Academic journal article Journal of Nursing Measurement

The Modified-Fetzer Multidimensional Measure of Religiousness and Spirituality: Examination of Construct Validity in Older Black Adults

Academic journal article Journal of Nursing Measurement

The Modified-Fetzer Multidimensional Measure of Religiousness and Spirituality: Examination of Construct Validity in Older Black Adults

Article excerpt

Background and Purpose: Sociocultural explanatory frameworks are increasingly being considered to address causes of health disparities, and attention has been focused on religion among Black Americans and its subsequent influence on health. The purpose of this study was to examine a multidimensional measure of religiousness and spirituality (Modified-Fetzer Multidimensional Measure of Religiousness and Spirituality [M-FMMRS]) in a sample of Black older adults. Methods: The M-FMMRS was administered to 130 study participants, and confirmatory factor analysis was conducted. Results: Findings did not support the hypothesized factor structure. Conclusions: Overall, the M-FMMRS is a reliable survey, but the validity needs to be further addressed. Historical documentation, review of data, and participant feedback are used to examine findings.

Keywords: confirmatory factor analysis; religiousness and spirituality; Blacks; older adults; Fetzer Multidimensional Measure of Religiousness and Spirituality; community-based

Health disparities among Blacks are a major public health problem given that the projected estimates of their population growth will reach approximately 19% of the population by 2050 (Centers for Disease Control and Prevention [CDC], 2005). Even so, it will continue to suffer a broadening health disparities gap (Brach & Fraserirector, 2000; Levine et al., 2001). Blacks have disproportionately higher rates of preventable and modifiable illnesses when compared to the majority population. For example, death rates from heart disease and stroke are 27.4% and 32.3% higher in Blacks than their White counterparts, respectively (CDC, 2011), and they have a prevalence rate of obesity that is 51% higher than in Whites (CDC, 2009). As a result, elimination of health disparities among ethnic minorities is one of the overarching goals for Health People 2020 toward improving the health of U.S. residents (HealthyPeople.gov, 2012). The purpose of this article is to describe the construct validity of modified version of an instrument, the Modified-Fetzer Multidimensional Measure of Religiousness and Spirituality (M-FMMRS) in a sample of community-dwelling older Black adults. Instruments developed to assess religiousness and spirituality provide useful approaches to addressing health disparities for researchers investigating the impact of religiousness and spirituality on health beliefs, outcomes, and behaviors.

BACKGROUND

The causes of the health disparities experienced by Blacks are complex. Clearly, social, cultural, and economic factors impact health care access, health care provider and patient relationships, and health-related values to varying degrees. Although socioeconomic causes of disparities pose clear and widespread barriers to attainment of optimal health, investiga- tions are increasingly focused on sociocultural explanatory frameworks for addressing the problem. Some have even suggested that health disparities are largely socially determined because despite all that is available to address health disparities in ethnic minorities, such as the biomedical advances in diagnosis and treatment of chronic illness, and an increased outreach of health promotion and education efforts, health disparities still persist (Link, 2008). Sociocultural factors impact health beliefs, determine health behaviors, underlie health-related values, and impact how health interventions are perceived and acted on (Baldwin, 2003; Thomas, Fine, & Ibrahim, 2004).

Over the past three decades, a growing attention has been focused on the prevalence of religion in the lives of many Black Americans and the subsequent influence that religiousness has on their health. Numerous studies have attempted to address health disparities by examin- ing racial differences in how religiousness and spirituality predict or explain health beliefs in Blacks and Whites. They find that Blacks not only exhibit higher levels of religiousness than Whites, but that they may also embrace religion in a unique way, suggesting a personal and highly developed relationship with God, which may impact health beliefs (Holt, Lewellyn, & Rathweg, 2005; Marks, Nesteruk, Swanson, Garrison, & Davis, 2005; Underwood & Powell, 2006). …

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