Clergy play an important role in the health of their congregations and communities. Unfortunately, high rates of chronic disease and burnout exist, and health promotion programs have been limited in their ability to change behaviors. This study psychometrically tested the Caring Factor Survey—Caring for Self (CFS-CS), developed to understand self-care among nurses, with clergy. Initially, five experts established face validity of the survey. Ordained Christian clergy actively ministering in the United States were then recruited for a two-phase study. In phase 1, six clergy assessed the content validity of the survey using the Content Validity Index (CVI). In phase 2, 70 clergy completed the CFS-CS, demographic questions, and two Likert scale questions assessing the importance of and their effort to care for themselves daily. Cronbach’s alpha, average inter-item correlations, and exploratory factor analysis were conducted , as were correlations between the survey and the Likert scale items. During phase 1, individual CVI ranged from 1.00 to 0.83 and scale-level CVI was 0.95 , indicating that the content of the scale was adequate. During phase 2, one item, Teaching & Learning, did not perform well. When removed, Cronbach’s alpha and the average inter-item correlation were 0.81 and 0.33, respectively. Correlations between the nine-item survey (CFS-CS, Clergy) and the measures of importance and effort towards caring for self were r = 0.50 and 0.68, respectively, p < 0.001 for both. The CFS-CS, Clergy was found to be a valid and reliable measure for future studies to assess self-care beliefs and attitudes of clergy and their impact on clergy health.

Objective: Faith leaders often serve as health-related role models yet many struggle with obesity and self-care engagement. The purpose of this scoping review was to examine how the faith leader literature has defined self-care and examined obesity and obesity-related chronic disease.Data Source: Studies were identified through database (eg, PubMed, CINAHL, PsycINFO), backward, and grey literature (eg, dissertations) searches.Inclusion/Exclusion Criteria: Studies published in English with participants who were 18 years or older and examined leaders across all faiths. Studies also included an examination of self-care behaviors among faith leaders within the context of obesity or obesity-related chronic diseases.Data Extraction/Synthesis: Data synthesis was qualitative and informed by the six-step framework developed by Arksey and O'Malley (2005) as well as updated recommendations by Daudt et al (2013). Of the 418 studies identified and screened, 20 met the eligibility criteria.Results: Studies were primarily cross-sectional and participants Christian faith-leaders in the US. Most studies did not define self-care or incorporate theory, but focused on vegetarian diets and physical activity engagement. Other self-care related behaviors (eg, sleep, days off), some unique to faith leaders (eg, sabbatical), were included but not systematically.Conclusions: Research with more diverse faith leaders and that uses theory is needed to guide development of strategies for engaging this population in self-care to reduce obesity and related chronic diseases.

Fit with Faith is a 10-week, diet, physical activity, and stress reduction intervention for African-American clergy and spouses, which included: meetings, phone calls, a behavior tracking app. Survey, 24-h recall, accelerometer, anthropometric, and blood pressure data were collected. Wilcoxon signed ranked tests were used for analyses. In this one-arm study, clergy and spouses ( n = 20) attended most meetings and calls, but only half posted daily goals or tracked behaviors using the app. Spouses’ body mass index (BMI) decreased and physical activity self-regulation cognitive scores increased pre-post intervention. Statistically significant changes in BMI, systolic blood pressure, and self-regulations scores also were seen among younger (< 51 years) participants ( n = 8). As positive changes were seen mostly among women and younger participants, more research is needed on how to engage all clergy in behavior change programs.

Sedentary behavior (SB) can be defined as any waking activity that requires an energy expenditure of less than 1.5 metabolic equivalents (METs). The primary types of SB are lying, sitting and standing still. SB has been linked to many health issues such as type II diabetes and cardiovascular disease and daily time spent participating in these behaviors keeps increasing. The measurement of SB is difficult and is traditionally done via subjective means such as a self-report questionnaire or daily log. When compared to objective methods such as accelerometers there are often large differences between the measures of daily SB. College students are at high risk for excessive SB and the current COVID-19 pandemic has created even more of an opportunity for SB. Due to lockdowns, online synchronous classes, and gym restrictions, students have become even less active than before. The Past-day Adult’s Sedentary Time-University (PAST-U) questionnaire is designed to measure self-reported sitting time. The activPal is an accelerometer that is specifically designed to measure various SBs including sitting/lying time. PURPOSE: The primary purpose of this study was to compare self-reported sitting time from the PAST-U to sitting/lying time as measured with the activPal accelerometer in college students. METHODS: Forty university students were recruited via mass emails. They were asked to track their daily sedentary behavior using the PAST-U questionnaire for 7 days. This questionnaire is designed to track sitting behaviors over the course of the day. During this time, all participants wore an activPal accelerometer 24-hr/day for the same period. A paired-samples t-test was used to see if there were differences in the daily sitting from the PAST-U to sit/lie time from the activPal. RESULTS: There was no significant difference (p = 0.891) in daily sitting time between the PAST-U questionnaire (9.9 ± 3.2 hrs) when compared sitting/lying time from the activPal (9.9 ± 1.7 hrs). CONCLUSION: The results of this study show that estimates of sitting time in college students can be obtained either by using the PAST-U questionnaire or the activPal accelerometer.

Objective: The aim of this study was to identify the effects of menopausal and body composition statuses on measures of total and regional body composition and dyslipidemia in women. Methods: Sedentary, non-smoking women (N = 212), not currently treated for dyslipidemia were grouped based on 2 categories: (1) menstrual status: premenopausal or postmenopausal and (2) body composition status: normal weight (NW; BMI < 25 kg/m² and body fat (BF) < 36%), normal weight obese (NWO; BMI < 25 kg/m² and BF > 36%), or obese (BMI > 25 kg/m² and BF > 36%), to determine differences in total and regional body composition and measures of lipid and lipoprotein-cholesterol concentrations. Results: Overall, a greater prevalence of NWO was observed in postmenopausal versus premenopausal women. Being postmenopausal was associated with higher TC, LDL-C, non-HDL-C, HDL-C, and HDL₃-C. Premenopausal NWO women had elevated LDL-C and VLDL-C comparable to obese women. Postmenopausal NWO women had elevated Tg and VLDL-C and lower HDL-C similar to obese women. Conclusions: Menopausal status was not associated with differences in fat distribution, however, the age-related differences in lipids and lipoproteins appear to be due to a difference in menopausal status exacerbated in women who are NWO.

PURPOSE:Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Qualitative methods were used to identify opportunities and resources for the development of an effective obesity-related program for clergy.APPROACH:Ninety-minute focus groups were held with clergy (3 groups) and spouses (3 separate groups). Discussion explored: Program target(s); Opportunities and barriers that influence diet, physical activity, and stress-reduction practices; Empowering and culturally relevant health promotion strategies.SETTING:All study activities took place in Memphis, TN.PARTICIPANTS:Eighteen clergy and fourteen spouses participated. All clergy were male, all spouses were female.METHOD:Previous research with clergy informed the interview guide and the PEN-3 framework aided in organizing the coding of clergy and spouse focus groups. Focus groups were audio recorded and transcripts analyzed using NVivo® 12.RESULTS:Themes included: 1) Intervention targets-clergy, spouses, congregations; 2) Opportunities and barriers-making time, establishing boundaries, church traditions, individuals who support and hinder behavior change; 3) Intervention strategies-tools for healthy eating, goal setting, camaraderie, combining face-to-face with eHealth modalities.CONCLUSION:The relationship between clergy, spouse, and congregation make it important for obesity-related programs to target the unique needs of both clergy and spouses. Strategies should focus on healthy eating and personal connections no matter the modality used.

Despite the abundance of literature examining the effects of mental toughness (MT) on increased athletic performance, challenge appraisal, and motivation within the context of sport, there is a paucity of literature examining mental toughness within the context of physical activity (PA). Furthermore, studies that have examined mental toughness within the context of PA only included athletes in their samples. PURPOSE: To examine MT and PA among college students enrolled in a mid-Western university. METHODS: Participants (N = 273) completed online questionnaires regarding age, sex, race, athlete status, MT, and PA. The Mental Toughness Questionnaire-48 (MTQ48) was used to measure MT while the International Physical Activity Questionnaire – Short Form (IPAQ-SF) was used to measure PA. Pearson’s Product-Moment Correlations were used to assess correlations between MT and PA. Independent samples t-tests were used to determine whether MT and PA varied according to sex (male vs female), race (White vs non-White), or athlete status (athlete vs non-athlete). RESULTS: There were no significant correlations between overall MT, total PA, VPA, MPA, and meeting PA guidelines. Of the six subscales of MT, only challenge showed significant correlations with overall PA, r(273) = .133, p < .05; VPA, r(273) = .199, p < .05; and meeting PA guidelines, r(273) = .119, p < .05. Scores on the challenge subscale of MT were higher for athletes compared to non-athletes (3.68±0.37 vs 3.55±0.43, p < .05). Furthermore, overall PA was higher for athletes compared to non-athletes (688.65±734.82 vs 324.80±511.70, p < .05), as was VPA (444.15±389.63 vs 191.73±269.78, p < .05). Additionally, PA was higher for males compared to females (329.57±16.44 vs 220.31± 323.72, p < .05). No significant differences were found between any form of MT and PA behaviors when regarding age and race. CONCLUSION: Mental toughness was not correlated with PA among college students. However, differences in MT and PA according to sex, race, and athletic status should be examined further.

The purpose of this study was to describe practices and perceptions related to promoting clergy health among a national sample of denomination-level faith-based organizations (FBOs) (N = 154). Stress was identified as the top health-related issue facing clergy. The most commonly offered health resource was employer-sponsored health insurance. Lack of financial resources was the most common barrier to providing health resources for clergy. This study highlights potential priorities for denomination-level FBOs interested in providing health resources for clergy.

To examine the association between occupational distress, physical and mental health, and health behaviors among clergy, a convenience sample of full-time Christian clergy ( N = 221) completed a questionnaire that included the Clergy Occupational Distress Index (CODI) as well as demographic, occupational, health, and behavioral variables. Descriptive statistics and regression analyses were used to analyze the data. Higher scores on the CODI were associated with high blood pressure, diabetes, chronic stress disorder, depression, anxiety, more hours spent sitting per day, and more hours worked per week. Although years in ministry was not associated with scores on the CODI, a covariate in the model (age) did exhibit an inverse relationship with scores on the CODI. The present study provides support for the potential of occupational distress to negatively influence the health of full-time Christian clergy, especially those who are younger. Further research is needed to examine the temporal relationships among occupational distress, health, and health behaviors among full-time clergy.

Large denominational faith-based organizations (FBOs, e.g., conferences, dioceses) have potential to impact population health, though current activities are largely unknown. This study examined how large denominational FBOs approach health promotion programming and relevant barriers and issues related to capacity. A self-report survey via email and mail collected responses from representatives of FBOs about their health programming. The sample (n = 154) was diverse and included Catholic, Presbyterian, and Lutheran traditions. The most common activities were inclusion of health-related topics at organizational events and the provision of educational resources. Working with FBOs at a macro-level has potential implications for population-level health improvements.

Religious leaders, particularly African–American pastors, are believed to play a key role in addressing health disparities. Despite the role African–American pastors may play in improving health, there is limited research on pastoral influence. The purpose of this study was to examine African–American pastors’ perceptions of their influence in their churches and communities. In-depth interviews were conducted with 30 African–American pastors and analyzed using a grounded theory approach. Three themes emerged: the historical role of the church; influence as contextual, with pastors using comparisons with other pastors to describe their ability to be influential; and a reciprocal relationship existing such that pastors are influenced by factors such as God and their community while these factors also aid them in influencing others. A conceptual model of pastoral influence was created using data from this study and others to highlight factors that influence pastors, potential outcomes and moderators as well as the reciprocal nature of pastoral influence.

A key public health goal in the U.S. is to increase the number of people that engage in regular physical activity. Faith-based organizations are prominent in many communities, making them a viable partner in pursuit of this goal. As leaders of FBOs, clergy are uniquely positioned to promote physical activity to a large segment of the U.S. population. The purpose of this study was to examine factors associated with physical activity promotion among clergy. A convenience sample of clergy (N = 497) from the largest denominations in Pennsylvania completed web-based questionnaires about their physical activity promotion practices. Multiple logistic regression was used to calculate odds ratios of clergy promoting physical activity. Forty-five percent of clergy reported that they had promoted physical activity to their congregation during sermons and 14% reported promoting physical activity during one-on-one counseling. Notable findings were that clergy who were female, reported fewer chronic diseases, had more health-related education, and were meeting physical activity recommendations were more likely to promote physical activity. The results of this study indicate that gender, health status, health-related education, and engaging in regular physical activity may be important influences on whether clergy promote physical activity to their congregations. More research is needed to better understand additional characteristics of clergy who engage in physical activity promotion, as well as whether changes in physical activity behavior would lead to changes in physical activity promotion practices among clergy.

Normal-weight obesity (NWO), defined as a normal body mass index (BMI), but possessing a high body fat percentage (BF), has been associated with increased risk for cardiovascular disease (CVD) comparable to women with obesity. Following menopause, fat redistribution and increased risk for dyslipidemia are common; however, the effect of menopausal-related shifts in fat distribution and lipids and lipoproteins in NWO women remains to be determined. PURPOSE: To determine the influence of menopausal status on changes in regional abdominal and hip fat masses and lipids and lipoproteins in NWO women. METHODS: Sedentary, non-smoking women (n=214), not taking medications for the treatment of dyslipidemia, were grouped based on two categories: 1) menstrual status: premenopausal (PRE) or postmenopausal (POST) and 2) BF status: non-obese (BMI <25 kg/m2 and BF <36%), NWO (BMI <25 kg/m2 and BF >36%), or obese (BMI >25 kg/m2 and BF >36%). Fasting (12 hr) serum samples were analyzed for lipid and lipoprotein-cholesterol concentrations. Percent BF and abdominal and hip regional fat masses were quantified by DXA. A 2x3 ANOVA was used to identify differences between groups. Statistical significance was set at P<0.05. RESULTS: Independent of menopausal status, both abdominal and hip fat mass in NWO was 27-39% (P<0.001) greater than non-obese women, but 37-43% (P<0.001) less than obese women. Cholesterol was greater in non-obese (186±33 vs. 212±28 mg/dL, P=0.001), NWO (196±35 vs. 219±26 mg/dL, P=0.028), and obese (201±34 vs. 223±25 mg/dL, P=0.005) POST women when compared to PRE women. LDL-C was not different between non-obese PRE and POST women; however, LDL-C was greater in POST women who are NWO (111±36 vs. 131±25 mg/dL, P=0.034) and obese (121±30 vs. 138±23 mg/dL, P=0.017) when compared to PRE women. In contrast, HDL-C was lower in only non-obese POST women (62±13 vs. 75±14 mg/dL, P < 0.001) when compared to non-obese PRE women. In POST women, only HDL-C was significantly lower (62±15 vs. 75±14 mg/dL, P=0.010) in NWO than non-obese women. CONCLUSIONS: Based on these findings, menopausal status was not associated with a change in fat distribution; however, the age-related changes in lipids and lipoproteins appear to be due to a change in menopausal status, not shifts in fat distribution.