Identifying Variation in Physical Health Behaviors and Depressive Symptoms among Religiosity Clusters of African American Adults in the United States.

Religiosity is an important factor in the lives of many African Americans, who suffer a greater health burden than their White counterparts. In this study, we examined associations between dimensions of religiosity with health behaviors and depressive symptoms in a sample of African American adults in the United States. Participants (N = 2086) completed five measures of religiosity (religious involvement, positive and negative religious coping, scriptural influence, belief in illness as punishment for sin) and measures of several health behaviors, cancer screening behaviors, and depressive symptoms. Using cluster analysis to examine the deep structure of religiosity, three clusters emerged: Positive Religious, Negative Religious, and Low Religious. In general, the Positive Religious group engaged in more healthy behaviors (e.g., fruit and vegetable consumption, fecal occult blood test) and fewer risky health behaviors (e.g., smoke and consume alcohol), and reported fewer depressive symptoms than did the Negative Religious and/or Low Religious groups. Theoretical implications and implications for interventions by clergy and mental health professionals are discussed.

A longitudinal study of social, religious, and spiritual capital and physical and emotional functioning in a national sample of African-Americans.

The present study builds on prior research by examining the moderating relationships between different types of capital on physical functioning, emotional functioning, and depressive symptoms using a 2.5-year longitudinal design with a national sample of African-American adults. Results indicated a significant T1 social capital × T1 religious capital interaction such that among low T1 religious capital participants, those with high T1 social capital had lower T2 physical functioning than those with lower T1 social capital. There was also a marginally significant T1 social capital × T1 spiritual capital interaction suggesting that among low T1 spiritual capital participants, those with higher T1 social capital reported a decline in depressive symptoms compared to those with lower T1 social capital. Future research and implications for intervention and policy development are discussed.

A longitudinal examination of social support as a mediator of the personality-health relationship in a national sample of African Americans.

The present study investigates whether social support mediates the relationship between personality traits and health among African Americans over a five-year period, filling a gap in the literature on longitudinal tests of the personality-health association. Data were collected from a national probability sample of African American adults (N = 200). Personality was assessed at Time 1 (T1), social support was assessed 2.5 years later (T2), and physical functioning was examined 5 years (T3) after T1. Telephone surveys included measures of the Five Factor Model personality traits (T1), social support (T2), and physical functioning (T3). Results suggested that relationships between the T1 personality traits and T3 physical functioning were not mediated by T2 social support. Secondary analyses found that among all T1 personality traits, higher openness and lower neuroticism uniquely predicted higher T2 social support. Further, among T1 personality traits, higher conscientiousness uniquely predicted better T3 physical functioning. This information may be useful to healthcare providers and community members in developing prevention and intervention strategies for African Americans.

Meaning in Life Predicts Decreased Depressive Symptoms and Increased Positive Affect over Time but Does Not Buffer Stress Effects in a National Sample of African-Americans.

Few studies have specifically focused on meaning in life in African Americans and many important questions remain, including whether effects of meaning in life are direct or moderated by levels of stress. In a national sample of 909 African Americans, we tested meaning in life as a prospective predictor of changes in depressive symptoms and positive affect over a 2.5-year period. Controlling for demographics and hassles, meaning in life predicted decreased depressive symptoms and increased positive affect across the span of 2.5 years. Moderation effects were not found for hassles, age, or income. Gender moderated the effect of meaning on positive affect such that effects were stronger for women than for men. These results suggest that, for African Americans, meaning in life appears to robustly protect against future depressive symptoms and promote positive affect over time unaffected by amount of stress experienced or most demographic factors.

Unique contribution of education to behavioral and psychosocial antecedents of health in a national sample of African Americans.

Education has demonstrated consistent links with many aspects of physical health and is theorized to relate to a variety of behavioral and psychosocial antecedents of health that may ultimately account for these associations. However, many of these associations and the extent to which they manifest specifically for African Americans have not been thoroughly tested. We examined associations of education-distinct from income-with established behavioral and psychosocial antecedents of health in a national sample of African Americans. Education favorably related to many behavioral (e.g., fruit/vegetable intake, lifetime smoking) and psychosocial (e.g., self-efficacy, personality traits, self-esteem, psychological well-being) antecedents of health, but not to all. Some evidence of stronger salutary relations of education for women was found. Results suggest that, for African Americans, education is generally favorably associated with an array of behavioral and psychosocial antecedents of physical health, partially explaining health disparities and providing a point of intervention moving forward.

Role of religious social support in longitudinal relationships between religiosity and health-related outcomes in African Americans.

This study tested a longitudinal model of religious social support as a potential mediator of the relationship between religious beliefs and behaviors, and multiple health-related outcomes (e.g., depressive symptoms, functioning, diet, alcohol use, cancer screening). A national probability sample of African Americans enrolled in the religion and health in African Americans study completed three waves of telephone interviews over a 5-year period (N = 766). Longitudinal structural equation models indicated that religious behaviors, but not beliefs, predicted the slowing of a modest overall decline in positive religious social support, while negative interactions with congregational members were stable. Positive religious support was associated with lower depressive symptoms and heavy drinking over time, while negative interaction predicted increases in depressive symptoms and decreases in emotional functioning. Positive religious support mediated the relationship between religious behaviors and depressive symptoms and heavy drinking. Findings have implications for mental health interventions in faith-based settings.

Personality, Social Capital, and Depressive Symptomatology Among African Americans.

The present study examined the relationship between social capital and depressive symptoms and the moderating role of the Big Five personality constructs in a national sample of African American adults. Data were collected from a national probability sample of 803 African American men and women using a telephone survey including measures of the Big Five personality traits, social capital, and depressive symptomatology. Most interestingly, there was evidence for Personality X Social Capital interactions on depressive symptoms. Higher social capital was related to lower depressive symptomology among persons with low conscientiousness, low extraversion, or high neuroticism. However, social capital was significantly but not as strongly related to depressive symptoms among those with high conscientiousness, high extraversion, or low neuroticism. This study reinforces the importance of personality traits when considering potential protective health effects of social capital in understanding depressive symptoms. This information may be useful to practitioners and community members in prevention and treatment.

A Longitudinal Study of Religiosity, Spiritual Health Locus of Control, and Health Behaviors in a National Sample of African Americans.

The present longitudinal study examined religious beliefs and behaviors, spiritual health locus of control (SHLOC), and selected health-related behaviors and outcomes in a national sample of 766 African American adults. Participants were interviewed by telephone three times over a 5-year period. Results indicated that stronger religious beliefs and religious behaviors were associated with greater changes in active SHLOC. There was some evidence of direct effects of religious beliefs and behaviors on changes in health behaviors. Religious behaviors were related to greater passive SHLOC over time across some health outcomes. Passive SHLOC was associated with some less desirable health outcomes over time.

Religious Involvement and Health over Time: Predictive Effects in a National Sample of African Americans.

In this study, two telephone interviews that assessed both religious involvement and health-related quality of life were conducted approximately 2.5 years apart in a national sample of 290 African Americans. Religious involvement was assessed with an instrument that measured both personal religious beliefs (e.g., having a personal relationship with God) and more public religious behaviors (e.g., attending church services). Health-related quality of life was measured with version 2 of the Medical Outcomes Study 12-item short form (SF-12v2). Structural equation models indicated that higher religious beliefs at baseline predicted better physical and mental health 2.5 years later. Higher religious behaviors at baseline contributed smaller, complementary suppression effects. Physical and mental health indicators from the SF-12v2 at baseline did not predict changes in either religious beliefs or religious behaviors over time. These findings indicate that, for African Americans, personal religious beliefs lead to beneficial health effects over time, whereas individual differences in health do not appear to predict changes in religious involvement.

Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans.

This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. RHIAA participants were 3173 African American men (1281) and women (1892). A total of 1251 men (456) and women (795) participated in wave 2 of data collection. Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p < .001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p < .001), emotional support provided (p < .001), negative interaction (p < .001), and anticipated support (p < .001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people's lives.

Participant Retention in a Longitudinal National Telephone Survey of African American Men and Women.

OBJECTIVE: The purpose of this article is to describe participant demographic factors related to retention, and to report on retention strategies in a national study of African Americans re-contacted 2.5 years after an initial baseline telephone interview. DESIGN & SETTING: The Religion and Health in African Americans (RHIAA) study was originally developed as a cross-sectional telephone survey to examine relationships between religious involvement and health-related factors in a national sample of African Americans. The cohort was re-contacted on average of 2.5 years later for a follow-up interview. PARTICIPANTS: RHIAA participants were 2,803 African American men (1,202) and women (1,601). INTERVENTIONS: RHIAA used retention strategies consistent with recommendations from Hunt and White. Participants also received a lay summary of project findings. MAIN OUTCOME MEASURES: Retention at the follow-up interview. RESULTS: Retention rates ranged from 39%- 41%. Retained participants tended to be older and female. In age- and sex-adjusted analyses, retained participants were more educated, single, and in better health status than those not retained. There was no difference in religious involvement in adjusted analyses. CONCLUSIONS: Although overall retention rates are lower than comparable longitudinal studies, RHIAA was not originally designed as a longitudinal study and so lacked a number of structures associated with long-term studies. However, this project illustrates the feasibility of conducting lengthy cold call telephone interviews with an African American population and helps to identify some participant factors related to retention and study strategies that may aid in retention.

Social integration and health insurance status among African American men and women.

Using 2010 national data, we investigate the relationship between social integration and health insurance for African American adults. During the previous year 21.6% of men and 19.8% of women lacked continuous health insurance. The effect of marital status, income, and employment on insurance coverage differed by age and gender. Additionally, frequency of church attendance was positively associated with continuous health insurance for women aged 51-64. Spiritual/religious identity was marginally associated with insurance status for men aged 36-50. As provisions of the Affordable Care Act take effect, implementation programs should expand enrollment efforts to include the conjugal unit and the church.

Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans.

Self-esteem and self-efficacy are theorized to serve as mediators of the relationship between religious involvement and health outcomes. Studies confirming these relationships have produced mixed evidence. This study examined whether self-esteem and self-efficacy mediate the relationship between religious involvement (beliefs, behaviors) and a set of modifiable health behaviors in a national probability sample of African Americans. African Americans, in general, are relatively high in religious involvement and have higher than average rates of chronic disease. Participants were interviewed by telephone, and a Religion-Health Mediational Model was tested using structural equation modeling. Results suggest that self-esteem and self-efficacy at least in part mediate the relationship between religious beliefs (e.g., relationship with God) and greater fruit and vegetable consumption, and lower alcohol consumption. Religious behaviors (e.g., service attendance) were found to have direct, unmediated effects on health behaviors. Findings have implications for church-based health promotion in African American communities such as education or support groups.

Relationship between religious social support and general social support with health behaviors in a national sample of African Americans.

Chronic diseases are the leading cause of death and disability in the United States and have significant behavioral origins. African Americans suffer a disproportionate burden of chronic disease relative to other US racial/ethnic groups. Previous research supports an association between both general and religious social support and health behaviors that impact the risk of chronic disease. The present study examined the relative contributions of these constructs to a variety of health behaviors in a national probability sample of African American men and women (N = 2,370). A telephone interview assessing fruit and vegetable consumption, physical activity, alcohol consumption, and current cigarette use was completed by participants. Results showed that several dimensions of religious social support predicted fruit and vegetable consumption, moderate physical activity, and alcohol use over and above the role of general social support. Findings highlight the unique role of religious support in this population in the context of health behaviors. Implications for health promotion interventions are discussed.

Assessment of religious and spiritual capital in African American communities.

African American faith communities are an important source of social capital. The present study adapted a theory-based social capital instrument to result in religious (e.g., from organized worship) and spiritual (e.g., from relationship with higher power) capital measures. Data from a national sample of 803 African Americans suggest the instruments have high internal reliability and are distinct from general religiosity. Measurement models confirmed factor structures. Religious capital was positively associated with self-rated health status. Religious and spiritual capital were negatively associated with depressive symptoms, but these associations largely became nonsignificant in multivariate models that controlled for demographic characteristics. An exception is for spiritual capital in the form of community participation, which retained a negative association with depressive symptoms. These instruments may have applied value for health promotion research and practice in African American communities.

Religious involvement measurement model in a national sample of African Americans.

This study examined the factor structure of a brief measure of religious involvement developed previously in research with African American women. Telephone interview methods were used with a national sample of both African American women and men (N = 2,370). Confirmatory factor analyses supported the distinction between religious beliefs and religious behaviors factors and indicated that the factor loadings were equivalent for women and men. Women reported higher levels of religious involvement than men. These results support the validity of this relatively brief instrument for assessing these two dimensions of religious involvement for both African American women and men.

Disability and Health in African Americans: Population Research and Implications for Occupational Therapy Community-Based Practice.

Background: Population-based research and community-based interventions are integral to occupational therapy's scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model. Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions. Results: Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators. Conclusion: This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans.

Lessons learned from a decade of focused recruitment and training to develop minority public health professionals.

From 1999 to 2009, the Eliminating Health Disparities Pre-doctoral Fellowship Program provided specialized education and mentoring to African American graduate students in public health. Fellows received a public health degree, coursework in understanding and eliminating health disparities, experiential learning, mentored research, and professional network building with African American role models. We describe successful strategies for recruiting and training fellows and make 5 recommendations for those seeking to increase workforce diversity in public health: (1) build a community of minority students, not a string of individual recruits; (2) reward mentoring; (3) provide a diverse set of role models and mentors; (4) dedicate staffing to assure a student-centered approach; and, (5) commit to training students with varying levels of academic refinement.

Can we be (and stay) friends? Remaining friends after dissolution of a romantic relationship.

Although many individuals report being friends with their ex-romantic partners (Wilmot, Carbaugh, & Baxter, 1985), the literature regarding post-romantic friendships is very limited. We investigated whether satisfaction in the dissolved romantic relationship could predict post-romantic friendships and friendship maintenance. We found that the more satisfied individuals were during the dissolved romance, the more likely they were to remain friends and the more likely they were to engage in friendship maintenance behaviors. We also found that friendship maintenance fully mediated the association between past romantic satisfaction and current friendship satisfaction.

The gray area: exploring attitudes toward infidelity and the development of the Perceptions of Dating Infidelity Scale.

Prior research has distinguished between emotional versus sexual infidelity. Two studies examined the development of the Perceptions of Dating Infidelity Scale (PDIS) to assess attitudes toward specific behaviors that constitute these types of infidelity in romantic relationships. Exploratory and confirmatory factor analyses indicated three factors to the scale: Ambiguous, Deceptive, and Explicit behaviors. In both studies, there were gender differences on ratings of the behaviors. The construct validity of the scale was assessed with measures of sociosexual orientation, guilt, and coping with unwanted sexual situations. It was found that the Ambiguous behaviors were positively correlated with avoidance of unwanted sexual situations, while the Deceptive and Explicit scales were positively correlated with guilt and avoidance and negatively associated with an unrestricted sociosexual orientation and acting on attractions toward friends.