Below you will find abstracts, contact information and the schedule for the paper presentations at the upcoming 2nd Annual Meeting of the Society for Spirituality, Theology & Health. All presentations will take place Thursday, June 4 between 3:00 PM and 5:30 PM. You may search by topic or author's last name, or scroll down to see information about all of the sessions.
Co-authors: Stephanie Hawkins, PhD; Erin Hardy, MA
There is a dearth of research focusing on the effects of religiosity and spirituality on health outcomes among economically vulnerable families. Policymakers and health practitioners are interested in understanding whether religiosity and spirituality can buffer the deleterious effects of poverty on family and community health over the life course by encouraging productive health practices, developing positive social networks, and encouraging utilization of health services. Alternatively, it has been suggested that religiosity could be a source of stigma or concern that negatively impacts poor families, particularly single parent families who can feel stigmatized due to religious beliefs emphasizing marriage. This presentation will highlight the results of our HHS-sponsored review of the conceptual models and empirical research examining the impact of religiosity and spirituality on a broad set of health outcomes for families with low incomes. Implications for future research and federal faith-based policies will also be discussed.
Albert Schweitzer Fellow, Medical Student
Loyola University Stritch School of Medicine
Many students enter medical school with strong interest in the realm of underserved medicine and health inequalities. However, this interest is often teamed with a relative lack of experience with the realities of underserved communities and the unique challenges they sometimes present. In light of this, a new service-learning program titled Project CARE (Community Advocacy through Relationships and Education) was started at Loyola Stritch School of Medicine. The program connected eight first-year medical students with families struggling with their healthcare and other social services. The role of the students was to act as health system navigators, patient advocates and listening supporters. The students also attended training sessions and group reflections. The presentation will focus on individual stories from the program's first year and the lessons learned by the participating students. Concluding remarks will touch on the value of utilizing a relationship model in medical education and the responses of faith communities to health disparities.
Director of Community Services
Glendale Adventist Medical Center
Co-authors: Sally Fotamillas Shaw, DrPh; Lee S. Berk, DrPh; Michelle Prowse, MS; Dana E. King, MD
Background: Studies have shown an association between perceived stress and elevated high sensitivity-C-reactive protein (CRP) levels. CRP levels >3 mg/L indicate high risk for cardiovascular disease. This study assessed the relationship between perceived stress, religiosity and CRP. Methods: Participants completed a health risk survey that incorporated traditional and lifestyle psychoneuroimmunology assessments, including perceived stress, and religiosity defined as regular church, synagogue or temple attendance. Serum CRP levels were analyzed in a cohort of 1,023 adults ages 18 to 89. Results: Those who commonly felt overstressed were 1.4 times more likely to have CRP levels >3 mg/L (p<0.01). Conversely, those who regularly attended church, synagogue or temple were 26% less likely to have CRP levels >3 mg/L (p<0.05). When stress and religiosity were combined, the effect on CRP remained significant (p<0.05). Conclusions: There may be clinical relevance suggesting religiosity reduces the negative effect of stress on elevated CRP levels.
Research Associate Professor
Director of Research, Center for Spirituality and Social Work
National Catholic School of Social Service, The Catholic University of America
African-American elders are expected to quadruple from 2000 to 2050, with an estimated 1 to 1.4 million of them in poor health by 2030. The majority of caregivers of this vulnerable population are family members who are often at increased risk for health problems themselves. The current research examines the specific mechanisms underlying the influence of religious involvement on the physical and mental health of 147 African American Christians providing intensive caregiving to elderly family members. Analyses tested the "Spiritual-Stress-Adaptation Model of Caregiving and Health," which proposes that a) religious involvement enhances the spiritual aspects of caregiving rewards, which, in turn, b) decreases caregiving stressors while increasing supports and positive coping strategies, which c) increases the likelihood of positive health outcomes. Results show support for much of this proposed pathway, especially in terms of mental health. The presentation will explore the role of both organized religion and personal spirituality in maintaining health among family caregivers.
Duke University Center for Health Policy
Co-authors: John James, MA; Amanda Wallace, MDiv; Sara LeGrand, MS
Clergy health is important because of the large numbers of clergy and the impact that they have on congregants. Although mortality rates for clergy have historically been favorable, numerous studies indicate concern about clergy stress and its impact on clergy families. We conducted 11 focus groups with 59 United Methodist (UMC) pastors and 29 UMC superintendents. Participants were asked about their conceptualization of health and barriers to, and facilitators of, health promotion. Audiotapes were transcribed and coded by two people each. Grounded theory analysis was used to develop a theoretical model of physical, mental, and spiritual health. Forty-three conditions at the individual, interpersonal, congregational, UMC institutional, and civic community level are proposed to impact clergy self-care practices and stress and coping, which in turn impact holistic health. Key conditions include: amount and complexity of work; financial strain; unhealthy churches; itinerancy, and support for work-life balance from UMC and church leaders.
Virginia Commonwealth University School of Nursing
Co-authors: Wantana Thinganjana, PhD
Spirituality positively effects disease progression and improves quality of life and well being. This study explores the meaning of spirituality voiced by 75 healthy adults and persons living with HIV. They answered two questions: What is the meaning of spirituality to you? How does spirituality affect your daily life? Responses were content analyzed. Six categories emerged for each. Themes for persons living with HIV: spirituality is relating and believing in God; spirituality is being guided or helped; spirituality is being inspired or given unto; spirituality is expressed in outward ways; spirituality is journeying, discovering, centering; and spirituality is feeling the presence of God. Themes for healthy adults: a belief in a personal relationship with God; a connection and relationship with others; spiritual journey, guide or struggle; spiritual essence of self; spirituality expressed in actions and finally, integral spirituality. An exhaustive statement summarizes these relationships. Findings support previous views of spirituality.
Coordinator of Research, Chaplain Services
Assistant Professor of Psychiatry
Mayo Clinic College of Medicine
Co-authors: Maria I. Lapid, MD; Susan M. Ryan, MEd; Susanna R. Stevens, MS
We investigated the spirituality of 45 elderly depressed psychiatric inpatients, and explored associations between spirituality, depression, and quality of life (QOL). Standardized questionnaires (HamD, SF36, QOL LASA, COPE) were used to measure depression, QOL, and coping at admission and discharge. Spirituality was assessed with items from these questionnaires and a structured spiritual assessment. Most participants reported positive, active spirituality at baseline, but prior to hospitalization several experienced more spiritual distress and less spiritual activity, comfort, and guidance. At discharge, participants reported increased spiritual well-being (SWB) on the QOL LASA (p=0.007), and less hopelessness (p<0.001), worthlessness (p= 0.028), and guilt (<0.001) on the HAM-D. Associations were detected between several spiritual variables and QOL and depression, including discharge SWB and QOL (ρ=0.34;p=.0.025) and discharge SWB and depression (ρ= -0.47;p=0.001) Research is needed to determine whether and what spiritual interventions may help improve or maintain depression and QOL in the elderly.
Duke University Medical Center
Co-authors: Stephanie Daniel, PhD; W. Vaughn McCall, MD, MS; Harold Koenig, MD, MHSc
Medical literature generally treats religiousness as a static trait. However, longitudinal stability of religiosity is understudied. As religion/health research develops among adolescent subject populations, given tremendous emotional and cognitive changes in adolescence, this question becomes particularly relevant. 104 adolescent psychiatric outpatients completed a multidimensional religiosity measure at two time points. Stability of 14 subscales over time was assessed using intraclass correlation coefficients (ICC), in full and stratified samples. Median follow-up was 205 days. Overall, ICC ranged from 0.41-0.96, with most subscales showing moderate stability. Substantial differences in ICC were not observed when stratified by gender or race, but were evident when considering subject age. Among adolescents endorsing substance abuse or significant depressive symptoms, ICC tended to decrease. Religiousness does not show marked stability over time among adolescent psychiatric outpatients; religious change may be associated with substance abuse or depression. Design and interpretation of religion/health literature should take possible longitudinal variation into account.
Administrator, Holy Family Home
Assistant Professor, Thomas More College
This descriptive survey and study explores issues related to the general research questions: "What is the perceived level of elder abuse and neglect awareness, knowledge and intervention preferences among Protestant clergy in Kentucky?" Survey responses are paired to examine relationships between demographic characteristics and the facets measured - awareness, knowledge intervention preferences, and perceived severity of elder abuse and neglect. Of the 300 clergy solicited, 160 participated for a response rate of 53.3%. The survey data indicate that 56% of the clergy sample do not know that Kentucky is a mandatory reporting state for elder abuse and neglect. Overall, clergy are generally not aware of their responsibilities and lack detailed knowledge about elder abuse and neglect. Participating clergy have a gap in knowledge about elder abuse and perceived types of abuse differently and initial training and continuing education does not appear to be tailored to elder abuse and neglect.
Associate Professor, School of Theology
Charles Sturt University
Director, Centre for Ageing and Pastoral Studies
St. Mark's National Theological Centre
This paper addresses ways that two groups of older people addressed issues of grief and resilience in loss. The qualitative studies used ground theory with twenty frail cognitively competent elders and 113 with dementia, aged 62-96, in residential care. Interviews used spirituality in ageing model (MacKinlay 2006). The frail elderly group were interviewed and data analysed, but no treatments were instituted, due to their level of frailty. Following in-depth interviews the group with dementia was assigned to small groups that participated in weekly sessions of spiritual reminiscence over six or 24 weeks. The group with dementia had a mean MMSE of 18.12 at entry and 16.09 at exit. Data were analysed using NVivo7 qualitative data package, for this paper, expressions of grief and signs of resilience are reported. Grief was an important topic for both groups, although those with dementia often found the naming of a relationship difficult.
Duke University Medical Center
African American pastors often endorse health promotion programs in their churches, but will not participate. It has been hypothesized that if pastors are healthy, they have healthy relationships with family and healthy congregations. Yet, little is known about their interests in participating in health promotion programs. This preliminary report assessed their interests in such an intervention. A total of 118 Baptist and African Methodist Episcopal senior male pastors were asked to respond to, within two weeks of receiving a mailed survey, questions about participation, topics of greatest educational interest, and preferred mode of education. Of the 46 respondents, 85% were willing to participate, yet less than 45% with their spouse (98% were married). Healthy food on-the-go, preventing or managing chronic diseases, and preparing a sermon/bible study on healthy lifestyles were the most common education preferences. Seminars with other pastors were the preferred education mode. Implications for these findings are discussed.
Senior Research Associate
Center for Spirituality, Theology and Health
Duke University Medical Center
Co-authors: G. Swamy, MD; S. Floyd, MD; Keith Meador, MD, ThM, MPH
Parents planning pregnancy termination at DUMC because of fetal anomaly were invited to participate in a survey of spiritual needs. The birth defect was considered lethal in 4/6 cases. Parents in the study preferred to discuss their spirituality/religious beliefs with clergy. Professionals who might play such a role were rated as "Yes" in these ratios: Nurse (0/9), Obstetrician (1/9), Social Worker/Mental Health Worker (2/9), Hospital Chaplain (4/9), Own Pastor (7/9). None of these parents wanted members of their healthcare team (other than clergy) to pray with them. Personal religiosity was most important for them. Parents facing the termination loss of a wanted pregnancy would prefer to discuss their beliefs or pray with clergy, rather than medical staff. They stress the need for guidance and forgiveness. Training should be offered to community clergy to help them meet the needs of these families.
"The Relationship between Physicians' Beliefs about the Effect of Religion on Health and their Willingness to Discuss Religion with Patients in Different Clinical Settings"
Kenneth A. Rasinski, PhD
Research Assistant Professor
The University of Chicago
Co-author: Farr A. Curlin, MD
The importance of religion to patients' health and well-being has been well documented, but little is known about the determinants of physicians' willingness to discuss religion with their very ill or troubled patients. This research examines the role of physicians' beliefs about the effects of religion on patients' health on their reports of talking about religion and spirituality to patients in difficult circumstances. It is important to examine this because physicians' beliefs can be changed through education, implying that this type of doctor-patient communication can increase. Data were from a national survey of physicians. Doctors were asked to give their attitudes to three items indicating negative effects of religion on health behaviors and four items indicating positive effects. Endorsement of positive items was significantly related to talking about religion and spirituality; none of the negative beliefs were related. The results held after various background characteristics were taken into account.
Emeritus Clinical Professor, Duke Divinity School
Regional Director, The Association of Professional Chaplains
Co-authors: Rev. John J. Gleason, DMin, BCC; Rev. Yoke Lye Lim Kwong, MA, BCC
The Ideal Intervention Paper for CPE students was adapted from a cognitive therapy template to consolidate learnings and to allow replication. Since 2006 a growing number of students across the ACPE regions have completed Ideal Intervention Papers. These, and lately more concise Ideal Intervention Forms for students and for experienced practitioners, are being collected for editing and inclusion in a knowledge base. Editors will transform these IIPs and IIFs into Potential Best Practices. Other practitioners then access the knowledge base to inform their own interventions. If recipients of that care rate it as effective, the designation Tentative Best Practice will be applied and the cycle repeated by other chaplains, culminating in the designation Spiritual Care Best Practice. An introductory presentation was given at the Society's First Annual Conference. A case study and scenario are the foci of this second presentation.
Intervention Form & Instructions
Assistant Professor and Chaplain
Rush University Medical Center
Co-author: George Fitchett, PhD
Religious belief has been shown to be associated with lower levels of depression through the mediation of hopelessness. The purpose of this study was to examine the impact of religious belief on response to treatment for depression. It further hypothesized that hopelessness would mediate the effect of belief on response. Shortly after admission to inpatient or outpatient treatment for clinical depression and 8 weeks later, 136 adult patients completed the Beck Depression Inventory, the Beck Hopelessness Scale and the Religious Well-Being Scale. Logistic regression models supported an association of baseline religious belief, but not baseline hopelessness, with a 50% reduction in symptoms from admission. Belief in a concerned God might be important for patients in countering negative aspects of depression. It is possible that persons experiencing religious distress might do more poorly in recovery. Clinicians need to be aware of the role of religion for their clients.
Counseling Psychology Intern, Duke University
Doctoral Candidate, Indiana University-Bloomington
The study uses qualitative methodology to understand the nature of spiritual experiences that resemble self-realization or oneness of participants who come from different religious and national backgrounds. The study draws upon Habermas' theory of communicative action to explore narratives, the linguistic structures, and representational knowledge used by participants to comprehend and communicate such an indescribable experience. Reconstructive analysis was used to draw out implicit meanings and linguistic structures such as metaphors, paradoxes, analogies, stories, and implicit theories from comprehensive interviews and make them explicit. Results show striking similarities in insights across all four participants regarding core aspects of spirituality. These findings are also well reflected in spiritual teachings and literature across different religions, nations, and traditions. The analysis showed differences between participants in the symbolic representations and their own unique imagery they used to communicate their experience. In spite of varied experiences and diverse representations, the essence of spiritual understanding was similar across all participants.
Associate Professor and Director of Research
Department of Religion, Health and Human Values
Rush University Medical Center
Co-authors: Barth Riley, PhD; Leila Shadhabi, MS; Lynda Powell, PhD
A common hypothesis about how religion/spirituality affects health is by improving host resistance to the negative effects of stress. Daily spiritual experiences have been thought to play a key role in this process. Having a valid and reliable measure of daily spiritual experiences is a prerequisite for testing this hypothesis. We employed the Rasch model to examine the psychometric properties of the Daily Spiritual Experiences Scale (DSES). The Rasch model estimates the probability of item endorsement based on person ability and item difficulty. Data were taken from 420 white and African-American midlife women participants in the Chicago site of SWAN. We found the DSES had reasonably good person and item reliability, but there were problems with the response scale, with multi-dimensionality, item misfit, and assessment of the continuum of the construct. Developing additional items that measure a continuum of daily spiritual experiences will improve the scale.
Rhode Island College School of Nursing
For over 40 years, spirituality can be traced back in the Nursing Cumulative Index. From 1956-1975 the term "Religion and Religions" was used as the subject heading. As the articles were published in the 1950's, the literature was dominated by the Catholic religion. During this time, nurses were seen as servants and served as a secondary role to the Roman Catholic priest. In addition, the focus at the that time was action oriented and focused on what the nurse could do for the patient. It wasn't until 1976 that spiritual assessment was addressed in the nursing literature. As the years progressed, spirituality in the nursing literature began to explode into a life of its own and began to surface in the area of research. Spirituality broadened to include all areas of faith and the literature began to also investigate spirituality from the patient's perspective.
Associate Professor and Director, Offices for Teaching Excellence
Johns Hopkins University School of Nursing
The purpose of this study was to determine clients' perceptions of religion and spirituality and their impact on their lives. After a pilot study indicated that these clients could and would participate in a focus group, nursing students at the setting recruited a group of men and women to be in one of two focus groups. Queries to which the paticipants responded included the following: how do you define religion? Tell me about religious practices in which you engage. How do you define spirituality? Have you ever experienced spiritual distress? What religious or spiritual practices give you comfort? Participants in each group focused on organized religion and the church most often in answering each of the questions. They were attentive to one another and asked for additional sessions in which to further explore religious and spiritual coping strategies. Recommendations for clinical practice, education and further research will be presented.
President, Sand Point Statistics Group
MDiv Student, Fuller Seminary Northwest
Co-authors: Richard Rogers, MD; Aileen Loranger, RN, ARNP, PhD
The lifecourse has been described as "a multidisciplinary paradigm for the study of people's lives, structural contexts, and social change. This approach encompasses ideas and observations from an array of disciplines, notably history, sociology, demography, developmental psychology, biology, and economics. In particular, it directs attention to the powerful connection between individual lives and the historical and socioeconomic context in which these lives unfold." It is not surprising that theology is not mentioned as one of the disciplines informing the lifecourse, since it is widely presumed not to contribute knowledge relevant to public discussion of the conditions of human life. If to the contrary theology (as practices of the church including prayer, sacraments and training in the virtues) does provide objective knowledge of human existence, an assessment of human health ought to begin with theology.
Doctor of Theology Student
Duke Divinity School
Protestants profess a healing faith and concern for those who suffer. Bodies are healed, souls are saved, but how do Protestants react when illness affects believer's minds? How are common mental illnesses like depression, schizophrenia and addiction understood by Protestants? Is mental illness discussed openly? Are churches understood as sites of healing and support? Do believers stage collective responses? Heather Vacek examines post World War II American Mainline Protestants and Evangelicals, as represented in the Christian Century and Christianity Today respectively, for their changing discourse on mental health. As the Mainline response moved from outrage to pious abdication, Evangelical response moved from discomfort to alternate institution building. And, as the 21st century dawned, both groups slid toward accommodation. Vacek's work explores the beliefs and practices that underlie these changes.
Assistant Dean, Curricular Initiatives
University of Pennsylvania School of Nursing
Co-authors: Anne Belcher, PhD, RN
Despite increased awareness of and interest in spirituality among health care providers at all levels, in all roles and in all settings, there is a genral consensus that the knowledge base about and provision of spiritual care is inadquate. The strong correlation between spiritual health and physical health mandates that all health care providers assume responsibility for spiritual care. The focus of this paper is on the snythesis of data from seven studies that addressed spiritual expression and spiritual care among nurses practicing in educational, hospital and community settings. The findings have been used to create a framework for spiritual care education that can be used in academic and health care settings to prepare nursing students and nurses for meeting the spiritual needs of patients/clients.
Chaplain Resident, Westbrook Fellow
Durham VA Medical Center
As a member of the care team on an acute psychiatric ward, I have had the privilege of sitting in on the team meetings. Time and again residents claimed that patients were "hyper religious" because they were seen reading their Bibles all day, or because they talked about God. Often, as a chaplain, I had to remind the residents that this behavior simply might have been what their community expected them to do in their spare time. Such patients were often theologically very insightful, and had important things to say about religion and resiliency. "Hyper-Religiosity" is a subjective diagnosis in psychiatry, often made by medical staff without knowledge of the practices and expectations of the religious communities from which their patients come. Pathologizing religious behavior in psychiatry should not be simply a medical diagnosis based on behavior but a careful exploration of the patients' formational communities.
Professor, Department of Psychology
East Tennessee State University
The medical community has been largely unsuccessful at preventing preterm birth once preterm labor begins; therefore it would be advantageous to prevent rather than attempt to halt it. Stress has been implicated in the etiology of some cases of preterm birth so it follows that reduction of stress, or reduction of the effects of stressors, could impact the incidence of preterm birth. Stress interventions have been shown to reduce the incidence of pregnancy complications, beneficially affect physiology of mother and fetus, and in at least one study lengthen gestation. We are interested in the effects of religious coping as a means of reducing the impact of stressors during pregnancy; specifically the coping mechanism of surrender to the God of the Christian faith. We are currently attempting to develop an explanatory model demonstrating how women's measured surrender to God predicts reported stress, gestation length, and number of pregnancy complications.
Staff Psychologist, G.V. (Sonny) Montgomery VAMC
Assistant Professor of Neuropsychology and Geropsychology
University of Mississippi Medical Center
Co-authors: Rev. Mary McQueen Porter, MSW, MDiv, DMIn; Rev. Clara Lynn Bledsoe, MS, MDiv
In order to meet the spiritual needs of individuals residing in long-term care settings, their families, and their professional caregivers, Ruth and Naomi Senior Outreach (RNSO) developed a multi-faceted program for spiritual transformation. In this presentation, participants will receive:  an overview of the empirical base for the relationship between spirituality/religiosity and health especially as it pertains to long-term care settings;  an introduction to the theological and philosophical underpinnings of the RNSO approach;  a detailed description of our potentially replicable interfaith program which utilizes several healing modalities (spiritual companioning, the human-animal bond, and the spirituality of sound); and  a demonstration of two spiritually based exercises used by RNSO. The aim of RNSO is to support culture change in long-term care through building relationships and community; providing antidotes to loneliness, helplessness, and boredom which can be present in long-term care settings; and instilling hope.