The Duke Clergy Health Initiative (DCHI) is a seven-year program intended to improve the health and well-being of United Methodist clergy in North Carolina. This $12 million initiative has continued to obtain press due to the research of Assistant Research Professor and DCHI Research Director, Dr. Rae Jean Proeschold-Bell, and Research Scholar, Dr. Sara LeGrand. The Christian Century and North Carolina Health News interviewed Dr. Proeschold-Bell for a story on DCHI’s work in addressing the crisis in clergy health, while Philanthropy.com invited Proeschold-Bell’s insights on the importance of evaluating interventions in order to determine whether or not DCHI’s programs were ameliorating the health of clergy.

Beyond this publicity, the fruit of Drs. Proeschold-Bell and LeGrand’s research is three peer-reviewed articles produced with their other research colleagues at DCHI, examining how health interventions can be tailored to address clergy health (see abstracts below).

For more information the Duke Clergy Health Initiative, click here.

In the News

“Fit for Ministry: Addressing the crisis in clergy health” by Amy Frykholm, The Christian Century

“Who is Behind the Evaluation Curtain?” by Caroline Preston, Philanthropy.com

“Study Shows Ministers Sacrifice Their Own Health To Serve” by Rose Hoban, North Carolina Health News

“Forty percent of clergy were obese compared to 29 percent of comparable North Carolinians” – Dr. Rae Jean Proeschold-Bell

For more news stories on DCHI, please click here.

Publications and Presentations

ABSTRACT: Clergy often face a great deal of occupational stress that in turn can lead to psychological distress. In recent years, denominations have been turning to peer support groups to combat these challenges, but little research exists regarding their effectiveness. This study explores the utility of peer support groups for reducing psychological distress among pastors by analyzing data from two waves of an ongoing study of United Methodist Church (UMC) clergy in North Carolina, as well as focus group data from the same population. Results indicate that participation in peer support groups had weakly beneficial direct and indirect relationships to psychological distress (measured as mentally unhealthy days, anxiety, and depression). Focus group data indicated that the weak results may be due to an interplay between varied group activities and differences in individual coping styles, which in turn lead to a mix of positive and negative group experiences. The results caution against assuming that peer groups are a uniformly effective solution to the occupational demands of pastoral work.

ABSTRACT: The health of clergy is important, and clergy may find health programming tailored to them more effective. Little is known about existing clergy health programs. We contacted Protestant denominational headquarters and searched academic databases and the Internet. We identified 56 clergy health programs and categorized them into prevention and personal enrichment; counseling; marriage and family enrichment; peer support; congregational health; congregational effectiveness; denominational enrichment; insurance/strategic pension plans; and referral-based programs. Only 13 of the programs engaged in outcomes evaluation. Using the Socioecological Framework, we found that many programs support individual-level and institutional-level changes, but few programs support congregational-level changes. Outcome evaluation strategies and a central repository for information on clergy health programs are needed.

ABSTRACT: United Methodist clergy have been found to have higher than average self-reported rates of obesity, diabetes, asthma, arthritis, and high blood pressure. However, health diagnoses differ from physical health functioning, which indicates how much health problems interfere with activities of daily living. Ninety-five percent (n = 1726) of all actively serving United Methodist clergy in North Carolina completed the SF-12, a measure of physical health functioning that has US norms based on self-administered survey data. Sixty-two percent (n = 1074) of our sample completed the SF-12 by self-administered formats. We used mean difference tests among self-administered clergy surveys to compare the clergy SF-12 Physical Composite Scores to US-normed scores. Clergy reported significantly better physical health composite scores than their gender- and age-matched peers, despite above average disease burden in the same sample. Although health interventions tailored to clergy that address chronic disease are urgently needed, it may be difficult to elicit participation given pastors’ optimistic view of their physical health functioning.

ABSTRACT: Research indicating high rates of chronic disease among some clergy groups highlights the need for health programming for clergy. Like any group united by similar beliefs and norms, clergy may find culturally tailored health programming more accessible and effective. There is an absence of research on what aspects clergy find important for clergy health programs. We conducted 11 focus groups with United Methodist Church pastors and district superintendents. Participants answered open-ended questions about clergy health program desires and ranked program priorities from a list of 13 possible programs. Pastors prioritized health club memberships, retreats, personal trainers, mental health counseling, and spiritual direction. District superintendents prioritized for pastors: physical exams, peer support groups, health coaching, retreats, health club memberships, and mental health counseling. District superintendents prioritized for themselves: physical exams, personal trainers, health coaching, retreats, and nutritionists. Additionally, through qualitative analysis, nine themes emerged concerning health and health programs: (a) clergy defined health holistically, and they expressed a desire for (b) schedule flexibility, (c) accessibility in rural areas, (d) low cost programs, (e) institutional support, (f) education on physical health, and (g) the opportunity to work on their health in connection with others. They also expressed concern about (h) mental health stigma and spoke about (i) the tension between prioritizing healthy behaviors and fulfilling vocational responsibilities. The design of future clergy health programming should consider these themes and the priorities clergy identified for health programming.

ABSTRACT: Scholars have shown that clergy work can be stressful, and that these occupational strains can lead to negative physical and mental health outcomes. Despite the fact that nearly one-third of all congregations in the United States are rural, little work has examined how occupational conditions and clergy experiences might vary systematically by geographical context. This study uses recent data from United Methodist Church clergy in North Carolina to test extant depictions of rural ministry, which typically portray rural churches as challenging occupational settings. It finds that although rural clergy face several unique challenges (such as multichurch ministry and lower salaries), they report lower levels of several stressors and more positive experiences. These differences disappear once controls are added, suggesting that rural ministry per se is neither particularly harmful nor beneficial when compared with ministry in other settings.

  • Adams, C. & Proeschold-Bell, R.J. “An Update on the Duke Clergy Health Initiative: Recent findings on clergy mental and physical health.” Presented at The Society for the Study of Psychology and Wesleyan Theology Annual Conference. Trevecca Nazarene University: Nashville, TN. February 2012.
  • Adams, C. & Proeschold-Bell, R.J. “The Duke Clergy Health Initiative.” Presented at the Christian Association for Psychological Studies International Conference: Washington, D.C. (2012, March).
  • Proeschold-Bell, R.J. “Leading a spirited life: Health disparities among clergy and their possible origins and solutions.” Presented at the East Carolina University Center for Health Disparities Fall 2012 Lecture Series, East Carolina University, Greenville, North Carolina. (2012, September).

2012 Tearfund Accomplishments

The Tearfund Evaluation, or what is more accurately known as the Prevalence of Sexual and Physical Violence among Women in Faith-based Drug Residential Rehabilitation Centres study, was commissioned in 2011 but was analyzed and completed in 2012. This study sought to

examine the rate of sexual abuse among women in treatment for drug and/or alcohol abuse in 3 cities in the Russian Federation. This study surveyed a totally of 161 women in residential rehabilitation centers and 88 ‘controls’ – women who were not in rehabilitation but who could be compared to the women in rehab. In 2012 the following was achieved:

* In January 2012 the trained interviewers began data collection

* In March 2012, data entry and transmission to CHPIR began

* In April 2012, data cleaning began and analysis began

* In May 2012, Rachel Whetten (PI) and Anna Both (now Koons – PC) began to write the final report as the data analysis became available

* In June, the first draft of the report was released to Tearfund

* In July, 2012, 2 colleagues from Teafund visited CHPIR to discuss future collaborations

* In September 2012 a second iteration of the report was completed by Anna Koons and Rachel Whetten. Major findings below:

o In November, 2012, CHPIR enters into serious discussions with colleague from Tearfund and Russian collaborator to respond to an NIH RFA as a direct result of the successful evaluation contract completion.

Teen Outreach Program (TOP) in 2012

2012 Accomplishments: TOP of Craven County, NC

CHPIR continues to partner with the Craven County Health Department (CCHD) in New Bern, NC to offer the Teen Outreach Project (TOP).  In 2012, Genevieve Ankeny Hunter (GV), a CHPIR project coordinator, brought on board Tova Hairston, a native of Craven County, as they successfully led a program that reached over one hundred youth, ages 11-17, in Craven County. The TOP curriculum not only provided these youth with an essential education on teen pregnancy and HIV/STD transmission, it also promoted essential abilities to reduce future risk behavior by focusing on three important tenants in youth development: a sense of purpose, life skills and healthy behaviors.

In order to develop their capacity to effectively educate the youth in Craven County as well as to promote their work in New Bern, NC, GV and Tova attended the NC Annual Teen Pregnancy Prevention Conference. Tova also participated in the National Teen Pregnancy Prevention Conference in Washington, D.C., while they both continued training in the TOP curricula. What’s more, GV and CHPIR faculty member, Rae Jean Proeschold-Bell, worked with other scholars to write the journal article, “The increasing impact of HIV infections, sexually transmitted diseases and viral hepatitis in Durham County, North Carolina: A call for coordinated and integrated services,” which was published in the North Carolina Medical Journal.”

Publications

Conclusions: Durham County has experienced an increase in the number of HIV-infected persons in the county, and coinfections with STDs and hepatitis B or C are common. Multiple barriers to testing/treatment exist in the community. Coordinated care models are needed to improve access to HIV care and to reduce testing and treatment barriers.

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