Journal of Religion and Health

, Volume 57, Issue 3, pp 1168–1178 | Cite as

Spiritual Fitness for Military Veterans: A Curriculum Review and Impact Evaluation Using the Duke Religion Index (DUREL)

  • Kate H. Thomas
  • Justin T. McDaniel
  • David L. Albright
  • Kari L. Fletcher
  • Harold G. Koenig
Original Paper
  • 54 Downloads

Abstract

Suicide rates among military veterans exceed those found in the general population. While the exact reasons for these high rates are unknown, contributing factors may include the military’s perceived rejection of patient identities, creating barriers to mental health care within the clinical sector and a mandate for prevention programs. Spiritual fitness has emerged over the last decade as an important concept in human performance optimization and is included among holistic approaches to developing and maintaining mentally fit fighting forces. In attempts to better understand the role that spiritual fitness and religion play in mitigating and/or reducing suicide risk among veterans, the aims of this study were twofold (1) to assess the utility of the Duke Religion Index as a psychometric instrument for use with veterans completing spiritual fitness training and (2) to offer a post-intervention process evaluation of the spiritual fitness module from one resilience program offered to military veterans of Iraq and Afghanistan in 2016. Twenty-eight attendees at the JRWI Wellness Resilient Leadership Retreat completed post-retreat surveys to assess their satisfaction with the coursework and specifically, to assess the spiritual fitness module of the resiliency retreat’s curriculum. In total, the research team reviewed 25 completed post-intervention survey responses (89.3% response rate). Descriptive statistics indicated that respondents (n = 25) were subjectively religious, defined as belief in a higher power practiced in ritualized ways. Over half of program participants indicated they (a) attended religious meetings at least once a week and (b) engaged in private religious activity—such as meditation—at least once a day. Results showed that most program participants reported that the spiritual fitness skills learned during the resilient leadership program were useful (88%) (Z = 3.000, p < 0.001). Additionally, most program participants reported their interest in spiritual exploration was affirmed, renewed, or raised as a result of attending the peer-led resilient leadership program (76%) (Z = 6.000, p = 0.015). Culturally informed prevention programs that emphasize spiritual fitness are indicated for use in veteran outreach and well-being programs. More detailed research is needed to assess curriculum specifics.

Keywords

Veterans health Resilience Mental health Religiosity Spiritual fitness 

References

  1. Altman, D. G. (1991). Practical statistics for medical research. London: Chapman and Hall.Google Scholar
  2. Bartlett, M. S. (1951). A further note on tests of significance in factor analysis. The British Journal of Psychology, 4(1), 1–2.Google Scholar
  3. Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245–276.CrossRefPubMedGoogle Scholar
  4. Cronbach, L. (1951). Coefficient alpha and the internal structure of tests. Psychomerika, 16, 297–334.CrossRefGoogle Scholar
  5. Dein, S., Cook, C. C., Powell, A., & Eagger, S. (2010). Religion, spirituality and mental health. The Psychiatrist, 34(2), 63–64.CrossRefGoogle Scholar
  6. Foley, P. S., Albright, D. L., & Fletcher, K. L. (2016). Navigating the minefield: A model for integrating religion and spirituality in social work practice with service members and veterans. Social Work and Christianity, 43(3), 73–96.Google Scholar
  7. Franke, T. M., Ho, T., & Christie, C. A. (2011). The Chi square test: Often used and more often misinterpreted. American Journal of Evaluation, 33(3), 448–458.CrossRefGoogle Scholar
  8. Garcia, B., & Petrovich, A. (2011). Strengthening the DSM: Incorporating resilience and cultural competence. New York: Springer.Google Scholar
  9. Green, T. K., Hayward, L. C., Williams, A. M., Dennis, P. A., Bryan, B. C., Taber, K. H., et al. (2014). Examining the factor structure of the Connor-Davidson Resilience Scale (CD-RISC) in a post-9/11 U.S. military veteran sample. Assessment, 21(4), 443–451.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Guadagnoli, E., & Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103(2), 265–275.CrossRefPubMedGoogle Scholar
  11. Hoge, C. W. (2010). Once a warrior, always a warrior (1st ed.). Guilford, CT: Lyons Press.Google Scholar
  12. Hotelling, H. (1933). Analysis of a complex of statistical variables into principal components. Journal of Educational Psychology, 25, 417–441.CrossRefGoogle Scholar
  13. Jha, A. P., Stanley, E. A., Kiyonaga, A., Wong, L., & Gelfand, L. (2010). Examining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion, 10(1), 54–64.CrossRefPubMedGoogle Scholar
  14. Kaiser, H. F. (1958). The varimax criterion for analytic rotation in factor analysis. Psychometrika, 23, 187–200.CrossRefGoogle Scholar
  15. Kaiser, H. F. (1961). A note on Guttman’s lower bound for the number of common factors. British Journal of Statistical Psychology, 14, 1.CrossRefGoogle Scholar
  16. Koenig, H. G. (2008). Medicine, religion, and health: Where science and spirituality meet. West Conshohocken, PA: Templeton Press.Google Scholar
  17. Koenig, H. G. (2017). Religion and mental health: Research and applications. Cambridge, MA: Academic Press.Google Scholar
  18. Koenig, H. G., & Bussing, A. (2010). The Duke University Religion Index (DUREL): A five-item measure for use in epidemiological studies. Religions, 1(1), 78–85.CrossRefGoogle Scholar
  19. Koenig, H. G., Parkerson, G. R., & Meador, K. G. (1997). Religion index for psychiatric research. American Journal of Psychiatry, 153, 885–886.Google Scholar
  20. Koltko-Rivera, M. E. (2006). Rediscovering the later version of Maslow’s hierarchy of needs: Self-transcendence and opportunities for theory, research, and unification. Review of General Psychology, 10(4), 302.CrossRefGoogle Scholar
  21. Koss, S. E. & Holder, M. D. (2015). Toward a global understanding of spirituality and religiosity: Definitions, assessments, and benefits. In Spirituality: Global practices, societal attitudes and effects on health. Hauppauge, NY: Nova Science Publishers.Google Scholar
  22. Koyn, B. (2015). Religious participation: The missing link in the ready and resilient campaign. Military Review, 95(5), 119–129.Google Scholar
  23. Levin, J. (2002). God, faith, and health: Exploring the spirituality-healing connection. New York: Wiley.Google Scholar
  24. Mann, H. B., & Whitney, D. R. (1947). On a test of whether one or two random variables is stochastically larger than the other. The Annals of Mathematical Statistics, 18(1), 50–60.CrossRefGoogle Scholar
  25. Masters, K. S., & Spielmans, G. I. (2007). Prayer and health: Review, meta-analysis, and research agenda. Journal of Behavioral Medicine, 30(4), 329–338.CrossRefPubMedGoogle Scholar
  26. Newberg, A., & d’Aquili, E. G. (2008). Why god won’t go away: Brain science and the biology of belief. New York, NY: Ballantine Books.Google Scholar
  27. Richardson, G. (2002). The metatheory of resilience and resiliency. Journal of Clinical Psychology, 58(3), 307–321.CrossRefPubMedGoogle Scholar
  28. Sherman, A. L. (2011). Kingdom calling: Vocational stewardship for the common good. Downers Grove, IL: InterVarsity Press.Google Scholar
  29. Siegel, S. (1957). Nonparametric statistics. The American Statistician, 11(3), 13–19.Google Scholar
  30. Storch, E. A., Roberti, J. W., Heidgerken, A. D., Storch, J. B., Lewin, A. B., Killiany, E. M., et al. (2004). The Duke Religion Index: A psychometric investigation. Pastoral Psychology, 53(2), 175–181.CrossRefGoogle Scholar
  31. Thomas, K. H., & Albright, D. L. (Eds.). (2018). Bulletproofing the psyche: Preventing mental health problems in our military and veterans. Santa Barbara, CA: ABC-CLIO/Praeger Publishing.Google Scholar
  32. Thomas, K. H., & Plummer Taylor, S. (2015). Bulletproofing the psyche: Mindfulness interventions in the training environment to improve resilience in the military and veteran communities. Advances in Social Work, 16(2), 312–322.CrossRefGoogle Scholar
  33. Thomas, K. H., Plummer Taylor, S., Hamner, K., Glazer, J., & Kaufman, E. (2015a). Multi-site programming offered to promote resilience in military veterans: A process evaluation of the just roll with it bootcamps. Californian Journal of Health Promotion, 13(2), 15–24.Google Scholar
  34. Thomas, K. H., Turner, L. W., Kaufman, E., Paschal, A., Knowlden, A. P., Birch, D. A., et al. (2015b). Predictors of depression diagnoses and symptoms in veterans: Results from a national survey. Military Behavioral Health, 3(4), 255–265.CrossRefGoogle Scholar
  35. Whitfield, J. W. (1947). Rank correlation between two variables, one of which is ranked, the other dichotomous. Biometrika, 34(3/4), 292–296.CrossRefPubMedGoogle Scholar
  36. Zar, J. H. (1972). Significance testing of the spearman rank correlation coefficient. Journal of the American Statistical Association, 67, 578–580.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kate H. Thomas
    • 1
  • Justin T. McDaniel
    • 2
  • David L. Albright
    • 3
  • Kari L. Fletcher
    • 4
  • Harold G. Koenig
    • 5
  1. 1.College of Health SciencesCharleston Southern UniversityNorth CharlestonUSA
  2. 2.Department of Public Health and Recreation ProfessionsSouthern Illinois UniversityCarbondaleUSA
  3. 3.School of Social WorkThe University of AlabamaTuscaloosaUSA
  4. 4.St. Catherine University-University of St. Thomas School of Social WorkSt. PaulUSA
  5. 5.School of MedicineDuke UniversityDurhamUSA

Personalised recommendations