Advancing our understanding of religion and spirituality in the context of behavioral medicine
Open accessAbstract
Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.
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Written from the paper’s full text.
TL;DR
This narrative review summarizes evidence on religiousness/spirituality (RS) in relation to cardiovascular disease, cancer, and substance abuse, and proposes a conceptual model to guide future behavioral medicine research. It argues that RS is multidimensional and that progress requires clearer conceptualization, attention to mediators and moderators, and more rigorous methodology.
Key findings
- CVD: Earlier population studies and a meta-analysis (Chida et al., 2009) suggested an independent association between organizational religiosity (service attendance) and lower CVD mortality, but more recent longitudinal cohorts (Women's Health Initiative; MESA, ~5000 healthy men and women) found no protective association, with point estimates actually showing higher CVD risk among the more religiously involved; the authors conclude the evidence is "inconclusive."
- Cancer: Meta-analyses of 1341 effects from over 44,000 cancer patients found an overall positive relationship between RS and self-reported health outcomes, but strength varied by RS dimension and outcome type; strongest links were between affective RS dimensions (meaning, purpose, connection) and mental health, while behavioral RS constructs showed few significant associations except a modest link to social health. NRC (spiritual struggle) was consistently associated with greater distress, depression, anxiety, and worse adjustment.
- Substance abuse: Strong evidence for an inverse relationship between RS and substance abuse, with accumulating causal evidence (e.g., DeWall et al., 2014 experimental prayer manipulation predicted increased religiosity and decreased alcohol use); evidence is weaker for spirituality than for religiosity.
- The authors propose a conceptual model emphasizing that RS comprises many diverse constructs, mechanisms are varied (health behaviors, physiological processes, social support), and a range of health-relevant outcomes may be affected.
Methods
- Design: Narrative review/critical synthesis, not a primary study; framed by a conceptual model (Fig. 1) derived from prior models (e.g., Fitchett & Canada, 2010; Levin & Vanderpool, 1989; Masters, 2008).
- Scope: Brief summary and critique of existing evidence for RS in three exemplary conditions (cardiovascular disease, cancer, substance abuse), followed by discussion of conceptual issues, mediators/moderators, methodology, barriers, and recommendations.
- Analysis: Qualitative synthesis of cited literature; the authors note they were limited to the RS terminology used by original study authors and therefore use the broad umbrella term "RS."
Limitations
- Stated by the paper: the review is limited to the terminology chosen by original study authors, so it reflects that heterogeneity; a full discussion of competing RS definitions is beyond its scope.
- Stated by the paper: much of the underlying evidence is cross-sectional (more than 90% of cancer studies), many studies fail to control for relevant covariates or confounds, and RS cannot be randomly assigned, making strong causal inference difficult.
- Evident from the text: this is a selective narrative review rather than a systematic one, with no stated search strategy, inclusion criteria, or formal quality appraisal; the three health conditions were chosen as "exemplary" rather than exhaustively.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Claims the paper makes
0 of 110 cited sources checked · 0 supported · 0 flagged
- Findingreasoning
There is, with few exceptions, reluctance to fund research projects that feature RS as a primary focus.
“It is our distinct impression, based on reviews of projects funded by NIH and discussions with NIH staff, that there is, with few exceptions, reluctance to fund research projects that feature RS as a primary focus.”
Quote in the paperSubstantial claim - Interpretationcitation
Overall, positive associations between RS and CVD were found in studies conducted among younger healthy individuals.
“Overall, positive associations between RS and CVD were found in studies conducted among younger healthy individuals (Chida et al., 2009; Friedlander et al., 1986; Goldbourt et al., 1993; Hummer et al., 1999; Oman et al., 2002).”
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A prospective study among MI survivors did not show associations between organizational religiosity, private religious practice, or spiritual experiences and all-cause mortality or risk of recurrent MI.
“A prospective study conducted among a select group of myocardial infarction (MI) survivors who were at risk for a second MI due to their high rates of depression and social isolation did not show associations between organizational religiosity, private religious practice, or spiritual experiences and all-cause mortality or risk of recurrent MI (Blumenthal et al., 2007).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Blumenthal et al., 2007 source
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- Premisecitation
In the WHI and MESA cohorts, point estimates showed a higher risk of CVD among the more religiously involved.
“In both the WHI and MESA cohorts, point estimates actually showed a higher risk of CVD among the more religiously involved.”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Evidence from rigorously designed population studies and a seminal meta-analysis suggested an independent association between organizational religiosity (religious service attendance) and CVD mortality.
“The evidence from rigorously designed population studies and from a seminal meta-analysis suggested the existence of an independent association between organizational religiosity (i.e., religious service attendance) and CVD mortality (Chida et al., 2009; Hummer et al., 1999; Oman et al., 2002).”
Quote in the paperSubstantial claim0 of 3 sources checked
- Premisecitation
RS are associated with salutary health behaviors.
“as well as salutary health behaviors (Benjamins, 2006; Salmoirago-Blotcher et al., 2011)”
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- cites Salmoirago-Blotcher et al., 2011 source
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- Premisecitation
RS are associated with mental health variables.
“RS are associated with mental health variables (Koenig, 2012)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Koenig, 2012
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- Premisecitation
Adherence to orthodox practices has been associated with reduced cardiovascular mortality and morbidity in Jewish populations.
“In addition, adherence to orthodox practices has been associated with reduced cardiovascular mortality and morbidity in Jewish populations (Friedlander et al., 1986; Goldbourt et al., 1993).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
Colantonio et al. (1992) did not find significant associations between organizational religiosity and risk of stroke among older non-institutionalized individuals.
“Colantonio et al. (1992) did not find significant associations between organizational religiosity and risk of stroke among older non-institutionalized individuals.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Colantonio et al., 1992 source
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- Premisecitation
Social scientists have historically distanced themselves from religious and spiritual matters in the context of clinical research and practice.
“social scientists have historically distanced themselves from religious and spiritual matters in the context of clinical research and practice (Delaney et al., 2007)”
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- Premisecitation
RS have shown possible influences on many important outcomes, including lower mortality.
“RS have shown possible influences on many important outcomes, including lower mortality (Powell et al., 2003).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Powell et al., 2003 source
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- Interpretationnone given
A range of different types of health and health-relevant outcomes may be influenced by RS.
“a range of different types of health and health relevant outcomes may be influenced by RS”
- Also stated in: § Introduction · hedged
“a range of health-relevant outcomes may be influenced by RS”
Quote in the paperNot a substantial claim - Also stated in: § Introduction · hedged
- Premisecitation
RS are linked to improved health and health-relevant outcomes among individuals with cardiovascular disease, cancer, and substance abuse.
“are linked to a number of improved health and health-relevant outcomes among individuals with a variety of conditions such as cardiovascular disease (Chida et al., 2009), cancer (Laubmeier et al., 2004), and substance abuse (Geppert et al., 2007).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Peer-reviewed research indicates a magnitude of associations between RS and health outcomes ranging from small to large.
“peer-reviewed research appears to indicate a magnitude of associations between RS and health outcomes ranging from “small” to “large” (Hwang et al., 2011).”
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- Interpretationreasoning
Current epidemiological evidence suggests a more complex picture than a consistent protective association between RS and CVD outcomes at the population level.
“Instead, the current epidemiological evidence suggests a more complex picture.”
Quote in the paperNot a substantial claim - Premisecitation
After a cancer diagnosis, many patients report that RS are important to their adjustment.
“After a cancer diagnosis, many patients report that RS are important to their adjustment (Asgeirsdottir et al., 2013).”
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- Premisecitation
There is overwhelming consensus that religiosity, particularly attendance and often spirituality, are negatively related to alcohol, tobacco, and illicit substance use across the U.S. and other countries.
“There is overwhelming consensus that religiosity, particularly attendance and often spirituality, are negatively related to alcohol, tobacco, and illicit substance use across the U.S. and other countries (El Ansari et al., 2014; Hatta, 2010; Hayatbakhsh et al., 2014; Kovaks et al., 2011; Rasic et al., 2011; Wang et al., 2015).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Study design and conductnone given
Studies with null or negative findings extensively adjusted for coronary risk factors as well as a wealth of confounding and mediating variables that were not considered or available in earlier studies.
“We note that studies with null or negative findings extensively adjusted for coronary risk factors as well as a wealth of confounding and mediating variables that were not considered or available in earlier studies.”
Quote in the paperNot a substantial claim - Premisecitation
A smaller but respectable literature empirically supports the notion that RS provide protection against substance abuse, especially RS beliefs established during childhood.
“A smaller but respectable literature empirically supports the notion that RS provide protection against substance abuse, especially RS beliefs established during childhood (Porche et al., 2015).”
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- Interpretationreasoning
Current evidence linking RS and cardiovascular mortality and morbidity remains inconclusive.
“Taken together, the above findings indicate that despite the earlier meta-analytical finding of an independent association between RS and CVD outcomes (Chida et al., 2009), the current evidence linking RS and cardiovascular mortality and morbidity remains inconclusive”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Chida et al., 2009 source
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- Premisecitation
84% of advanced cancer patients report relying on their religious beliefs to cope.
“84 % of advanced cancer patients report relying on their religious beliefs to cope (Vallurupalli et al., 2012).”
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- Premisecitation
A few experimental studies demonstrate a possible causal relationship between RS and changes in substance use.
“A few experimental studies even demonstrate a possible causal relationship between RS and changes in substance use (e.g., DeWall et al., 2014).”
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- Premisecitation
A review of 18 studies examining the risk for cancer in Christian and non-Christian samples concluded that lifestyle factors explained the reduced risk for cancer associated with a Christian affiliation.
“A review of 18 studies examining the risk for cancer in Christian and non-Christian samples concluded that lifestyle factors explained the reduced risk for cancer associated with a Christian affiliation (Hoff et al., 2008).”
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- Interpretationreasoning
Such findings suggest that RS may be part of a profile associated with reduced risk for cancer.
“Such findings suggest that RS may be part of a profile associated with reduced risk for cancer.”
Quote in the paperSubstantial claim - Premisecitation
In twin studies, Kendler and Myers (2009) found that the inverse relationship between religious service attendance and both alcohol and tobacco use became stronger over time.
“In twin studies, Kendler and Myers (2009) found that the inverse relationship between religious service attendance and both alcohol and tobacco use became stronger over time”
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- Interpretationreasoning
Generally, there appears to be less evidence for a protective relationship for spirituality.
“Generally, there appears to be less evidence for a protective relationship for spirituality.”
Quote in the paperNot a substantial claim - Premisecitation
Many pathways have been proposed to explain how religion and spirituality may exert salutary influences on well-being.
“Many pathways have been proposed to explain how religion and spirituality may exert salutary influences on well-being (Clements & Ermakova, 2012; Fitchett & Canada, 2010; Lee & Newberg, 2005; Levin & Vanderpool, 1989; Masters, 2008; Oman & Thoresen, 2005; Park, 2007; see Aldwin et al., 2014, for a review).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Premisecitation
Although a number of conceptualizations of RS have been advanced, surprisingly few studies that use RS variables explicitly use these conceptualizations.
“Although a number of conceptualizations of RS have been advanced, surprisingly few studies that use RS variables explicitly use these conceptualizations (Rosmarin et al., 2011).”
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- Premisecitation
RS have been related to lower levels of risky health behaviors in diverse samples.
“RS have been related to lower levels of risky health behaviors in diverse samples including inner-city cocaine-using methadone-maintained patients (Avants et al., 2006) and pregnant women in Appalachia (Jesse & Reed, 2006).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationcitation
There is intriguing evidence of a causal relationship between RS and substance use whereby increases in RS predict decreased substance abuse.
“There is intriguing evidence of a causal relationship between RS and substance use whereby increases in RS predict decreased substance abuse.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites DeWall et al., 2014 source
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- Premisecitation
Findings were less clear for spirituality.
“Findings were less clear for spirituality (Geppert et al., 2007; Walton-Moss et al., 2013).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
A recent and broadly accepted self-correction occurred with the updating of the domains of the FACIT-Sp, from a two-factor model (meaning/peace and faith) to three domains (meaning, peace, and faith) that provide more informative constructs and better psychometric properties.
“A recent and broadly accepted self-correction occurred with the updating of the domains of a widely used instrument, the FACIT-Sp. This instrument initially conceptualized RS as a two factor model: meaning/peace and faith (Peterman et al., 2002). However, further study of the two factor structure indicated that the meaning/peace component was too closely related to anxiety and that separating this”
Quote in the paperNot a substantial claim0 of 2 sources checked - Study design and conductcitation
Using the FACIT-Sp as a predictor of well-being outcomes is a common misuse which confounds predictor and outcome variables.
“care should be taken to avoid using the measure as a predictor of well-being outcomes—a common misuse which confounds predictor and outcome variables (Park et al., 2015).”
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- Premisecitation
Large-scale epidemiological studies have demonstrated that health behaviors partially mediate the effects of service attendance on physical health, including mortality.
“Large-scale epidemiological studies have demonstrated that health behaviors partially mediate the effects of service attendance on physical health, including mortality (e.g., Koenig & Vaillant, 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Koenig & Vaillant, 2009 source
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- Premisecitation
Starting in the 2000s, conceptualization of the domains moved toward seeing religiousness and spirituality as interrelated.
“However, starting in the 2000’s, conceptualization of the domains moved toward seeing R and S as interrelated (Hill et al., 2000).”
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- Interpretationcitation
RS appear to promote a healthier lifestyle.
“RS appear to promote a healthier lifestyle.”
Quote in the paperSubstantial claim - Premisecitation
Other RS constructs are, within certain limits, amenable to randomization or manipulation.
“But others are, within certain limits, amenable to such treatments.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Wachholtz & Pargament, 2005, 2008
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- cites Wachholtz et al., 2015 source
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- Premisecitation
Sociodemographics have been shown to be important moderators in RS-health linkages.
“Sociodemographics have been shown to be important moderators in RS-health linkages.”
Quote in the paperSubstantial claim - Interpretationreasoning
Since it is not possible to randomly assign individuals to particular RS beliefs or views, establishing strong causal inference becomes nearly impossible with particular variables.
“Further, since it is not possible to randomly assign individuals to particular RS beliefs or views, establishing strong causal inference becomes nearly impossible with particular variables.”
Quote in the paperSubstantial claim - Premisereasoning
Individuals who believe that God is ultimately in control of their health do not necessarily display an external locus of health control and passive coping strategies; this is often not the case.
“it may be presumed that individuals who believe that God is ultimately in control of their health display an external locus of health control and are characterized by passive coping strategies. This is often not the case (e.g., Masters & Wallston, 2005; Umezawa et al., 2012)”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
It is possible to study the effects of spiritual meditation, prayer, or other RS behavioral variables on stress reactivity in the laboratory by including only willing participants, using random assignment with designed controls, and exposing participants to a stressor and measuring stress responses.
“it is quite possible to study the effects of spiritual meditation, prayer, or other RS behavioral variables (e.g., scripture reading) on stress reactivity in the laboratory”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Wachholtz & Pargament, 2005, 2008
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- cites Wachholtz et al., 2015 source
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- Premisecitation
Many individuals who believe God is in control of health also believe that God has charged them with responsibility to engage in certain behaviors, some health related.
“because many of those who believe God is in control also believe that God has charged them with the responsibility to engage in certain behaviors, some health related.”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Different dimensions of RS, including religious beliefs, religious involvement, and religious coping, were related to health behaviors, including diet, exercise, and smoking, in a nationally representative sample of African Americans.
“A nationally representative sample of African Americans showed that different dimensions of RS, including religious beliefs (Debnam et al., 2012a), religious involvement (Holt et al., 2014b), and religious coping (Holt et al., 2014a) were related to health behaviors, including diet, exercise, and smoking.”
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- cites Holt et al., 2014b
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- Interpretationreasoning
The high levels of within-group variability on health outcomes among individuals with high levels of RS suggests that moderating factors may play critical roles in these linkages.
“The high levels of within-group variability on health outcomes among individuals with high levels of RS suggests that moderating factors may play critical roles in these linkages”
Quote in the paperSubstantial claim - Premisecitation
Analyses of a recent nationally representative sample in the US demonstrated moderated mediation such that the mediational pathway of social support linked religious involvement and beneficial health effects only among African Americans.
“Analyses of a recent nationally representative sample in the US demonstrated moderated mediation such that the mediational pathway of social support linked religious involvement and beneficial health effects only among African Americans (Assari, 2013).”
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- Premisecitation
Hooker et al. (2016) reported on a feasible and acceptable behavioral medicine intervention for patients with heart failure that encourages patients to explore their own sense of RS and seek meaning, purpose or forgiveness within their own spiritual framework.
“Hooker et al. (2016) recently reported on a feasible and acceptable behavioral medicine intervention, in this case for patients with heart failure, that encourages patients to explore their own sense of RS and seek meaning, purpose or forgiveness within their own spiritual framework.”
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- Interpretationreasoning
The potential influence of religions on the lives of believers is quite encompassing and likely to influence many relevant psychological and behavioral concepts.
“The potential influence of religions on the lives of believers is quite encompassing and, therefore, likely to influence many relevant psychological and behavioral concepts.”
Quote in the paperNot a substantial claim - Premisecitation
The courts have agreed that funding research in this area is not a violation.
“though the courts have agreed that funding research in this area is not a violation (Miller & Thoresen, 2003)”
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- Interpretationreasoning
RS informed interventions are potentially of significant public health benefit.
“RS informed interventions are: (a) appropriate when delivered with proper sensitivity and understanding; and (b) potentially of significant public health benefit.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 30
- May combine two claims. 36
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Interpretationnone givenThe mechanisms through which RS may influence health outcomes are diverse.
“the mechanisms through which RS may influence health outcomes are quite diverse”
- Also stated in: § Introduction · hedged
“the mechanisms through which RS may influence health-related outcomes are likewise varied”
Quote in the paperSubstantial claim- Also stated in: § Introduction · hedged
Classified as probably not a substantial claim.
Premisenone givenReligiousness and spirituality (RS) comprise many diverse constructs.
“RS comprise many diverse constructs”
- Also stated in: § Introduction · plain
“RS comprise many diverse and varied constructs”
Quote in the paperSubstantial claim- Also stated in: § Introduction · plain
May combine two claims.
PremisecitationStudies documented multiple beneficial effects associated with certain RS dimensions (e.g., private spiritual practices and intrinsic religiosity), such as higher levels of cardiac autonomic control and lower blood pressure reactivity to stressors.
“These studies documented multiple beneficial effects associated with certain RS dimensions (e.g., private spiritual practices and intrinsic religiosity), such as higher levels of cardiac autonomic control (Berntson et al., 2008) and lower blood pressure reactivity to stressors (Masters et al., 2004).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThe multidimensional nature of RS and the complexity of its associations with different health endpoints present formidable challenges to empirical study in behavioral medicine.
“The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine.”
- Also stated in: § Introduction · plain
“The multidimensional nature of RS and the complexity of its associations with different types of health endpoints present formidable challenges to empirical study.”
Quote in the paperNot a substantial claim- Also stated in: § Introduction · plain
Classified as probably not a substantial claim.
PremisecitationThe achievement of satisfactory definitions of religiousness and spirituality remains elusive.
“In spite of these efforts, the achievement of this goal remains elusive.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Oman, 2013
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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
Premisenone givenRS collectively represents a constellation of affective, behavioral, and cognitive variables that may affect feelings, actions, and thoughts in ways that influence health-related outcomes.
“RS collectively represents a constellation of important affective, behavioral, and cognitive variables that may affect the feelings, actions, and thoughts of people in ways that influence important health-related outcomes.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationPRC has also been associated with greater transplant concerns in multiple myeloma patients and more physical symptoms in advanced cancer patients.
“However, PRC has also been associated with greater transplant concerns in multiple myeloma patients (Sherman et al., 2009) and more physical symptoms in advanced cancer patients (Tarakeshwar et al., 2006).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationPositive religious coping (PRC) is much more prevalent than negative religious coping (NRC) but has shown mixed relationships with various types of psychological well-being in cancer patients.
“PRC is much more prevalent than NRC (Hebert et al., 2009) but has shown mixed relationships with various types of psychological well-being in cancer patients (Gall et al., 2011).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationRecent meta-analyses of 1341 effects drawn from over 44,000 patients with cancer demonstrated an overall positive relationship between RS and self-reported measures of health outcomes, but the strength varied as a function of RS dimension and physical, mental, and social outcomes assessed.
“Recent meta-analyses of 1341 effects drawn from over 44,000 patients with cancer demonstrated an overall positive relationship between RS and self-reported measures of health outcomes (Park et al., 2015) but the strength of that relationship varied as a function of both the RS dimension and the physical (Jim et al., 2015), mental (Salsman et al., 2015), and social (Sherman et al., 2015) outcomes”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
PremisecitationRS beliefs and practices are associated with health behaviors associated with reduced cancer risk such as lower levels of smoking and alcohol use, greater use of preventive health services and cancer screening, and greater adherence to health behaviors.
“This finding is consistent with research indicating that RS beliefs and practices are associated with health behaviors associated with reduced cancer risk such as lower levels of smoking and alcohol use (Rew & Wong, 2006), greater use of preventive health services and cancer screening (Benjamins & Brown, 2004), and greater adherence to health behaviors (Park et al., 2008).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationApproximately 66% of cancer patients report using prayer to cope with their illness.
“Approximately 66 % of cancer patients report using prayer to cope with their illness (Ross et al., 2008)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Ross et al., 2008 source
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PremisecitationIn systematic reviews of RS and cancer mortality or progression, there are consistent failures to support the hypotheses that RS slows cancer progression, and inadequate evidence to support the hypothesis that RS protects against cancer mortality.
“In systematic reviews of RS and cancer mortality or progression, there are consistent failures to support the hypotheses that RS slows cancer progression, and inadequate evidence to support the hypothesis that RS protects against cancer mortality (Powell et al., 2003).”
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PremisecitationMany studies suggest PRC is associated with better emotional, interpersonal, and global functioning, better overall quality of life, and greater growth.
“Many studies suggest that PRC is associated with better emotional, interpersonal, and global functioning (Agarwal et al., 2010; Gall, 2004), better overall quality of life (Tarakeshwar et al., 2006), and greater growth (Urcuyo et al., 2005).”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
PremisecitationNRC is consistently associated with greater psychological distress, including higher levels of depression and lower levels of life satisfaction and quality of life, higher levels of anxiety and poorer physical health, and worse mental health and adjustment to illness.
“Though endorsed at far lower rates than PRC, NRC is consistently associated with greater psychological distress, including higher levels of depression and lower levels of life satisfaction and quality of life (Hebert et al., 2009), higher levels of anxiety and poorer physical health (Sherman et al., 2009), and worse mental health (Pérez & Smith, 2015) and adjustment to illness (Exline et al., 2011”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
PremisecitationThe strongest relationships were found between affective dimensions of RS and mental health outcomes, whereas behavioral RS constructs showed few significant associations with health, except for a modest positive relationship with social health outcomes.
“The strongest relationships were found between affective dimensions of RS (e.g., sense of meaning, purpose, or connection to a source larger than oneself) and mental health outcomes, whereas behavioral RS constructs (e.g., service attendance, prayer and meditation) showed few significant associations with health, except for a modest positive relationship with social health outcomes.”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
Study design and conductnone givenMore than 90% of the studies in these meta-analyses were cross-sectional and more than 50% failed to account for relevant covariates or confounds.
“However, more than 90 % of the studies were cross-sectional and more than 50 % failed to account for relevant covariates or confounds.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe findings from cardiovascular disease, cancer, and substance abuse are provocative and suggest a potential benefit of RS on multiple physical health and health-relevant outcomes.
“The findings from cardiovascular disease, cancer, and substance abuse are provocative and suggest a potential benefit of RS on multiple physical health and health-relevant outcomes.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe separation of behavior from function allows researchers to identify individual domains without completely separating the concepts of religion and spirituality.
“The separation of behavior from function allows researchers to identify individual domains without completely separating the concepts of religion and spirituality (Hill & Pargament, 2008).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hill & Pargament, 2008 source
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Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
Interpretationnone givenToo often, researchers fail to clearly operationalize RS constructs and use RS measures that are confounded with their outcomes of interest or have poor psychometrics.
“Too often, researchers fail to clearly operationalize RS constructs and use RS measures that are confounded with their outcomes of interest or have poor psychometrics.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationButton et al. (2010) showed that religiosity moderated the relationship between genetic factors and alcohol use only in adolescent twins-reduced genetic variance for problem alcohol use with increasing levels of religiosity for both males and females-but religiosity did not moderate alcohol use for either gender in early adulthood.
“however, Button et al. (2010) showed that religiosity moderated the relationship between genetic factors and alcohol use only in adolescent twins—reduced genetic variance for problem alcohol use with increasing levels of religiosity for both males and females—but religiosity did not moderate alcohol use for either gender in early adulthood.”
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May combine two claims.
InterpretationreasoningIn summary, there is strong evidence for an inverse relationship between RS and substance abuse and accumulating evidence for causal effects of RS on substance use and abuse in that increases in RS have predicted reduced substance use in controlled experimental studies.
“In summary, there is strong evidence for an inverse relationship between RS and substance abuse and accumulating evidence for causal effects of RS on substance use and abuse in that increases in RS have predicted reduced substance use in controlled experimental studies.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationRS have been linked to lower levels of cigarette smoking and higher levels of preventive health behaviors.
“RS have been linked to lower levels of cigarette smoking (e.g., Whooley et al., 2002) and higher levels of preventive health behaviors [e.g., flu shots, cholesterol screening, breast self-exams, mammograms, pap smears, and prostate screening (Benjamins & Brown, 2004)].”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationRecent comprehensive reviews concluded that RS consistently negatively predicted substance use, possibly due in part to prohibitions against alcohol and other substance use inherent in some religions.
“Recent comprehensive reviews concluded that RS consistently negatively predicted substance use, possibly due in part to prohibitions against alcohol and other substance use inherent in some religions (Geppert et al., 2007; Kub & Solari-Twadell, 2013; Walton-Moss et al., 2013; Yeung et al., 2009)”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
Study design and conductreasoningVery few cited studies found nonsignificant relationships between RS and substance abuse, and none reported a positive relationship, but many were cross-sectional in design, and their definitions and measurements of RS varied widely.
“Very few cited studies found nonsignificant relationships between RS and substance abuse, and none reported a positive relationship, but many were cross-sectional in design, and their definitions and measurements of RS varied widely.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationDifferent aspects of RS may affect different aspects of health by influencing the practice of health behaviors, through direct influences on physiological processes, or through the provision of social support.
“different aspects of RS may affect different aspects of health by influencing the practice of health behaviors, through direct influences on physiological processes, or through the provision of social support.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationOther longitudinal findings demonstrated that religious coping, church attendance, high religiosity, and high or increasing RS in an inpatient population predict lower or decreasing substance use rates.
“Other longitudinal findings demonstrated that religious coping (Brechting & Giancola, 2007), church attendance (Jessor et al., 2006), high religiosity (White et al., 2006), and high or increasing RS in an inpatient population (Conner et al., 2009) predict lower or decreasing substance use rates.”
Quote in the paperSubstantial claim0 of 3 sources checkedClassified as probably not a substantial claim. May combine two claims.
PremisecitationReligions provide their adherents with their basic view of reality, or world view, and prescribe ways to live and behave within this reality.
“Hill et al. (2000) stated that religions provide their adherents with their basic view of reality, or world view, and prescribe ways to live and behave within this reality.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hill et al. (2000) source
Not checked in the free run.
May combine two claims.
InterpretationreasoningLaboratory studies of RS variables are limited in generalizability but provide a method for experimentally manipulating RS variables in a controlled environment.
“Such studies, as is true of all laboratory studies, are limited in terms of many aspects of generalizability, but they do provide a method for experimentally manipulating RS variables in a controlled environment.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationEffects of RS-related social support are inconsistent, and although this type of social support is consistently related to mortality, it often functions as an independent predictor rather than as a mediator.
“However, effects of RS-related social support are inconsistent (George et al., 2002), and it appears that although this type of social support is consistently related to mortality, it often functions as an independent predictor rather than as a mediator.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites George et al., 2002 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone givenAlthough daunting, these difficulties are neither insurmountable nor unique to RS as they are common in many of the social sciences.
“Although daunting, these difficulties are neither insurmountable nor unique to RS as they are common in many of the social sciences.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningUse of ecological momentary assessment technologies can be advantageous in ascertaining whether effects seen in the lab are found in the natural setting.
“In similar fashion, use of new technologies associated with ecological momentary assessment can be advantageous in ascertaining whether effects seen in the lab are found in the natural setting.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationWhen studies of the service attendance-mortality link control for social support, relations between attendance and mortality often become substantially weaker, indicating that social support mediates at least some of the relationship of RS with health.
“When studies of the service attendance-mortality link control for its influence, relations between attendance and mortality often become substantially weaker (George et al., 2002), indicating that social support mediates at least some of the relationship of RS with health.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites George et al., 2002 source
Not checked in the free run.
May combine two claims.
PremisecitationSome aspects of RS are related to cardiovascular reactivity, levels of cardiac autonomic control, and immune functioning.
“Some aspects of RS are related to cardiovascular reactivity (Masters et al., 2005), levels of cardiac autonomic control (Berntson et al., 2008), and immune functioning (Ai et al., 2010).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenLarge scale longitudinal investigations have provided some of the most compelling evidence regarding relations among RS constructs and behavioral medicine variables.
“Large scale longitudinal investigations have provided some of the most compelling evidence regarding relations among RS constructs and behavioral medicine variables.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationIn a nationally representative sample of older adults, congregational social support led to a sense of belongingness and satisfaction with one's health, and in a national sample of African Americans, religious social support predicted fruit and vegetable consumption, physical activity, and alcohol use over and above general social support.
“In a nationally representative sample of older adults, congregational social support in particular led to a sense of belongingness and satisfaction with one’s health (Krause & Wulff, 2005) and in a national sample of African Americans, religious social support predicted fruit and vegetable consumption, physical activity, and alcohol use over and above general social support (Debnam et al., 2012b).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Krause & Wulff, 2005 source
Not checked in the free run.
- cites Debnam et al., 2012b
Not checked in the free run.
May combine two claims.
InterpretationreasoningRS may be especially related to health among older adults, women, those from specific religious groups, minorities, and those with less education.
“RS may be especially related to health among older adults, women, those from specific religious groups, minorities, and those with less education.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
PremisereasoningVirtually no one conducting research in this area would now ask whether RS is related to health so broadly.
“virtually no one conducting research in this area would now ask this question so broadly”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
InterpretationreasoningIncluding behavioral measures of RS variables will balance the literature by providing data of a different type from other (non-self-report) sources.
“Including behavioral measures of RS variables will balance the literature by providing data of a different type from other (non-self-report) sources.”
Quote in the paperNot a substantial claim- Rests on an assumption: Much of RS experience is internal and best measured by self-report.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
Premisenone givenIt is now commonly recognized that RS is multidimensional and the associations are unlikely to be the same across different RS dimensions and different dependent variables.
“It is now commonly recognized that RS is multidimensional and the associations are unlikely to be the same across different RS dimensions and different dependent variables.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone givenThe study of personality factors and marital relationships carry many of the same conceptual and methodological obstacles.
“The study of personality factors and marital relationships carry many of the same conceptual and methodological obstacles.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationAspects of social support specific to religion appear to be qualitatively different than non-religious social support and may have more potent effects on health.
“Aspects of social support specific to religion appear to be qualitatively different than non-religious social support (Krause, 2008), and may have more potent effects on health (Hayward & Elliott, 2009).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationA study of maternal caregivers of chronically ill children found few relations of religious salience and prayer with quality of life and health symptoms, but taking education and income into account, prayer was associated with fewer health symptoms and better quality of life among less educated maternal care-givers, and unrelated in those with more education.
“A study of maternal caregivers of chronically ill children found few relations of religious salience and prayer with quality of life and health symptoms (Banthia et al., 2007). However, taking education and income into account, the relationships became statistically significant, such that prayer was associated with fewer health symptoms and better quality of life among less educated maternal care”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Banthia et al., 2007 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThe study of RS in behavioral medicine has made significant methodological progress.
“It is our view that, these difficulties notwithstanding, the study of RS in behavioral medicine has made significant methodological progress.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Study design and conductnone givenMany of these investigations were conceptualized around other primary variables, and findings regarding RS were ancillary to the major purpose of the investigation.
“However, many of these investigations were conceptualized around other primary variables, and findings regarding RS were ancillary to the major purpose of the investigation.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationReligion itself has the defining characteristics to be considered a culture, and various religions differ in many ways along culturally-relevant dimensions.
“Cohen (2009) argues that religion, itself, has the defining characteristics to be considered a culture, and that various religions differ in many ways along culturally-relevant dimensions.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Cohen (2009) source
Not checked in the free run.
May combine two claims.
InterpretationreasoningIndividuals who believe God is in control of health and individuals are responsible for healthy behavior hold these two apparently contradictory statements to be simultaneously true.
“These individuals hold two apparently contradictory statements to be simultaneously true: that is, God is in control of health and individuals are responsible for healthy behavior.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationcitationAn enlightened understanding of basic theological tenets and the insider's point of view is likely to produce stronger theoretical lines of research with greater practical salience.
“An enlightened understanding of these constructs, the so-called insider’s point of view (Cohen & Kitayama, 2007), is likely to produce stronger theoretical lines of research that will have greater practical salience.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Cohen & Kitayama, 2007
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationreasoningStudies experimentally manipulating RS variables may be useful in examining mediating constructs and may enhance understanding of mechanisms responsible for health-relevant outcomes.
“These studies may be useful in examining mediating constructs and therefore may not only shed light on health-relevant outcomes but may also enhance understanding of the mechanisms responsible for those outcomes.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningObserver ratings of time spent in daily scripture study, service attendance, or spiritually motivated activities can provide access to RS data that have been rarely obtained.
“Observer ratings of time spent in daily scripture study, service attendance, or spiritually motivated activities (e.g., serving in a soup kitchen as the manifestation of a spiritual calling to serve the disadvantaged) can provide access to RS data that have been rarely obtained.”
Quote in the paperSubstantial claim- Rests on an assumption: Much of RS experience is internal and best measured by self-report.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
InterpretationreasoningIt will take time to develop the systematic and sustained types of investigations that can produce the sorts of findings we envision, but this type of effort will greatly advance the entire field.
“It will take time to develop the systematic and sustained types of investigations that can produce the sorts of findings we envision, but this type of effort will greatly advance the entire field.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationMasters and Hooker (2013) argued that approaching RS variables apart from their cultural underpinnings is not only limiting but likely to lead to erroneous conclusions.
“Masters and Hooker (2013) argued that such an approach is not only limiting but likely to lead to erroneous conclusions, and offer examples to highlight this point.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Masters and Hooker (2013) source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone givenRS connects with health across myriad topics, disease and health domains, and outcomes.
“RS connects with health across myriad topics, disease and health domains, and outcomes, and we desire to help build bridges with researchers in other areas who may be interested in integrating RS factors into their work.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningIf RS variables are considered within the religious culture in which they are embedded, a much deeper and more sophisticated and nuanced understanding of RS in relation to behavioral medicine will be gained.
“If this is done, a much deeper and more sophisticated and nuanced understanding of RS in relation to behavioral medicine will be gained.”
Quote in the paperNot a substantial claim- Rests on an assumption: Current behavioral medicine studies in this area are characterized by a near-complete neglect of cultural understanding and analysis.
- Rests on an assumption: Psychological and behavioral medicine studies are usually based on the assumption that RS variables can be meaningfully understood apart from their cultural (religious) underpinnings.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationRelated work exists in Djuric et al. (2009) for obese African American breast cancer survivors, Holt et al. (2009a; b) addressing prostate cancer screening among church-attending African American men, and Delaney et al. (2011) for community dwelling adults with CVD.
“Examples of related work can be found in that of Djuric et al. (2009) for obese African American breast cancer survivors, Holt et al. (2009a; b) addressing prostate cancer screening among church-attending African American men, and Delaney et al. (2011) for community dwelling adults with CVD.”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningSubstantial public health benefits could be gained through collaboration between the behavioral medicine community and local and national religious leaders to develop behavioral medicine interventions that are religiously sensitive and can be delivered in the context of the religious community.
“Substantial public health benefits could be gained through collaboration between the behavioral medicine community and local and national religious leaders to develop behavioral medicine interventions that are religiously sensitive and that can be delivered in the context of the religious community.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
InterpretationreasoningAddressing these issues in virtually any area of behavioral medicine research will yield more complete, valid, and useful findings.
“We are confident that addressing these issues in virtually any area of behavioral medicine research will yield more complete, valid, and useful findings.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningConsequences of lack of funding will multiply across the academic and research generations.
“These consequences will multiply across the academic and research generations.”
Quote in the paperNot a substantial claim- Rests on an assumption: New faculty may be advised to append their RS measures onto studies designed to answer other questions rather than make RS a central focus of their research careers because they are warned they will fail to be funded and thus not progress through tenure and review systems.
The paper relies on this without support.
The literature reviewed is sufficiently comprehensive and representative to support conclusions about the state of evidence on RS and health.
“Given that this article provides an overview of the current state of the field, we are limited in our review to the usage of terms chosen by the authors of the original studies.”
The authors state this as an assumption.
The constructs of religiousness and spirituality can be meaningfully grouped under the umbrella term 'RS' for the purpose of this review.
“Thus, we have elected to use the term “RS” to allow a broad scope.”
The paper relies on this without support.
For many years, RS research, whether cross-sectional or longitudinal, remained strictly observational.
“For many years, RS research, whether cross-sectional or longitudinal, remained strictly observational.”
The paper relies on this without support.
Some RS constructs defy randomization or manipulation and must simply be measured.
“Indeed, some RS constructs defy either randomization or manipulation and must simply be measured.”
The paper relies on this without support.
Much of RS experience is internal and best measured by self-report.
“Though much of RS experience is internal and best measured by self-report”
The paper relies on this without support.
Current behavioral medicine studies in this area are characterized by a near-complete neglect of cultural understanding and analysis.
“Yet current behavioral medicine studies in this area are characterized by a near-complete neglect of this level of understanding and analysis.”
The paper relies on this without support.
Psychological and behavioral medicine studies are usually based on the assumption that RS variables can be meaningfully understood apart from their cultural (religious) underpinnings.
“Psychological and behavioral medicine studies are usually based on the assumption that RS variables can be meaningfully understood apart from their cultural (religious) underpinnings, what Geertz (1983) referred to in another context as the view from nowhere.”
The paper relies on this without support.
Religious cultures are quite foreign to many social scientists, and fear and reluctance to engage the culture with an even hand and open mind may arise.
“Religious cultures are quite foreign to many social scientists and, as is often the case when encountering unfamiliar cultures, fear and reluctance to engage the culture with an even hand and open mind may arise.”
The paper relies on this without support.
Large numbers of people consider RS important and their lives are influenced by these concerns.
“given the large proportions of people who consider RS as quite important to them.”
“Given the large numbers of citizens who find RS concerns of substantial importance and whose lives are influenced by these concerns”
The paper relies on this without support.
New faculty may be advised to append their RS measures onto studies designed to answer other questions rather than make RS a central focus of their research careers because they are warned they will fail to be funded and thus not progress through tenure and review systems.
“New faculty may be advised to append their RS measures onto studies designed to answer other questions rather than make RS a central focus of their research careers because, they are warned, they will fail to be funded and thus not progress through the tenure and review systems.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Spirituality is associated with happiness, well-being, and life satisfaction.
“Spirituality has been associated with happiness, well-being, and life satisfaction (Park et al., 2017).”
From The relationship between spirituality and resilience and well-being: a study of 529 care leavers from 11 nations. (2023) · cites this paper as Park et al., 2017
Findings from the current study are consistent with previous research on other vulnerable populations that suggests that spirituality has a positive association on well-being.
“Findings from the current study are consistent with previous research on other vulnerable populations that suggests that spirituality has a positive association on well-being (Bryant-Davis & Wong, 2013; Campbell & Bauer, 2021; Park et al., 2017; Tuck & Anderson, 2014).”
From The relationship between spirituality and resilience and well-being: a study of 529 care leavers from 11 nations. (2023) · cites this paper as Park et al., 2017
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“This model is derived from, and similar to, a number of proposed models (e.g., Fitchett & Canada, 2010; Lee & Newberg, 2005; Levin & Vanderpool, 1989; Masters, 2008; Oman & Thoresen, 2005; see Aldwin et al., 2014, for an overview of models).”
BackgroundMethodReligiousness and Treatment Adherence in Congestive Heart Failure Patients
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Meaning, spirituality, and growth: Protective and resilience factors in health and illness.
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Self-citationFitting in with the flock: Social attractiveness as a mechanism for well‐being in religious groups
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Howard, A. H., Roberts, M., Mitchell, T., & Wilke, N. G. (2023) · Adversity and Resilience Science · doi:10.1007/s42844-023-00088-y · Cited by 50 · see citing works
Narayanan, S., Milbury, K., Wagner, R., & Cohen, L. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.04.029 · Cited by 17 · see citing works
A Mixed Method Evaluation of the Role of Religion in Desistance and Reentry
Said, I., & Davidson, K. M. (2023) · Justice Quarterly · doi:10.1080/07418825.2021.2016893 · Cited by 13 · see citing works
- Authors
- Park, C. L., Masters, K. S., Salsman, J. M., Wachholtz, A., Clements, A. D., Salmoirago-Blotcher, E., Trevino, K., & Wischenka, D. M.
- Affiliations
- University of Connecticut (US)
- University of Colorado Denver (US)
- Wake Forest Baptist Comprehensive Cancer Center (US)
- University of Massachusetts Chan Medical School (US)
- East Tennessee State University (US)
- Weill Cornell Medicine (US)
- Yeshiva University (US)
- Corresponding author
- Park, Crystal L.
- ORCID
- Venue
- Journal of Behavioral Medicine
- Published
- 2016-06-24
- Volume
- 40
- Issue
- 1
- Pages
- 39-51
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- PMC
- PMC5183527
- OpenAlex
- W2469612941
- Semantic Scholar
- b3b331c2cd1e2d5a1d580e571dbf1555b6300892
- Cited by
- 119
- References
- 146
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 12 · 2023: 9 · 2022: 13 · 2021: 18 · 2020: 16 · 2019: 18 · 2018: 10 · 2017: 5 · 2016: 1
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - East Tennessee State University (East Tennessee State University) (submittedVersion)
- eScholarship@UMassChan (submittedVersion)
- Funders
- National Institute on Aging (K23AG048632)
- National Institute on Drug Abuse (K23DA030397)
- National Cancer Institute (K07CA158008)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Demography › Workplace Spirituality and Leadership
- Social Sciences › Sociology and Political Science › Religion, Ecology, and Ethics
- Keywords
- religion and spirituality, behavioral medicine, cardiovascular disease, cancer, substance abuse, health-related quality of life, symptom management, disease prevention, mediators and moderators, conceptual model, research methodology
- MeSH terms
- Behavioral Medicine, Health Status, Humans, Quality of Life, Religion, Religion and Medicine, Research Design, Substance-Related Disorders, Spirituality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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