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Summary: 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 I2 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Clergy are tasked with multiple interpersonal administrative, organizational, and religious responsibilities, such as preaching, teaching, counseling, administering sacraments, developing lay leader skills, and providing leadership and vision for the congregation and community. The high expectations and demands placed on them put them at an increased risk for mental distress such as depression and anxiety. Little is known about whether and how clergy, helpers themselves, receive care when they experience mental distress. All active United Methodist Church (UMC) clergy in North Carolina were recruited to take a survey in 2019 comprising validated depression and anxiety screeners and questions about mental health service utilization. Bivariate and Poisson regression analyses were conducted on the subset of participants with elevated depressive and anxiety symptoms to determine the extent of mental health service use during four different timeframes and the relationship between service use and sociodemographic variables. A total of 1,489 clergy participated. Of the 222 (15%) who had elevated anxiety or depressive symptoms or both, 49.1% had not ever or recently (in the past two years) seen a mental health professional. Participants were more likely to report using services currently or recently (in the past two years) if they were younger, had depression before age 21, or "very often" felt loved and cared for by their congregation. The rate of mental health service use among UMC clergy is comparable to the national average of service use by US adults with mental distress. However, it is concerning that 49% of clergy with elevated symptoms were not engaged in care. This study points to clergy subgroups to target for an increase in mental health service use. Strategies to support clergy and minimize mental health stigma are needed. [ABSTRACT FROM AUTHOR]

The dominant view of megachurches claims they represent a new religious form, born in the United States in the 1970s and 80s. Contrary to this position, this research demonstrates that megachurches enjoy a long history in Protestantism. An important example from the 16th Century Huguenot architect Jacques Perret reveals an early Protestant vision for a large, multi-functional worship space. Soon after, this vision became realized in bricks and mortar. Revivalism and the Institutional Church Movement of the 19th and early 20th Centuries provide further connections between megachurches and the past. Revivalism provided the motivation for Protestants to go out and reach the masses, and the Institutional Church Movement provided the infrastructure to attract, convert, and nurture them. The demographic shifts that occurred following WWII led to the proliferation of churches in post-war America. This meant that large churches became increasingly visible, but journalists and social commentators mistook their increase in prevalence for lack of historical precedent. Pastors and other leaders, capitalizing on the appeal of innovation, reinforced this view. This research offers an important corrective that helps situate megachurches in the United States in their proper context. [ABSTRACT FROM AUTHOR]

Purpose - To assess the following question. Do large Protestant congregations in the United States exert social and political influence simply as afunction of their size, or do other characteristics amplify their influence? Methodology/Approach - Using the U.S.-based National Congregations Study and the General Social Survey, the chapter employs a multivariate regression model to control for other factors related to church size. Findings - Larger congregations contain a larger proportion of regular adult participants living in high-income households and possessing college degrees, and a smaller proportion of people living in low-income households. In congregations located in relatively poor census tracts, the relationship between high socioeconomic status (SES) and congregation size remains significant. Across Protestant groups, size and proportion of the congregation with high SES are correlated. Individual-level analyses of linked data from the General Social Survey confirm the positive relationship between the size of congregation the respondent attends with both high household income and possessing a college degree. These analyses also reveal a negative relationship between size and low house- hold income. Social implications - Size is an important factor when considering the social impact of congregations. Originality/Value of chapter - This chapter identifies a systematic d~fference between churches of d~fferent sizes based on SES. This relationship has not been previously identified in a nationally representa- tive sample. [ABSTRACT FROM AUTHOR]

Introduction: This study sought to determine the effect of a 2-year, multicomponent health intervention (Spirited Life) targeting metabolic syndrome and stress simultaneously.Design: An RCT using a three-cohort multiple baseline design was conducted in 2010-2014.Setting/participants: Participants were United Methodist clergy in North Carolina, U.S., in 2010, invited based on occupational status. Of invited 1,745 clergy, 1,114 consented, provided baseline data, and were randomly assigned to immediate intervention (n=395), 1-year waitlist (n=283), or 2-year waitlist (n=436) cohorts for a 48-month trial duration.Intervention: The 2-year intervention consisted of personal goal setting and encouragement to engage in monthly health coaching, an online weight loss intervention, a small grant, and three workshops delivering stress management and theological content supporting healthy behaviors. Participants were not blinded to intervention.Main Outcome Measures: Trial outcomes were metabolic syndrome (primary) and self-reported stress and depressive symptoms (secondary). Intervention effects were estimated in 2016 in an intention-to-treat framework using generalized estimating equations with adjustment for baseline level of the outcome and follow-up time points. Log-link Poisson generalized estimating equations with robust SEs was used to estimate prevalence ratios (PRs) for binary outcomes; mean differences were used for continuous/score outcomes.Results: Baseline prevalence of metabolic syndrome was 50.9% and depression was 11.4%. The 12-month intervention effect showed a benefit for metabolic syndrome (PR=0.86, 95% CI=0.79, 0.94, p<0.001). This benefit was sustained at 24 months of intervention (PR=0.88; 95% CI=0.78, 1.00, p=0.04). There was no significant effect on depression or stress scores.Conclusions: The Spirited Life intervention improved metabolic syndrome prevalence in a population of U.S. Christian clergy and sustained improvements during 24 months of intervention. These findings offer support for long-duration behavior change interventions and population-level interventions that allow participants to set their own health goals.Trial Registration: This study is registered at www.clinicaltrials.gov NCT01564719. [ABSTRACT FROM AUTHOR]