The effect of observing religious or faith-based fasting on cardiovascular disease risk factors: A systematic review and meta-analysis

AIMS

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Fasting is common in many religions and is associated with health benefits. This systematic review to compares the impact of different religious fasting practices, on risk of cardiometabolic diseases.

DATA SYNTHESIS

The search covered five databases following PRISMA guidelines to identify papers published in English from inception to March 2023 (updated January 2024). Inclusion criteria were healthy adults in observational studies, who engaged in religious fasting practices, studies were included where data on matched non-fasting individuals was available. Outcomes were systolic and diastolic blood pressure, body mass index (BMI), triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), and fasting plasma glucose levels. A meta-analysis was conducted, and the review was registered (CRD42022352197). Fourteen studies were met the inclusion criteria with ten studies data being suitable for meta-analysis, reporting on 755 adults participating in fasting practices and 661 non-fasting controls. Religious fasting was associated with a reduction in BMI (-0.40 kg/m2, 95% CI [-0.70, -0.10], p < 0.01). Observance of Ramadan fasting was associated with decreased systolic blood pressure (-3.83  mmHg, 95% CI [-7.44, -0.23], p = 0.04). The observance of Orthodox Christian fasting was associated with a reduction in TC (-0.52 mmoL/l, 95%CI [-0.64, -0.39], p < 0.01). No difference was found for the other outcomes.

CONCLUSION

This review found religious fasting practices which were associated with a reduction in some biomarkers of cardiometabolic diseases risk. Further research on other fasting practices is needed due to limited data.

'I've just got to take that risk and have faith . . .': The challenge of gaining and maintaining trust in patients undergoing knee surgery with a regional anaesthetic

Traditionally, the focus of the operating theatre has been on conducting safe, efficient surgery with unconscious patients. However, the care of awake patients is now a prominent feature of modern perioperative practise as the volume of surgery performed under regional anaesthesia increases. The aim of this novel study was to understand the experience of being a conscious patient during regional anaesthesia and knee surgery in the perioperative environment. Data were gathered through observation and ethnographic interview and analysis followed a constant comparative grounded theory approach. The concepts of Trust and Faith are identified as recurrent themes highlighted in the data. This article identifies the need to understand patients' expectations regarding the clinical encounter and how subsequent treatment will develop, so that, reasons for any deviation can be discussed openly and an explanation provided. Each clinical encounter takes place within a relationship based upon an uneven distribution of power, enacted through the interaction itself, with the health care professional in a dominant role. It is the responsibility of health care staff to recognise and negate this power imbalance and reinforce trusting relationships so information and treatment options are not presented as a 'fait accompli' but negotiated through jargon free easy to understand language.

Spirituality in Oncology: Relations between Spirituality, Its Facets, and Psychological and Demographic Factors in Cancer Patients in Germany

INTRODUCTION

Cancer diagnoses are constantly increasing in clinical practice. Therefore, more and more patients are interested in how they can actively participate in the process of treatment. Spirituality represents a hidden issue of the population, which counts as a branch of complementary and alternative treatment. Therefore, the aim of our study was to investigate whether there are associations between spirituality and demographic and psychosocial factors, as well as religious beliefs, in cancer patients.

METHODS

We conducted a survey with 451 participants in 10 oncology centers between March and July 2021. A composition of the following 9 different questionnaires was used to collect data on spirituality, demographics, resilience, self-efficiency, life satisfaction, and sense of coherence: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp12), General Life Satisfaction Short Scale (L-1), Resilienzskala Kurzform (RS-13), Sense of Coherence Scale - Leipziger Kurzform (SOC-L9), Allgemeine Selbstwirksamkeit Kurzskala (AKSU), Adolescent Food Habits Checklist, Likert-Scale of daily activities, questionnaire of the Working group Prävention und Integrative Onkologie (PRiO), and personal opinion on the cause of the disease. Calculated data and analyzed group differences using ANOVA Bonferroni were used to test associations between spirituality and the variables studied. For more detailed examination of spirituality, we took a closer look at the different components of spirituality - peace, meaning, and faith - and their relation to each other (three-factor spirituality analyses).

RESULTS

Higher spirituality scores in total as well as meaning, peace, and faith were each associated with higher levels of resilience and life satisfaction. Higher religious belief was found to be associated with higher spiritual attitudes. High personal self-efficiency was found in people with higher spiritual beliefs in general as well as higher meaning and peace. Meaning and peace emerge as essential components of spiritual well-being and show a stronger association with expressions of general spirituality than faith.

CONCLUSION

Spirituality takes a crucial role among the resources of life-threatening diseases. As such, further research is needed to expand and integrate patient options into a modernized concept of care. Our data indicate that higher spiritual well-being is associated with a more tolerant approach to illness. Thus, addressing spiritual needs in therapy is associated with better psychological adjustment to the individual situation and reduces negative distress. To promote spiritual needs in the future, cognitive as well as affective components of spirituality should be emphasized.

The Pilgrimage on the Camino de Santiago and Its Impacts on Marital and Familial Relationships: An Exploratory Study

This paper presents the results of a survey conducted among people walking the pilgrimage route to the shrine of St James in Santiago de Compostela. The aim of the research was to investigate how a pilgrimage on the Camino de Santiago among a married couple or family affects marital or familial relationships, whether walking the trail to Compostela together influences the behaviour of family members towards each other and whether it forms positive attitudes and behaviour. The empirical basis of the study is the results of a survey among respondents who made the Camino de Santiago pilgrimage, as well as in-depth interviews conducted with 24 spouses of pilgrims along the Way of St James. The study revealed that doing the pilgrimage as a married couple or family had a positive impact on intra-family relationships. According to the interviewees, going on the pilgrimage together helped to strengthen marital bonds and trust, improve communication and mutual connection, show care and affection and improve contact with children.

The Role of Religion, Spirituality and Social Media in the Journey of Eating Disorders: A Qualitative Exploration of Participants in the "TastelifeUK" Eating Disorder Recovery Programme

This study explores the religious and spiritual aspects of eating disorder recovery and the role of social media in the context of a third sector community-based recovery group in the UK. Four online focus groups explored participant perspectives (17 participants in total) using thematic analysis. The qualitative findings highlight that relational support from God is important in eating disorder recovery and coping, although this can be challenged by spiritual struggles and tensions. Relational support from people is also relevant where it offers a place to share different experiences together giving a sense of community belonging. Social media was also found to be important in relation to eating disorders, either providing a community of support or exacerbating existing issues. This study suggests that the role of religion and social media should be acknowledged where it is important for that individual in relation to eating disorder recovery.

Spiritual Dimension in Neurological and Neurodegenerative Diseases: A Systematic Mapping Review

Previous studies have shown the benefits of spirituality/religiosity with regard to health and quality of life for people. The high prevalence of neurological disorders, which are the main diseases that cause disability and dependency around the world, makes neurological disorders especially relevant. This systematic mapping review aimed to map the knowledge of spirituality experienced by people with neurological/neurodegenerative disorders and its influence on outcomes and the ability to cope with the disease. Following specified methodological criteria, a total of 13 articles were selected. The spiritual dimension should be considered a fundamental component of the quality of life and well-being of neurological patients as it can significantly influence their ability to cope with their disease.

Faith healing based on narratives of healing experiences: A psycho-spiritual interpretation

This study investigated 216 individual transcripts of faith healing experiences drawn from the healing ministries of 2 Catholic priests in the Philippines. The accounts of these healing narratives were generously provided to the researcher in hard copies for analysis by the 2 Catholic priests. The narratives were individual stories of healing experiences and written voluntarily by the healees themselves. Five themes were extracted from the narratives, namely, sensation of warmth, feeling of lightness, electrifying sensation, feeling of heaviness, and a weeping episode. Further, the study was able to unfold four themes on spiritual coping, namely, empowering faith, letting God be in control, acceptance leading to renewal, and connectedness with God. Faith healing experience begins with multisensory-physiological changes (e.g., sensation of warmth, electrifying sensation, feeling of heaviness) leading to affective/emotional, changes (e.g., weeping moment and feeling of lightness) that occur simultaneously, or in succession as antecedent conditions that awaken or activate inner adaptive spiritual coping responses with illness such as empowering faith, God being in control, acceptance leading to renewal, and connectedness with God.

Identifying Systemic Factors when Counseling Black Women of Christian Faith in the USA

When Black women of Christian faith in the USA receive secular help for psychological symptoms, their spiritual and religious communities often view the decision negatively. The women may feel shamed, ostracized, and condemned. They often experience emotional, physical, and spiritual trauma from the rejection that increases the frequency, duration, and intensity of their psychological symptoms. This article identifies specific community-based and systemic factors that exacerbate mental health issues in Black women of Christian faith. The authors discuss the influence of such factors on mental health and provide evidence-based practices for mental health clinicians working with Black women of Christian faith.

Informing the UK Muslim Community on Organ Donation: Evaluating the Effect of a National Public Health Programme by Health Professionals and Faith Leaders

There is a significant shortage of transplantable organs in the UK particularly from Black, Asian and Minority Ethnic (BAME) groups, of which Muslims make a large proportion. The British Islamic Medical Association (BIMA) held a nationwide series of community gatherings with the aim of describing the beliefs and attitudes to organ donation amongst British Muslims and evaluate the efficacy of a national public health programme on views and uncertainties regarding religious permissibility and willingness to register. Eight public forums were held across the UK between June 2019 and March 2020 by the British Islamic Medical Association (BIMA). A panel of experts consisting of health professionals and Imams discussed with audiences the procedures, experiences and Islamic ethico-legal rulings on organ donation. Attendees completed a self-administered questionnaire which captured demographic data along with opinions before and after the session regarding religious permissibility and willingness to register given permissibility. A total of 554 respondents across seven UK cities were included with a M:F ratio 1:1.1. Only 45 (8%) respondents were registered as organ donors. Amongst those not registered multiple justifications were detailed, foremost of which was religious uncertainty (73%). Pre-intervention results indicated 50% of respondents were unsure of the permissibility of organ donation in Islam. Of those initially unsure or against permissibility or willingness to register, 72% changed their opinion towards deeming it permissible and 60% towards a willingness to register indicating a significant change in opinion (p < 0.001). The effectiveness of our interventions suggests further education incorporating faith leaders alongside local healthcare professionals to address religious and cultural concerns can reduce uncertainty whilst improving organ donation rates among the Muslim community.

Quality of life and psychological distress of patients with advanced cancer in the Philippines

PURPOSE

This study aimed to describe the quality of life (QOL) and psychological distress (anxiety and depression) of Filipino patients with advanced solid cancers and identify sociodemographic and clinical-related factors associated with them.

METHODS

195 patients with advanced cancer were recruited from a major hospital treating cancer patients in the Philippines. Participants completed self-reported surveys on Quality-of-life (QOL-FACT-G) and psychological distress (HADS-D, HADS-A). Multi-variable OLS regression models were performed where sociodemographic, health history and clinical characteristics were included as predictors.

RESULTS

The average total FACT-G score was 65.39/108 (Standard deviation (SD) = 13.76), with the physical well-being scale having the lowest scores (M = 14.14/28, SD = 5.92). The two most common symptoms reported were fatigue (88%) and pain (86.5%). Physical symptom burden was significantly negatively associated with QOL and psychological distress. The average HADS-total score was 14.46/21 (SD = 5.77), with 8% with probable anxiety and 27% with probable depression. Participants who reported greater reliance on their spiritual faith for strength in coping with illness reported lower depression scores.

CONCLUSIONS

Our findings underline the importance of understanding the multi-dimensional outcomes of Filipino advanced cancer patients. Results may be used to improve QOL and reduce the psychological distress of advanced cancer patients.

How Does Spiritual Well-Being Change Over Time Among US Patients with Heart Failure and What Predicts Change?

Few studies have examined how spiritual well-being changes over time in patients with heart failure. We conducted a secondary analysis of data from the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) trial (N = 314). Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) at baseline and 12-month follow-up. Of the 165 patients with spiritual well-being data at follow-up, 65 (39%) experienced probable clinically meaningful changes (> 0.5 SD) in spiritual well-being (35 improved, 30 declined). Increased pain (p = 0.04), decreased dyspnea (p < 0.01), and increased life completion (p = 0.02) were associated with improvement in overall spiritual well-being. Exploratory analyses found different predictors for FACIT-Sp subscales.

Mental health and spiritual well-being in humanitarian crises: the role of faith communities providing spiritual and psychosocial support during the COVID-19 pandemic

Across the globe, people's reactions to the COVID-19 pandemic and its accompanying lockdowns highlighted, and continued to stress, the relevance of mental health and psychosocial support (MHPSS) in responding to crises, including in low-income and emergency settings. They also demonstrated the importance of faith practices and communities of faith as core needs and important coping mechanisms for many affected people in times of crisis. Drawing on data collected by World Vision International, the world's largest child-focused humanitarian and development organisation, in the course of its response to COVID-19 in 70 different countries, this article explores the ways in which faith groups and faith leaders responded to the perceived needs of their communities. While keen to offer psychosocial support to people suffering anxiety and fear in the context of the crisis, this has often been integrated with spiritual support. Analysing their work from the framework of a rights-based approach to mental health, we conclude that they did contribute to psychosocial support through their MHPSS, in part through their provision of spiritual care. However, spiritual well-being should not be conflated with psychosocial well-being. While faith groups play an important role in MHPSS, their primary role is to offer spiritual care.

"Everything the hujur tells is very educative but if I cannot apply those in my own life then there is no meaning": a mixed-methods process evaluation of a smoke-free homes intervention in Bangladesh

BACKGROUND

Second-hand smoke exposure from tobacco significantly contributes to morbidity and mortality worldwide. A cluster RCT in Bangladesh compared a community-based smoke-free home (SFH) intervention delivered in mosques, with or without indoor air quality (IAQ) feedback to households to no intervention. Neither was effective nor cost-effective compared to no intervention using an objective measure of second-hand smoke. This paper presents the process evaluation embedded within the trial and seeks to understand this.

METHODS

A mixed method process evaluation comprising interviews with 30 household leads and six imams (prayer leader in mosque), brief questionnaire completed by 900 household leads (75% response), fidelity assessment of intervention delivery in six (20%) mosques and research team records. Data were triangulated using meta-themes informed by three process evaluation functions: implementation, mechanisms of impact and context.

RESULTS

IMPLEMENTATION: Frequency of SFH intervention delivery was judged moderate to good. However there were mixed levels of intervention fidelity and poor reach. Linked Ayahs (verses of the Qur'an) with health messages targeting SHS attitudes were most often fully implemented and had greatest reach (along with those targeting social norms). Frequency and reach of the IAQ feedback were good.

MECHANISMS OF IMPACT

Both interventions had good acceptability. However, views on usefulness of the interventions in creating a SFH were mixed. Individual drivers to behaviour change were new SFH knowledge with corresponding positive attitudes, social norms and intentions. Individual barriers were a lack of self-efficacy and plans.

CONTEXT

Social context drivers to SFH intervention implementation in mosques were in place and important. No context barriers to implementation were reported. Social context drivers to SHS behaviour change were children's requests. Barriers were women's reluctance to ask men to smoke outside alongside general reluctance to request this of visitors. (Not) having somewhere to smoke outside was a physical context (barrier) and driver.

CONCLUSIONS

Despite detailed development and adaption work with relevant stakeholders, the SFH intervention and IAQ feedback became educational interventions that were motivational but insufficient to overcome significant context barriers to reduce objectively measured SHS exposure in the home. Future interventions could usefully incorporate practical support for SFH behaviour change. Moreover, embedding these into community wide strategies that include practical cessation support and enforcement of SFH legislation is needed.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN49975452.

Higher religiosity and spirituality are associated with ethnic group membership among middle-aged and older adults living with HIV

Background: HIV is a chronic illness that impacts the lives of more than 1 million people in the United States. As persons living with HIV (PWH) are living longer, it is important to understand the influence that religiosity/spirituality has among middle-aged and older PWH.

Objective: Compare the degree of religiosity/spirituality among middle-aged and older PWH and HIV-negative individuals, and to identify demographic, clinical, and psychosocial factors associated with religiosity/spirituality among PWH.

Method: Baseline data on 122 PWH and 92 HIV-negative individuals (ages 36-65 years; 61.1% Non-Hispanic White) from a longitudinal study were analyzed for the current study. Recruitment occurred through HIV treatment clinics and community organizations in San Diego. Participants completed questionnaires on religiosity, spirituality, and psychosocial functioning. Independent samples t-tests, Pearson correlations, and multiple linear regression analyses were conducted to test the study objective.

Results: No significant differences in religiosity/spirituality were found between PWH and HIV-negative individuals. Demographic and psychosocial variables were unrelated to religiously/spirituality among HIV-negative individuals. Among PWH, multiple linear regression models indicated higher daily spirituality was significantly associated with racial/ethnic minority membership (Hispanic/Latino, African American/Black, or Other), fewer years of estimated duration of HIV, greater social support, and higher grit. Greater engagement in private religious practices was significantly associated with racial/ethnic minority membership and higher social support.

Conclusions: For PWH, being a racial/ethnic minority and having higher social support was associated with greater engagement in religious/spiritual practices. Future longitudinal studies should examine whether religion/spirituality impacts well-being across the lifespan among racial/ethnic minority groups of PWH.

"There is 'Plenty' of Grace-it is Not a Limited Commodity!:" Experiences of Grace in Australian Faith Communities During the Pandemic

During the pandemic years of 2020 and 2021, Melbourne in Australia endured one of the longest lockdowns in the world. Although the severe restrictions for faith communities in particular posed many setbacks, new opportunities for worship were experienced. This paper focuses on a research project that explored hope, grace, and resilience during COVID-19 in Melbourne. A total of 106 participants from a variety of Christian denominations in Melbourne completed an online survey in relation to the notion of grace. Thematic analysis of the qualitative data was employed to explore the lived experiences of the participants. Two overarching themes-God's grace offers favour, and God's grace provides strength and builds resilience-are discussed. The findings indicate that while grace is bountiful through faith, it can also be found in unexpected places within faith settings and the wider community. While generalizations from this study cannot be made to other faith communities, recommendations are offered in relation to ways in which 'church' may be experienced in 2022 and beyond. The study showed that "there is 'plenty' of grace". Its transformational power offers hope and builds resilience as God's grace "is not a limited commodity!"

Health Effects of Religion, Spirituality, and Supernatural Beliefs in Mainland China: A Systematic Review

Effects of religion, spirituality and supernatural beliefs (RSS) upon health in mainland China remain poorly understood, despite strong RSS beliefs influencing Chinese society. We conducted a Chinese-English bilingual systematic review to summarize the state of RSS-health research in mainland China. Study quality was assessed using the Critical Appraisal Skills Program tool. We screened 1858 studies, 162 of which were included in the review. From 2000-2004 to 2015-2019, the number of RSS-health studies in China increased from five to 73. However, only 7% of studies were rated as higher quality. Cross-sectional and case-control studies represented the vast majority of study designs (94%) and religious affiliation was the only RSS measure for 58% of studies. Higher, moderate, and lower quality studies indicated that RSS has both beneficial and adverse health implications. RSS-health research in China has accelerated rapidly in the last 20 years, but fundamental gaps in knowledge remain. Longitudinal study designs and nuanced RSS measures are needed to advance understanding of RSS health effects in China.

The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature

The pandemic caused by the new coronavirus SARS-CoV-2 has been affecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientific literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our findings revealed the importance of including spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pandemic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

Is stronger religious faith associated with a greater willingness to take the COVID-19 vaccine? Evidence from Israel and Japan

Achieving high vaccination rates is important for overcoming an epidemic. This study investigates the association between religious faith and intentions to become vaccinated against COVID-19 in Israel and Japan. Most of Israel's population is monotheistic, whereas most Japanese are unaffiliated with any religion. Therefore, our findings might be applicable to various countries that differ in their religions and levels of religiosity. We conducted almost identical large-scale surveys four times in Israel and five times in Japan from March to June 2020 to obtain panel data. We found that intentions of getting vaccinated depend on people's level of religiosity in a non-linear way. Those who have strong religious beliefs are less likely to become vaccinated than those who say they are less religious. Two other factors that play a role in this relationship are religious denomination in Israel and identifying with a religion in Japan.

Providing Spiritual Care to In-Hospital Patients During COVID-19: A Preliminary European Fact-Finding Study

Historically, there has be a close relationship between the nursing services and spiritual care provision to patients, arising due to the evolvement of many hospitals and nursing programmes from faith-based institutions and religious order nursing. With increasing secularism, these relationships are less entwined. Nonetheless, as nurses typically encounter patients at critical life events, such as receiving bad news or dying, nurses frequently understand the need and requirement for both spiritual support and religious for patients and families during these times. Yet there are uncertainties, and nurses can feel ill-equipped to deal with patients' spiritual needs. Little education or preparation is provided to these nurses, and they often report a lack of confidence within this area. The development of this confidence and the required competencies is important, especially so with increasingly multicultural societies with diverse spiritual and religious needs. In this manuscript, we discuss initial field work carried out in preparation for the development of an Erasmus Plus educational intervention, entitled from Cure to Care Digital Education and Spiritual Assistance in Healthcare. Referring specifically to post-COVID spirituality needs, this development will support nurses to respond to patients' spiritual needs in the hospital setting, using digital means. This preliminary study revealed that while nurses are actively supporting patients' spiritual needs, their education and training are limited, non-standardised and heterogeneous. Additionally, most spiritual support occurs within the context of a Judeo-Christian framework that may not be suitable for diverse faith and non-faith populations. Educational preparation for nurses to provide spiritual care is therefore urgently required.

COVID-19 and the Sikh Community in the UK: A Qualitative Study

The COVID-19 pandemic has had, and continues to have, a significant effect on individuals worldwide, and it is clear that minority communities including the Sikh community have been particularly affected by the virus. The current study assessed the impact of the pandemic in a sample of 44 British Sikhs across 11 virtual focus groups. Three main themes emerged including making meaningful connections, struggling to adjust and the organisation of gurdware (Sikh places of worship) in coping with the COVID-19 pandemic. Findings highlight that faith may promote collective action for collective healing especially during mass trauma, with specific insight into what this may entail for the Sikh community.

Cancer Survivorship: Religion in Meaning Making and Coping Among a Group of Black Prostate Cancer Patients in South Africa

The purpose of the study was to explore the role of religion in meaning making and coping among a group of black patients receiving some form of prostate cancer treatment at a public hospital in Limpopo Province, South Africa. A sample of 20 prostate cancer survivors, with ages ranging from 67 to 85 years (mean_age = 76yrs; SD = 5.3) selected through purposive sampling. Data were collected through in-depth, semi-structured individual interviews and analysed using interpretative phenomenological analysis (IPA). The findings demonstrated that religion is an important factor in meaning making and coping by prostate cancer survivors. The findings suggest that healthcare practitioners need to pay close attention to the meanings that cancer patients assign to their illness to provide the appropriate care and support.

Faith in localisation? The experiences of local faith actors engaging with the international humanitarian system in South Sudan

Localisation, as it aims to shift power in the humanitarian system, will involve the increased inclusion of local faith actors, those national and local faith-affiliated groups and organisations that are often first, and last, responders in crises and have been responding in humanitarian contexts for many years, but often in parallel to humanitarian coordination mechanisms. In primary research in South Sudan with local faith actors and international humanitarian actors, this article aims to examine the inroads and barriers to local faith actor involvement in the humanitarian system and the realisation of localisation with local actors such as these. The research is based on an ethnographic study in which researchers were imbedded in a humanitarian project that aimed to help bridge divides between local faith actors and the international humanitarian system. The findings are based on one-on-one and group interviews with 89 participants from a range of international and local, and faith and secular, organisations. Findings indicate that local faith actors are active in responding to crises and want to be linked to the humanitarian system, but they feel distanced from it and pigeonholed as local faith actors. Formalisation through the appropriate registration systems and then training and networking with the humanitarian system helped them build legitimacy and feel confident to participate in humanitarian coordination. International humanitarian actors can help bridge barriers by understanding and connecting with the local faith actors and challenging their own assumptions about who local faith actors are.

Relations Among Locus of Control, Religiosity, and Resiliency in Collegiate Football Players

Resiliency in athletes is related to effective coping strategies. Expectedly, during the COVID-19 pandemic, this attribute was highlighted in collegiate football players. To date, the relations among locus of control (LOC), strength of religious beliefs (i.e., religiosity), and resiliency in collegiate football players have not been explored in the literature. Exploring the relation of LOC and religious beliefs to resiliency may shed light on avenues to foster resiliency in football players, which in turn can determine players' behaviors, performance, and actions during adverse times. The purpose of this study was to gain a more in-depth understanding of the relations among LOC, religiosity, and resiliency in NCAA Division II football players at a public university located in the southwestern United States. A structured online survey containing the Rotter's Locus of Control Scale (Rotter in Psychological Monographs: General and Applied, 80(1), 1-28, 1966), the Santa Clara Strength of Religious Faith Questionnaire (Plante & Boccaccini in Pastoral Psychology, 45(6), 429-437, 1997), and the Conner Davidson Resilience Scale (Connor & Davidson in Depression and Anxiety, 18(2), 76-82, 2003) was completed by 91 Division II football players. Statistically significant correlations were found between LOC and resiliency (r = -.42) as well as religiosity and resiliency (r = .26). Regression analysis indicated, on average, that football players with greater internal LOC and higher strength of religious beliefs had a higher level of resiliency than players with higher external LOC and lower strength of religious beliefs.

Faith and resilience

In this short essay, we sketch a theory of faith that features resilience in the face of challenges to relying on those in whom you have faith. We argue that it handles a variety of both religious and secular faith-data, e.g., the value of faith in relationships of mutual faith and faithfulness, how the Christian and Hebrew scriptures portray pístis and 'ĕmûnāh, and the character of faith as it is often expressed in popular secular venues.

Assessing the Feasibility of an Online Training Designed to Enable Community Health Workers to Deliver a Comprehensive, Evidence-Based Weight Loss Intervention for Rural African Americans of Faith

Obesity is a critical modifiable risk factor in cancer prevention, control, and survivorship. Comprehensive weight loss interventions (e.g., Diabetes Prevention Program (DPP)) have been recommended by governmental agencies to treat obesity. However, their high implementation costs limit their reach, especially in underserved African American (AA) communities. Community health workers (CHWs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. CHW-led interventions have increased weight loss. However, in-person CHW training can be costly to deliver and often requires extensive travel to implement. Web-based trainings have become common to increase reach at reduced cost. However, the feasibility of an online CHW training to deliver the DPP in AAs is unknown. The feasibility of an online CHW training to deliver the DPP adapted for AAs was assessed. The online training was compared to an in-person DPP training with established effectiveness. CHW effectiveness and satisfaction were assessed at baseline and 6 weeks. Nineteen participants (in-person n = 10; online n = 9) were recruited. At post-training, all scored higher than the 80% on a knowledge test required to deliver the intervention. All participants reported high levels of training satisfaction (88.9% of online participants and 90% of in-person participants rated the training as at least 6 on a 1-7 scale) and comfort to complete intervention tasks (78% of online participants and 60% of in-person participants scored at least 6 on a 1-7 scale). There were no significant differences in outcomes by arm. An online CHW training to deliver the DPP adapted for AAs faith communities produced comparable effectiveness and satisfaction to an evidence-based in-person CHW training. Further research is needed to assess the cost-effectiveness of different CHW training modalities to reduce obesity.

Religion and the state in an episodic moment of COVID-19 in Ghana

The goal of this paper is to discuss the role religions are playing to stem the tide against the spread of coronavirus (COVID-19) in Ghana. Focusing on the ubiquity of religions in Ghana, the paper argues that religious experts deploy their ability to invoke the transcendental being to compel adherents to comply with the lockdown rules, as well as follow precautionary measures to fight the virus in Ghana. The paper also maintains that the state has, in the face of the current crisis, passed a law that could be inimical to the future of religious freedom in the country. Methodologically, I draw on critical reflections on electronic and social media reports about religion and humanitarian services in Ghana to argue that religions are bridging the mundane and spiritual gaps to aid the state, while the state is also creatively engaging religions to invest in prayers and also pass laws that are potentially inimical to the future of religious freedom.

'Playing the game': Contemporary landscapes of alcohol policy and faith-based service-users everyday lives

Against a backdrop of faith-based alcohol treatment 'filling the gaps' left by long term restructuring of service provision, funding cuts and marketisation of health and social care this paper makes connections between critical geographies of alcohol policy and service-users everyday lives in England and Wales. Presenting ethnographic research I highlight strategies, practices and performances - 'playing the game'- as service users navigate the multi-scalar impacts of 'austerity' policies, rollback neoliberal governance and 'recovery citizenship' focused on notions of vulnerablity, responsibilisation and 'underclass' behavioural politics. More specifically, the study foregrounds 'fitting in'; 'faking it'; 'conspiracy theories'; and/or 'spiritual journeys' to evidence service-users complex and sophisticated knowledges and experiences of contemporary landscapes of alcohol policy and treatment regimes. The conclusion signposts future directions for research.

Religion in the US during the time of a Pandemic: A Medical Perspective

Approximately 80% of Americans identify as religious. As physicians caring for patients with COVID-19, we have seen both positive and negative effects of religious activity during the pandemic. Religious worship generally supports close social interaction, which provides many benefits, especially in mental health, but it can also contradict infection control measures. These forces do not necessarily have to be in opposition to each other. Herein, we present three case vignettes of religious patients who were infected with and recovered from COVID-19. We review the potential benefits and risks of religious activity in the current pandemic, as supported by the medical literature. Finally, we offer some thoughts on how to engage with patients so that the benefits of both religious activity and public health measures are optimized.

What Are the Perceptions and Experiences of Care Delivery Among Faith Community Nurses? A Systematic Review

OBJECTIVE

This systematic review set out to identify the unique perceptions and experiences of care delivery among faith community nurses (FCNs).

DATA SOURCES

This review was conducted and has been reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted using the following databases, Medline (OVID), EmCare for Nurses (OVID), PsycINFO (OVID), CINAHL (EBSCO), Cochrane, and PubMed. The search strategies included the use of truncations, adjacency search parameters, and Boolean operators using a range of key search terms. Predetermined eligibility criteria were applied to all studies. The review process was managed using Covidence systematic review software. Data extraction and quality assessment was conducted across all included studies. Data were analyzed using a narrative synthesis approach.

CONCLUSION

This review has made an important contribution by identifying the role that FCNs play in care delivery as trusted members of their communities who act as a conduit at the intersect of faith and health care. Irrespective of the location or faith denomination, what was common to FCNs was that they delivered care to address the physical, psychological, spiritual, congregational, communication, health system, and family-related needs of those in their care.

IMPLICATIONS FOR NURSING PRACTICE

The nurses represented in the included studies expressed concerns that patients experienced unmet supportive care needs because of a fragmented and highly complex existing health care system. Often, FCNs provided a valuable contribution in supporting patients in their care pathways and facilitated continuity of care among people who lived with preexisting comorbidities and who had complex health care needs. Further research is needed to understand the role that faith community nursing models might have in cancer care from the perspective of patients and other members of the multidisciplinary team across different international contexts.

Considering religion and spirituality in precision medicine

The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.

Faith-sensitive end of life care for children, young people and their families

This article is part of an at a glance series on palliation and end of life care in paediatrics and focuses on the provision of faith-sensitive end of life care. Particular religions are discussed, with some key points for care of patients from some of the most prevalent religions within the UK. This article is intended to give points for discussion and consideration, but health professionals are encouraged to speak to every patient and family on an individual level to ensure an understanding of their personal beliefs. Although there is a range of literature discussing faith during end-of-life care, there is litte that outlines the practical specifics and for this reason some of the supporting literature in this article is dated and, where possible, this has been supported with contemporary sources.

Year, Location, and Variety Impact on Grape-, Soil-, and Leaf-Associated Fungal Microbiota of Arkansas-Grown Table Grapes

With the recent advancement of next-generation sequencing methods, there has been an increase in studies on identification of vineyard microbiota, winery-associated microbiota, and microbiota in wine fermentation. However, there have been few studies investigating the fungal microbiota of table grapes which present distinct spoilage and food safety challenges. The aims of this study were to identify and compare the impact of year, variety, and vineyard location on grape, leaf, and soil fungal communities of two varieties of table grapes, Faith and Gratitude, grown in two open-air vineyards and one high tunnel vineyard. The grape, leaf, and soil mycobiota were analyzed using high throughput amplicon sequencing of the ITS region. The sampling year and location of table grapes had an impact on grape, leaf, and soil mycobiota. Fungal diversity of grape, leaf, and soil was greater in 2017 than in 2016. Grape and leaf samples presented strong similarities in fungal communities with abundance of Sporidiobolaceae and Filobasidium in two vineyards and Cladosporium in another one. The high tunnel structure had distinct grape and leaf fungal communities compared to the two other vineyard locations. Mortierella was the predominant genus (27%) in soil samples for the three locations; however, genera of lower abundance varied between locations. These results provide extensive description of fungal communities in less-studied table grape vineyards and high tunnels, providing useful insight of potential threats and preventive strategies to help improve the production and marketability of table grapes.

Setting the global research agenda for community-based HIV service delivery through the faith sector

BACKGROUND

While leading AIDS organizations expect faith and health collaborations to play a crucial role in organizing and scaling up community-based HIV services, it is unclear how this can be realized. Little primary research has been conducted into which strategies for collaboration and service provision are most effective, efficient, scalable and sustainable. Seeking to align research with urgent needs, enhance coordination and increase the likelihood that results are used, this study aimed to set an inclusive global research agenda that reflects priority research questions from key stakeholders at the intersection of HIV healthcare and faith.

METHODS

In order to develop this global research agenda, we drew from document analyses, focus group discussions, interviews with purposively selected key informants from all continents (policy-makers, healthcare providers, faith leaders, academics and HIV activists), an online questionnaire, and expert meetings at several global conferences. We carried out focus group discussions and interviews with faith leaders in South Africa. Other stakeholder focus groups and interviews were carried out online or in person in France, Switzerland, the Netherlands and South Africa, and virtual questionnaires were distributed to stakeholders worldwide. Respondents were purposively sampled.

RESULTS

We interviewed 53 participants, and 110 stakeholders responded to the online questionnaire. The participants worked in 54 countries, with the majority having research experience (84%), experience with policy processes (73%) and/or experience as a healthcare provider (60%) and identifying as religious (79%). From interviews (N = 53) and questionnaires (N = 110), we identified 10 research themes: addressing sexuality, stigma, supporting specific populations, counselling and disclosure, agenda-setting, mobilizing and organizing funding, evaluating faith-health collaborations, advantage of faith initiatives, gender roles, and education. Respondents emphasized the need for more primary research and prioritized two themes: improving the engagement of faith communities in addressing sexuality and tackling stigma.

CONCLUSIONS

A wide range of respondents participated in developing the research agenda. To align research to the prioritized themes and ensure that results are used, it is essential to further engage key users, funders, researchers and other stakeholders, strengthen the capacity for locally embedded research and research uptake and contextualize priorities to diverse religious traditions, key populations and local circumstances.

Individuals' conceptions of COVID-19 pandemic through metaphor analysis

The main purpose of the current study is to investigate the perceptions of individuals' living in Turkey during the COVID-19 pandemic through metaphor analysis. The current study employed the descriptive phenomenological design, one of the qualitative research methods. A total of 210 individuals living in Turkey (114 females (68.6%) and 66 males (31.4%)) participated in the current study through an online questionnaire on a voluntary basis. As the data collection tool, the online questionnaire form developed by the researchers was used. The collected data were analyzed within the framework of five-stage metaphor analysis. As a result of the analysis, a total of seven metaphor categories called being restricted, restlessness, uncertainty/obscurity, deadly/dangerous, struggling, faith/destiny, and supernatural were obtained. These categories were subsumed under three themes called "anxiety/concern, risk, and faith".

[Fewer cancer diagnoses during the COVID-19 epidemic according to diagnosis, age and region]

De COVID-19-crisis en de intelligente lockdown hebben ertoe geleid dat het Nederlandse zorgsysteem maandenlang voor niet-COVID-patiënten op slot kwam te zitten. Patiënten durfden of konden niet naar hun huisarts, huisartsen waren terughoudend met doorverwijzingen naar het ziekenhuis en de zorg- en diagnostische processen werden vertraagd of aangepast. Dit gold ook voor kankerpatiënten. Hoe ernstig deze onderdiagnostiek is voor de prognose van de kankerpatiënt, hangt vooral af van kenmerken van de betreffende soorten kanker. In dit onderzoek hebben we de onderdiagnostiek in kaart gebracht met behulp van gegevens uit de Nederlandse Kankerregistratie en het Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief. Vanaf de week waarin de eerste COVID-19-patiënt in Nederland werd gediagnosticeerd, is een daling van 20–40% in het aantal kankerdiagnoses te zien. De daling geldt voor vrijwel alle tumorsoorten, ook voor kankers waarbij het niet tijdig stellen van de diagnose levensbedreigend is, zoals bij patiënten met kanker in de luchtwegen (gemiddeld 23%) en het hoofd-halsgebied (gemiddeld 36%), en bij hematologie (gemiddeld 26%). Er moet meer aandacht komen voor de gesignaleerde onderdiagnostiek en de rol van de eerstelijnszorgverleners, zoals huisartsen en tandartsen. Daarbij is het zeer belangrijk dat patiënten altijd het vertrouwen houden dat ze bij klachten hun zorgverlener kunnen raadplegen.

Religion and Faith Perception in a Pandemic of COVID-19

The COVID-19 pandemic has impacted religion and faith in different ways. Numerous restrictions have been implemented worldwide. Believers are in conflict with authorities' warnings that gatherings must be limited to combat the spread of the virus. Religion has always played a role of the balm for the soul, and the regular religious participation is associated with better emotional health outcomes. In our study, we examined whether the exposure to COVID-19 enhances the faith. The instrument used was a survey verifying the power of spirituality in the face of the coronavirus pandemic.

"Tenemos que ser la voz": Exploring Resilience among Latina/o Immigrant Families in the Context of Restrictive Immigration Policies and Practices

Research investigating associations between immigration policies and practices and indicators of mental health among Latina/o immigrant families has identified a number of risk factors for this population, such as family separation. The role of protective factors tied to the mental health of Latina/o immigrants, however, often has been neglected. This study explored internal and external sources of resilience that may protect Latina/o immigrant families against the potentially negative effects of restrictive immigration policies and practices on psychological well-being. Six focus groups (N = 50) were conducted with Latina/o immigrant parents of varying residency statuses (i.e., undocumented, permanent residents, Temporary Protected Status beneficiaries, and U.S. citizens). Data were analyzed using thematic analysis. Three themes were identified: Social Support, Faith, and Civic Commitment and Action. Across groups, Latina/o parents referenced family, peer, and community support, as well as their spiritual faith and involvement in advocacy efforts as coping mechanisms. Overall, results suggest that Latina/o immigrant parents of varying residency statuses rely on both internal and external sources of resilience to protect themselves and their families when navigating restrictive immigration policies and practices. This research is particularly timely in light of the increasingly restrictive nature of immigration policies in the U.S. and the growing literature on the influence these may have on immigrant wellbeing. Intervention efforts should build upon existing strengths, such as providing opportunities for Latina/o immigrant families to participate in political activism.

Faith-based alcohol treatment in England and Wales: New evidence for policy and practice

While the historical importance of religion in alcohol treatment is well known, the size, scope and significance of contemporary activities remain unclear. Here we begin to address this gap in knowledge by presenting results from a mixed methods study of faith-based alcohol treatment in England and Wales. The paper begins by mapping location, religious affiliation, organisational structure and service provision. We then discuss evidence regarding challenges, opportunities and tensions bound up with faith-based organisations 'filling gaps' left by long term restructuring of alcohol service provision, recent 'austerity' funding cuts and relationships between secular and faith-based organisations. In the final substantive section, we engage with questions of ethics and care by focusing on the internal workings of a subset of faith-based programs that make requirements for religious participation. Drawing on the variegated experiences of service-users, we reflect on the ethics of religious conversion in faith-based alcohol treatment. The conclusion offers policy and practice relevant insights and outlines areas for future research on religion, austerity, and alcohol treatment.

Engaging with faith groups to prevent VAWG in conflict-affected communities: results from two community surveys in the DRC

Background

An evaluation was conducted of a three-year intervention focused on violence against women and girls (VAWG) and implemented in the conflict-affected north-east of the Democratic Republic of Congo (DRC), a country with high rates of VAWG. The intervention addressed VAWG, and especially sexual violence, by specifically engaging with communities of faith and their leaders.

Methods

Two community surveys were conducted, one before and one after the intervention, in three health areas in Ituri Province in the DRC. At both baseline and endline, data was collected from male and female members of randomly selected households in 15 villages (five per health area) in which the intervention was being implemented. At baseline the sample comprised 751 respondents (387 women, 364 men) and at endline 1198 respondents (601 women, 597 men). Questionnaires were interviewer-administered, with sensitive questions related to experience or perpetration of violence self-completed by participants.

Results

The study showed significantly more equitable gender attitudes and less tolerance for IPV at endline. Positive attitude change was not limited to those actively engaged within faith communities, with a positive shift across the entire community in terms of gender attitudes, rape myths and rape stigma scores, regardless of level of faith engagement. There was a significant decline in all aspects of IPV in the communities who experienced the intervention. While the experience and perpetration of IPV reported at endline did not track with exposure to the intervention, it is plausible that in a context where social norm change was sought, the impact of the intervention on those exposed could have had an impact on the behaviour of the unexposed.

Conclusion

This intervention was premised on the assumption that faith leaders and faith communities are a key entry point into an entire community, able to influence an entire community. Research has affirmed this assumption and engaging with faith leaders and faith communities can thus be a strategic intervention strategy. While we are confident of the link between the social norms change and faith engagement and project exposure, the link between IPV reduction and faith engagement and project exposure needs more research.

Help-seeking, trust and intimate partner violence: social connections amongst displaced and non-displaced Yezidi women and men in the Kurdistan region of northern Iraq

Background

Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capital that shapes patterns of help-seeking in these circumstances - especially with stigmatised issues such as violence against women (VAW) and intimate partner violence (IPV).

Methods

A novel social mapping methodology was adopted amongst a Yezidi population displaced by ISIS (ISIS: Islamic State of Iraq and Syria, locally known as Da’esh) occupation and a neighbouring settled Yezidi population in the Kurdistan region of northern Iraq in late 2016. Six participatory workshops were conducted to identify available resources with respect to: meeting basic needs, dispute resolution and VAW. Subsequently, 51 individual interviews were conducted (segmented by gender and settlement status) to identify connectedness to, and trust in, the resources identified, with a focus on IPV against women.

Results

90% of participants reported God as a key source of help in the previous 6 months, representing the most widely cited resource. Following God, the most accessed and trusted resources were family and community, with NGO (non-governmental organisation) provision being the least. Women drew more strongly upon familial resources than men (Χ² = 5.73, df = 1, p = 0.017). There was reduced trust in resources in relation to seeking help with IPV. A distinction between trust to provide emotional support and trust to resolve issues was identified. Settled women were 1.6 times more likely to trust community members and government services and 3.7 times more likely to trust NGOs than displaced women.

Conclusions

Mapping social connections and trust provides valuable insight into the social capital available to support help-seeking in populations of humanitarian concern. For these Yezidi populations, family, religious and community resources were the most widely utilised and trusted. Trust was mostly reserved for family and their main religious leader regarding IPV against women. Lack of trust appeared to be a major barrier to stronger engagement with available NGO provision, particularly amongst displaced women. The role of faith and religious resources for this population is clearly significant, and warrants an explicitly faith-sensitive approach to humanitarian assistance.

Led by the Holy Spirit

The vocational call to being a physician has been one of the greatest honors and blessings of my life. As a Catholic physician, being a direct extension of the healing hands of our Lord is something this is not easily translated into words. I reflect on two cases that remind me of this great calling.

Religion, Health, and Life Satisfaction: Evidence from Australia

In this article, we examine the influence of religion on health and life satisfaction while controlling for an extensive range of demographic characteristics and life conditions-marital satisfaction, job satisfaction, financial stress, and social resources-using data drawn from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Our findings suggest that, on average, high levels of faith and attendance at religious services are associated with lower health. In contrast, however, we find no relationship between high levels of faith, attendance, and life satisfaction. Further research is required to unravel how faith and attendance influence health and life satisfaction.

An Exploration of the Relationship Between Spirituality, Religion and Mental Health Among Youth Who Identify as LGBT+: A Systematic Literature Review

There is a growing interest in addressing spirituality in health care with evidence emerging that personal spiritual and religious practices, and support of these, can influence mental health in a positive way. However, there can be distinct challenges to spiritual expression and mental health issues for youth who identify as LGBT+. The goal of this paper was to undertake a systematic review of the available evidence to investigate the relationship between mental health, spirituality and religion as experienced by LGBT+ youth. A comprehensive literature search was conducted using medical and psychological databases that focused on spirituality, mental health and LGBT+ youth. The search yielded a total of ten articles published in English between May 2008 and June 2018. The key findings highlighted issues around discriminatory attitudes, shame related to disclosure, spirituality as a supportive resource, internalised conflict and external factors around sexual orientation concerns. The psychological, social and health implications are presented and discussed.

Faith Maturity and Mental Well-Being: A Longitudinal Study of Indian American Followers of a Guru Tradition

This article is based on a longitudinal study of Indian Americans devoted to a guru tradition, aiming to explore how faith contributes to their mental well-being. Respondent sample size at phase 1 (2003-2004) was 1872 and at phase 2 (2013-2014) was 1764. Two scales were used to measure faith maturity and well-being. Results showed that phase 2 well-being scores of the devotees were higher, influenced by faith maturity and engagement regularity, thereby corroborating the faith-religiosity-well-being link, further reinforced by the structural equation model. Faith emerges as critical variable in working with this cohort and planning interventions towards promoting their well-being.

No Strings Attached: Faith Divested of Reciprocity

A mature faith, as exemplified by David, confirmed by Jesus, and explained by Gerkin, is one that is not contingent on a preferred outcome: there is no positive or negative reciprocal altruism with God. God does not reward good behavior nor does God punish poor behavior. A mature faith is not one that expects the present to continue into the future, but one that trusts God's contingent providence in the future.

Love with No Exceptions: A Statewide Faith-Based, University-Community Partnership for Faith-Based HIV Training and Assessment of Needs in the Deep South

This project established a faith-based, university-community partnership with the African Methodist Episcopal (AME) church in Alabama to develop a statewide training model to address HIV knowledge and stigma, promote discussion and generate action plans to address HIV in the Deep South. A community-engaged research team consisting of church leadership and university researchers developed and implemented the model, "Love with No Exceptions." Mixed methods were used to evaluate the model delivered in 3-h sessions in five state regions (N = 146 clergy and laity). The majority of participants reported feeling better prepared to serve those living with or affected by HIV and would implement education and awareness activities in their churches. Participants' HIV knowledge increased from pre- to post-training. Stigma-related attitudes showed minor changes from baseline. These results reflect that partnerships between academic institutions and churches can deliver promising steps towards impactful HIV education in the Deep South.

Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse

This study reviews the voluminous empirical evidence on faith's contribution to preventing people from falling victim to substance abuse and helping them recover from it. We find that 73% of addiction treatment programs in the USA include a spirituality-based element, as embodied in the 12-step programs and fellowships initially popularized by Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher Power to stay sober. We introduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups. This typology provides important background as we then move on to make an economic valuation of nearly 130,000 congregation-based substance abuse recovery support programs in the USA. We find that these faith-based volunteer support groups contribute up to $316.6 billion in savings to the US economy every year at no cost to tax payers. While negative experiences with religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor to substance abuse among some victims, given that more than 84% of scientific studies show that faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse prevention and recovery is indisputable. And, by extension, we also conclude that the decline in religious affiliation in the USA is not only a concern for religious organizations but constitutes a national health concern.

Role of religion, spirituality, and faith in assisted reproduction

Purpose: The purpose of this study is to evaluate the impact of the patient's faith, religion, and spirituality on the outcomes of intracytoplasmic sperm injection (ICSI) cycles. Materials and methods: Eight hundred and seventy-seven patients received a questionnaire containing information on faith, religiosity, and spirituality and the results of the questionnaires were correlated with ICSI outcomes. Patients stated to be Catholic (n = 476), spiritists (n = 93), Evangelical (n = 118), and other religion (n = 32), and 78 did not identify with any religious group. Results: A significant increase in fertilization, high-quality embryos, and pregnancy rate was found among Spiritists and Evangelicals. Patients who included the infertility diagnosis and treatment in their prayers showed an increased pregnancy rate, and those who reported their faith to be affected by the infertility diagnosis presented a decreased high-quality embryos rate. The high-quality embryos rate was increased among patients who answered that their faith contributed to their decision to undergo infertility treatment. The cycle's cancelation was negatively correlated with the frequency of religious meetings, and the frequency of prayers was positively correlated with the response to ovarian stimulation. Finally, belief in treatment success positively influenced the embryo quality. Conclusion: The findings suggest that spirituality plays a role in adjusting the psychological aspects of an infertile patient.

Physical Activity of Arab Muslim Mothers of Young Children Living in the United States: Barriers and Influences

Objectives

To examine physical activity (PA) levels, and how sociocultural factors, acculturation, self-efficacy and religion influence PA levels of Arab Muslim mothers of young children living in the United States.

Participants and Setting

Arab Muslim mothers of young children (aged <5 years) living in the United States (N=447).

Variables Measured

PA levels, sociocultural and religious barriers to PA, self-efficacy, strength of religious faith, and acculturation.

Results

Barriers to PA included dress code and negative perception of women who engaged in PA, lack of motivation and stress, and responsibilities. Barriers and self-efficacy significantly influenced PA levels (P<.001) but strength of religious faith and acculturation did not.

Conclusions

Confirmation of the relations among self-efficacy, barriers and PA levels among Arab Muslim mothers of young children in the United States may help professionals tailor culturally sensitive interventions to combat obesity and other chronic diseases among this growing population.