Looking Inside the Black Box of “Attendance at Services”: New Measures for Exploring an Old Dimension in Religion and Health Research

Abstract

Research in religion and health has spurred new interest in measuring religiousness. Measurement efforts have focused on subjective facets of religiousness such as spirituality and beliefs, and less attention has been paid to congregate aspects, beyond the single item measuring attendance at services. We evaluate some new measures for religious experiences occurring during congregational worship services. Respondents (N=576) were religiously-diverse community-dwelling adults interviewed prior to cardiac surgery. Exploratory factor analysis of the new items with a pool of standard items yielded a readily interpretable solution, involving seven correlated but distinct factors and one index variable, with high levels of internal consistency. We describe religious affiliation and demographic differences in these measures. Attendance at religious services provides multifaceted physical, emotional, social, and spiritual experiences that may promote physical health through multiple pathways.Measurement of religion, religiousness, and spirituality for the purposes of health research has been an evolving enterprise. Beginning with Durkheim's Suicide (1897/1951, and continuing through the 1960s and 1970s, epidemiological studies focused on mortality or health differences among religious affiliations. Studies of suicide, cardiovascular disease, and cancer deaths were based on comparisons of mortality rates of mainstream and sectarian religious groups such as Seventh Day Adventists, Mormons, and the Amish, which were often lower than those of other religious groups or standard populations (Jarvis & Northcott, 1987). Religion was treated as a characteristic of groups, not individuals. The dependent variables were rates (all-cause, or cause-specific mortality), and the mechanisms of effect remained NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript speculative, or focused specifically on health-risk-related practices, including vegetarian diet and prohibitions against smoking or alcohol.A second wave of studies beginning in 1979 took an entirely different approach. These studies treated religiousness as a characteristic of individuals, and conceptualized it as one type of social tie making up an individual's social network, along with families, friendships, and voluntary and community group memberships (House, Landis, & Umberson, 1988). In these studies religiousness was measured with a single item asking about attendance at services or membership in a congregation; the individual's specific religious affiliation, the basis for all of the previous research, was now usually absent. Reviews during this period of research consistently criticized the unidimensional, typically single-item operationalization of religiousness, and pointed out that lack of development in measurement of the key concept was a major barrier to progress in the field (e.g. Levin, 1994).Since then, research on religion and health has maintained a focus at the individual level of analysis. Innovations in measurement largely h...

Attendance at Religious Services, Prayer, Religious Coping, and Religious/Spiritual Identity as Predictors of All-Cause Mortality in the Black Women's Health Study

“…Idler et al (44), in a recent analysis examining numerous aspects of religious service experience, used exploratory factor analysis to derive 7 components of the religious service experience, including frequency, positive worship emotions, devotional activities, belonging, beliefs, purpose and meaning, and sad worship emotions. Clearly service attendance is related to a diverse range of cognitive and affective experiences, but further research is needed to understand which of these components is most strongly related to health and to the more distal mechanisms discussed above.…”

Psychosocial factors in heart surgery: Presurgical vulnerability and postsurgical recovery.

“…More than anxiety, depression involves a lack of behavioral activation that may slow postoperative recovery. Consistent with this view, depressive symptoms were related to low levels of purpose and meaning, Tables 3 and 4). constructs with motivational implications (Idler et al, 2007). However, depressive symptoms also were associated with poor presurgical biomedical status, which, while not inconsistent with a motivational interpretation, also might reflect biological processes that more directly influenced LOS.…”

Religious social capital: Its measurement and utility in the study of the social determinants of health

“…First, there is already a large body of research showing correlations between religious attendance and a variety of health outcomes (Koenig, McCullough, & Larson, 2001) and so it is not clear what new information is gained when a church attendance variable is the main component of a religious social capital measure. Second, the use of religious attendance in health research has itself been criticized for lack of conceptual clarity as to what it is that is actually being measured (Idler et al, 2009). The theoretical and empirical connection between a ‘frequency of attendance’ variable and actual levels of religious social capital needs to be better clarified.…”