The purpose of this prospective cohort study (n = 21,658) was to assess the association of a mother''''''''''''''''s initial infant feeding method intention at time of her maternity hospitalization admission, maternal characteristics, and early skin-to-skin maternal/infant contact during the first 3 hours following birth with the likelihood of exclusive breastfeeding during the remainder of the maternity hospital stay. Participants were mother/infant dyads from 19 hospitals throughout San Bernardino and Riverside counties in California from July 2005 through June 2006. Statistical analysis included univariate and multivariate logistic regression. The likelihood of exclusive breastfeeding improved as the length of time in early skin-to-skin mother/infant contact increased in both mothers who had intended to breastfeed (OR 27.597; 95% CI 23.655-32.197) and in mothers who were undecided regarding their intention to breastfeed.(OR 11.291; 95% CI 7.961-16.013). The increased likelihood of exclusive breastfeeding among both mothers who were initially undecided regarding their infant intention and mothers who were intending to mix-feed their infants was unexpected. These findings confirm the need to prioritize early skin-to-skin mother/infant contact during the immediate postpartum period to increase breastfeeding initiation to all mothers regardless of their infant feeding intention.

Background: There is growing evidence of the benefits of religious coping on health, though the effect on caregiver well-being remains elusive. Latinos readily employ religion as a mechanism for mitigating caregiving stress. However, there is little research on either the association of religiosity with caregiver health outcomes in this population or which styles of religious coping are most valuable in effecting change on health outcomes. Objective: We explored the association of religious and spiritual coping with multiple measures of well-being in Latinos caring for older, dependent relatives, either with or without dementia. Methods: We conducted in-home interviews with 66 predominantly Mexican-American Catholic family caregivers near the U.S.-Mexico border. The Duke Religiosity Index and Pargament''s brief positive and negative spiritual coping scales were used to survey caregivers'' intrinsic, organizational, and non-organizational religiosity with mental and physical health, depressive symptomatology, and perceived burden. Results: Using regression analysis, we controlled for sociocultural factors (e.g familism, acculturation), other forms of formal and informal support, and characteristics of the caregiving dyad and arrangement. Intrinsic and organizational religiosity were associated with lower perceived burden, while non-organizational religiosity was associated with poorer mental health. Negative religious coping (e.g., feelings that the caregiver burden is a punishment) predicted greater depression. Conclusion: Measures of well-being should be evaluated in relation to specific styles of religious and spiritual coping, given our range of findings. Further investigation is warranted regarding how knowledge of the positive and negative associations between religiosity and caregiving may assist healthcare providers in supporting Latino caregivers. Learning Objectives: 1. Explain the sociocultural context of as well as emotional and physical health consequences of caregiving among Mexican American family caregivers. 2. Describe the different forms of religious coping. 3. Evaluate the impact of specific forms of religious coping on caregiver health outcomes (e.g. mental health, physical health, and perceived burden). 4. Discuss ways that health and social service providers can apply these findings in supporting distressed family caregivers.

BRHS is a sub-study of the 95,000 person Adventist Health Study-2 (AHS-2). 11,506 of these Adventists (34% Black, 60% White) returned 20-page questionnaires based on a 5-stage model.  Assessed were: Cumulative Risk (e.g., Lifetime traumatic events, stress from early and adult relationships; 18 multi-item scales), Religion (e.g., religious support, prayer, religious coping; 31 scales), potential mediating variables, (e.g., lifestyle, social support, emotions; 22 scales), and outcomes (e.g., mental and physical health, life satisfaction; 7 scales).  A 524 person subgroup also provided blood, urine, saliva, and fat samples to assess allostatic load; and had memory, physical performance and biometrics assessed.  Three years after this sample, all participants will again be assessed.  Nutrition, mortality and hospitalization data from AHS-2 will also be available.  Adventist Blacks and Whites are above national norms and for mental health the gap was largest in the oldest group. Comparisons with the general social survey have been made.

Though Foa (1947) created a scale to measure Sabbath attitudes and Golner (1982) and Goldberg (1986, 1987) argued that Sabbath-keeping might be considered conducive to mental health, there has been virtually no empirical research on Sabbath observance other than worship attendance.   A web survey including 74 Sabbath behavior and belief items was carried out of 1,123 employees, faculty and students of Loma Linda University Health Sciences center.  Exploratory factor analysis of 400 Seventh-day Adventists a nine factor, 38-item measuring tool was developed.  Examples of scales include: belief that Sabbath relieves tension, spiritual activities on Sabbath, secular activities on Sabbath, etc.   Confirmatory factor analysis showed the same nine factors in the remaining 282 Adventists.  Confirmatory factor analysis also showed the nine factors invariant across 682 Adventists and 441 non-Adventists. Mean levels of each factor across groups and associations of these factors with health quality of life variables (SF-8) were explored.

Maselko et al. (2007) report religious attendance predicts lower allostatic load for women but not men.  They posit religiousness becomes salient when vulnerable; and, because older women are more vulnerable they are more likely to benefit from religious social support.  To further test this proposition, race, gender and marital status were examined in a cohort of 3802 adults to examine the effects of religious support given vs. received.  Brown et al. (2003) found that giving social support improved 5-year mortality for married adults while receiving support had no impact.  After controlling for worship attendance, income and education, there were significant effects of gender, marital status and race on religious support variables.  Females and Blacks received more religious support and males and widows had more negative church interactions.  Married and Black participants anticipated more religious support.  Several interactions are discussed and the impact of religious support on health is explored in different groups.

The impact of childhood and adult psychosocial stress on quality of life was examined in a cohort of 9,473 Black and White adults aged 35-99 years. Child/adult psychosocial stressors (risky family, violence, social integration) predicted quality of life and passive religious engagement exacerbated the effects of these stressors on quality of life.

The impact of childhood and adult psychosocial stress on depression and physical comorbidity was examined in a cohort of 9473 Black and White adults aged 35-99 years.  Child/adult psychosocial stressors (risky family, traumatic events, and poverty in last year) predicted hostile interpersonal style and depression.  Parental bond was protective against depression in Whites but not Blacks. Collaborative religious coping and active religious surrender were protective factors for depression in Whites and Blacks.  Passive religious deferral and self-directed religious coping were risk factors when predicting depression.  Risk factors predicting comorbidity were age, traumatic events and passive deferral in Blacks.  Risk factors predicting comorbidity in Whites were age, poverty in last year, parental abuse, trauma impact, and hostility.  The mechanism of a hostile interpersonal style linking risky family experiences to health outcomes was supported for predicting depression, but not comorbidities.  Religious coping strategies do mediate the effects of these high risk experiences though there were some ethnic differences in these findings. Religion, particularly church attendance, has been associated with lower mortality, but the specific mechanisms underlying this connection are not understood.   A framework was used connecting psychosocial risk exposure to depression and comorbidities while certain types of religious coping were protective and others harmful. 

This study provides an analysis of 63 Latino caregivers in Southeast Texas and the role community-based care management plays in influencing caregiver physical and emotional well-being. Caregiver physical and emotional well-being was studied through burden, depression,perceived health and resourcefulness. Regression, correlation and comparison analysis was performed. Acculturation was positively correlated with care management use. In comparing dementia and nondementia caregivers both groups had similar levels of depression and burden. Additionally,the dementia group had significantly lower levels in perceived health and social resourcefulness. Mental and physical health outcomes did not change significantly in the group receiving care management over the 3-month evaluation period. Further research is necessary to assess whether care management services can positively influence caregiver health outcomes and findings need to drive policy for program remodeling and implementation.

Studies of Asian American women caregivers have suggested that filial values are associated with positive caregiver outcomes including better health and lower burden. Cross-ethnic assessment and comparison of filial values (adult children''''s attitudes and devotion toward their aging parents) has been limited since no valid comprehensive measure has been available for use with multiple ethnic groups. The goal of this study was to develop a multidimensional filial values scale that is valid for use with the five main ethnic groups in the United States (American Indians, Asian, African, Asian, Euro and Hispanic Americans) to facilitate this kind of research. Constructing the Filial Values Index involved seven steps and five stages of concept development. Factor analysis identified three primary factors in the tool: Care, Obligation, Respect. The 20-item Filial Values Index is a big step toward examining and comparing filial values in the increasingly diverse population in the United States.

Few studies have examined filial values across a broad range of cultures. Using the new Filial Values Index (FVI, Jones, Lee, & Zhang, this symposium) we examined the influence of gender and ethnicity on the three scales of the FVI—caring for parents, obligation to parents, and respect and valuing of parents—in five ethnic groups (n = 567). Females were higher on Respect (p = .03) and slightly higher on Care. There was little difference between males and females on Obligation. African and Asian Americans were higher on Obligation than Euro Americans and American Indians. Hispanics were midway between these groupings. There were no significant differences among ethnic groups on Respect or Care. Among non-Euro Americans those rating themselves as American (highly acculturated) felt less Obligation and Respect than those rating themselves as mostly of their own culture. Implications of these findings will be discussed.

A long tradition of work (e.g., Lofland and Stark; Stark and Bainbridge) explores the role of social networks in shaping patterns and processes of religious conversion, especially to unconventional religious groups such as sects and cults. However, few studies have attempted to clarify the role of specific network members (e.g., spouse, other household members, associates, closest friends) in shaping adherence to distinctive or unconventional religious beliefs and related practices among the members of sectarian groups. Our work addresses this gap in the literature, using data on a large random nationwide sample of Seventh-day Adventists. Results confirm that religious network composition predicts support for a broad array of doctrinal beliefs and distinctive practices, although specific network components differ in their links with specific types of beliefs and behaviors. The results are discussed in terms of their relevance for the literatures on (a) social determinants of religion, (b) the construction and maintenance of religious plausibility structures, and (c) the links between religion and healthy lifestyles. Study limitations and directions for future research are also identified.