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纵向研究非裔美国人中宗教参与对宗教应对方式和健康行为的影响。

Longitudinal effects of religious involvement on religious coping and health behaviors in a national sample of African Americans.

机构信息

University of Maryland, School of Public Health, Department of Behavioral and Community Health, United States.

Johns Hopkins University, Center on Aging and Health, United States.

出版信息

Soc Sci Med. 2017 Aug;187:11-19. doi: 10.1016/j.socscimed.2017.06.014. Epub 2017 Jun 15.

Abstract

Many studies have examined associations between religious involvement and health, linking various dimensions of religion with a range of physical health outcomes and often hypothesizing influences on health behaviors. However, far fewer studies have examined explanatory mechanisms of the religion-health connection, and most have overwhelmingly relied on cross-sectional analyses. Given the relatively high levels of religious involvement among African Americans and the important role that religious coping styles may play in health, the present study tested a longitudinal model of religious coping as a potential mediator of a multidimensional religious involvement construct (beliefs; behaviors) on multiple health behaviors (e.g., diet, physical activity, alcohol use, cancer screening). A national probability sample of African Americans was enrolled in the RHIAA (Religion and Health In African Americans) study and three waves of telephone interviews were conducted over a 5-year period (N = 565). Measurement models were fit followed by longitudinal structural models. Positive religious coping decreased modestly over time in the sample, but these reductions were attenuated for participants with stronger religious beliefs and behaviors. Decreases in negative religious coping were negligible and were not associated with either religious beliefs or religious behaviors. Religious coping was not associated with change in any of the health behaviors over time, precluding the possibility of a longitudinal mediational effect. Thus, mediation observed in previous cross-sectional analyses was not confirmed in this more rigorous longitudinal model over a 5-year period. However, findings do point to the role that religious beliefs have in protecting against declines in positive religious coping over time, which may have implications for pastoral counseling and other faith-based interventions.

摘要

许多研究都考察了宗教参与与健康之间的关系,将宗教的各个方面与一系列身体健康结果联系起来,并常常假设对健康行为有影响。然而,很少有研究考察宗教与健康关系的解释机制,而且大多数研究都压倒性地依赖于横断面分析。鉴于非裔美国人的宗教参与程度相对较高,以及宗教应对方式在健康中可能发挥的重要作用,本研究测试了宗教应对作为多维宗教参与结构(信仰;行为)对多种健康行为(例如饮食、体育活动、饮酒、癌症筛查)的潜在中介的纵向模型。一项针对非裔美国人的全国概率抽样被纳入 RHIAA(非裔美国人的宗教与健康)研究,并在 5 年期间进行了 3 轮电话访谈(N=565)。首先拟合测量模型,然后拟合纵向结构模型。在样本中,积极的宗教应对方式随时间逐渐减少,但对于信仰和行为较强的参与者,这些减少幅度较小。消极的宗教应对方式减少甚微,与宗教信仰或宗教行为均无关。宗教应对方式与任何健康行为随时间的变化均无关,从而排除了纵向中介效应的可能性。因此,在这个为期 5 年的更严格的纵向模型中,先前横断面分析中观察到的中介作用并未得到证实。然而,研究结果确实指出了宗教信仰在保护积极宗教应对方式随时间下降方面的作用,这可能对牧师咨询和其他基于信仰的干预措施具有意义。

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