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Objective: This systematic review aims to summarize the current body of evidence concerning the prevalence of obesity among clergy (i.e., the officially designated leaders of a religious group) in the United States., Method: From November 2022 to February 2023, five databases, one data repository, and gray matter were searched for articles and data sources. The search was restricted to articles published or raw data collected from 2001 to 2021. Study quality was assessed with a template, and heterogeneity was assessed using the I 2 statistic. The protocol for this review was registered with PROSPERO (CRD42022376592)., Results: Forty-seven studies of clergy obesity involving 35,064 individuals were eligible. The pooled prevalence estimate of obesity across studies was 34.8% (95% confidence interval [CI]: 32.5-37.2). Obesity prevalence was found to be increasing over time and to vary considerably between clergy from different religious traditions. Compared to national estimates, from 2005 onwards, obesity prevalence was higher than in the US adult population., (© 2024 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions., (© 2023. The Author(s).)

As an occupational group, clergy exhibit numerous physical health problems. Given the physical health problems faced by clergy, understanding where physical health falls within the priorities of seminary students, the ways students conceptualize physical health, and how seminary students do or do not attend to their physical health in the years immediately prior to becoming clergy, can inform intervention development for both seminary students and clergy. Moreover, understanding and shaping the health practices of aspiring clergy may be particularly impactful, with cascading effects, as clergy serve as important role models for their congregants. Drawing on 36 in-depth, qualitative interviews with first-year seminary students, this study examines the complex dynamics between religious frameworks related to physical health, explicit intentions to maintain healthy practices, and reported physical health behaviors. Our findings suggest that even students who deploy religious frameworks in relation to their physical health-and who, as a result, possess positive intentions to implement and maintain healthy behaviors-often report being unable to live up to their aspirations, especially in the face of barriers to health practices posed by the seminary program itself. After reviewing these findings, we offer suggestions for physical health focused interventions, including action and coping planning, which could be implemented at seminaries to reduce the intention-behavior gap and improve clergy health., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms., Methods and Analysis: The overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control., Ethics and Dissemination: Ethical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community., Strengths and Limitations of This Study: While evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals. Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training. If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day. This study is limited by the inclusion of Christian clergy of only one denomination., Trial Registration: ClinicalTrials.gov NCT04625777 . November 12, 2020., (© 2021. The Author(s).)

Aim: Sophisticated adjustments for socioeconomic status (SES) in health disparities research may help illuminate the independent role of race in health differences between Blacks and Whites. In this study of people who share the same occupation (United Methodist Church clergy) and state of residence (North Carolina), we employed naturalistic and statistical matching to estimate the association between race-above and beyond present SES and other potential confounds-and health disparities., Methods: We compared the health of 1414 White and 93 Black clergy. Then, we used propensity scores to match Black and White participants on key socioeconomic, demographic, occupational, and physical activity characteristics and re-examined differences in health., Results: Prior to propensity score matching, Black clergy reported worse physical health than their White counterparts. They had greater body mass index, higher prevalence of diabetes and hypertension, and lower physical health functioning. White clergy reported less favorable mental health. They had higher severity of depression and anxiety symptoms as well as lower quality of life and mental health functioning. Propensity score analysis revealed that matching on SES and other key variables accounted for most, but not all, of the observed racial differences. Racial disparities in hypertension, depression severity, and mental health functioning persisted despite adjustments., Conclusions: Race contributed to health disparities in some outcomes in our study population, above and beyond our measures of participants' present SES and key demographic, occupational, and physical activity variables. This study provides evidence supporting the position that race contributes to health disparities through pathways other than SES.

Background: Metabolic syndrome (Met-S) has a robust concurrent association with depression. A small, methodologically limited literature suggests that Met-S and depression are reciprocally related over time, an association that could contribute to their overlapping influences on morbidity and mortality in cardiovascular disease, diabetes, and cancer., Purpose: Using a refined approach to the measurement of Met-S as a continuous latent variable comprising continuous components, this study tested the prospective associations between Met-S and depression., Methods: This study of 1114 clergy included four annual assessments of depressive symptoms and Met-S components. Standard methods were used to measure Met-S risk factors, and the Patient Health Questionnaire-8 was used to assess depressive symptoms. We used confirmatory factor analysis to verify the structure of Met-S and depression and structural equation modeling to quantify the prospective relationships., Results: The statistical models confirmed the validity of quantifying Met-S as a continuous latent variable, replicated previous evidence of a concurrent association, and indicated a significant prospective association of initial depressive symptoms with subsequent Met-S. Initial Met-S was at most only weakly associated with subsequent depressive symptoms, and the former prospective effect was significantly larger. Associations of depressive symptoms and Met-S were significant for both men and women, but somewhat stronger among men., Conclusions: Results support representation of Met-S as a continuous latent variable. The association of initial depressive symptoms with later Met-S suggests that interventions addressing these correlated risk factors may prove useful in preventive efforts.

The Seminary to Early Ministry (SEM) Study is a mixed-method, prospective study designed to provide high-quality empirical data on student formation in theological education. The study will use a series of surveys and in-depth interviews to track three cohorts of divinity school students from matriculation into the early years of their careers. As a result, the study hopes to compile the most comprehensive longitudinal dataset on theological education to date, enabling researchers to better understand who attends seminaries, how seminaries form students, and how the training of future religious leaders can be improved.

In this study, we examine the role of spiritual struggles among clergy, in the form of "divine struggle" or feelings of alienation from God and their associations with well-being (depressive symptoms and burnout) among clergy. Drawing from a life-stress perspective, we also test whether received and anticipated congregational support moderates these associations. Using two waves of data (2016–2019) of the Clergy Panel Health Survey of United Methodist clergy in North Carolina (n = 1,261), results suggest that it was clergy who increased in divine struggles over time who had the highest depressive symptom and burnout scores. However, clergy who received significant emotional support from members of their congregation were protected from elevated depressive symptoms and greater burnout. Anticipated congregational support only buffered the relationship between increasing divine struggles and one component of burnout (positive achievement). We offer some broader implications for supporting clergy well-being in the face of divine struggles. [ABSTRACT FROM AUTHOR]

Are religious leaders unusually unhealthy? This question has long occupied scholars interested in the study of religious institutions, and a significant body of research has examined the causes, correlates, and effects of poor health among clergy. In this study, we aimed to: (1) outline the development of, and bias inherent to, the scholarly understanding of clergy health over the past 50 years; (2) test, using a recently collected nationally representative sample of clergy, the standing assumption that clergy are an especially unhealthy vocational group, specifically in terms of depression, obesity, and self‐rated health; and (3) identify the major correlates of health among clergy using these data. Contrary to the recent tenor of scholarly research on this subject, our research revealed that clergy are not a particularly unhealthy group. We suggest potential pathways forward to ameliorate the bias inherent in the research into clergy well‐being. [ABSTRACT FROM AUTHOR]

Background: In the wake of the COVID-19 pandemic, churches in the United States were forced to stop meeting in person and move to remote forms of worship and congregational life. This shift likely impacted congregational finances, which are primarily driven by individual donations. Initial research has suggested that there is a great deal of heterogeneity in the financial impact on congregations, but there has been scant research examining how pastors and congregations are managing finances during this period. Purpose: This research examines the impact of COVID-19 and its associated restrictions on congregational finances and the strategies pastors used to adapt their church's finances to the health restrictions. Methods: We conducted in-depth, qualitative interviews with 50 pastors in the North Carolina and Western North Carolina Conferences of the United Methodist Church appointed to 70 congregations. Using applied thematic analysis, we analyzed transcripts at both the pastor and congregation-level to identify similarities and differences in financial impact, financial strategies, and pastor experiences during the pandemic. Results: Most congregations reported small decreases in giving that were offset by federal Paycheck Protection Program (PPP) loans and other grants from the denomination. Some congregations, mostly urban and fairly large, reported significant increases in giving, while several other, predominantly small congregations, reported their church's finances had been negatively impacted by the pandemic. Even in cases where the net impact of the pandemic was small or non-existent, pastors were forced to adopt a host of new strategies to manage finances. In general, small and large congregations experienced and responded to the financial impact of the pandemic very differently.and Implications. Conclusions: This research suggests that the pandemic's impact on congregational finances were more than just on the bottom line. And while most churches weathered the economic challenges without severe impacts, questions remain as to the long-term impact of the pandemic on church finances. [ABSTRACT FROM AUTHOR]

Weight-loss maintenance is essential to sustain the health benefits of weight loss. Studies with lower intensity intervention supports under real-world conditions are lacking. This study examined changes in weight and cardiometabolic biomarkers among Spirited Life participants following initial 12-month weight loss at 12–24 months and 24–42 months. A total of 719 clergy received a wellness intervention, including a 10-week online weight-loss program in the first 12 months and monthly health coaching throughout 24 months. Mean changes in weight, blood pressure, high-density lipoproteins, and triglycerides were estimated using random effects linear models, accounting for repeated measures. Weight was additionally analyzed in subsamples stratified by body mass index (BMI). At baseline, 17.1% of participants had BMI < 25 kg/m2 and 11.8% had BMI ≥ 40 kg/m2. Mean 12-month weight loss was −2.4 kg (95% CI: −2.8 kg, −2.1 kg). On average, at 42 months, participants regained weight but did not exceed baseline (−0.5 kg, 95% CI: −1.2 kg, 0.2 kg), improvements in triglycerides were completely sustained (−13.9 mg/dL, 95% CI: −18.6 mg/dL, −9.2 mg/dL), and systolic blood pressure improvements remained significant (−1.9 mmHg, 95% CI: −3.0 mmHg, −0.9 mmHg). Participants with a BMI ≥ 40 kg/m2 lost significantly more weight that was sustained at 42 months (−5.8 kg, 95% CI: −8.9 kg, −2.7 kg). The Spirited Life wellness intervention produced weight loss and, for participants with higher levels of obesity, sustained weight-loss maintenance. The intervention was effective for long-term prevention of weight gain among participants with BMI of 25 to ≤40 kg/m2, through 42 months. Wellness interventions such as Spirited Life should be considered for adoption. [ABSTRACT FROM AUTHOR]

We argue that perceived support is best conceptualized more as a measure of how an individual appraises his/her situation rather than a true reflection of how much support he/she receives. To test this theory, we used survey data from the Clergy Health Initiative Panel Survey to examine the relationship between perceived and received social support and their association with depressive symptoms in clergy (N = 1,288). Overall, analyses revealed perceived support had a weak association with received support. Greater perceived support had a significant relationship with lower depressive symptoms. In contrast, greater received support had only a small relationship with lower depressive symptoms, which was fully mediated by perceived support. Our results raise questions about the effectiveness of many clergy social support interventions, which often aim to boost the quality and/or quantity of received social support. We suggest it may be more advantageous to boost perceptions of social support, possibly through cognitive reframing or positive mental health interventions. [ABSTRACT FROM AUTHOR]

With data from the Clergy Health Initiative Longitudinal Survey, we look for interviewer effects, differences between web and telephone delivery, and panel conditioning bias in an “important matters” name generator and interpreter, replicated from the U.S. General Social Survey. We find evidence of phone interviewers systematically influencing the number of confidants named, we observe that respondents assigned to the web survey reported a larger number of confidants, and we uncover strong support for panel conditioning. We discuss the possible mechanisms behind these observations and conclude with a brief discussion of the implications of our findings for similar studies. [ABSTRACT FROM AUTHOR]