Initiative on Islam and Medicine, The University of Chicago, Chicago IL, USA; Section of Emergency Medicine, The University of Chicago, Chicago IL, USA; Comprehensive Cancer Center, The University of Chicago, Chicago IL, USA.
Initiative on Islam and Medicine, The University of Chicago, Chicago IL, USA; School of Social Welfare, Stony Brook University, Stony Brook, NY, USA.
Soc Sci Med. 2018 May;204:92-99. doi: 10.1016/j.socscimed.2018.03.023. Epub 2018 Mar 21.
As community health interventions advance from being faith-placed to authentically faith-based, greater discussion is needed about the theory, practice, and ethics of delivering health messages embedded within a religious worldview. While there is much potential to leverage religion to promote health behaviors and improve health outcomes, there is also a risk of co-opting religious teachings for strictly biomedical ends.
To describe the development, implementation, and ethical dimensions of a conceptual model for religiously-tailoring health messages.
We used data from 6 focus groups and 19 interviews with women aged 40 and older sampled from diverse Muslim community organizations to map out how religious beliefs and values impact mammography-related behavioral, normative and control beliefs. These beliefs were further grouped into those that enhance mammography intention (facilitators) and those that impede intention (barriers). In concert with a multi-disciplinary advisory board, and by drawing upon leading theories of health behavior change, we developed the "3R" model for crafting religiously-tailored health messages.
The 3R model addresses barrier beliefs, which are beliefs that negatively impact adopting a health behavior, by (i) reframing the belief within a relevant religious worldview, (ii) reprioritizing the belief by introducing another religious belief that has greater resonance with participants, and (iii) reforming the belief by uncovering logical flaws and/or theological misinterpretations. These approaches were used to create messages for a peer-led, mosque-based, educational intervention designed to improve mammography intention among Muslim women.
There are benefits and potential ethical challenges to using religiously tailored messages to promote health behaviors. Our theoretically driven 3R model aids interventionists in crafting messages that address beliefs that hinder healthy behaviors. It is particularly useful in the context of faith-based interventions for it highlights the ethical choices that must be made when incorporating religious values and beliefs in tailored messages.
随着社区卫生干预措施从基于信仰转变为真正基于信仰，需要更多地讨论在宗教世界观中传递健康信息的理论、实践和伦理问题。虽然利用宗教来促进健康行为和改善健康结果有很大的潜力，但也存在将宗教教义纯粹用于生物医学目的的风险。
描述为宗教信仰量身定制健康信息的概念模型的制定、实施和伦理维度。
我们使用了来自不同穆斯林社区组织的 6 个焦点小组和 19 个访谈的数据，这些数据来自 40 岁及以上的女性，以描绘宗教信仰和价值观如何影响与乳房 X 光检查相关的行为、规范和控制信念。这些信念进一步分为增强乳房 X 光检查意向的信念（促进因素）和阻碍意向的信念（障碍）。在一个多学科咨询委员会的配合下，并借鉴健康行为改变的主要理论，我们制定了“3R”模型，用于制定与宗教信仰相符的健康信息。
“3R”模型通过以下方式解决了会对采用健康行为产生负面影响的障碍信念：（i）在相关宗教世界观内重新构建该信念；（ii）通过引入与参与者更相关的另一个宗教信念来重新确定该信念的优先级；（iii）通过揭示逻辑缺陷和/或神学误解来重新塑造该信念。这些方法被用于为一个基于同伴、基于清真寺的教育干预措施创建信息，旨在提高穆斯林妇女的乳房 X 光检查意向。
使用与宗教信仰相符的信息来促进健康行为有好处，也存在潜在的伦理挑战。我们基于理论的“3R”模型有助于干预者制定可以解决阻碍健康行为的信念的信息。在基于信仰的干预措施方面，它特别有用，因为它突出了在量身定制的信息中纳入宗教价值观和信仰时必须做出的伦理选择。
