may help address health emergencies, but in the longer run and in the absence of a credible space for discussion, it may affect the constructive criticism of health system responses and health system strengthening. The faith leaders are putting forward the desire for a relationship that is not just subordination of the religious to the imperatives of health care but a dialogue that allows the experiences of the faithful in conflict zones to be brought to the fore.

Comparing community-driven COVID-19 vaccine distribution methods: Faith-based organizations vs. outpatient clinics

Background

Minority and low socioeconomic communities may face practical barriers to vaccination, including decreased access to health care and less trust in healthcare organizations; however, few studies have focused on these barriers as the cause of differential vaccine uptake. We worked with community partners to implement and evaluate two community-driven approaches to COVID-19 vaccination distribution-through faith-based organizations (FBOs) and outpatient clinics-with a focus on understanding the differences between the populations who accessed each distribution method.

Methodology

Participants who came to the vaccination locations were approached and asked to complete a survey during their 15 min post-vaccination observation period. Differences between distribution locations were examined using Chi-square tests.

Results

The survey rendered 1,476 valid responses, with a total of 927 participants recruited at clinical locations and 519 at FBOs during vaccination events. There were significant differences by race/ethnicity, with distribution methods at FBOs reaching a higher proportion of Hispanic/Latino and Marshallese participants. The proportion of uninsured participants who had lower health literacy and had lower educational attainment was higher with the FBO distribution method. FBO participants were more likely to report "completely" trusting the COVID-19 vaccine. There was no significant difference between FBO and clinic participants with regard to the level of vaccine hesitancy. There were no statistically significant differences with regard to access.

Conclusion

A higher proportion of Hispanic/Latino and Marshallese participants utilized FBOs for vaccination, suggesting collaborations with FBOs can potentially increase vaccination uptake among minority communities and help mitigate vaccination disparities.

Vaccine acceptance in rural India: Engaging faith leaders as vaccine ambassadors

Introduction

Religious faith is a key marker of identity and shapes community perspectives and trust. Faith leader involvement in vaccine campaigns in India have been beneficial to counter misinformation regarding infectious diseases such as polio. Faith leaders are influential stakeholders who bear potential to enhance public confidence in vaccine campaigns.

Context

While vaccine coverage has been increasing in India, inequities abound, especially in populations with historically low vaccine confidence. The COVID-19 pandemic has led to major disruptions in delivery of routine immunization services for children. To address these challenges, we co-designed interventions aimed at contextual communication strategies and peer support. Engaging faith leaders was an important part of this intervention. In this report we describe our experience and highlight the perspectives of faith leaders and their expectations of the outcomes for this intervention.

Programmatic elements

The CIVIC Project, conducted from January to December 2021 aimed to engage caregivers, community health workers and key stakeholders, particularly, faith leaders in co-designing interventions to address vaccine hesitancy in Mewat. The project, deeply rooted in community based participatory research, used a three-E approach (Exploration of community perspectives, Establishment of vaccine trust and awareness, Engagement in vaccine promotion activities) to successfully engage faith leaders in the design and dissemination of media messages advocating for vaccine acceptance and uptake.

Lessons learned

The involvement of faith leaders in the intervention benefited the community in two ways. First, faith leaders were spotlighted via videos, often disseminating advice and personal anecdotes about vaccines, thus reassuring caregivers and community members who previously expressed distrust in vaccines. Second, involvement of trusted faith leaders provided a platform for a two-way dialogue for the community to openly discuss and address myths and misconceptions regarding vaccines. This project provided the learning that co-creating interventions with faith leaders who are often gatekeepers of close-knit communities can lead to the development of vaccine positive messaging that community members relate with, motivating increased vaccine confidence.

Heightened religiosity proactively and reactively responds to the COVID-19 pandemic across the globe: Novel insights from the parasite-stress theory of sociality and the behavioral immune system theory

According to the parasite-stress theory of sociality and the behavioral immune system theory, heightened religiosity serves an anti-pathogen function by promoting in-group assortative sociality. Thus, highly religious countries/territories could have better control of the COVID-19 (proactively avoids disease-threat), and heightened COVID-19 threat could increase religiosity (reactively responds to disease-threat). As expected, country-level religiosity (religion-related online searches (Allah, Buddhism, Jesus, etc.) and number of total religions/ethnoreligions) negatively and significantly predicted COVID-19 severity (a composite index of COVID-19 susceptibility, reproductive rate, morbidity, and mortality rates) (Study 1a), after accounting for covariates (e.g., socioeconomic factors, ecological factors, collectivism index, cultural tightness-looseness index, COVID-19 policy response, test-to-case ratio). Moreover, multilevel analysis accounting for daily- (e.g., time-trend effect, season) and macro-level (same as in Study 1a) covariates showed that country-level religious searches, compared with the number of total religions/ethnoreligions, were more robust in negatively and significantly predicting daily-level COVID-19 severity during early pandemic stages (Study 1b). At weekly level, perceived coronavirus threat measured with coronavirus-related searches (corona, covid, covid-19, etc.), compared with actual COVID-19 threat measured with epidemiological data, showed larger effects in positively predicting religious searches (Study 2), after accounting for weekly- (e.g., autocorrelation, time-trend effect, season, religious holidays, major-illness-related searches) and macro-level (e.g., Christian-majority country/territory and all country-level variables in Study 1) covariates. Accordingly, heightened religiosity could proactively and reactively respond to the COVID-19 pandemic across the globe.

An investigation into religious awareness as a crucial factor in adherence to COVID-19 medical directives in Palestine

BACKGROUND

Coping with the pandemic caused by the SARS-COV- 2 has been a global challenge. To this end, several measures have been adopted to control the transmission of the disease and to ensure public safety. One factor that has greatly affected the community's behaviors, attitudes, and practices in Palestine has been religious beliefs.

AIM

This study aims to investigate the role of religion as a factor in adherence to the COVID-19 medical directives in Palestine.

METHODS

A descriptive cross-sectional study was performed from August to October 2021. In this study, 1,353 participants were asked to complete a questionnaire that consisted of 20 items that measured the impact of religious beliefs and the role played by religious scholars in the promotion and application of medically-approved health directives and the rectification of COVID-19 related information. The data were analyzed by using SPSS version 22 software.

RESULTS

More than 50% of the participants agreed that religion has a positive impact on community adherence to the health instructions in the majority of studied items. The responses were significantly variable based on the age and place of residence in most of the questions (p-value < 0.05). However, gender and to a lesser extent, the level of education affected the responses to many research aspects less significantly.

CONCLUSIONS

Religion could be an effective tool in dealing with challenging health issues such as COVID-19. Intervention programs can be developed based on the community's religious beliefs, attitudes, and practices, to dispel myths regarding the disease and to encourage community commitment and adherence to health directives.

Pandemic Disruptions of Older Adults’ Meaningful Connections: Linking Spirituality and Religion to Suffering and Resilience

The COVID-19 pandemic has upended the lives of persons of all ages throughout the world. Older adults have been particularly susceptible to the virus and have died at higher rates than any other age group. Starting from the early days of the pandemic, gerontologists rallied to address a wide variety of issues affecting older people’s lives. This paper reviews gerontological research that began shortly after the pandemic was declared and examines how a model of meaningful connectedness undergirding spiritual and religious experiences sheds light on the suffering and the resilience of older people during the pandemic. It notes that despite over four decades of research on the role of religion and spirituality in older people’s lives, there has been little mention in major gerontology journals of the role of elders’ religiousness and spirituality in their responses to the pandemic. The paper concludes with a call for gerontologists to pay closer attention to elder religiousness and spirituality and the many questions that need to be addressed regarding older people’s experiences during the pandemic.

E-Learning Satisfaction, Stress, Quality of Life, and Coping: A Cross-Sectional Study in Italian University Students a Year after the COVID-19 Pandemic Began

(1) Background: The objective was to investigate e-learning satisfaction in a sample of university students by evaluating quality of life, stress sociality, and coping. (2) Methods: This was an online survey involved 471 students attending the University of L′Aquila from June to July 2021. The primary goal was estimating the e-learning satisfaction as measured by the E-learning Satisfaction Scale, while the secondary outcomes were studying its relationship with demographic factors, the perception of quality of life, sociality, stress, and coping strategies using a hierarchical regression model. (3) Results: A total of 136 participants were males (29%); the mean age was 25 years. The results revealed that the satisfaction score was 30.6, and the mean stress level was 19.4. Students suffered psychologically and physically for 14 days a month. The sociality score was 36. With respect to coping strategies, students reported higher scores for “Acceptance” (6.0), “Active coping” (6.2), and “Planning” (6.4). E-learning satisfaction was significantly related to age and course attendance. It was positively associated with the social presence score and coping strategies such as self-blame and religion, while it was inversely related to stress and unhealthy days. (4) Conclusions: The students revealed a positive propensity to use e-learning despite the end of quarantine. Sociality, stress, quality of life, and coping seemed to play an important role in student′s e-learning satisfaction.

Changes in intensification of religious involvement during the COVID-19 pandemic in Poland

Introduction

The emergence of the virus Sars-CoV-2, and subsequent COVID-19 pandemic, caused a global threat to public health. In such challenging and worrying situations it can be expected that people will seek comfort in religion. However, before the pandemic there were never such wide world disruptions of religious practice–because of social distancing regulations, religiosity cannot be practiced in the same way as it was before the pandemic.

Methods

Two anonymous online surveys were conducted of adult Poles, one during the second wave (N = 1072; November 2020) and one during the third wave of the pandemic (N = 1080; April 2021). The survey samples of participants reflected the Polish population structure in terms of age, sex, size of place of residence, education, and province.

Results

Participation in institutional religious practices fell threefold to 11.9% during the pandemic, as compared to pre-pandemic times (31.2%). The number of people who did not go to church at all increased from 23.1% to 57.0%. Between the second and third waves, there was a small return to regular practice (from 10.1% to 14.1%). Based on the subjective assessment of the amount of time devoted to prayer, fewer people reporting an increase (10.6%) than a decrease (20.1%) in religious commitment during the pandemic. Logistic regressions showed that an increase in religious commitment can be predicted by older age, more frequent participation in religious practices before the pandemic, and higher life satisfaction. A decrease in religious commitment can be predicted by younger age, less frequent participation in religious practices before the pandemic, and greater number of children in the household.

Conclusion

Our research indicates a deintensification of religious practices during the COVID-19 pandemic in Poland. The pandemic has accelerated process of polarization of Polish religiosity.

Perceived Changes of Attitudes and Behaviors of Seventh-Day Adventists During the COVID-19 Pandemic: Findings from a Cross-Sectional Survey in Germany

To analyze which pandemic related changes of attitudes and behaviors were perceived by Seventh-day Adventists (SDA) and how these relate to wellbeing, a cross-sectional survey with standardized questionnaires was performed. Participants (n = 1,494) stated changes for Relationships, Digital media usage and Nature/Silence/Contemplation, but not for Spirituality or Reflection of life. Best predictors of psychological wellbeing (WHO-5) were Spiritual wellbeing, perceived Restrictions and Awe/Gratitude (R² = .32). Mediation analyses (R² = 0.51) revealed a mediation effect of Awe/Gratitude between spiritual to psychological wellbeing (β = 0.11, p < 0.0001). Perceived changes were less relevant to buffer the negative effects of the pandemic; instead, they were related to fears of future. More relevant to stabilize SDAs´ wellbeing was their spirituality.

Well-being assessment in medical students since the COVID-19 pandemic: a mixed method study

INTRODUCTION

Since the COVID-19, changes have occurred for the Moroccan medical students, which represent a vulnerable population. Coping with this situation could be difficult. Our objective was to estimate and understand the psychosocial barriers to the medical students' well-being at the Faculty of Medicine and Pharmacy of Marrakesh (FMPM) by evaluating their coping strategies, difficulties and needs.

METHODS

We conducted a mixed method study among pre-graduate medical students. For the quantitative part, we did a cross-sectional study using an online four-part self-administered questionnaire. We compared Likert scales of perceived well-being before and one year after the lockdown. The scales ranged from 0 (very low state of well-being) to 10 (complete state of well-being). Coping strategies were assessed by the Brief-COPE questionnaire. The qualitative perspective was a case-study with semi-structured interviews using an interview guide based on the literature review. Finally, a one-phase triangulation analysis, underlined by a convergence model, was done.

RESULTS

We had 355 participants for the quantitative part (participation rate of 16.6%). The mean age was 19.2±1.6. The female/male sex ratio was 1.8. The first cycle students represented 76%. The well-being mean state was better before than after the pandemic (7.8 vs 5.4; p<0.001). The main coping strategy was the acceptance of the situation (5.8±1.7). According to the students, their principal need for promoting their well-being at the faculty was having courses about technologies for studies (89.3%). For the qualitative part, we interviewed 16 students. Thirteen had a decline of their well-being after the lockdown. Isolation and adaptation to e-learning were the principal difficulties. However, mainly, they adopted engaging in coping strategies.

CONCLUSION

The medical students' well-being decreased since the COVID-19 pandemic. Students adopting coping strategies were in the best well-being state. Psychosocial and solution-based measures should be put in place at the FMPM to foster the students' well-being.

A Rapid Survey of State and Territorial Public Health Partnerships With Faith-Based Organizations to Promote COVID-19 Vaccination

During the COVID-19 pandemic, media accounts emerged describing faith-based organizations (FBOs) working alongside health departments to support the COVID-19 response. In May 2021, the Department of Health and Human Services, Centers for Disease Control and Prevention, and the Association of State and Territorial Health Officials (ASTHO) sent an electronic survey to the 59 ASTHO member jurisdictions and four major US cities to assess state and territorial engagement with FBOs. Findings suggest that public health officials in many jurisdictions were able to work effectively with FBOs during the COVID-19 pandemic to provide essential education and mitigation tools to diverse communities. (Am J Public Health. 2022;112(3):397-400. https://doi.org/10.2105/AJPH.2021.306620).

Role of Religious Leaders in COVID-19 Prevention: A Community-Level Prevention Model in Sri Lanka

The COVID-19 pandemic has affected all countries irrespective of their state of development. In countries with traditional societies, religious leaders have been acknowledged as key stakeholders in community engagement activities, including disease prevention. A community-level prevention model was established in 2020 by the Health Promotion Bureau (HPB), Sri Lanka, which incorporated mobilisation of the clergy to support the prevention and response schemes to COVID-19 with non-governmental stakeholders. This model was part of a more extensive community engagement network established by the HPB in cooperation with the country offices for WHO and UNICEF. Building trust, empowering behavioural traits applicable to minimise risks from COVID-19, leadership and coordination, message dissemination, addressing stigma and discrimination, supporting testing procedures, contact tracing activities and vaccination, building community resilience, spiritual and psychosocial support, and welfare provision are some of the useful factors that were identified in the model. Furthermore, a much broader and holistic approach is needed to focus on health behaviours and social and cultural aspects in a multi-faceted nature. This paper highlights a novel COVID-19 prevention model with active involvement of religious leaders that can be implemented in low resource settings. Our experience from Sri Lanka demonstrates the feasibility of implementing this model to mitigate the disastrous situation following the COVID-19 outbreak.

Loss of Faith and Decrease in Trust in a Higher Source During COVID-19 in Germany

Many people relied on their faith as one resource in order to cope during the COVID-19 pandemic. In Germany, between the eighteen months from June 2020 to November 2021, different participants at different times were assessed during different phases of the COVID-19 pandemic. The total sample of this continuous cross-sectional survey consisted of 4,693 participants. Analyses revealed that with the 2nd wave of the infection and its 2nd lockdown, trust in a Higher Source, along with praying and meditation decreased. Also, the sharp increase in corona-related stressors was associated with a decline of wellbeing and a continuing loss of faith. These developments were observed in both Catholics and Protestants, and in both younger and older persons. In addition, the long phases of insecurity and social isolation lacking the significant support usually given by religious communities may have likewise challenged the religious-coping capacities of religious/spiritual people themselves.

Engaging Religious Institutions and Faith-Based Communities in Public Health Initiatives: A Case Study of the Romanian Orthodox Church During the COVID-19 Pandemic

The success of public health interventions is highly dependent on the compliance of the general population. State authorities often implement policies without consulting representatives of faith-based communities, thereby overlooking potential implications of public health measures for these parts of society. Although ubiquitous, these challenges are more readily observable in highly religious states. Romania serves as an illustrative example for this, as recent data identify it as the most religious country in Europe. In this paper, we discuss the contributions of the Romanian Orthodox Church (ROC), the major religious institution in the country, to the national COVID-19 mitigation efforts. We present not only the positive outcomes of productive consultations between public health authorities and religious institutions but also the detrimental impact of unidirectional communication. Our work highlights that an efficient dialogue with faith-based communities can greatly enhance the results of public health interventions. As the outlined principles apply to a variety of contexts, the lessons learned from this case study can be generalized into a set of policy recommendations for the betterment of future public health initiatives worldwide.

Challenges in Implementing the National Health Response to COVID-19 in Senegal

Since the beginning of the COVID-19 pandemic in Africa, many epidemiological or anthropological studies have been published. However, few studies have yet been conducted to understand the implementation of State interventions to fight the COVID-19 pandemic. In Senegal, the national response plan was planned before the country experienced its first official case of COVID-19 on 2 March 2020. This qualitative study, conducted in March and April 2021, based on 189 interviews, aims to understand how the national response has been implemented in several regions of Senegal. Implementation of the response to the pandemic was favoured by good preparation, capacity to adapt, responsiveness of health actors, and commitment for both the political and religious authorities. The implementation response was confronted by several constraining factors such as the coercive approach, the challenges of coordinating actors, and the lack of intersectoral response. The central level has sometimes used reflexivity processes to adapt its response, but it has remained highly politicized, centralized, directive, and with little involvement of civil society. In Senegal, the response to the pandemic has been implemented in a relatively political and directive, even coercive manner, without necessarily considering prior knowledge and the need to adapt it to local contexts and to involve civil society and community actors in the process.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s43477-022-00053-4.

The first major vaccination campaign against smallpox in Lombardy: the mass vaccination campaign against coronavirus…nothing new…only terminology

Terminology, technology, communication and organizational strategies are different but we tried to compare the mass vaccination campaign against smallpox with the one we are doing against coronavirus.

Social Adaptation in Context: The Differential Role of Religiosity and Self-Esteem in Vulnerable vs. Non-vulnerable Populations - A Registered Report Study

There is evidence that religiosity and self-esteem are positively related, while self-esteem and religiosity in turn predict successful social adaptation. Moreover, self-esteem has been shown to be directly related to social adaptation in vulnerable contexts. In this registered report study, we tested the hypothesis that religiosity has a positive influence on social adaptation for people living in vulnerable contexts and that self-esteem is a mediator of this relationship. Evidence from this study indicates that neither there is any effect of religiosity on social adaptation nor on self-esteem, independent of whether people live in vulnerable contexts or not.

Religious practice in the pandemic of COVID-19 and the nursing diagnoses

PURPOSE

Identify the elements (defining characteristics, related factors, and risk factors) of the diagnoses of NANDA international impaired religiosity (00169), risk for impaired religiosity (00170), and readiness for enhanced religiosity (00171), in a period of social distancing in the pandemic of COVID-19, and associate them with the behavior of individual and collective religious practice, before and during the pandemic.

METHODS

Survey study, released via social media to members of religious communities in Brazil. Data collection took place in June 2020, by online questionnaire.

FINDINGS

Participants were 719 people, 563 (78.3%) were women, with a median age of 39 years (min 18-max 73), of Catholic religion (64.7%), with a median of 29 years of religious practice (min 0-max 70). The participants were from Southeast 652 (90.68%), South 49 (6.82%), Northeast 13 (1.82%), Midwest 4 (0.56%), and North 01 (0.14%) of Brazil. The increase of individual religious practice was associated with two diagnostic elements and the reduction of individual practice to nine elements. The reduction of collective religious practice was associated with seven diagnostic elements and the maintenance of the practice associated with five elements. The increase of collective religious practice was associated with five diagnostic elements.

CONCLUSIONS

In individuals who presented during the pandemic reduction of individual religious practice, reduction of collective religious practice, and maintenance of collective religious practice, the elements of the diagnosis impaired religiosity were predominant. In individuals who presented increased practice of collective religious activity during the pandemic, the elements of the diagnosis readiness for enhanced religiosity were predominant.

IMPLICATIONS FOR NURSING PRACTICE

This study highlights defining characteristics, risk factors, and related factors of the religiosity diagnoses presented due to social distancing in the pandemic; these should be screened during nursing consultations in primary health care.

Perceptions of Spiritual Dryness in Iran During the COVID-19 Pandemic

This study addresses perceptions of spiritual dryness (a specific form of spiritual struggle) during the COVID-19 pandemic among Iranian Muslims (n = 362), and how these perceptions can be predicted. Spiritual dryness was perceived often to regularly by 27% and occasionally by 35%. Regression models revealed that the best predictors of spiritual dryness (SDS-7) were usage of mood-enhancing medications, loneliness/social isolation and praying as positive predictors, and being restricted in daily life concerns as negative predictor. The pandemic challenges mental stability of people worldwide and may also challenge trust in God. Reliable and humble support of people experiencing these phases is required.

COVID-19 Vaccination in Developing Nations: Challenges and Opportunities for Innovation

Vaccines offer a hope toward ending the global pandemic caused by SARS-CoV2. Mass vaccination of the global population offers hope to curb the spread. Developing nations, however, face monumental challenges in procurement, allocation, distribution and uptake of vaccines. Inequities in vaccine supply are already evident with resource-rich nations having secured a large chunk of the available vaccine doses for 2021. Once supplies are made available, vaccines will have to be distributed and administered to entire populations—with considerations for individual risk level, remote geography, cultural and socio-economic factors. This would require logistical and trained personnel support that can be hard to come by for resource-poor nations. Several vaccines also require ultra-cold temperatures for storage and transport and therefore the need for specialized equipment and reliable power supply which may also not be readily available. Lastly, attention will need to be paid to ensuring adequate uptake of vaccines since vaccine hesitancy has already been reported for COVID vaccines. However, existing strengths of local and regional communities can be leveraged to provide innovative solutions and mitigate some of the challenges. Regional and international cooperation can also play a big role in ensuring equity in vaccine access and vaccination.