A small but growing literature recognizes the varied roles that clergy play in identifying and addressing mental health needs in their congregations. Although the role of the clergy in mental health services delivery has not been studied extensively, a few investigations have attempted a systematic examination of this area. This article examines the research, highlighting available information with regard to the process by which mental health needs are identified and addressed by faith communities. Areas and issues where additional information is needed also are discussed. Other topics addressed include client characteristics and factors associated with the use of ministers for personal problems, the role of ministers in mental health services delivery, factors related to the development of church-based programs and service delivery systems, and models that link churches and formal services agencies. A concluding section describes barriers to and constraints against effective partnerships between churches, formal services agencies, and the broader practice of social work.

The volume and quality of research on what we term the religion-health connection have increased markedly in recent years. This interest in the complex relationships between religion and mental and physical health is being fueled by energetic and innovative research programs in several fields, including sociology, psychology, health behavior and health education, psychiatry, gerontology, and social epidemiology. This article has three main objectives: (1) to briefly review the medical and epidemiologic research on religious factors and both physical health and mental health; (2) to identify the most promising explanatory mechanisms for religious effects on health, giving particular attention to the relationships between religious factors and the central constructs of the life stress paradigm, which guides most current social and behavioral research on health outcomes; and (3) to critique previous work on religion and health, pointing out limitations and promising new research directions.

CONTEXT:Evidence synthesized from social epidemiology, psychophysiology, and behavioral medicine suggests that religiousness may represent a significant correlate of absorption, a construct for which few if any psychosocial determinants have been identified.OBJECTIVE:To examine the association between absorption and intrinsic and extrinsic religiousness.PARTICIPANTS:83 respondents of a self-administered survey of adult survivors of cancer or other life-threatening diseases, recruited from participants in a pilot study of psychosocial factors related to recovery from illness.MAIN MEASURES:Tellegen Absorption Scale and Religious Orientation Scale.RESULTS:Absorption, as assessed by the Tellegen Absorption Scale, was positively and significantly associated with intrinsic religiousness, as measured by the Religious Orientation Scale. Predominantly intrinsic subjects had absorption scores at least 20% higher than did predominantly extrinsic, proreligious, or nonreligious subjects.DISCUSSION:Prior research has found that absorption and hypnotizability have psychophysiological correlates, and that religiousness shows protective effects against morbidity and mortality. In light of this work, the present findings suggest that certain religious cognitions, emotions, or experiences may generate an internally focused state that enhances health and attenuates disease through self-soothing psychophysiological mechanisms.

This panel study explores the effects of eight measures of religious involvement on three indicators of well-being in a national probability sample of African Americans. Religious measures include religious attendance, church membership, church activity, reading religious books, listening to religious TV/radio, prayer, asking for prayer, and subjective religiosity. web-being indicators include single-hem measures of life satisfaction and happiness, and a 10-item version of the RAND Mental Health Index (MHI), a scale assessing psychological distress. Using data from multiple waves of the National Survey of Black Americans, religious effects on well-being are examined both cross-sectionally at each wave and longitudinally across waves. Findings reveal strong, statistically significant, and consistent religious effects on well-being contemporaneously within each wave, which withstand controlling for the effects of health and seven sociodemographic variables. Longitudinal religious effects on well-being are present bivariately, but disappear after controlling for the effects of baseline well-being, lagged religious involvement, and health. The meaning and interpretation of contemporaneous as opposed to longitudinal religious effects on wellbeing are discussed.

This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

OBJECTIVES This article summarizes the deliberations of the Quantitative Methods Working Group convened by the National Institutes of Health (NIH) in support of the NIH Office of Alternative Medicine. METHODS The working group was charged with identifying methods of study design and data analysis that can be applied to empirical research on complementary and alternative medicine. This charge was broad and inclusive and addressed the evaluation of alternative therapies, the investigation of the basic science of complementary medical systems, studies of health promotion and disease prevention, and health services research. RESULTS The working group produced a "methodological manifesto," a summary list of seven recommended methodological guidelines for research on alternative medicine. These recommendations emphasize the robustness of existing research methods and analytic procedures despite the substantive unconventionality of alternative medicine. CONCLUSIONS Contrary to the assertions of many researchers and alternative practitioners, established methodologies (eg, experimental trials, observational epidemiology, social survey research) and data-analytic procedures (eg, analysis of variance, logistic regression, multivariate modeling techniques) are quite satisfactory for addressing the majority of study questions related to alternative medicine, from clinical research on therapeutic efficacy to basic science research on mechanisms of pathogenesis and recovery.

This study examined the effects of religious attendance on three dimensions of psychological well-being using panel data from a three-generations study of Mexican Americans from Texas (N = 624). Well-being dimensions included life satisfaction (the 13-item LSIA), and respective seven- and four-item depressed and positive affect subscales of the CES-D. Two-wave path analyses revealed a cross-sectional association between religious attendance and life satisfaction in the two oldest generations, and a salutary longitudinal effect of religious attendance on subsequent depressed affect in the youngest generation. Findings for life satisfaction and depressed affect withstood controlling for health and five sociodemographic correlates of religious attendance and well-being.

This article highlights the major descriptive findings of an exploratory, quantitative study of American autobiographies published before 1945. Of particular importance for gerontology, age-cohort distributions of autobiographers are graphed, demonstrating that the genre itself has been created predominantly by men and women aged 55 and over. This study suggests that these writers offer scholars a virtually untapped resource for the historical phenomenology of aging.

This study tests a theoretical model linking religiosity, health status, and life satisfaction using data from the National Survey of Black Americans, a nationally representative sample of Blacks at least 18 years old. Findings reveal statistically significant effects for organizational religiosity on both health and life satisfaction, for nonorganizational religiosity on health, and for subjective religiosity on life satisfaction. Analyses of structural invariance reveal a good overall fit for the model across three age cohorts (< or = 30, 31-54, > or = 55) and confirm that assuming age-invariance of structural parameters does not significantly detract from overall fit. In addition, after controlling for the effects of several sociodemographic correlates of religiosity, health, and well-being, organizational religiosity maintains a strong, significant effect on life satisfaction. These findings suggest that the association between religion and well-being is consistent over the life course and not simply an artifact of the confounding of measures of organizational religiosity and health status.

This paper reviews evidence for a relationship between religion and health. Hundreds of epidemiologic studies have reported statistically significant, salutary effects of religious indicators on morbidity and mortality. However, this does not necessarily imply that religion influences health; three questions must first be answered: "Is there an association?", "Is it valid?", and, "Is it causal?" Evidence presented in this paper suggests that the answers to these respective questions are "yes," "probably," and "maybe." In answering these questions, several issues are addressed. First, key reviews and studies are discussed. Second, the problems of chance, bias, and confounding are examined. Third, alternative explanations for observed associations between religion and health are described. Fourth, these issues are carefully explored in the context of Hill's well-known features of a causal relationship. Despite the inconclusiveness of empirical evidence and the controversial and epistemologically complex nature of religion as an epidemiologic construct, this area is worthy of additional investigation. Further research can help to clarify these provocative findings.

This article describes the confirmation and validation of a multidimensional measure of religious involvement using data from the National Survey of Black Americans (N = 2,107). This model was developed through a multistep strategy of confirmatory factor analysis and structural-equation modeling. First, a three-dimensional factor structure comprising organizational, nonorganizational, and subjective religiosity was confirmed for twelve religious indicators. This measurement model was found to exhibit excellent overall fit; it compared favorably to alternative models; and all hypothesized factor loadings were strong and statistically significant. Second, several constructs identified by prior research as correlates of religious involvement (gender, age, education, region, and urbanicity) were found to exhibit significant associations with one or more dimensions of the model. All analyses were conducted in LISREL 8.03, using maximum-likelihood estimation and a strategy of split-sample replication.

Gender and age differences were examined in over a dozen religious indicators using cross-sectional data from the National Survey of Black Americans (N = 2,107). Although both genders manifested moderate to high levels of organizational, nonorganizational, and subjective religiosity, black women significantly exceeded black men in levels of religiosity at all ages, even when controlling for the effects of education, marital and employment status, region, urbanicity, and health satisfaction.

Age differences are examined in reports of deja vu, ESP, clairvoyance, spiritualism, and numinous experience. According to the 1988 General Social Survey (N = 1481), these mystical experiences are somewhat more common now than in 1973, and deja vu, clairvoyance, and a composite mysticism score have increased with successively younger age cohorts. Further, private and subjective religiosity are positively related to overall mystical experience, while organizational religiosity is inversely related.

In this study we examined the relationship between praying for one's baby during pregnancy and self-ratings of health. Data were collected from a biethnic (black and Hispanic) sample of postpartum mothers in Galveston, Tex, from 1986 to 1987. This sample is representative of the annual biethnic population of live births in Galveston. Subjective health was assessed for the periods both before and during pregnancy with self-ratings of global or overall health, worry over health, and functional health or lack of disability. Analyses controlled for the effects of the mother's age, marital status, gravidity, education, and self-rated religiosity. Findings revealed that all three prepregnancy health measures were associated with prayer. Subjectively unhealthier mothers prayed more for their baby during pregnancy regardless of their perceived health during pregnancy, and subjectively healthier mothers prayed less for their baby regardless of their self-reported religiosity. Additional analyses revealed that the effect of poor health on the frequency of prayer was not simply an outcome of the mother's worry over her own health.

This study proposed and tested a measurement model of religiosity among a sample of older (55 years of age and above) Black Americans. This model incorporates three correlated dimensions of religious involvement, termed organizational, nonorganizational, and subjective religiosity. Findings indicate that the proposed model provides a good fit to the data, is preferable to other alternative models, and exhibits convergent validity with respect to exogenous or antecedent variables (age, gender, marital status, income, education, urbanicity, and region) known to predict religious involvement. In addition, these antecedents exhibit stronger effects on subjective religiosity than on the two more behavioral dimensions of religiosity. Interpretation of these status-group differences in religiosity focuses on socialization experiences and social environment factors which may promote a religious world-view.

Findings are presented from the Galveston Low Birthweight Survey (GLOWBS), conducted at The University of Texas Medical Branch from 1986 through 1987. One full year of delivery logbook data were abstracted on all live, single births (N = 3904) to Anglo (n = 2114), black (n = 902), and Hispanic (n = 888) mothers. Analyses include triethnic comparisons of pregnancy outcomes and maternal characteristics through analysis of variance and both crude and adjusted logistic regression for deleterious pregnancy outcomes in blacks relative to non-blacks. The most striking finding is a consistent black disadvantage that withstands controlling for parity, age, and marital status. Blacks have a significantly lower mean birthweight, shorter mean gestation, lower 1-minute and 5-minute Apgar scores, and a higher incidence of both low birthweight (RR = 1.89) and prematurity (RR = 1.57) than either Anglos or Hispanics, between whom no differences are found.

Findings are presented from an analysis of patterns and predictors of religious involvement among 135 Hispanic and 118 Black mothers interviewed postpartum as part of the Galveston Low Birthweight Survey in 1986. Three indicators of religious involvement were examined (religious attendance, frequency of prayer, and self-rated religiosity), and six predictors were included (age, education, marital status, prepartum parity, subjective health, and pregnancy anxiety). Results of analysis of covariance and multiple regression include ethnic differences in both patterns and predictors of religious involvement. These findings are compared to similar research on religious involvement in older Hispanics and Blacks.

Despite growth in the field of gerontological research over the past 50 years, no consensus has emerged on either the definition of gerontology or on its scope and boundaries. This confusion is rooted historically in developments involving the origins and adoption of the term. These include the divergent agendas and world views of particular disciplines and gerontological institutions, as well as conflicts over both ideology and turf among major gerontologists. Speculation is offered on the potential, as well as the costs, of developing consensus-in the future.

A measurement model of mental health for the Older Americans Resources and Services (OARS) questionnaire is described. Using confirmatory factor analysis on noninstitutionalized elderly from Cleveland (N = 1834) and Virginia (N = 2146), the 21 OARS mental health items were fit to a 15-item model. In addition to the second-order construct of mental health, there were four first-order dimensions: life satisfaction, psychosomatic symptomatology, alienation, and cognitive deficit. Analyses were further replicated by splitting both samples in half. The model fit well and compared favorably to other alternative specifications. In addition to this analysis of internal structure, the model was also examined in relation to several exogenous factors including age, sex, race, education, and physical health. While the model again fit well, a model with cognitive deficit separate from the other factors seemed more reasonable.