Associations between the Duke University Religion Index (DUREL) and patients’ perceptions of care, requesting to see a chaplain, and 30-day readmissions were examined in this cross-sectional study. Participants were recruited from an inpatient setting in Memphis, TN and asked the DUREL, three patient experience questions, and if they would like to see a chaplain. The electronic medical record was monitored for readmissions within 30 days of discharge. Logistic regression models included age, length of stay, sex, race, insurance status, and rating of overall health. Two models examining requests to see a chaplain were run. One model included if a chaplain had previously been seen. Associations with DUREL subscale scores (attendance, non-organized activities, intrinsic religiosity) were examined if associations with the total score were statistically significant. Participants (n = 482) were on average 62 years old and most identified as female and Black. Higher total DUREL scores were associated with greater confidence in enacting care plans, with attendance and intrinsic religiosity scores driving the association. Participants with higher total DUREL scores and longer hospital stays were more likely to request a chaplain. Higher attendance and non-organized activity subscale scores were associated with making a request. No statistically significant association was identified for 30-day readmission. Findings add to our understanding of the role religious engagement plays within inpatient settings and to the literature emphasizing the role of religious and spiritual discussions during discharge. More research is needed to see if confidence translates into better health post-hospital stay.

Previous studies have found that support that is uplifting in nature (i.e., positive social support) can have a positive influence on the spiritual well-being of individuals with chronic diseases. However, few studies have explored positive and negative social support’s (i.e., the individual receiving the support feeling unsupported) impact. The purpose of this study is to assess the relationship between positive and negative social support and spiritual well-being among individuals of African descent with chronic illnesses. Survey items that focused on positive and negative social support as well as spiritual well-being were obtained from a secondary dataset, the National Survey of American Life. Missing imputation models were adjusted by demographic characteristics (gender, age, income, education, marital status, employment, length of stay in the U.S., insurance, and religious service attendance). Findings from the analysis revealed a positive association between positive social support and spiritual well-being (β: 0.07, SE: 0.01, p < 0.0001). No significant associations were observed between negative social support and spiritual well-being (β: 0.01, SE: 0.01, p = 0.51). Future researchers should continue to explore the impact of social support on the spiritual well-being of individuals of African descent through the implementation of a culturally tailored program designed to reduce chronic diseases within this population.

Purpose To examine associations between sociodemographic variables, social determinants of health (SDOHs) and diabetes using health needs assessment data.Design Cross-sectional study.Setting Faith-based communities in the Mid-South U.S.Sample Of the 378 churches, 92 participated in the study (24% response rate); N = 828 church leaders and members completed the survey.Measure The Mid-South Congregational Health Survey assessed perceived health-related needs of congregations and the communities they serve.Analysis Generalized linear mixed modeling examined the associations between sociodemographic variables (age, sex, race/ethnicity, educational level), SDOHs (affordable healthcare, healthy food, employment), and diabetes.Results Individuals with less education had lower odds of reporting all SDOHs as health needs compared to individuals with more education (ORrange = .59-.63). Men had lower odds of reporting diabetes as a health need or concern compared to women (OR = .70; 95% CI = .50, .97). African Americans had greater odds of reporting diabetes as a health need compared to individuals in the 'Other' race/ethnicity category (OR = 3.91; 95% CI = 2.20, 6.94). Individuals who reported affordable healthcare (OR = 2.54; 95% CI = 1.73, 3.72), healthy food (OR = 2.24; 95% CI = 1.55, 3.24), and employment (OR = 3.33; 95% CI = 2.29, 4.84) as health needs had greater odds of reporting diabetes as a health need compared to those who did not report these SDOHs as needs.Conclusions Future studies should evaluate strategies to merge healthcare and faith-based organizations' efforts to address SDOHs impacting diabetes.

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.

OBJECTIVES:Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction.METHODS:Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30-60 min each) online or by phone. Interviews (n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28.RESULTS:Four themes emerged: (a) Chronic disease management and stress-perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness-knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators-interest, barriers, and facilitators to attending; (d) Mindfulness program structure-logistics to increase access and appeal to diverse audiences.DISCUSSION:Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.

Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders ( n = 369) and members ( n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [ OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes ( OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.

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.

Health needs assessments identify important issues to be addressed and assist organizations in prioritizing re-sources. Using data from the Mid-South Congregational Health Survey, top health needs (physical, mental, social determinants of health) were identified, and differences in needs by key demographic variables (age, sex, race/ ethnicity, education) were examined. Church leaders and members (N = 828) from 92 churches reported anxiety/depression (65 %), hypertension/stroke (65 %), stress (62 %), affordable healthcare (60 %), and over-weight/obesity (58 %) as the top health needs in their congregations. Compared to individuals < 55 years old and with a college degree, individuals >= 55 years old (ORrange=1.50-1.86) and with < high school degree (ORrange=1.55-1.91) were more likely to report mental health needs (anxiety/depression; stress). African Americans were less likely to report physical health needs (hypertension/stroke; overweight/obesity) than individuals categorized as Another race/ethnicity (ORrange=0.38-0.60). Individuals with < high school degree were more likely to report affordable healthcare as a need compared to individuals with some college or a college degree (ORrange=1.58). This research highlights the need for evaluators and planners to design programs that are comprehensive in their approach to addressing the health needs of congregations while also considering demographic variation that may impact program participation and engagement.

Artificial intelligence-enabled applications on edge devices have the potential to revolutionize disease detection and monitoring with smart health (sHealth) applications. The major challenges are user-friendly and flexible sensors for seamless collection of physiological data for long hours, online and on-device processing of sensitive medical data to facilitate privacy protection, reliable extraction of disease-related biomarkers, and implementation of lightweight artificially intelligent algorithms for inference at the edge without degrading the system performance. In this pilot project, we conducted a yearlong field study with 9 participants conducting 480 data collection sessions in the “living lab” environment. We used smartphones as the edge computing device and implemented pre-trained machine learning algorithms in the smartphone app for computing disease-related Events-of-Interest (EoI). We considered real-time data processing on the smartphone itself without sharing raw data with the cloud or any other computing facility to minimize privacy concerns, and network bandwidth requirements. We used a commercial smart band and a custom-designed zero-power inkjet-printed sensor for physiological sensing and capturing health biomarkers such as heart rate variability (HRV) and core body temperature. The extracted HRV feature values are within the 95% confidence interval of normative values. On top of that, the extracted HRV shows some informative trends i.e. hammock pattern for healthy subjects which may be helpful in subsequent research studies. Moreover, we used core body temperature with user-reported outcomes for estimating flu-related symptoms severity and visualizing the spatiotemporal trend in a cloud-server to facilitate personalized as well as community-wide health monitoring. Inference at the edge provided a data reduction of 3 order while the runtime latency, power consumption, memory requirement, and storage size of the smartphone app were 500 ms, 51.90 mAH, 9.4 MB, and 2.4 MB, respectively. Our developed framework of sHealth enables automated community-wide monitoring of symptoms severity in addition to personalized monitoring which paves the way for early monitoring of a disease outbreak for a smart and connected community.

Objective: While cardiometabolic abnormalities are associated with elevated risk of morbidity, they may not occur in all individuals with obesity. Less is known about associations with mortality, especially cancer mortality. This study examined associations between cardiometabolic-weight categories and mortality from cardiovascular disease (CVD), cancer, and all causes.Methods: Cox proportional hazards regressions of time to all-cause, CVD, and cancer mortalities were used to examine associations with cardiometabolic-weight status, in the Multiethnic Cohort (n=157,865). Cardiometabolic-weight status categories were: Metabolically Healthy Normal Weight, Metabolically Healthy Obese, Metabolically Healthy Overweight, Metabolically Unhealthy Normal Weight, Metabolically Unhealthy Obese, and Metabolically Unhealthy Overweight.Results: Higher mortality, especially for all-cause and CVD, was found for all metabolically unhealthy groups no matter the weight classification when compared to the Metabolically Healthy Normal Weight category across sex-ethnic groups. For all-cause mortality, a reduction in mortality was seen for males in the Metabolically Healthy Overweight category (HR: 0.88, 95% CI: 0.84, 0.93), especially for African American, Native Hawaiian, and Latino males. Mortality was elevated in the Metabolically Healthy Obese category for all-cause and CVD mortality in both sexes (HRrange: 1.08-1.93). Few associations were seen with cancer mortality.Conclusions: Past examinations of cardiometabolic-weight status and mortality have been hampered by a lack of diversity. In a racially/ethnically diverse population, metabolically unhealthy groups exhibited a substantially higher risk of death from all causes and CVD than metabolically healthy groups. A reduction in all-cause mortality was seen for some males classified as Metabolically Healthy Overweight; however, being classified as Metabolically Healthy Obese elevated mortality risk for males and females compared to Metabolically Healthy Normal Weight. Future research is needed to examine how sex-ethnic differences in body fat distribution and changes in weight over time influence associations between cardiometabolic-weight status and mortality.

While physical activity and diet behaviors are correlated, mechanisms underlying associations have rarely been examined. This study examined associations between physical activity identity and eating identity among college-aged adults in Hawai'i to provide guidance for future multiple behavior change interventions. This study was a cross-sectional analysis of data collected between September 2013 and January 2014. Participants were 40 college students attending 4-year and 2-year institutions within the University of Hawai'i system. Total physical activity identity score and dimensions were measured using the Athlete Identity Questionnaire. Eating identity subtypes were measured using the Eating Identity Type Inventory. Associations between physical activity identity total score, 4 physical activity identity dimensions (appearance, importance, competence, and encouragement), and 4 eating identity subtypes (healthy, emotional, meat, and picky) were examined using multiple linear regressions. A significant positive association was found between total physical activity identity score and the healthy eating subtype and a negative association with the picky eating subtype. The physical activity dimension importance had a significant positive association with the healthy eating subtype, appearance a negative association with the emotional eating subtype, and competence a positive association with the meat eating subtype but a negative association with the picky eating subtype. The findings suggest important overlap in identities for physical activity and diet. Measurement of physical activity identity and eating identity as well as tailored intervention strategies should be incorporated into more behavior change research.

This quantitative study examined the presence of culturally relevant health messages for African-Americans based on a preexisting dataset from 21 African-American churches in South Carolina (USA). Content analysis served as the primary methodological approach to code printed media messages based on their cultural relevance among African-Americans (Cohen’s kappa = .74). Within the dataset (n = 2166), 477 (22%) items were identified as culturally relevant. A low prevalence of culturally relevant messages was found across the three message topics, two media types, and one media source. Due to the limited presence of culturally relevant messages, researchers should collaborate with African-American churches to design health promotion messages.

Background It is currently unknown if within high-quality dietary intake there exist distinct dietary patterns associated with health benefits that are identifiable with multidimensional dietary pattern analyses. The purpose of this study was to identify specific dietary patterns and groups therein and their associations with all-cause, CVD, and cancer mortality. Methods We conducted sex-specific k-means cluster analyses within Healthy Eating Index 2015 (HEI-2015) quintile 5 in 3 US cohorts [NIH-American Association of Retired Persons Diet and Health Study (AARP), the Multiethnic Cohort (MEC), Women's Health Initiative Observational Study (WHI OS)], clusters ranging from n = 1190 to n = 12,007. Characterizations incorporated HEI-2015 overall and component-specific percentage adherence goals, using untruncated and truncated radar graphs and shape analyses. Using cohort- and sex-specific Cox proportional hazards models, associations of quintile 5 clusters with all-cause, cardiovascular disease (CVD), and cancer mortality were evaluated relative to quintile 1. Results In each cohort sex-specific sample, 3 identified clusters included 16%-62% of participants, providing evidence for variation within high-quality dietary intake. Clusters revealed commonalities in total fruits and whole fruits intakes that exceeded goals and high sodium intake. Dairy and whole grain intakes oftentimes fell below goal. Some clusters were in addition characterized by total vegetables, greens & beans, and seafood & plant protein intakes exceeding goals. All high-quality dietary patterns were associated with a multivariable-adjusted significant 15%-26% lower risk of all-cause death than diet intake in quintile 1 (except for cluster 2 in WHI OS), and with a 16%-25% lower risk of CVD mortality in the AARP and MEC cohorts. Cancer mortality results were inconsistent. Conclusions Multiple ways to achieve a high-quality diet were identified and significant associations with lower all-cause and CVD mortality were seen in some cohorts.