Effects of the association between spirituality, religiosity and physical activity on health/mental health: a systematic review

Moreira, Wanderson Carneiro; Nóbrega, Maria do Perpétuo Socorro de Sousa; Lima, Fernanda Púpio Silva; Lago, Eliana Campêlo; Lima, Mário Oliveira

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Review • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2019012903631 copy

Effects of the association between spirituality, religiosity and physical activity on health/mental health: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify evidence in the literature about the effects of the association between spirituality, religiosity and physical activity on physical and mental health.

Method:

A systematic review conducted in January 2019 in the MEDLINE/PubMed, SCOPUS, Web Of Science, CINAHL, PsycINFO, LILACS and SciELO databases with the descriptors: “spirituality”, “religion”, “physical activity” and “physical exercise ”. Primary studies carried out with adults published until 2018 in Portuguese, English or Spanish were included.

Results:

Nine international studies were selected which had been published between 2011 and 2017, with cross-sectional design (55%) and an evidence level of four (78%). Eight studies addressed effects on physical health and one addressed effects on mental health.

Conclusion:

The association between spirituality, religiosity and physical activity promotes effects on physical and mental health, however the available evidence is not sufficient for this association to be applied in clinical practice.

DESCRIPTORS
Spirituality; Religion; Motor Activity; Exercise; Mental Health; Systematic Review

Database	Search Strategy
MEDLINE/PubMed Web of Science CINAHL PsycINFO	((“Spirituality” OR “Spiritualities” OR “Religion” OR “Religions”) AND (“Exercises” OR “Physical Activity” OR “Activities, Physical” OR “Activity, Physical” OR “Physical Activities” OR “Exercise, Physical” OR “Exercises, Physical” OR “Physical Exercise” OR “Physical Exercises”))
SCOPUS	TITLE-ABS-KEY(((“Spirituality” OR “Spiritualities” OR “Religion” OR “Religions”) AND (“Physical Activity” OR “Exercise, Physical”)))
LILACS SciELO	((“Spirituality” OR “Espiritualidade” OR “Espiritualidad” OR “Religion” OR “Religião” OR “Religión”) AND (“Physical Activity” OR “Atividade física” OR “Actidad física” OR “Physical Exercise” OR “Exercício físico” OR “Ejercicio físico”))

Title	Year/Country	Design/Sample	Objectives	Outcome	LE/DR
Perceptions of Clinical Athletic Trainers on the Spiritual Care of Injured Athletes⁽²³23. McKnight CM, Juillerat S. Perceptions of clinical athletic trainers on the spiritual care of injured athletes. J Athl Train. 46(3):303-11. DOI: 10.4085/1062-6050-46.3.303 https://doi.org/10.4085/1062-6050-46.3.3... ⁾.	2011/USA	Transversal/n=564	To determine the coaches’ perceptions and practices regarding the spiritual care of injured athletes.	Positive correlations were found between spirituality and items which favor the implementation of spiritual care.	IV/A
Are Religiosity and Spirituality Associated with Obesity Among African Americans in the Southeastern United States (the Jackson Heart Study)?⁽²⁴24. Reeves RR, Adams CE, Dubbert PM, Hickson DA, Wyatt SB. Are religiosity and spirituality associated with obesity among African Americans in the Southeastern United States (the Jackson Heart Study)? J Relig Health. 2012;51(1):32-48.⁾.	2012/USA	Cohort and longitudinal/n=2,387	To examine the associations between dimensions of religiosity/spirituality and health behaviors among African Americans in central Mississippi.	Religiosity and spirituality promote good health behaviors. The practice of physical activity was not significant.	IV/B
Efficacy-mediated effects of spirituality and physical activity on quality of life: A path analysis⁽²⁵25. Konopack JF, McAuley E. Efficacy-mediated effects of spirituality and physical activity on quality of life: a path analysis. Health Qual Life Outcomes [Internet]. 2012 [cited 2019 Apr 27]; 10:57. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406955/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾.	2012/USA	Transversal/n=215	To replicate the model of physical activity and quality of life as validated by McAuley et al. to examine self-efficacy as a mediator of the association between spirituality and quality of life	The most spiritual and physically active participants reported higher quality of life and the effects of these factors on quality of life can be partially mediated by perceptions of self-efficacy.	IV/A
Physical activity with spiritual strategies intervention: a cluster randomized trial with older African American women⁽²⁶26. Anderson KJ, Pullen CH. Physical activity with spiritual strategies intervention: a cluster randomized trial with older African American women. Res Gerontol Nurs. 2013;6(1):11-21.⁾.	2013/USA	Randomized/n=27	To determine whether African American women who received a physical activity intervention with spiritual strategies would demonstrate differences over time in health behaviors compared to a control group.	Physical activity with spiritual strategies improves health behavior.	II/A
The Influence of Spirituality and Physical Activity Level on Responsible Behaviour and Mountaineering Satisfaction on Mount Kinabalu, Borneo⁽²⁷27. Esfahani M, Musa G, Khoo S. The influence of spirituality and physical activity level on responsible behaviour and mountaineering satisfaction on Mount Kinabalu, Borneo. Curr Issues Tour [Internet]. 2014 [cited 2019 Apr 27];20(11):1162-85. Available from: http://www.tandfonline.com/doi/abs/10.1080/13683500.2014.987733 http://www.tandfonline.com/doi/abs/10.10... ⁾.	2014/Indonesia	Transversal/n=916	To analyze the influence of spirituality and the level of physical activity on the behavior and satisfaction of climbers.	Spirituality positively influences the behavior and satisfaction of climbers. A high level of physical activity moderates these two relationships.	IV/A
Participation in Physical, Social, and Religious Activity and Risk of Depression in the Elderly: A Community-Based Three-Year Longitudinal Study in Korea⁽²⁸28. Roh HW, Hong CH, Lee Y, Oh BH, Lee KS, Chang KJ, et al. Participation in physical, social, and religious activity and risk of depression in the elderly: a community-based three-year longitudinal study in Korea. PLoS One [Internet]. 2015 [cited 2019 Apr 27];10(7):e0132838. Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132838. http://journals.plos.org/plosone/article... ⁾.	2015/South Korea	Longitudinal/n=6,647	To examine the association between physical, social and religious activity and risk of depression in older adults.	Participation in physical, social and religious activity was associated with a decreased risk of depression in older adults.	IV/A
The impact of religiosity on dietary habits and physical activity in minority women participating in the Health is Power (HIP) study⁽²⁹29. Ansari S, Soltero EG, Lorenzo E, Lee RE. The impact of religiosity on dietary habits and physical activity in minority women participating in the Health is Power (HIP) study. Prev Med Rep [Internet]. 2017 [cited 2019 Apr 27];5:210-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219644/pdf/main.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ⁾.	2017/USA	Randomized/n=132	To investigate the influence of religiosity on physical activity and consumption of fruits, vegetables and fat in women.	There was no association between religiosity and changes in physical activity and diet.	II/B
Spirituality and physical activity and sedentary behavior among latino men and women in Massachusetts⁽¹⁶16. Silfee VJ, Haughton CF, Lemon SC, Lora V, Rosal MC. Spirituality and physical activity and sedentary behavior among latino men and women in Massachusetts. Ethn Dis [Internet]. 2017 [cited 2019 Apr 27];27(1):3-10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245605/pdf/ethndis-27-3.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ⁾.	2017/USA	Transversal/n=602	To examine the relationship between spirituality, physical activity and sedentary behavior.	Greater spirituality was associated with an increased likelihood of engaging in physical activity.	IV/B
Spirituality/Religiosity (SpR), Leisure-Time Physical Activity, and Sedentary Behaviour in Students at a Catholic University⁽³⁰30. Waters EK, Doyle Z, Finlay E. Spirituality/Religiosity (SpR), leisure-time physical activity, and sedentary behaviour in students at a catholic university. J Relig Health. 2018;57(2):869-882. DOI: 10.1007/s10943-017-0440-y https://doi.org/10.1007/s10943-017-0440-... ⁾.	2017/Australia	Transversal/n=175	To explore the association between spirituality/religiosity, physical activity and leisure.	Physical activity is not related to spirituality/religiosity, but unconventional spiritual practices (meditation, yoga, mindfulness) provide physical activity and leisure.	IV/B

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Wanderson Carneiro Moreira, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, Escola de Enfermagem da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, Cerqueira César CEP 05403-000 – São Paulo, SP, Brazil wanderson.moreira@usp.br