Skip to main content

Advertisement

SpringerLink
Log in

Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Self-esteem and self-efficacy are theorized to serve as mediators of the relationship between religious involvement and health outcomes. Studies confirming these relationships have produced mixed evidence. This study examined whether self-esteem and self-efficacy mediate the relationship between religious involvement (beliefs, behaviors) and a set of modifiable health behaviors in a national probability sample of African Americans. African Americans, in general, are relatively high in religious involvement and have higher than average rates of chronic disease. Participants were interviewed by telephone, and a Religion-Health Mediational Model was tested using structural equation modeling. Results suggest that self-esteem and self-efficacy at least in part mediate the relationship between religious beliefs (e.g., relationship with God) and greater fruit and vegetable consumption, and lower alcohol consumption. Religious behaviors (e.g., service attendance) were found to have direct, unmediated effects on health behaviors. Findings have implications for church-based health promotion in African American communities such as education or support groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Agency for Healthcare Research and Quality. (2001). Diabetes disparities among racial and ethnic minorities. November 2001. AHRQ Publication No. 02-P007. Agency for Healthcare Research and Quality, Rockville, MD. [Online]. http://www.ahrq.gov/research/diabdisp.htm. Accessed Oct 20, 2012.

  • Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411–423.

    Article  Google Scholar 

  • Arias, E. (2004). United States life tables, 2001. National vital statistics reports (p. 52). National Center for Health Statistics.

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Belgrave, F. Z. (1998). Psychosocial aspects of chronic illness and disability among African Americans. Westport, CT: Auburn House Publishing Co.

    Google Scholar 

  • Belgrave, F. Z., & Allison, K. W. (2010). Introduction to African American psychology. African American Psychology: From Africa to America (2nd edn.). Thousand Oaks, CA: Sage Publications.

  • Block, G., Hartman, A. M., Dresser, C. M., Carroll, M. D., Gannon, J., & Gardner, L. A. (1986). A data-based approach to diet questionnaire design and testing. American Journal of Epidemiology, 124, 453–469.

    CAS  PubMed  Google Scholar 

  • Braam, A. W., Beekman, A. T. F., Knipscheer, C. P. M., Deeg, D. J. H., van den Eeden, P., & van Tilburg, W. (1998). Religious denomination and depression in older Dutch citizens: Patterns and models. Journal of Aging and Health, 9, 483–503.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2011). Fact sheet: Health disparities in hypertension and hypertension control. [Online]. http://www.cdc.gov/minorityhealth/reports/CHDIR11/FactSheets/Hypertension.pdf. Accessed Oct 20, 2012.

  • Chen, G., Gully, S. M., & Eden, D. (2001). Validation of a new general self-efficacy scale. Organizational Research Methods, 4, 62–83.

    Article  CAS  Google Scholar 

  • Ellison, C. G. (1993). Religious involvement and self-perception among black Americans. Social Forces, 71, 1027–1055.

    Google Scholar 

  • Ellison, C. G. (1994). Religion, the life stress paradigm, and the study of depression. In J. S. Levin (Ed.), Religion in aging and health: Theoretical foundations and methodological frontiers (pp. 78–121). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Ellison, C. G., Boardman, J. D., Williams, D. R., & Jackson, J. S. (2001). Religious involvement, stress, and mental health: Findings from the 1995 Detroit Area Study. Social Forces, 80, 215–249.

    Article  Google Scholar 

  • Ellison, C. G., & Flannelly, K. J. (2009). Religious involvement and risk of major depression in a prospective nationwide study of African American adults. The Journal of Nervous and Mental Disease, 197, 568–573.

    Article  PubMed  Google Scholar 

  • Ellison, C. G., Hummer, R. A., Burdette, A. M., & Benjamins, M. R. (2010). Race, religious involvement, and health: The case of African Americans. In Ellison, C. G., Hummer, R. A. (Eds.). Religion, families, and health: Population-based research in the United States (pp. 321–348). Rutgers University Press: New Brunswick, NJ.

  • Ellison, C. G., & Levin, J. S. (1998). The religion-health connection: Evidence, theory, and future directions. Health Education and Behavior, 25, 700–720.

    Article  CAS  PubMed  Google Scholar 

  • Gallup, Inc. (2010). Americans’ church attendance inches up in 2010. [online] Available: http://www.gallup.com/poll/141044/americans-church-attendance-inches-2010.aspx. Accessed Oct 18, 2012.

  • George, L. K., Ellison, C. G., & Larson, D. B. (2002). Explaining the relationships between religious involvement and health. Psychological Inquiry, 13, 190–200.

    Article  Google Scholar 

  • Holt, C. L., Caplan, L., Schulz, E., Blake, V., Southward, P., Buckner, A., et al. (2009a). Role of religion in cancer coping among African Americans: A qualitative examination. Journal of Psychosocial Oncology, 27, 248–273.

    Article  PubMed Central  PubMed  Google Scholar 

  • Holt, C. L., Clark, E. M., Debnam K. J., & Roth, D. L. (2012a). Religious involvement and health behaviors in a national sample of African Americans: The role of religious coping. Manuscript submitted for publication.

  • Holt, C. L., Clark, E. M., Wang, M. Q., Williams, B. R., & Schulz, E. (2012b). The religion-health connection among African Americans: What is the role of social capital? Manuscript submitted for publication.

  • Holt, C. L., Haire-Joshu, D. L., Lukwago, S. N., Lewellyn, L. A., & Kreuter, M. W. (2005a). The role of religiosity in dietary beliefs and behaviors among urban African American women. Cancer Control, Cancer Culture and Literacy Supplement, 12, 84–90.

    Google Scholar 

  • Holt, C. L., Lewellyn, L. A., & Rathweg, M. J. (2005b). Exploring religion-health mechanisms among African American parishioners. Journal of Health Psychology, 10, 511–527.

    Article  PubMed  Google Scholar 

  • Holt, C. L., & McClure, S. (2006). Perceptions of the religion-health connection among African American church members. Qualitative Health Research, 16, 268–281.

    Article  PubMed  Google Scholar 

  • Holt, C. L., Oster, R. A., Clay, K. S., Urmie, J., & Fouad, M. (2011a). Religiosity and physical and emotional functioning among African American and White colorectal and lung cancer patients. Journal of Psychosocial Oncology, 29, 372–393.

    PubMed Central  PubMed  Google Scholar 

  • Holt, C. L., Schulz, E., Williams, B., Clark, E. M., Wang, M. Q., & Southward, P. L. (2012d). Assessment of religious and spiritual capital in African American communities. Journal of Religion and Health. Article first published online: Jul 19, 2012. doi:10.1007/s10943-012-9635-4

  • Holt, C. L., Schulz, E., & Wynn, T. A. (2009b). Perceptions of the religion-health connection among African Americans in the Southeastern United States: Sex, age, and urban/rural differences. Health Education and Behavior, 36, 62–80.

    Article  PubMed  Google Scholar 

  • Holt, C. L., Wang, M. Q., Caplan, L., Schulz, E., Blake, V., & Southward, V. L. (2011b). Role of religious involvement and spirituality in functioning among African Americans with cancer: Testing a mediational model. Journal of Behavioral Medicine, 34, 437–448.

    Article  PubMed Central  PubMed  Google Scholar 

  • Holt, C. L., Wang, M. Q., Clark, E. M., Williams, B., & Schulz, E. (2012c). Religious involvement and physical and emotional functioning among African Americans: The mediating role of religious support. Psychology and Health. Article first published online: Aug 06, 2012. doi:10.1080/08870446.2012.717624

  • Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. New York: Oxford University Press.

    Book  Google Scholar 

  • Krause, N. (1992). Stress, religiosity, and psychological well-being among older Blacks. Journal of Aging and Health, 4, 412–439.

    Article  Google Scholar 

  • Krause, N. (1995). Religiosity and self-esteem among older adults. Journal of Gerontology: Psychological Sciences, 50, P236–P246.

    Article  CAS  Google Scholar 

  • Kreuter, M. W., Skinner, C. S., Holt, C. L., Clark, E. M., Haire-Joshu, D., Fu, Q. J., et al. (2005). Cultural tailoring for mammography and fruit and vegetable consumption among low-income African American women in urban public health centers. Preventive Medicine, 41, 53–62.

    Article  PubMed  Google Scholar 

  • Levin, J. S. (2001). God, faith, and health: Exploring the spirituality-healing connection. Hoboken: Wiley.

    Google Scholar 

  • Levin, J. S., Taylor, R. J., & Chatters, L. M. (1994). Race and gender differences in religiosity among older adults: Findings from four national surveys. Journal of Gerontology, 49, S137–S145.

    Article  CAS  PubMed  Google Scholar 

  • Lincoln, C. E., & Mamiya, L. H. (1990). The black church in the African American experience. Durham, NC: Duke University Press.

    Book  Google Scholar 

  • Lukwago, S. L., Kreuter, M. W., Bucholtz, D. C., Holt, C. L., & Clark, E. M. (2001). Development and validation of brief scales to measure collectivism, religiosity, racial pride, and time orientation in urban African American women. Family and Community Health, 24, 63–71.

    CAS  PubMed  Google Scholar 

  • MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.

    Article  PubMed Central  PubMed  Google Scholar 

  • MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000). Equivalence of the mediation, confounding, and suppression effect. Prevention Science, 1, 173–181.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Musick, M. A., Traphagan, J. W., Koenig, H. G., & Larson, D. B. (2000). Spirituality in physical health and aging. Journal of Adult Development, 7, 73–86.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2010). Mplus software version 6.0. Los Angeles, CA: Muthén & Muthén.

  • Pleis, J. R., & Lethbridge-Çejku, M. (2007). Summary health statistics for US adults: National Health Interview Survey, 2006. National Center for Health Statistics. Vital Health Statistics, 10, 1–153.

  • Pollner, M. (1989). Divine relations, social, relations, and well-being. Journal of Health and Social Behavior, 30, 92–104.

    Article  CAS  PubMed  Google Scholar 

  • Poloma, M. M., & Gallup, G. (1991). Varieties of prayer: A survey report. Philadelphia: Trinity Press International.

    Google Scholar 

  • Potts, R. G. (1996). Spirituality and the experience of cancer in an African-American community: Implications for psychosocial oncology. Journal of Psychosocial Oncology, 14, 1–19. doi:10.1300/J077v14n01_01

    Article  Google Scholar 

  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education Quarterly, 15, 175–183.

    Article  CAS  PubMed  Google Scholar 

  • Roth, D. L., Mwase, I., Holt, C. L., Clark, E. M., Lukwago, S., & Kreuter, M. W. (2012). Religious involvement measurement model in a national sample of African Americans. Journal of Religion and Health, 51, 567–578.

    Article  PubMed Central  PubMed  Google Scholar 

  • Schulz, E., Holt, C. L., Caplan, L., Blake, V., Southward, P., Buckner, A., et al. (2008). Role of spirituality in cancer coping among African Americans: A qualitative examination. Journal of Cancer Survivorship, 2, 104–115.

    Article  PubMed Central  PubMed  Google Scholar 

  • Silber, E., & Tippett, J. S. (1965). Self-esteem: Clinical assessment and measurement validation. Psychological Reports, 16, 1017–1071.

    Article  Google Scholar 

  • Stein, A. D., Lederman, R. I., & Shea, S. (1993). The Behavioral Risk Factor Surveillance System questionnaire: its reliability in a statewide sample. American Journal of Public Health, 83, 1768–1772.

    Article  CAS  PubMed  Google Scholar 

  • Strawbridge, W. J., Shema, S. J., Cohen, R. D., & Kaplan, G. A. (2001). Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships. Annals of Behavioral Medicine, 23, 68–74.

    Article  CAS  PubMed  Google Scholar 

  • Taylor, R. J., Chatters, L. M., Jayakody, R., & Levin, J. S. (1996). Black and white differences in religious participation: A multisample comparison. Journal for the Scientific Study of Religion, 35, 403–410.

    Article  Google Scholar 

  • Thoresen, C. E. (1998). Spirituality, health, and science: The coming revival? In S. Roth-Roemer & S. R. Kurpius (Eds.), The emerging role of counseling psychology in health care (pp. 409–431). New York: W. W. Norton.

    Google Scholar 

  • Wilson, S. M., & Miles, M. S. (2001). Spirituality in African-American mothers coping with a seriously ill infant. Journal of the Society of Pediatric Nurses, 6, 116–122. doi:10.1111/j.1744-6155.2001.tb00133.x

    Article  CAS  PubMed  Google Scholar 

  • Wood, R., & Bandura, A. (1989). Impact of conceptions of ability on self-regulatory mechanisms and complex decision making. Journal of Personality and Social Psychology, 56, 407–415.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a Grant from the National Cancer Institute, (#1 R01 CA105202) and was approved by the University of Maryland Institutional Review Board (#08-0328). The team would like to acknowledge the work of OpinionAmerica, who conducted participant recruitment and data collection activities for the present study.

Author information

Authors and Affiliations

  1. Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2369 Public Health Building (255), College Park, MD, USA

    Cheryl L. Holt & Katrina Debnam

  2. Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA

    David L. Roth

  3. Department of Psychology, Saint Louis University, St. Louis, MO, USA

    Eddie M. Clark

Authors
  1. Cheryl L. Holt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David L. Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eddie M. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Katrina Debnam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cheryl L. Holt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Holt, C.L., Roth, D.L., Clark, E.M. et al. Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans. J Behav Med 37, 102–112 (2014). https://doi.org/10.1007/s10865-012-9472-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-012-9472-7

Keywords

Search

Navigation