Initial Validation and Findings From the Willing/Ready Subscale of the Church Addiction Response Scale.

Addiction has been a global health crisis over recent decades and worsened substantially during COVID-19 lockdowns. We report on the development, validation, and findings from an instrument developed to assess the readiness of churches in the Appalachian Highlands to address addiction. The Church Addiction Response Scale (CARS) is a 41-item, three section measure assessing "What are your views about addiction?" (14 items), "What are your views about interacting with people who are addicted to drugs?" (11 items), and "What do you think the church's role is in addressing addiction?" (16 items). The CARS was found to be unidimensional with strong internal consistency and initial evidence of construct validity was positive. Most respondents reported willingness to assist people living with addiction, but many reported that they felt underprepared, thus were not ready. Areas of preparation were largely those that could be addressed through training, such as understanding the physiology and psychology of addiction, available treatment options, and how to avoid doing harm. Thus, with adequate training, the likelihood of equipping a church-based workforce to provide support for people living with addiction seems attainable.

Using Trauma Informed Principles in Health Communication: Improving Faith/Science/Clinical Collaboration to Address Addiction.

Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration's (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.

Creating a Communitywide System of Trauma-Informed Care.

The past few decades of research support both the impact of trauma (e.g., abuse, neglect, violence) particularly in childhood, and the ability to lessen its effects through the implementation of trauma-informed care (TIC). We have successfully developed a communitywide system of TIC enhancing collaboration and common language across sectors and organizations within sectors. The collaboration involved more than 100 individuals from more than 45 organizations including healthcare, education, children's services, the faith community, behavioral health providers, criminal justice, law enforcement, private businesses, and others. The process for developing a system of care has been evaluated through community surveys and focus groups, verifying its ability to increase understanding and implementation of TIC principles, replication in a nearby city, and the development of an instructional toolkit to aid other communities in creating such systems of care.

Prenatal substance use: Religious women report lower use rates, but do they use less?

An inverse relationship exists between self-reported religiousness and substance use. However, we question whether religious culture impacts the veracity of self-reported substance use. The primary aim of this study of low-income pregnant women in South Central Appalachia was to determine the accuracy of self-reported substance use in pregnant women as well as to determine whether there were differences in use rates and/or differences in the degree to which women would accurately report substance use depending on their religiousness. Self-reported use and toxicology screening results taken from a larger prospective, longitudinal, smoking cessation study were compared for five substances (cannabinoids [marijuana or other cannabinoids], benz/barb/sed [including benzodiazepines, barbiturates, or any sedative], opioids [including heroin, methadone or other medication-assisted treatment medications, or other opiates], crack/cocaine [crack or cocaine], and meth/amph [including methamphetamine or any other amphetamine]). Women who attend church frequently reported lower rates of substance use than infrequent or nonattenders, as did women who rated themselves as high in intrinsic religiosity (IR), although the difference between high and low groups is less extreme for IR as opposed to attendance. Women who attended church frequently were far less likely to report use or to have use confirmed than any of the other groups including those high in IR. Rates of positive toxicology screens did not differ statistically across religiousness groupings, but the pattern of proportionally fewer positive toxicology results was seen in frequent attenders but not in women self-reporting as high IR. Women's tendency to underreport substance use was unrelated to religiousness variables, indicating underreporting is not necessarily driving this difference in reported substance use.

Effect of Psychoacoustic Learning on Cardiac Auscultation Proficiency in Nurse Practitioner Students.

BACKGROUND: Assessment is a vital role of all nurses, yet cardiac murmur identification remains difficult for students. Cardiac auscultation is a technical, not intellectual, skill, and a psychoacoustic approach to learning is recommended. A psychoacoustic approach involves repetition of cardiac sounds to facilitate auditory perceptual learning. PURPOSE: The purpose of this study was to determine the effectiveness of a psychoacoustic learning modality for identification of cardiac murmurs by nurse practitioner (NP) students. METHODS: A repeated-measures design was used. Following a pretest, NP students listened to repetitions of heart sounds, then took a posttest. Students were instructed to listen to the heart sounds weekly, then given posttests at 1 and 3 months. RESULTS: All posttest scores were higher than pretest scores; no significant difference in scores was noted between posttests. CONCLUSIONS: Psychoacoustic learning may improve cardiac assessment. Further research is recommended with prelicensure nursing and NP students.

Assessing Religious Commitment and Satisfaction: The Religious Surrender and Attendance Satisfaction Scale.

Survey instruments have been developed to measure whether someone claims to be religious but do not address the degree to which someone is satisfied with their religious commitment. The Religious Surrender and Attendance Satisfaction Scale (RSASS) was revised to measure both a person's level of religious commitment and satisfaction with level of religious commitment. This study was conducted to determine initial validity for the satisfaction portion of the RSASS. Construct validity measures provided initial confirmation of the utility of RSASS as a measure of satisfaction with religious commitment, that can be used by nurses in practice and research.

The Relationship Between Religiosity and Health-Promoting Behaviors in Pregnant Women.

Pender's health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they "sometimes" or "often" engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did not attend classes. In separate multiple linear regressions, organized, non-organized, and intrinsic religiosity and satisfaction with surrender to God explained additional variance in health-promoting behaviors above and beyond what Hispanic ethnicity and attending classes at the PRCs explained in pregnant women at PRCs.

RSAS-3: validation of a very brief measure of Religious Commitment for use in health research.

Religious Commitment is a construct known to be predictive of various health-related factors of importance to researchers. However, data collection efficiency and instrument brevity in healthcare settings are priorities regardless of the construct being measured. Brief, valid instruments are particularly valuable in health research and will be vital for testing mechanisms by which health may be improved or maintained. This series of studies aims to demonstrate that Religious Commitment can be validly measured with a very brief instrument, the Religious Surrender & Attendance Scale-3 (RSAS-3), which combines a 2-item measure of Surrender, a specific type of religious coping, with a 1-item measure of Attendance at religious services. Three studies are reported, two utilizing undergraduate university students (Ns = 964 and 466) and one utilizing a clinical-based pregnant population (N = 320), all in southern Appalachia. The original 12-item Surrender Scale, a 2-item subset of Surrender items, and Attendance were found to be highly positively correlated with each other and with Intrinsic Religiosity, an additional measure of Religious Commitment employed to demonstrate concurrent validity. Religiosity variables were found to be strongly negatively correlated with Anxiety and stress, which were the health outcomes of interest. Hierarchical multiple regression analysis was used to confirm the similarity of Anxiety and stress prediction using the 12-item and 2-item Surrender measures and to confirm the superior stress prediction of the 3-item instrument RSAS-3. The RSAS-3 is recommended as a measure of Religious Commitment in future health research.