Date of Award


Document Type

Campus Access Dissertation


College of Nursing


Center for Health Promotion & Risk Reduction in Special Populations

First Advisor

Ken Watkins


Given that the older adult population is increasing at unprecedented rates (Himes, 2002), remaining in community settings (Federal Interagency Forum on Age Related Statistics, 2005), and often aging alone (Federal Interagency Forum on Age Related Statistics, 2006), there are concerns regarding older adults' health and quality of life. Church based health promotion (CBHP) programs provide a promising opportunity to enhance emotional, physical, and spiritual health, in a context that the body, mind, and soul are equally valued (Peterson, 2002). In a response to the need to create CBHP programs for older adults the Heart, Soul, Mind, and Strength (HSMS) program was developed based on previous literature and values in faith communities: 1) Religiosity, spirituality, and social support are associated with positive physical and mental health outcomes, and quality of life (Chiu et al., 2004; Koenig et al., 2001; Nasser, 2005; Shaw & Janevic, 2004); 2) John Wesley's (1703-1791) belief that church members are to care for others, and that such care has mutual health benefits- for those receiving the care, and those providing the care (Sermon 98); and 3) the opportunity for friendships with individuals of different ethnic backgrounds will lead to positive perceptions of one another (Dovidio et al., 2003). This study included two major study aims. The first study aim was to determine the extent to which the HSMS program positively impacted the participants' religiosity, spirituality, and social support. Two-way ANOVAs found results of the outcome measures were mixed, which may partially be explained by the historical significance and multi-faceted role church plays for many African Americans. Future research using longitudinal data and a control group is needed to determine if the program provided protective effects for social support, religious motivation, and spirituality. The second aim of the study determined 1) the participants' overall descriptions of the benefits related to the religious/ spiritual and social components of the HSMS program; 2) if race was associated with descriptive themes; and 3) if the program's impact on outcomes differed by group composition for age, race, and education (group homogeneity compared to group heterogeneity). Qualitative analysis provided evidence that the HSMS program provided spiritual and social formation. From participation in the spiritual component of the program, participants from both race groups discussed: spiritual beliefs, spiritual study, and spiritual social support. From participation in the social component of the program, participants from both race groups discussed: fellowship, emotional social support, and acceptance of others of a different race group were also reported. This finding is particularly important given the HSMS program took place in a state that has historical problematic race relation issues (Webster & Leib, 2001) and that participants are from a cohort that experienced historical events marked with racial division. Responses by group composition for age, race, and education (group homogeneity compared to group heterogeneity) were also examined. Qualitative analysis indicated it may be beneficial for CBHP programs to consider group composition for older adults to maximize spiritual study and spiritual support. However, more research is needed to understand how culture, education attainment, and other demographic variables impacts religious/ spiritual and social formation among older adults in a CBHP setting.