Table 6.

Spiritual experiences

Author	Date	Sample	Method	Findings
Chatters et al. (72)	1992	446 AA, age >55	Survey	Older age, women and living in south had higher religiosity
Powe (73)	1997	55 AA & 18 White elders	Cross sectional survey	Fatalism was present but no sig relationships were shown between fatalism and spirituality
Bourjolly et al. (51)	1999	41 AA and 61 White women with breast CA	Comparative survey	Black women relied on both public and private religiousness as a coping resource to a greater extent than white women.
Cunningham et al. (74)	1999	99 AA elderly, age 60–95	Cross sectional survey	When measuring health related-Quality of Life (HR-QOL)- spiritual well being was found to be more important than physical, social or psychological well being
Henderson et al. (53)	2003	66 AA women with breast CA	Focus groups	Spirituality played a strong role in coping. Coping strategies used were: relying on prayer; avoiding negative people; developing a positive attitude; having a will to live; and receiving support from family, friends and support groups
Bowie et al. (52)	2003	14 AA and 24 white males with prostate CA	Mixed focus groups and survey	Religion and spirituality was important for AA. This importance included membership in a church and regular attendance Due to this important role of spirituality, most had spoken with their physicians about their beliefs
Ark et al. (75)	2006	274 AA, age >55	Survey	AA elder women had higher subjective religiosity and engaged in more religious behaviors vs. non-Hispanic White (NHW) participants. Higher religiosity was associated with better health status and decreased use of health services
Harvey (76)	2006	10 AA female with arthritis, severe HTN or heart disease	Narrative analysis	Self -management of illnesses combined traditional medicine and spiritual practices
Taylor et al. (36)	2007	837 AA, 298 Non- Hispanic White (NHW) and 304 Carribean Blacks (CB), over age 65	Survey	AA and CB reported higher levels of religious participation, religious coping and spirituality than NHW
Arcury et al. (77)	2007	220 AA, 181 Native American, 297 White with diabetes	Survey	AA engaged in more private religious practices. No differences in public religious practices amongst groups. No associations found among mental health and religious participation
Dunn et al. (78)	2007	17 non-White and 11 White community dwelling older adults	Focus groups	Activities reported contributing to well being were: Participating in faith ways- intrinsic or extrinsic Keeping positive energy by: staying active, engaging in leisure activities, having a sense of self motivation, and for older male adults- being competitive Keeping active support systems by: visiting health care provider, attending support groups, participating in rehab and/or staying connected to family and friends Participating in wellness activities through: doing= taking meds, prescribed and OTC, using medical devices, diet, exercising, getting plenty of rest Being= meditating, listening to music, putting bad things out of your mind Engaging in affirmative self-appraisal through positive self -reflection and having a sense of accomplishment
Hamilton et al. (79)	2007	15 AA women with breast CA; 13 AA men with prostate CA	Grounded theory	Participants discussed their personal relationship with God as: I called on god I know God was with me God will do his will Types of support believed to come directly or indirectly from God were: Healing their cancer Taking away worries Giving no more than they could bear Sending someone to help Keeping cancer from spreading Giving them the medicine Participants discussed need for repaying God through acts of service to him and others
Levine et al. (80)	2007	36 AA, 52 Asian/Pacific, 52 Caucasian, 21 Latino females with breast CA	Mixed- survey then interviews	Themes found: God as comforting presence Questioning faith and anger at God Spiritual transformation of self and attitude toward others Recognition of one’s own mortality Deepening of faith and acceptance AA, Latino’s or Christians with spiritual beliefs had higher comfort from god over other groups. Higher spiritual well- being was found in survivors who used prayer. No significant differences existed amongst the ethnic groups in psychological or social QOL
Hamilton et al. (79)	2007	54 AA male/female with stressful life events, average age= 68	Mixed methods- survey and interviews	Overall themes noted: 1. God as Protector 2. God as beneficent, praise and thanksgiving 3. God as healer 4. Memory of forefathers, 5. Prayers to God and 5. Life after death
Koffman et al. (39)	2008	26 CB and 19 British with CA	Interviews	Stronger religious beliefs were more pronounced in CB. Themes found: Religious beliefs in God helped them comprehend their cancer Their faith, emotional and practical support provided by church communities assisted them to live with the physical and psychological effects of the illness The experiences of cancer promoted their religious identity
Samuel-Hodge et al. (81)	2008	185 AA with diabetes	Cross sectional Survey	A positive role for church involvement was associated with psychological adaptations to living with diabetes and was linked to self-efficacy and competence
Levine et al. (82)	2009	41 AA, 52 Asian/Pacific, 53 Caucasians, 23 Latino females with breast CA	Mixed methods	Higher spiritual well-being was found in survivors who used prayer. No significant differences existed among the ethnic groups in psychological, social support of QOL
Black et al. (56)	2009	6 AA male >80 years of age	Ethnographic interviews	Religious beliefs helped decrease suffering caused by racism
Zavala et al. (83)	2009	9% AA, 53% Latino, 20% Caucasian males with prostate CA	Survey	Higher levels of spirituality were noted in AA and Latino men with high school education. HR-QOL was higher when spirituality was measured as purposeful meaning and peace
Hamilton et al. (84)	2009	28 AA with cancer, average age=63 Context experts 7 post-doc and 5 faculty 38 AA cancer, average age=65 382 AA cancer, average age=64.1	Mixed methods: Multiphasic- Samples 1 and 2-Interviews Sample 3-Cognitive interviewing Sample 4-Survey	Findings: developed Ways of Helping instrument Ways of helping were: Help received- emotional, instrumental, and information support received from family and friends Help given to others-activities that made them feel connected to and supported by their network of family and friends Help from God Self help strategies- staying busy, praying, meditating, thinking positively
Taylor et al. (35)	2011	3,570 AA, 1,621 CB, 891 NHW	Survey	In AA and CB, 90% reported religion and spirituality as important vs. 75% of NHW
Casarez et al. (63)	2010	4 AA male and 14 AA women with diabetes	Qualitative descriptive	The ability to self manage their illness was connected to relationship with God
Agarwal et al. (46)	2010	50 AA with head/neck CA	Cross sectional survey	Higher QOL was found if “turned to God”, had family and friends for support, and helped others by encouraging their participation in cancer screening and/or treatment If participants coped by being strong/self-reliant, then dependence on others for physical care was associated with lower QOL and social functioning
Jones et al. (57)	2011	23 AA males with prostate CA	Phenomenological interviews	Rural participants had higher spirituality than urban counterparts
Holt et al. (8	5) 2011	98 AA and 171 White with lung/colorectal CA	Survey	Women were more religious. AA’s were more religious than whites. AA religious behaviors were positively associated with mental health and vitality and were negatively associated with depression
Dilorio et al. (61)	2011	320 AA males with prostate CA	Cross sectional survey	Higher levels of religious coping were associated with high school education or less, lower income and/or those with one or more comorbid conditions
Hamilton et al. (86)	2013	65 AA male/female with stressful life events	Qualitative descriptive	Religion expressed through song was a coping strategy
Harper et al. (62)	2013	17 AA male/female colorectal CA	Focus groups	Cultural beliefs regarding spirituality, religious practices and/ or expression of faith were related to higher power, god or spiritual being. Fatalism about their illness was linked to beliefs about divine control and destiny