Chaplaincy, Clergy, Prayer, Cancer and Measuring Religion and Health.

This third issue of JORH for 2023 revisits a number of themes previously highlighted in JORH, along with the addition of two new themes. Since JORH's first special issue on 'Chaplaincy' (JORH, 2022, 61:2), this area of research within JORH has now flourished, with a total of three JORH issues now incorporating the allied health discipline of chaplaincy. Two new article collections in this JORH issue relate to clergy 'faith leaders' and research related to 'prayer.' This issue also revisits the topic of cancer-a recurrent focus within JORH which has, over the past six decades, examined nearly every type of known cancer in the context of religion/spirituality. Finally, JORH collates once again, a number of articles relating to the empirical measurement of religion and health-an increasingly important area of research.

A Bibliometric Analysis of the Journal of Religion and Health: Sixty Years of Publication (1961-2021).

In 1961, the Journal of Religion and Health (JORH) commenced publishing articles that examined modern religious and spiritual philosophy in relation to psychology and health. The year 2021 marked the 60th anniversary of the founding of JORH. This research paper retrospectively analyses the journal's content. It provides insight into JORH's publication trends, citation records, prominent themes, authors' collaboration and its aggregate contribution to the field of religion and health. Over time, the number of publications, citations and downloads of JORH articles have substantially increased, as has the journals prominence and diverse contributions to the study of religion, spirituality and health.

Atención de las necesidades espirituales y religiosas de pacientes por personal de salud: un modelo basado en el acompañamiento espiritual / Attention to the spiritual and religious needs of patients by health personnel: a model based on spiritual accompaniment

Resumen Los aspectos espirituales y religiosos han retomado su importancia en la atención de salud, en la búsqueda de una atención integral, digna y más humana, teniendo en cuenta además, los múltiples beneficios clínicos asociados. Sin embargo, el cuidado de las necesidades espirituales y religiosas, históricamente asumidas por capellanes religiosos y guías espirituales, actualmente, en forma paulatina, son considerados parte de las obligaciones de los equipos de salud, no sin la reticencia de los mismos y sin una manera clara de cómo hacerlo. El objetivo del presente trabajo es presentar la importancia de la atención de las necesidades espirituales y religiosas en el cuidado de salud y un modelo de atención basado en el acompañamiento espiritual.

In the search for comprehensive, dignified and more humane care, the spiritual and religious aspects have regained their importance in health care. Furthermore, the múltiple associated clinical benefits must also be taken into account. However, the care of spiritual and religious needs, historically undertaken by religious chaplains and spiritual guides, have gradually become considered part of the obligations of the health teams, in spite of their reluctance and without a clear way on how to do it. The objective of this work is to present the importance of attending to the spiritual and religious needs in health care and a care model based on spiritual accompaniment.

Meanings of "the existential" in a Secular Country: A Survey Study.

"The existential" is a concept that many people use albeit associated with different meanings. In order to increase research-based insight into the meaning of "the existential," we conducted a questionnaire study in Denmark in 2018 in which we asked 1.106 Danes of various age, gender, educational and geographical background about personal associations linked to "the existential." Factor analysis of the answers resulted in three different groups of meaning: (1) essential meanings of life, (2) spirituality/religiosity and (3) existential thinking. The findings show that "the existential" serves well as an overarching construct potentially including secular, spiritual and religious meaning domains, at least within the European context.

Structural Dialectic Model of Care: A Guide to Beliefs, Scenarios and Social Actors Analysis in Nursing Research.

The structural dialectic model of care provides a data analysis method that facilitates the identification of beliefs and structural and functional characteristics. To demonstrate the relevance of the structural dialectic model of care for data analysis integrating beliefs, scenarios and social actors. The characteristics and functions of the model are described and explained through an analysis of its application in fifteen doctoral theses (2009-2017). This model has three structures, the functional unit (beliefs), the functional element (social agents), and the functional framework (scenarios). The Structural Dialectic Model of Care constitutes a useful methodological tool for studies of nursing, organizing analysis of the data according to the dynamic and dialectical nature of their structures.

Physical health conditions of the Amish and intervening social mechanisms: an exhaustive narrative review.

As an ethnic religion, the Amish are of interest to population health researchers due to a distinctive health profile arising from ethnic attributes, including a closed genetic pool and shared culture that shapes lifestyle practices. Amish-focused health research both furthers our knowledge of health conditions by comparing Amish with non-Amish and assists health practitioners in serving this rapidly growing population. Amish health research, now representing approximately a quarter of all Amish-focused publications, is in need of review, to the end of strengthening this knowledge body's coherence, clarifying research directions, and identifying knowledge gaps, lapses, and stagnations. Herein, we synthesize and discuss Amish physical health conditions research, both the population's distinctive health profile and mechanisms shaping this profile. Specifically, we summarize research addressing BMI, physical activity, and body image; diet and supplements; cancer; cardiovascular conditions; communicable diseases; immunity; sleep; genetic disorders; tobacco and alcohol use; periodontal conditions; traumatic injuries; natural treatments for burns; fertility; and sexually transmitted diseases. In reflection, we raise questions about the nature of intervening mechanisms shaping the Amish health profile, the strange omission of several common independent variables commonly used when studying other ethnic groups' health, several recurring methodological complications, and public health policy considerations.

The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description.

Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!

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.

Egg intake moderates the rate of memory decline in healthy older adults.

Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (<23 g/week, about half an egg), Intermediate (24-63 g/week, half to 1½ eggs) and High (≥63 g/week, about two or more eggs) tertiles. Participants were administered the California Verbal Learning Test - 2nd Edition (CVLT-II) Short Form in 2006-2007, and 294 of them were again tested in 2010-2011. Using linear mixed model analysis, no significant cross-sectional differences were observed in CVLT-II performance between egg intake levels after controlling for age, sex, race, education, body mass index, cardiovascular risk, depression and intake of meat, fish, dairy and fruits/vegetables. Longitudinally, the Intermediate egg group exhibited significantly slower rates of decline on the CVLT-II compared to the Low egg group. The High egg group also exhibited slower rates of decline, but not statistically significant. Thus, limited consumption of eggs (about 1 egg/week) was associated with slower memory decline in late life compared to consuming little to no eggs, but a dose-response effect was not clearly evident. This study may help explain discrepancies in previous research that did not control for other dietary intakes and risk factors.

The Amish health culture and culturally sensitive health services: An exhaustive narrative review.

As the Amish population is growing, researcher and practitioner interest in the Amish health culture is also growing. This is largely due to demand from practitioners for population-specific cultural guidance. Once a small area of study, health-themed publications in Amish studies (n = 246) now account for approximately one-fourth of all peer-reviewed publications, and a sizeable percentage address the health culture, i.e. Amish beliefs, practices, attitudes, decision-making processes, financing, and values. In this article, we provide a first-ever exhaustive narrative review of the Amish health culture literature (addressing Amish health conditions elsewhere). Specifically, we address Amish use of modern medicine, complementary & alternative medicine, cultural norms for birthing and intercourse, support and care for the sick and aged, health knowledge, payment for services, barriers to service access, service provider effectiveness, health programming, and ethical conflicts. Our goal is to organize the literature, synthesize findings, identify orienting perspectives, and clarify research questions and directions. Following our synthesis, we reflect on the current state of Amish health culture research, drawing particular attention to strengths and limitations of the oft-used cultural competency paradigm, and recommending more rigorous social scientific theorization of the Amish health culture.

An Exploration of U.S. Southern Faith Leaders' Perspectives of HIV Prevention, Sexuality, and Sexual Health Teachings.

Reducing human immunodeficiency viruses (HIV) and acquired immune deficiency syndrome (AIDS) racial/ethnic disparities in the Deep South has been a critical objective of the U.S. National HIV/AIDS Strategy. This finding, originally published in 2010 by the Office of National AIDS Policy, serves as a complement to the Health and Human Resources and Services Administration's Ending the HIV Epidemic (EtHE): A Plan for America. The EtHE plan, released in 2019, emphasizes community stakeholder involvement to achieve the planning goals of decreasing new HIV infections in key U.S. geographic areas. According to the plan, an important stakeholder is faith leaders, especially around stigma reduction. This paper focuses on a community-academic research partnership's exploration of southern Black faith leaders' teaching perspectives regarding HIV prevention, sexuality, and sexual health in predominantly Black congregations in Memphis, Tennessee. The partnership conducted four focus groups using a semi-structured discussion interview. Any adult faith leader involved in ministry work in a predominantly Black church was eligible to participate in the discussion. A total of 26 faith leaders with a mean age of 54, representing four Christian denominations, consented to participate in the study. Emerging themes included: (1) restriction of scripture to teach prevention and address sexuality, (2) role of secrecy and silence in living with HIV, and (3) impact of the stigma of HIV and sexuality. Findings may inform nationwide jurisdictional implementation plans, particularly for faith-based interventions in southern churches working toward ending the HIV epidemic.

Celebrating Sabbath as a Holistic Health Practice: The Transformative Power of a Sanctuary in Time.

Sabbath-keeping has several holistic health benefits when done for intrinsic reasons. Most research on Sabbath-keeping is about individuals where Sabbath-keeping is customary. This organic inquiry describes how a Sabbath promoted transformation for ten women where Sabbath-keeping was not the norm. Six themes emerged: Sabbath-keeping enhanced self-awareness, improved self-care, enriched relationships, developed spirituality, positively affected the rest of a Sabbath-keeper's week, and Sabbath-keeping practices and philosophies also evolved over time. The author argues that reviving the best parts of Sabbath-keeping is an effective, accessible, holistic practice that can contribute to the well-being of individuals, communities, and the earth.

Health beliefs and behaviours of families towards the health needs of children with intellectual and developmental disabilities (IDD) in Accra, Ghana.

BACKGROUND: This paper explored the health beliefs and behaviours of families towards the health needs of children with intellectual and developmental disabilities (IDD) in Accra, Ghana. The aim was to inform health promotion strategies for the children and their families. METHOD: Twenty-two parents of children with IDD participated in this study. Semi-structured interviews were the primary means of data collection. The interviews were analysed using constant comparison. RESULTS: The signs that alerted the parents that the children might be ill included high temperature, vomiting and excessive sleep. The parents explained that some children expressed feelings of ill-health through verbal or non-verbal communication. Most of the parents self-prescribed medication for the children or waited for symptoms to persist for a while before accessing health care because they experienced difficulties managing the behavioural challenges associated with the IDD of the children in public and attitudinal barriers when accessing health care. The parents did not often patronise health facilities in their neighbourhoods due to private health insurance requirements for accessing care at designated facilities, poor confidence in neighbourhood facilities and long-term established relationships with facilities elsewhere. Further, many parents did not patronise religious interventions for the children. However, some parents explained that in addition to seeking medical care to address the physical symptoms of the children's disabilities and/or illnesses, they sought religious interventions because they believed that there could be a spiritual dimension to the situation. CONCLUSION: The findings highlight key areas to address in health promotion for children with IDD and their families in Accra, Ghana.

Reducing Muslim Mammography Disparities: Outcomes From a Religiously Tailored Mosque-Based Intervention.

OBJECTIVE: To describe the design of, and participant-level outcomes related to, a religiously tailored, peer-led group education program aimed at enhancing Muslim women's mammography intention. METHOD: Using a community-engaged approach and mixed methods, we identified and addressed barrier beliefs impeding mammography screening among Muslim American women. Our religiously tailored, mosque-based, peer-led intervention involved facilitated discussions and expert-led didactics conveying health-related religious teachings, and information about the benefits and process of mammography. Barrier beliefs were addressed through reframing, reprioritizing, or reforming such beliefs. Participant surveys were collected preintervention, postintervention, 6 months postintervention, and 1 year postintervention. These measured changes in mammography intention, likelihood, confidence, and resonance with barrier and facilitator beliefs. RESULTS: A total of 58 Muslim women (mean age = 50 years) that had not had a mammogram in the past 2 years participated in the two-session program. Self-reported likelihood of obtaining a mammogram increased significantly ( p = .01) and coincided with a positive trend in confidence ( p = .08). Individuals with higher agreement with barrier beliefs preintervention had lower odds for positive change in likelihood (odds ratio = 0.80, p = .03), while those who were married had higher odds for positive change in likelihood (odds ratio = 37.69, p = .02). At 1-year follow-up, 22 participants had obtained a mammogram. CONCLUSION: Our pilot mosque-based intervention demonstrated efficacy in improving Muslim women's self-reported likelihood of obtaining mammograms, and increased their mammography utilization, with nearly 40% obtaining a mammogram within 12 months of the intervention. IMPACT: Our conceptual model for religiously tailoring messages, along with its implementation curriculum, proved effective in enhancing the likelihood and receipt of mammograms among Muslim American women. Accordingly, our work advances both the theory and practice of faith-based interventions and provides a model for addressing Muslim women's cancer screening disparities.

Developing religiously-tailored health messages for behavioral change: Introducing the reframe, reprioritize, and reform ("3R") model.

RATIONALE: As community health interventions advance from being faith-placed to authentically faith-based, greater discussion is needed about the theory, practice, and ethics of delivering health messages embedded within a religious worldview. While there is much potential to leverage religion to promote health behaviors and improve health outcomes, there is also a risk of co-opting religious teachings for strictly biomedical ends. OBJECTIVE: To describe the development, implementation, and ethical dimensions of a conceptual model for religiously-tailoring health messages. METHOD: We used data from 6 focus groups and 19 interviews with women aged 40 and older sampled from diverse Muslim community organizations to map out how religious beliefs and values impact mammography-related behavioral, normative and control beliefs. These beliefs were further grouped into those that enhance mammography intention (facilitators) and those that impede intention (barriers). In concert with a multi-disciplinary advisory board, and by drawing upon leading theories of health behavior change, we developed the "3R" model for crafting religiously-tailored health messages. RESULTS: The 3R model addresses barrier beliefs, which are beliefs that negatively impact adopting a health behavior, by (i) reframing the belief within a relevant religious worldview, (ii) reprioritizing the belief by introducing another religious belief that has greater resonance with participants, and (iii) reforming the belief by uncovering logical flaws and/or theological misinterpretations. These approaches were used to create messages for a peer-led, mosque-based, educational intervention designed to improve mammography intention among Muslim women. CONCLUSIONS: There are benefits and potential ethical challenges to using religiously tailored messages to promote health behaviors. Our theoretically driven 3R model aids interventionists in crafting messages that address beliefs that hinder healthy behaviors. It is particularly useful in the context of faith-based interventions for it highlights the ethical choices that must be made when incorporating religious values and beliefs in tailored messages.

Acceptability of Friday Sermons as a Modality for Health Promotion and Education.

Our objective was to assess the acceptability and feasibility of using sermons for health promotion in American Muslim mosque communities by deploying a tailored sermon in two mosque communities. With input from a community advisory board and resident imams, sermons communicated four health-related themes: (i) good health is a grant from Allah, (ii) one's body is trust and must be cared for, (iii) trusting in God's plan does not preclude taking actions to care for oneself, and (iv) community members are caretakers of one another. Self-administered, post-sermon questionnaires asked attendees about the acceptability of the sermon and the sermon-giver, and to identify survey themes. Data analyses involved descriptive statistics and regression modeling to assess variance in acceptability across race/ethnicity and gender. Of the 235 respondents, the majority found the sermon content acceptable and desired to hear health-based sermons more often (72 and 67% respectively). There were no significant differences in acceptability of sermon or sermon-giver by gender or race/ethnicity. Our study demonstrates that theologically-framed health messaging is acceptable within sermons in American Muslim mosque communities. This study underscores the potential utility of mosque sermons for health education programs and for health behavior interventions in American mosques.

Tuskegee as Sacred Rhetoric: Focal Point for the Emergent Field of African American Religion and Health.

Scholars in African American religion engage the Tuskegee Syphilis Study as the focal point of the African American experience in institutional medicine. Seeking a way forward from this history and its intentional evil, the author proposes to position Tuskegee as a form of Lynch's culturally contextual sacred rhetoric to make use of its metaphoric value in the emerging field of African American religion and health. In this broader meaning-making frame, Tuskegee serves as a reminder that African American religious sensibility has long been an agential resource that counters abuse of the Black body. It also acknowledges the complex decisions facing African American clinical trial participants.

Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea.

In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers' recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers.

"Wearing My Spiritual Jacket": The Role of Spirituality as a Coping Mechanism Among African American Youth.

There is growing evidence in the theoretical literature regarding the importance of religion and religiosity in people's lives, particularly concerning their health and well-being. Spirituality, a related but different concept, has been less well studied, especially empirically, but shows promise as a mechanism for coping with deleterious social and health circumstances. This article details a qualitative exploration of the role of spiritual coping in the lives of urban African American youth. Data were gathered through in-depth, semistructured interviews with 20 African American youth, ages 12 to 20 years. The findings indicate that urban African American youth have multifaceted dimensions of their spirituality, including the role of prayer in their lives, an unwavering faith in a higher power, and the importance of giving back to their communities. Such findings offer counterstories, generated through ethnographic research, to the dominant discourses regarding urban African American youth. Ultimately, this study's findings have implications for research and practice related to the mechanisms of both ill-health and wellness among youth.

The Types of Trust Involved in American Muslim Healthcare Decisions: An Exploratory Qualitative Study.

Trust in physicians and the healthcare system underlies some disparities noted among minority populations, yet a descriptive typology of different types of trust informing healthcare decisions among minority populations is limited. Using data from 13 focus groups with 102 American Muslims, we identified the types and influence of trust in healthcare decision-making. Participants conveyed four types of trust implicating their health-seeking behaviors-(I) trust in allopathic medicine, (II) trust in God, (III) trust in personal relationships, and (IV) trust in self. Healthcare disparity research can benefit from assessing how these types of trust are associated with health outcomes among minority populations so as to inform intervention programs that seek to enhance trust as a means to improve community health.