A systematic review of associations among religiosity/spirituality and adolescent health attitudes and behaviors

PurposeTo systematically review and synthesize literature concerning the relationships among religiosity, spirituality, health attitudes, and health behaviors in adolescents.MethodsForty-three studies between 1998 and 2003 were systematically reviewed to (a) determine if the studies were based on conceptual or theoretical frameworks, (b) identify the types of religiosity and spirituality measures used as well as their effects on health attitudes and behaviors, (c) evaluate the quality of these measures, (d) determine categories and frequency of measures of health attitudes and behaviors, (e) evaluate the quality of the research designs, and (f) determine the effects of religiosity or spirituality on adolescent health attitudes and behaviors.ResultsOver half (n = 26) the studies were atheoretical or had an unclear framework and the other half were based on a wide variety of conceptual and theoretical models. A total of 37 distinct religiosity/spirituality variables were identified and varied in specificity. Less than half (n = 21) reported reliability of the measures and only seven contained information about validity of the measures. All 43 studies included measures of health-risk behaviors and/or attitudes but only seven addressed health-promoting behaviors. Most studies (84%) showed that measures of religiosity/spirituality had positive effects on health attitudes and behaviors.ConclusionsThe variety of studies and measures indicate that religiosity and spirituality may be important correlates of adolescent health attitudes and behaviors. Although the majority of the studies reviewed were well designed, there was no consistency in the theoretical bases and operational definitions of religiosity/spirituality phenomena.