Recently, behavioral scientists have developed greater interest in understanding the relations between religiousness and spirituality (R/S) and health. Our objectives were to (a) provide an overview of the R/S and health literature specific to cardiovascular disease (CVD) and cancer, (b) discuss the importance of religious culture considerations to behavioral medicine research, (c) suggest methodological changes to advance this research toward greater depth of understanding, and (d) begin discussion on clinically appropriate ways to integrate R/S into treatment. Individual studies and meta-analyses on the relations of R/S with CVD and cancer were reviewed along with articles on the importance of culture to understanding R/S phenomena. Trends in the literature suggest that R/S predicts reductions in all-cause and CVD-related but not cancer mortality. R/S also shows relations with cardiovascular morbidity, and various dimensions of R/S show relations with cancer risk factors and well-being in cancer patients. Investigators have progressively studied more specific dimensions of R/S but have largely failed to consider them within religious cultural contexts. This context is essential for a deeper understanding of R/S and health relations and has profound methodological implications for future studies. R/S and health research is expanding; yet, the field needs more programmatic research and greater theoretical organization. We propose that consideration of R/S variables within their religious culture will provide structure for greater integrative understanding to move the field forward. This understanding is imperative if R/S is to be appropriately integrated into culturally sensitive clinical interventions.

Research has demonstrated a positive relation between particular religious/spiritual variables and health behaviors and outcomes. However, recent conceptualizations of religiousness/spirituality (R/S) and health acknowledge the multidimensionality of both constructs. Consequently, it is important to study these constructs in ways that allow for simultaneous consideration of their multiple dimensions and then determine relations between the latent higher order constructs formed by these analyses. The primary purpose of this study was to determine the relations between multidimensional constructions, based on multivariate analysis, of both R/S and health behaviors in first- and second-year college students, individuals who are at a time of transition. To achieve this aim, the authors used canonical correlation to determine if one or more latent R/S variables might be identified and associated with one or more latent health behavior variables. Participants were 266 first- and second-year undergraduates (61% female; M age = 18.6 years) who completed measures of R/S and health behaviors. Results indicated one significant canonical correlation relating the latent variable named Relational Personal Spirituality positively with the second latent variable, Healthy College Behavior. These findings suggest the need for multidimensional assessment and multivariate analysis of both R/S and health behaviors and support further exploration of the role of personal spirituality in promoting healthier behaviors among college students.

We examined the hypothesis that a tendency to experience the world in terms of a sense of ‘special’ connection is responsible for the self-transcendent value dimension identified by multi-dimensional scaling and constitutes a common factor for different religious and non-religious interpretations of spirituality. Eight different groups were studied including: (a) six different types of faith leaders in India and the UK, (b) people who self-rated as spiritual but not religious, and (c) those self-rating as neither spiritual nor religious. They completed a questionnaire that assessed (a) the strength of their spirituality irrespective of type (self-perceived spirituality) and (b) the experience of special connection to the following categories: people, nature, places and the universe, with and without using the term spiritual. For all eight samples the different types of connection were highly inter-correlated, and self-perceived spirituality correlated with the sum of connection items irrespective of whether items included the term spiritual or not. Variation between groups in the size of the latter correlation was consistent with different interpretations of spirituality in those groups. Although the meaning of spirituality is socially constructed, variability within faith leader groups suggests that its interpretation is also affected by personality.

Background: Meaning in life is positively associated with health, well-being, and longevity, which may be partially explained by engagement in healthier behaviors, including physical activity (PA). However, promoting awareness of meaning is a behavior change strategy that has not been tested in previous PA interventions. Objective: This study aims to develop, refine, and pilot-test the Meaningful Activity Program (MAP; MAP to Health), a web-based mobile health PA intervention, theoretically grounded in meaning and self-determination theory, for insufficiently active middle-aged adults. Methods: Following an iterative user-testing and refinement phase, we used a single-arm double baseline proof-of-concept pilot trial design. Participants included 35 insufficiently active adults in midlife (aged 40-64 years) interested in increasing their PA. After a 4-week baseline period, participants engaged in MAP to Health for 8 weeks. MAP to Health used a web-based assessment and just-in-time SMS text messaging to individualize the intervention; promote meaning salience; support the basic psychological needs of autonomy, competence, and relatedness; and increase PA. Participants completed measures of the hypothesized mechanisms of behavior change, including meaning salience, needs satisfaction, and autonomous motivation at pretest (−4 weeks), baseline (0 weeks), midpoint (4 weeks), and posttest (8 weeks) time points, and wore accelerometers for the study duration. At the end of the intervention, participants completed a qualitative interview. Mixed models compared changes in behavioral mechanisms during the intervention to changes before the intervention. Framework matrix analyses were used to analyze qualitative data. Results: Participants were aged 50.8 (SD 8.2) years on average; predominantly female (27/35, 77%); and 20% (7/35) Asian, 9% (3/35) Black or African American, 66% (23/35) White, and 6% (2/35) other race. Most (32/35, 91%) used MAP to Health for ≥5 of 8 weeks. Participants rated the intervention as easy to use (mean 4.3, SD 0.8 [out of 5.0]) and useful (mean 4.3, SD 0.6). None of the hypothesized mechanisms changed significantly during the preintervention phase (Cohen d values <0.15). However, autonomy (P<.001; Cohen d=0.76), competence (P<.001; Cohen d=0.65), relatedness (P=.004; Cohen d=0.46), autonomous motivation (P<.001; Cohen d=0.37), and meaning salience (P<.001; Cohen d=0.40) increased significantly during the intervention. Comparison of slopes before the intervention versus during the intervention revealed that increases during the intervention were significantly greater for autonomy (P=.002), competence (P<.001), and meaning salience (P=.001); however, slopes were not significantly different for relatedness (P=.10) and autonomous motivation (P=.17). Qualitative themes offered suggestions for improvement. Conclusions: MAP to Health was acceptable to participants, feasible to deliver, and associated with increases in the target mechanisms of behavior change. This is the first intervention to use meaning as a behavior change strategy in a PA intervention. Future research will test the efficacy of the intervention in increasing PA compared to a control condition.