When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for US Christian Clergy.

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.

Coming home: A feasibility study of self-guided dialogues to facilitate soldiers' social interactions and integration.

The success of service members' transition from military to civilian life is an ongoing concern for their personal well-being, for their families, and for our communities. There is a need for interventions to promote improved social integration. This one-arm feasibility study examined the ease of use, satisfaction, and desire for social interaction in response to the Warrior Spirit/Mission Homefront (WS/MH) self-guided dialogue program, which facilitates conversations among small groups of fellow service members through gamified activities (N = 299 service members). Through the use of a specially designed card deck and game, service members answer questions written to elicit responses about themselves and their military service. WS/MH dialogs and discussions model how persons can speak about deployment and military service with others. These discussions facilitate the articulation of experiences across a range of difficulties - according to persons' own comfort threshold - in order to cultivate language that can translate to conversations with which to reconnect with family and community. The activity demonstrated high satisfaction, and yielded the anticipated increases in positive emotion (p = .013) and desire for social interaction (p = .001) in pre-post comparisons. Satisfaction was associated with change in positive emotions and change in willingness to talk with others. This provides initial evidence of good feasibility and satisfaction with WS/MH, as a promising and readily scalable tool in the ongoing efforts to improve service members' and Veterans' social interactions, belongingness and emotional well-being as they come home.

Stigma in America: has anything changed? Impact of perceptions of mental illness and dangerousness on the desire for social distance: 1996 and 2006.

Data from the 1996 and 2006 General Social Survey were analyzed to examine the relationship between the desire for social distance from individuals with mental illness and a number of factors that were thought to contribute to it, including perceptions of mental illness and dangerousness. Random samples of participants were assigned to one of four experimental conditions, in which they were read a vignette describing a character who presented with alcoholism, depression, schizophrenia, or minor problems. The desire for social distance from characters whose presenting problems were alcoholism or depression was significantly lower in 2006 than in 1996. The participants' perceptions that the character was mentally ill and/or dangerous to others partially mediated the association between presenting problem and social distance. Participants who were younger, white, better educated, and attended religious services more often required less social distance from the vignette characters than did their counterparts.

The religion variable in community health promotion and illness prevention.

Religion is a source of beliefs and practices, which can in turn influence health behaviors. Therefore, religious communities represent potential public health partners to improve well-being across economic and ethnic diversity. This issue of the Journal of Prevention & Intervention in the Community presents six empirical studies with a breadth of methodologies, and a range of subjects. The associations of religion with cancer fatalism, prenatal substance abuse, bereavement, suicide prevention, clergy mental health and attitudes toward the Affordable Care Act are reported here. These research findings support the key importance of community. Like community, religion is complex. This issue's studies demonstrate the need to include ethnicity in analyses as well as the necessity to measure both religious belief and practice. Consistently, religious community participation predicted more positive outcomes than one's level of belief.

Are changes in positive mental health associated with increased likelihood of depression over a two year period? A test of the mental health promotion and protection hypotheses.

This paper investigates the mental health promotion and protection (MHPP) model of reducing depression. Data are from the Clergy Health Initiative Longitudinal Survey of United Methodist ministers in North Carolina that included the Mental Health Continuum Short Form (MHC-SF) for positive mental health and the Patient Health Questionnaire (PHQ-9) for depression in 2014 and 2016 (N = 955). The promotion hypothesis predicts reduced risk of depression in 2016 among clergy whose mental health increased to flourishing and the increased risk of depression in 2016 for clergy who stayed not flourishing. The protection hypothesis predicts increased risk of depression in 2016 for clergy who were flourishing in 2014 but went down to 'not flourishing' in 2016. The reference group is clergy who stayed flourishing. We used modified Poisson regression models for binary outcomes to estimate Prevalence Ratios (PR) and to estimate Incidence Rate Ratios (IRR) of depression in 2016 associated with changes in mental health status. Results support both hypotheses. Compared to clergy who stayed flourishing, clergy who improved to flourishing were as likely, while clergy who stayed not flourishing were nearly seven times more likely, to have depression in 2016. Clergy who declined to not flourishing were six times more likely to have depression in 2016 compared to those who stayed flourishing. Similar patterns were observed when the sample was restricted to clergy without depression in 2014. These findings suggest focusing on MHPP as a complementary approach to treatment to reduce the incidence, prevalence and burden of depression.

Disasters, psychological traumas, and religions: Resiliencies examined.

This special section in Psychological Trauma: Theory, Research, Practice, and Policy: "Religion and Spirituality in the Context of Disaster," demonstrates the heterogeneity and complexities of religion as a variable of psychological resilience in response to disaster. Research from hurricane, flood, and mass shooting disasters are reported. So too is the development of a new measure of disaster response. The section ends with a review of 51 empirical resilience studies of religion/spirituality and disaster. There are both ethnic and age differences in how salient a factor religion is after disasters. These papers demonstrate that to engage this complexity will require the expertise and effort-as with all cultural competence-to understand the "made meaning" of the lived experience of religion across one's life span. Religion is shown to be a robust objective for public health policy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Imam's role in meeting the counseling needs of Muslim communities in the United States.

OBJECTIVE: Muslims are one of the most rapidly growing minority groups in the United States and have experienced increased stress since September 11, 2001. The purpose of this study was to elucidate the roles of imams, Islamic clergy, in meeting the counseling needs of their communities. METHODS: An anonymous self-report questionnaire was mailed to 730 mosques across the United States. RESULTS: Sixty-two responses were received from a diverse group of imams, few of whom had received formal counseling training. Imams reported that their congregants came to them most often for religious or spiritual guidance and relationship or marital concerns. Imams reported that since September 11, 2001, there has been an increased need to counsel persons for discrimination. An increased need to counsel persons who were discriminated against was reported by all imams with congregations in which a majority are Arab American, 60 percent of imams with congregations in which a majority are South Asian American, and 50 percent of imams with congregations in which a majority are African American. CONCLUSIONS: Although imams have little formal training in counseling, they are asked to help congregants who come to them with mental health and social service issues. Imams need more support from mental health professionals to fulfill a potentially vital role in improving access to services for minority Muslim communities in which there currently appear to be unmet psychosocial needs.

Chaplaincy and mental health in the department of Veterans affairs and department of defense.

Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

The case for development of a new test of health literacy.

PURPOSE/OBJECTIVES: To review the need for reading assessments for patients with cancer, review existing reading assessment tools, and make a case for a new tool specific to patients with cancer. DATA SOURCES: Published articles, experiences, and discussions with published authors in the field of literacy. DATA SYNTHESIS: Valid and reliable tools that assess word recognition and comprehension exist for general use in health care. Word-recognition tests do not always predict comprehension, and a commonly used comprehension test has sections assessing only very low, second year of high school, and graduate-level skills. CONCLUSIONS: A new tool, developed specifically for patients with cancer, may better capture reading ability and comprehension. It is being evaluated for use in a clinical setting. IMPLICATIONS FOR NURSING: If nurses know their patients' reading levels, they can plan more effectively for teaching self-care and discussing decision making. Outcomes related to health and satisfaction may improve if poor readers are given materials they can understand.

Religious practice and depression among geriatric home care patients.

OBJECTIVE: To examine the relationship between religious practice and depression in a sample of geriatric patients receiving homecare nursing services. METHODS: Patients were sampled weekly for six months from all those aged 65 to 102, and newly enrolled in a visiting nurse agency (N = 130). Depression was assessed by home interviews using the SCID and HRSD. Patients reported their religious service participation prior to receiving homecare and currently. Health status, disability, pain, social support and history of depression were also assessed. RESULTS: The current prevalence of DSM-IV Major Depressive Disorder (MDD) was significantly greater (p < .05), and depressive symptoms were more severe (p < .02), among those persons who had not attended religious services prior to receiving homecare. Logistic regression demonstrated that the effect of religious attendance remained significant when controlling for health status, disability, pain, social support and history of depression. A subsequent analysis compared three groups of patients. They were those who had: 1) Not attended religious services; 2) Stopped attending since homecare; 3) Continued attending. Data demonstrated significantly decreasing prevalence of MDD (p < .03) across the groups. CONCLUSIONS: Prevalence of DSM-IV Major Depressive Disorder and the severity of depressive symptoms were significantly lower among homecare patients who attend religious services. Because a large proportion of persons stop attending religious services after initiating homecare, it is suggested that visitation by clergy may improve depressive symptoms for these patients.