The Role of Religiosity and Spirituality in the Lives of Low-Income Families

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1 The Role of Religiosity and Spirituality in the Lives of Low-Income Families Conducted by RTI International Sponsored by The Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services RTI International is a trade name of Research Triangle Institute

2 Presentation Roadmap Background Project Objectives/Outcomes Research Method for Report Conceptual Models/Pathways Identified Studies Findings Research Gaps New Research Broad Suggestions for Future Research

3 Background Why is religiosity and spirituality research on low-income families relevant to researchers, policymakers, and program developers? Religion and spirituality have a strong presence in U.S. culture, politics, media and policy circles. A recent Executive Order establishing the new Office of Faith- Based and Neighborhood Partnerships calls for rigorous evaluation and research. Religiosity and spirituality are hypothesized to buffer negative consequences of poverty. Survey data point to differences in religious involvement by income level. There is little empirical research on the topic for low-income population.

4 Project Objectives Provides a descriptive synthesis of the state of the research on the influence of religiosity and spirituality in the lives of the U.S. low-income population. Offers preliminary assessment: 1. Identify the key research questions that guide this topic area 2. Provide overview of research designs and document key methodological innovations and challenges 3. Document and distill existing evidence of the effects of religiosity and spirituality in the low-income population 4. Identify knowledge gaps 5. Identify new research projects that fill in gaps 6. Provide broad suggestions for future research.

5 Outcomes of Interest Focus on outcomes in key areas of program development targeting the low-income population: 1. Marriage and healthy relationships 2. Parenting 3. Youth 4. Health 5. Substance abuse 6. Crime and violence 7. Homelessness 8. Employment

6 Research Methodology Comprehensive review of the literature including published and unpublished articles. Included only studies that examine religiosity and association with outcomes of interest in samples that include low-income population or provide comparison between income groups. Broad definition of income (e.g. self identified, geographic, receipt of services that include means tests such as Medicaid) Searched 10 literature databases (e.g. Pubmed, JSTOR) Used pre-specified search terms (e.g. keywords and MeSH terms) Excluded evaluations of faith-based programs if religiosity/spirituality is not measured.

7 Limited Conceptual Models Several scholars hypothesize that religiosity and spirituality may help to buffer or protect from some of the negative consequences of living in poverty. Besides the buffering hypothesis, conceptual models described in empirical research targeted to the low-income population generally do not develop hypotheses about the specific pathways of effects. Conceptual models generally do not address why religiosity and spirituality would have different effects depending on income.

8 Some Identified Hypotheses Stigma associated with motherhood outside of marriage could deter single-parent families from seeking help from or participating in religious institutions. Urban churches may de-emphasize specific religious tenets so as not to offend their members. Possible gender differences in the effects of religiosity on marital outcomes due to differences in the strength of religious beliefs. The health literature highlights the potential for positive and negative religious coping strategies.

9 Key/Basic Research Questions Research questions, across topic areas, fall into two groups First order questions: Is religiosity associated with outcomes Direction of relationship Nature of relationship (i.e., religiosity intensity vs. denomination) Second order questions: HOW does religiosity influence outcomes Direct/Indirect Pathways Moderating effects

10 Potential Pathways of Religiosity/Spirituality Direct and/or indirect (mediating) effects of organizational religiosity on outcomes Direct: Religious sermons that includes specific directions/advice about health practices Indirect: Social networks formed at religious institutions Direct and/or indirect (mediating) effects of individual religiosity on outcomes Direct: Prayer/meditation about specific health conditions Indirect: Strong religious beliefs in general Effect of family-level and community-level religiosity on outcomes Family: Homogeny of beliefs Community: Peers and community members Moderating effect of religiosity on outcomes Race/ethnic differences Stress-buffering

11 Identified Studies Targeting the Low-Income Population Relative to the considerable body of research on religiosity and health, there is very limited research on the role of religiosity in the low-income population. At a recent conference Religious Practice and Health: What the Research Says, it was reported that there are over 7,000 studies focused on the broad topic of religiosity and health. We identified fewer than 100 studies, however, that focus on religiosity and the low-income population across eight outcome areas of interest to policymakers and practitioners. The greatest number of religiosity studies involving the low-income population focus on the area of health outcomes.

12 Identified Studies by Topic Areas Topic Area Total Qualitative Studies Marriage 11 0 Parenting 13 0 Youth 17 0 Health Substance Abuse 10 1 Crime and Violence 5 1

13 Religiosity Research Observations For the general population: Growing body of literature highlighting the positive, albeit modest, association between religiosity and spirituality and better life experiences. There have been several systematic reviews and meta-analyses conducted across a range of family and health outcomes. For the low-income population: The empirical literature is in the early stages of development. No systematic reviews and meta-analyses for this population.

14 Family Outcomes Marriage/Relationships: (11 studies) Religious affiliation: null Church attendance: positive association Joint Religious/Secular Activities: one study finds positive associations for both types of activities with couples marital quality. Parenting: (13 studies) Diverse outcomes, measures, and study populations: inconclusive Mediating Pathways: For both marriage and parenting outcomes, some studies suggest the presence of mediating (direct and indirect) effects.

15 Youth Outcomes Organized religiosity (public): In general, participating in organized religion is positively associated with positive psychological and academic outcomes and is negatively associated with risky behavior. Non-organizational religiosity (private): The associations between individual religious beliefs and positive outcomes for youths are mixed. Moderating Pathway: Among the 17 identified studies focusing on youth outcomes, there are no clear patterns of effects when gender differences are explored.

16 Health Outcomes Mental Health: Several studies 17 quantitative and 14 qualitative In general, religiosity has a positive association with several mental health indicators in quantitative studies. Qualitative studies highlight positive and negative religious coping strategies. Physical Health: Limited number of studies (5) Range of outcomes self-rated asthma to dental decay Results are inconclusive Preventive Health Services: 5 studies find null effect of religiosity 3 of the 5 studies include cancer screening interventions convened or promoted by churches

17 Substance Abuse & Criminal Justice Outcomes Substance Abuse: 11 studies show a range of positive, negative, and null effects depending on outcomes and the population studied. For example, in one study of an intervention program, religiosity is positively associated with seeking drug treatment. In another, there is no effect on smoking cessation. Criminal Justice/Violence: Limited number of studies (5) 2 studies find that frequent church attendance is associated with lower crime and violence outcomes for low-income youths, but the effects are mixed for low-income adults. 3 studies find that religious beliefs do not appear to be associated with crime and violence outcomes.

18 Research Gaps Lack of comprehensive logic models within outcome areas. A lack of national longitudinal data collection including detailed measures of outcomes, income, and religiosity and spirituality (measured at the individual, family and community levels). Inadequate measures of spirituality or religious beliefs and religious practices from diverse religions that are specific to outcome measures. Over-reliance on self-reported outcomes. Inconsistent testing of mediating pathways between religion and behavioral outcomes and a lack of consistent set of control variables. A lack of systematic analysis of whether religiosity has any buffering effects or operates differently for particular subgroups. Limited research designs that do not go beyond establishing correlations. A limited number of experimental studies.

19 Promising New / Recent Research Targeting Low-Income Populations Study Program Intervention Understanding the comparative effectiveness of faith-based and secular social service organizations Longitudinal Data Collection Geographic Sample Development and maintenance of lowincome newlywed marriages Longitudinal Data Collection Nationally Representative National Study of Youth and Religion Research Outcome This is a two-phase study designed to understand whether and how religiosity in substance abuse treatment programs increases, decreases, or has no impact on the effectiveness of such programs in treating low-income patients with substance abuse problems. Includes experimental research design and random assignment. Marriage licenses will be used to sample 513 Black, White, and Hispanic first-married newlywed couples living in low-income neighborhoods. Includes four interviews over the first 3 years of marriage. Focuses on a variety of indicators, including religiosity and spirituality. NSYR surveys over 3,000 American teenagers (and their parents) and conducts follow-up interviews for a subsample of respondents. Includes income measures. Preliminary analysis of income differences in participation in religious activities.

20 Summary of Potential Next Steps Short/Medium Term Define common measures of organizational and individual religiosity and spirituality across outcome areas. Consistently test for secular and religious-specific mediating pathways and for differences across sociodemographic characteristics and different resource levels. Use multiple estimation methods to conduct sensitivity analysis of the results. Such analyses can help identify appropriate rigorous methods in this area. Use existing studies and samples to interview low-income participants (and higher-income participants if they are available) Conduct observational research at the religious institutions of a subset of respondents and conduct a content analysis of religious activities, such as sermons, social networks, and available activities. Include measures of religiosity/spirituality in existing program evaluations of faith-based or church-based programs to examine their impact on religiosity and how religiosity affects outcomes.

21 Summary of Potential Next Steps Longer Term Add basic measures of religion to the Decennial Census. Link individuals to administrative records. Commission new household surveys that collect longitudinal extensive measures of religiosity, spirituality, income, and behavioral outcomes for households. In large surveys, oversample individuals who are non-christian to develop adequate sample sizes. Survey religious institutions about practices and activities that can be linked to individuals participating in panel surveys.

22 Questions? The full report is available online at. For more information, please contact: Pam Joshi, Alana Landey,

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