The Proceedings of the First AnnualJ. Woolard and Helen Peel & David Julian and Ellen Suther Whichard

Distinguished Professorships Religious Studies Symposium

“Religion and Public Health:Bridges to Collaboration”

April 5 - 7, 2018 East Carolina University, Greenville, NC, USA

Conference Program & Abstracts

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“Improvement in the health of populations depends upon a strong assessment of all factors affecting health, including the knowledge and beliefs of constituents . . . In many situations, in fulfillment of their social mission, religious communities can provide substantial and sustained resources to address health inequities to improve the public health.” - James Curran (Religion as a Social Determinant of Public Health, Ellen Idler, editor, Oxford University Press, 2014)

Conference Abstract The goal of this conference is to explore the intersection between religious values and practices, on one

hand, and public health on the other. As one of our keynote speakers Ellen Idler has noted, classic French sociologist Emile Durkheim first linked suicide to a range of social influences, including religion. Concerned with rising suicide rates in Europe in the 20th century, he saw patterns in these rates, arguing that a religious sense of belonging was a significant factor that worked against suicide. Durkheim’s recognition of religion as a key factor in public health has since spread across the social and medical sciences and humanities. We seek to reinvigorate at ECU the interdisciplinary conversation that Durkheim began. We aim to draw attention to the interdisciplinary nature of healthcare. As Charles Edward Amory Winslow, co-founder of the American Public Health Association argued, public health is the science and practice of preventing disease and promoting health through sanitation, infection control, education, organized health services, and the provision of adequate standards of living for the maintenance of health to protect the ability of individuals to realize their birth rights of health and longevity. As a result, the domain of public health overlaps with almost every other social domain, including religion. For example, according to the US National Health Interview Survey, fifty percent of those who never attend religious services are more likely to die from any given cause over a fifteen-year period than those who attend church service more often than once per week.

As we examine interconnections among health and food security, mental health, reproductive health,

environmental concerns, and social life—all through the lens of religion—we aim especially to reflect on health disparities that challenge many religious and ethical systems of value. We want to encourage healthcare providers to locate resources beyond their fields for promoting a holistic, integrative approach to health and healing. We hope to contemplate the challenges, concerns, and questions facing healthcare today and to bring scholars from various fields into conversation about them in ways that can lead to long-lasting collaborations.

Acknowledgments The conveners, Mary Nyangweso, Woolard/Peel Prof. & Dir., ECU’s Religious Studies Program, and Joseph

Hellweg, Whichard Prof. in the Humanities, 2017-18, wish to thank the following for their invaluable help, co-sponsorship, and participation: the Woolard/Peel & Whichard Funds; Dr. Ronny Bell, Chair, Dept. of Public Health; Dr. George Bailey, Chair, Dept. of Philosophy & Religious Studies; Ms. Mansi Trivedi, Brody School of Medicine; ECU’s Religious Studies Program, Dept. of Public Health & Thomas Harriot College of Arts and Sciences. And many thanks to all our presenters for participating!

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Thursday April 5, 2018 (Brewster D-313 & Sci-Tech C-209) 3:30 p.m. - 4:45 p.m. Session 1: “Public Health in Religious Perspective: Case Studies” Undergraduate Panel (Brewster D-313) Katie Chandler (ECU), Presiding Jesse Miller (Florida State University), Responding Hannah Allen (ECU), “Corporate Power & Politics as Vectors of Disease: Hog Production, Industrial Waste & Public Health in Eastern North Carolina” T. J. Blackmon (ECU), “Eugenics, Race, & the Extralegal State: From Nineteenth-Century Law to Birth Control & Mass Incarceration in the Twenty-First” Madeline Miconi (ECU), “Sangomas as Public Health Agents: An Analysis of Medical Pluralism in South Africa” Will Swain (ECU), “An Epidemic of Obeah: Suicide & Sorcery in Present-Day Guyana” Nadiya Yerich (ECU), “Alternative Strategies for Pregnancy Avoidance among Kenyan Women Sex Workers” 5:30 p.m. - 6:30 p.m. Registration & Refreshments (Sci-Tech C-209) 6:35 p.m. - 7:00 p.m. Welcome Ceremony (Sci-Tech C-209) 6:35 Video: “The Spirit Catches You, and You Fall Down,” by Lunda Onesias (YouTube.com) 6:40 Mary Nyangweso (ECU), Woolard/Peel Professor, Director, Religious Studies Program 6:45 George Bailey (ECU), Chair, Department of Philosophy & Religious Studies 6:50 Ronny Bell (ECU), Chair, Department of Public Health, Brody School of Medicine 6:55 Introduction of Keynote Speaker, Joseph Hellweg (ECU, FSU), Whichard Professor 7:00 p.m. - 8:30 p.m. Keynote Speaker: Ellen L. Idler (Rollins School of Public Health, Emory

University) Samuel Candler Dobbs Professor of Sociology Director of Religion & Public Health Collaborative, Depts. of Sociology & Epidemiology “Religion as the Invisible Social Determinant of Public Health” (Sci-Tech C-209) (A Wellness Passport Event)

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Friday April 6, 2018 – Joyner Library, 2nd Floor & Jenkins Building, Auditorium 8:30 a.m. - 9:00 a.m. Registration & Coffee, Faulkner Gallery Area, Joyner Library, Second Floor 9:00 a.m. - 10:00 a.m. Session 1: “Health & Healing in Africa: Multidisciplinary Perspectives” (Joyner Library, Room 2409) Sitawa Kimuna (ECU), Associate Professor of Sociology, Presiding Joseph Hellweg (Religious Studies, ECU/FSU), “Letters, Leaves & Elixirs: N’ko Healers and Collaborative Medical Pluralism as Public Health Resources in Guinea and Mali” Ari Mwachofi (Public Health, ECU), “A Clash between a Western Religion & African Holistic Healthcare: A Personal Story of Compromise & Loss” Mary Nyangweso (Religious Studies, ECU) “Social Determinants of Reproductive Health in Kenya: The Case of Virginal Fistula, in Child Marriage & Female Genital Cutting” 10:15 a.m. - 11:15 a.m. Session 2: “Partnering for Health: Enhancing Well-Being in Collaboration with North Carolina Religious Communities” (Faulkner Gallery, Joyner Library, Second Floor) Mona Russell (ECU), Associate Professor of History, Presiding

Mary Nyangweso (ECU), Responding

Gary Gunderson (Baptist Medical Center, Wake Forest University) & Teresa Cutts (Baptist Medical Center, Wake Forest University), “Working with Concrete: Lessons in Adapting the Memphis Model to the North Carolina Way” Samantha Miller (Asst. Dir., Association of Mexicans in North Carolina) “The Diverse Latino Religious Community and Opportunities for Whole Community Collaboration” Josie Walker (Partners in Health & Wholeness, NC), “Partners in Health & Wholeness: Being Healthy, Being Faithful”

11:30 a.m. - 12:30 p.m. Lunch, Faulkner Gallery, Joyner Library, Second Floor 12:45 p.m. - 2:00 p.m. Session 3: “Public Health between ‘Tradition’ & ‘Modernity’ in Africa” Graduate Student Panel (Joyner Library, Room 2409) Kathy Dawson (Religious Studies, ECU), Presiding Joseph Hellweg (Religious Studies, ECU/FSU), Responding Jesse Miller (Dept. of Religion, Florida State University), “Funerals as Pre-Natal Care: Enabling Future Mossi Generations” Hannah Potter (Maternal & Child Health, UNC Chapel Hill), “Changes in Birth Practices in Morocco & the Intersection of Biomedicine with Traditional Beliefs” Mansi Trivedi (Brody School of Medicine, ECU), “Educating Physicians on Socio-Cultural Factors that Influence the Effective Clinical Management of FGM/C”

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2:15 p.m. - 3:15 p.m. Session 4: “Church, Mosque & Health: Opportunities, Intersections & Partnerships” (Faulkner Gallery, Joyner Library, Second Floor) Joseph Hellweg (Religious Studies, ECU, FSU), Whichard Professor in the Humanities, Presiding Annie Hardison-Moody (Agriculture & Human Sciences, NC State), Sinikka Elliott (Sociology, University of British Columbia) & Sarah Bowen (Sociology & Anthropology, NC State), “‘Gifts from God’: Using Religious Agency to Subvert Stigma around Poverty, Food Assistance & Children’s Body Size” Jenée Rolonda Avent Harris (Public Health, ECU), “The Role of Religion in African American Mental Health and Mental Health Help-Seeking Behaviors” Jill Laurich Rushing (NC Dept. of Health & Human Services), “Implementation of Faithful Families Eating Smart & Moving More in One Church & One Mosque: Initial Results” 3:30 p.m. - 4:30 p.m. Session 5: “Public Health, Personal Concerns: Issues in Training, Practice & Ethics ” (Joyner Library, Room 2409) Derek Maher (Religious Studies, ECU), Associate Dean for Undergraduate Studies, Presiding Molly Cashion (Clinical Skills, Brody School of Medicine, ECU) “You Do What? A Brief History of Learning & My Experience Training Students, the Art of the Pelvic Exam” Ruth Little (Public Health, ECU), “Shared Values between Faith-Based Agencies & Academic Public Health” Cristina Richie (Bioethics, ECU), “Evangelicals, Contraception & the Affordable Care Act” 4:30 p.m. - 6:15 p.m. Dinner, on Your Own (See Restaurant Insert) 6:00 p.m. - 6:45 p.m. Registration - Foyer, Jenkins Auditorium 1220 6:50 p.m. Welcome, Mary Nyangweso (ECU), Director, Religious Studies Program 6:55 p.m. Introduction of Keynote Speaker, Derek Maher (Religious Studies, ECU), Associate

Dean of Undergraduate Studies 7:00 p.m. - 8:30 p.m. Keynote Speaker: John Blevins (Rollins School of Public Health, Emory

University) Acting Director, Interfaith Health Program, Hubert Department of Global Health “Religion, Politics & Global Health: Controversies & Compromises in the Primary Health Care Movement” (Jenkins Auditorium 1220) (A Wellness Passport Event) 8:30 p.m. Post-Conference Social Gathering - Winslow’s Tavern, 120 West 5th Street, Greenville 5

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Saturday, April 7, 2018 – Jenkins Building, Auditorium 8:30 a.m. - 9:30 a.m. Registration & Coffee, Foyer, Jenkins Auditorium 1220 9:30 a.m. - 10:45 a.m. Session 1: “Creating Caring Communities through Religion & Public Health” (Jenkins Auditorium) Derek Maher (Religious Studies, ECU), Assoc. Dean for Undergrad. Stds., Presiding, Responding Calvin Bradley Jr. (Chaplaincy, Vidant Medical Center) “Marginalized in a Time of Crisis: Micro- Aggressions, Stereotypes & Subliminal Messages in Healthcare”

Cherie Conley (Nursing, Duke University), “‘One Can Chase A Thousand, Two Can Chase Ten Thousand’: Perceptions of Using Dyadic Peer Support to Promote Healthy Weight in African American Churches”

Harris R. Jarmichael (Collegiate Recovery Community, ECU) “Change Agents, A Humanitarian Response to Substance Use Disorders” 11:00 a.m. - 12:30 p.m. Session 2: “Bridging Religion & Healthcare in the Humanities & Social Sciences: A Round Table Discussion” (Jenkins Auditorium) (A Wellness Passport Event) Joseph Hellweg (Religious Studies, ECU/FSU), Presiding John Blevins (Acting Dir., Interfaith Hlth. Prog., Rollins School of Public Hlth., Emory University) Ellen Idler (Dir., Rel. & Public Hlth. Collaborative, Rollins School of Public Health, Emory Univ.) Ronny Bell (Prof. & Chair, Department of Public Health, Brody School of Medicine ECU) Derek Maher (Religious Studies, Associate Dean of Undergraduate Studies, ECU) Naeema Muhammad (Co-Director, North Carolina Environmental Justice Network) Mary Nyangweso (Director, Religious Studies Program, ECU) Todd L. Savitt (Prof., Dept. of Bioethics & Interdisciplinary Studies, Brody School of Med., ECU) 12:45 p.m. - 1:45 p.m. Lunch, Foyer, Jenkins Auditorium 1220 2:00 p.m. - 3:15 p.m. Session 3: “Pork Grinds: Economics & Gender as Vectors of Health &

Illness in the Hog Farm Industry in the United States” Bob Edwards (Sociology, ECU) Chair, Department of Sociology, Presiding, Responding Naeema Muhammad (Co-Director, North Carolina Environmental Justice Network), “Environmental Justice & Health Disparities: Toward Ethical Stewardship” Christopher Neubert (PhD Candidate, Geography, UNC Chapel Hill; Food Policy Leadership Fellow, George Washington University) “‘So God Made A Farmer’–How Rural Masculinity Created (and Maintains) the Modern Hog Economy” Ayo Wilson (Administrative Co-Director, North Carolina Environmental Justice Network) 3:30 p.m. - 4:00 p.m. Concluding Remarks & Discussion Mary Nyangweso (ECU) J. Woolard & Helen Peel Distinguished Chair, Religious Studies Program Joseph Hellweg (EDU, FSU) David Julian & Virginia Suther Whichard Prof. in the Humanities Mansi Trivedi, MPH (ECU) Brody School of Medicine

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Ronny Bell (Public Health, ECU) Prof. & Chair, Dept. of Public Health, Brody School of Med. Derek Maher (Religious Studies, ECU) Associate Dean of Undergraduate Studies

Paper Abstracts (Alphabetically by First Key Word of Title)

“A Clash Between a Western Religion and African Holistic Healthcare: A Personal Story of Compromise and Loss,” Ari Mwachofi, Public Health, ECU This presentation is a personal story of the experiences of my family. The objectives of this story are to describe: a holistic traditional WaDawida* approach to health and healthcare; connections between health, healthcare, spirituality, art, social structure, and economic activities among WaDawida; effects of western religion on traditional religious practices; introduction of western religion as part of colonization; and to demonstrate the devastating impact of western religion on traditional healthcare, spirituality, art, social structure and economic wellbeing. *WaDawida is a small tribe that resides in the Taita Hills in Kenya’s coastal region.

“The Diverse Latino Religious Community and Opportunities for Whole Community Collaborations,” Samantha Miller (Asst. Dir., Association of Mexicans in North Carolina) The Latino Community is diverse in almost all of its aspects—in country of origin, language, cultural practices, social norms, values, and more. This is true due to differences between communities lived in, systems enrolled, and even religion. The populations at each religious institution are very different and require tailored approaches for programs, advocacy movements, and more. In addition, each population also creates opportunities for expanding collaborative, whole-community networks in order to pursue whole-community solutions. This presentation will detail opportunities and barriers for addressing Latino religious communities and strategies for collaborating with these entities for public health initiatives in addition to how membership within religious institutions effects public and individual health.

“Educating Physicians on Socio-Cultural Factors that Influence the Effective Clinical Management of FGM/C,” Mansi Trivedi (Brody School of Medicine, ECU) Purpose: We sought to create a curriculum and toolkit at the Brody School of Medicine that focused on educating Obstetrics and Gynecology physicians on the clinical and socio-cultural implications of Female Genital Mutilation/Cutting (FGM/C). Background: Increasing patterns of global migration have created diverse patient populations with unique health concerns that are greatly influenced by cultural beliefs and practices. Immigrants and refugees from Africa represent one of the largest growing communities in the United States. Many women from these countries have experienced FGM/C and require special cultural understanding within the clinical space that western doctors are unaware of. However, with changing patient demographics it is increasingly important for physicians to take into account minority populations’ health needs. Methods: An hour and half presentation was created for seventeen participants from the OBGYN department at the Brody School of Medicine. The presentation addressed the topic of culturally sensitive approaches to clinical management of FGM/C as guided by the WHO. A toolkit that could be easily accessed in clinic was also compiled with additional resources regarding the management of FGM/C. Results and Discussion: A post-presentation survey revealed that participants received a better understanding of identifying the different types of FGM/C, understood the importance of cultural sensitivity when conducting patient interviews, and felt they would be able to better treat patients who have undergone FGM/C. Participants also identified a need for additional lectures surrounding this subject. “Evangelicals, Contraception, and the Affordable Care Act,” Cristina Richie, PhD (Bioethics, ECU) Virtually all Evangelicals recognize the health benefits of limiting pregnancy and therefore endorse some form of artificial contraception. Moreover, some Evangelicals accept abortifacents and abortion. Indeed, Evangelical colleges and universities in Massachusetts—one of the first states to mandate health insurance coverage for all citizens—have provided employees and students their choice of contraception without objection for the last decade.

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Ronny Bell (Public Health, ECU) Prof. & Chair, Dept. of Public Health, Brody School of Med. Derek Maher (Religious Studies, ECU) Associate Dean of Undergraduate Studies

Paper Abstracts (Alphabetically by First Key Word of Title)

“A Clash Between a Western Religion and African Holistic Healthcare: A Personal Story of Compromise and Loss,” Ari Mwachofi, Public Health, ECU This presentation is a personal story of the experiences of my family. The objectives of this story are to describe: a holistic traditional WaDawida* approach to health and healthcare; connections between health, healthcare, spirituality, art, social structure, and economic activities among WaDawida; effects of western religion on traditional religious practices; introduction of western religion as part of colonization; and to demonstrate the devastating impact of western religion on traditional healthcare, spirituality, art, social structure and economic wellbeing. *WaDawida is a small tribe that resides in the Taita Hills in Kenya’s coastal region.

“The Diverse Latino Religious Community and Opportunities for Whole Community Collaborations,” Samantha Miller (Asst. Dir., Association of Mexicans in North Carolina) The Latino Community is diverse in almost all of its aspects—in country of origin, language, cultural practices, social norms, values, and more. This is true due to differences between communities lived in, systems enrolled, and even religion. The populations at each religious institution are very different and require tailored approaches for programs, advocacy movements, and more. In addition, each population also creates opportunities for expanding collaborative, whole-community networks in order to pursue whole-community solutions. This presentation will detail opportunities and barriers for addressing Latino religious communities and strategies for collaborating with these entities for public health initiatives in addition to how membership within religious institutions effects public and individual health.

“Educating Physicians on Socio-Cultural Factors that Influence the Effective Clinical Management of FGM/C,” Mansi Trivedi (Brody School of Medicine, ECU) Purpose: We sought to create a curriculum and toolkit at the Brody School of Medicine that focused on educating Obstetrics and Gynecology physicians on the clinical and socio-cultural implications of Female Genital Mutilation/Cutting (FGM/C). Background: Increasing patterns of global migration have created diverse patient populations with unique health concerns that are greatly influenced by cultural beliefs and practices. Immigrants and refugees from Africa represent one of the largest growing communities in the United States. Many women from these countries have experienced FGM/C and require special cultural understanding within the clinical space that western doctors are unaware of. However, with changing patient demographics it is increasingly important for physicians to take into account minority populations’ health needs. Methods: An hour and half presentation was created for seventeen participants from the OBGYN department at the Brody School of Medicine. The presentation addressed the topic of culturally sensitive approaches to clinical management of FGM/C as guided by the WHO. A toolkit that could be easily accessed in clinic was also compiled with additional resources regarding the management of FGM/C. Results and Discussion: A post-presentation survey revealed that participants received a better understanding of identifying the different types of FGM/C, understood the importance of cultural sensitivity when conducting patient interviews, and felt they would be able to better treat patients who have undergone FGM/C. Participants also identified a need for additional lectures surrounding this subject. “Evangelicals, Contraception, and the Affordable Care Act,” Cristina Richie, PhD (Bioethics, ECU) Virtually all Evangelicals recognize the health benefits of limiting pregnancy and therefore endorse some form of artificial contraception. Moreover, some Evangelicals accept abortifacents and abortion. Indeed, Evangelical colleges and universities in Massachusetts—one of the first states to mandate health insurance coverage for all citizens—have provided employees and students their choice of contraception without objection for the last decade.

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Based on this precedence, when the United States Affordable Care Act (ACA) was implemented nationwide, it was surprising to see some Evangelical corporations seeking religious exemptions from covering essential health benefits, including certain forms of contraception. My presentation will argue that Evangelicals did not need to bring lawsuits against the ACA, as contraception is viewed as a theologically acceptable part of women’s reproductive health. First, I will survey the litigious landscape of Evangelical lawsuits against the contraceptive mandate in the ACA. Then, I will provide a brief Evangelical theology of contraception and abortion, inclusive of both progressive and conservative stances. Finally, I will appeal to the internal coherence of Evangelical bioethical theology. Due to the willingness of the vast majority of Evangelicals to accept contraception—and abortion when the life of the mother is in danger—I will make the case that Hobby Lobby, Grace College, Biola University, and other Evangelical institutions could have accepted the Affordable Care Act as written. Should further exemptions be sought under “repeal and replace,” Evangelicals must consider the arguments presented above. “Funerals as Pre-Natal Care: Enabling Future Mossi Generations,” Jesse Miller (Religion, Florida State Univ.) Seen and unseen agents comprise Mossi society in Burkina Faso. In my paper, I unravel the special social roles that earth spirits and ancestors inhabit for Mossi, in particular their vital contribution to the process of human conception. First, my paper will outline the cosmological significance of earth spirits and ancestors and how their roles relate to Mossi oral histories. Then I will discuss how earth spirits shape Mossi bodies, by molding the ancestral essence, siiga, in the wombs of mothers. I then turn to Mossi funerals: their performance renegotiates the social contracts that exist between the living and the dead, while also creating new ancestors. These new ancestors, in turn, help create future generations of Mossi through conception, a type of pre-natal care. Finally, I will turn to a discussion of development politics in Burkina Faso and how thoughtless land use threatens the Mossi framework of conception. “‘Gifts from God: Using Religious Agency to Subvert Stigma around Poverty, Food Assistance, and Children’s Body Size,” A. Hardison-Moody (Sociology, NC State), S. Elliott (Sociol., Univ. of British Columbia) & S. Bowen (Sociol., NC State) Rooted in the deep-seated belief that self-reliance and neighborly concern are the best ways to help the poor, public discourse in the United States has long stigmatized and shamed people for receiving help from the government. People living in poverty are often framed as lazy, ignorant, and dependent. Drawing on five years of interviews and engagement around foodwork with 124 black, white, and Latina mothers in three North Carolina communities, this paper analyzes the intersection of women’s religious beliefs and practices and their experiences of food insecurity, feeding their families, and children’s body sizes. The women in this study narrated the harsh realities of life in poverty, including housing and work precariousness, the constant negotiations of food insecurity/hunger and an often-reluctant reliance on SNAP assistance and food pantries. However, many of these mothers interpreted these experiences through belief in a God who would “make a way” despite hardship. Among other things, women talked about their food stamps as “blessings” from God, challenged medical opinions of their children’s body shapes with reminders that their bodies were beautiful gifts from God, and made concrete suggestions for how faith communities could better support their families. Through these narratives, many of the women managed to carve out an alternate identity–one of chosen-ness, blessing, or perseverance–rooted in their religious or spiritual commitments. Following feminist and womanist theorists, we argue that these narratives reveal the subversive ways that women enact agency in the face of de-humanizing and oppressive political rhetoric and policy.

“Implementation of Faithful Families Eating Smart and Moving More in One Church and One Mosque: Initial Results,” Jill Laurich Rushing (NC Dept. of Health & Human Services) Public health professionals have joined faith communities to address the obesity epidemic in the United States. Programs like Faithful Families Eating Smart and Moving More (Faithful Families), have been offered to faith communities in an effort to promote healthy eating and physical activity. While there is a wealth of information about health programs in Christian settings, there is less information about programs in non-Christian settings. The purpose of this case study is to describe the implementation of Faithful Families in one church and one mosque in the

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Southeastern United States. The primary research question is, “How do personal, social, and environmental factors shape the implementation of the Faithful Families program?” While initial results from the first two interviews from the mosque will be shared at the event, the researcher will ultimately conduct sixteen interviews across the two faith communities. The findings may inform the development of more culturally responsive programs. “Letters, Leaves, and Elixirs: N’ko Healers and Collaborative Medical Pluralism as Public Health Resources in Guinea and Mali, West Africa,” Joseph Hellweg (Religious Studies, ECU, FSU) In Guinea and Mali, national health ministries struggle to fund basic healthcare for their citizens. In such circumstances, West Africans look for other resources beyond biomedicine to supplement their needs. In such a medically plural environment, non-biomedical experts have come to mediate working-class people’s interactions with biomedical providers while providing their own non-biomedical treatment options. Such is the case for practitioners of N’ko, an alphabet invented in 1949 to write Malinké a widely spoken West African language. N’ko’s inventor, Souleymane Kanté, also transcribed a book of medicinal plant remedies in Malinké, enabling anyone who reads N’ko and who has access to the volume to become a healer. This ethnographic presentation explores the reasons for which public health experts working in West Africa should see N’ko healers as allies in both medical treatment and health education. Ethnography can reveal cultural differences to be bridges rather than obstacles to collaborative health interventions. “‘One Can Chase a Thousand, Two Can Chase Ten Thousand’: Perceptions of Using Dyadic Peer Support to Promote Healthy Weight in African American Churches,” Cherie Conley, (Nursing, Duke University) Background: African-Americans suffer from a disproportionate burden of overweight, obesity, and obesity-related chronic diseases. African-American churches are popular places to implement healthy weight promotion programs. Although many health programs in churches have achieved positive outcomes, gains are often small and sustainability is lacking. Using dyadic peer support (i.e., two people working together) may be a way to optimize their efforts to combat obesity. Objectives: The aim of this preliminary study was to explore church members’ and county health educators’ perceptions of using dyadic support to promote healthy weight in African-American churches. Research Design: Recruited were ten African-American congregant members and four state health educator coordinators. This descriptive study used semi-structured, qualitative interviews which were analyzed using conventional content analysis. Results: Five common themes emerged from the interviews: (1) church members talk to family and friends about health as much as healthcare professionals about health; (2) pairing up members is natural and can help achieve health goals; (3) members want to help and be helped by other members; (4) personal motivation is as important as socioeconomic factors in improving health; and (5) dyadic activities should be structured, goal-oriented, frequent, and face-to-face. Conclusion: Because of strong ties and relationships, the African-American church is fertile ground for a dyadic support intervention. Participants provided clear direction on the desired structure of an intervention. Participants’ focus on personal motivation indicates the importance of goal setting and attainment strategies during the intervention. Adding a dyadic support component to healthy weight promotion programs may ultimately improve the effectiveness and sustainability of these programs. “Partners in Health and Wholeness: Being Healthy, Being Faithful,” Josie Walker (Partners in Health & Wholeness, NC) Partners in Health and Wholeness (PHW), an initiative of the North Carolina Council of Churches, is designed to bridge issues of faith, health, and social justice. In order to live out the example of Jesus Christ—someone who dedicated his life to healing the sick, guiding the lost, comforting the downcast, and even raising the dead—this initiative seeks to provide people of faith across North Carolina with the tools and support to enhance their capacity and readiness to address the health priorities of their congregation and surrounding community in order for everyone to lead healthier, more fulfilling lives. One of our goals is to improve the health and well-being of people of faith while helping their communities take the lead in addressing their own health issues. In strengthening

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the connection between faith, health, and social justice, we hope to reduce the health burden on our state and impact the larger community. “Religion as a Social Determinants of Reproductive Health in Kenya: The Case of Vaginal Fistula in Child Marriage and Female Genital Cutting,” Mary Nyangweso (Religious Studies, ECU) Reproductive health is central to human survival and to the survival of society. Through reproduction, society is propagated. While reproduction is central to human propagation, health is central to human flourishment, a factor central to human and women’s rights. Unfortunately, efforts to ensure reproductive health and human flourishment can be inhibited by gender-based cultural traditions. In countries like Kenya, women’s reproductive health is challenged by culturally legitimized practices such as child marriage and female genital cutting (FGC). Statistics indicate that health consequences such as hemorrhage, obstructed labor, fistula, ruptured uterus, toxemia, preeclampsia, postpartum sepsis, infectious diseases, cervical tears, nerve damage, and incontinence are rampant in girls and women who are exposed to FGC and child marriage. This paper (1) investigates why African Women are vulnerable to reproductive health conditions such as vaginal fistula, birth complication, and STI’s, (2) explores social-cultural determinants of vulnerability to reproductive health, (3) investigates policies regarding improving reproductive health concerns for African women, (4) and recommends initiatives towards policies that will improve the reproductive health of African women in Kenya. “The Role of Religion in African American Mental Health and Mental Health Help-Seeking Behaviors,” Janeé Avent Harris (Public Health, ECU)

African Americans experience mental health issues at rates higher than or comparable to other racial/ethnic groups (SAMSHA, 2015; U.S. Department of Health and Human Services Office of Minority Mental Health, 2016). Despite these higher rates of serious psychological distress, their participation in mental health treatment services (e.g., counseling) remains low (Alvidrez et al., 2008; NIMH, 2007; Ojelade et al., 2011). Compared to White adults, African Americans were nearly 50% less likely to seek professional mental health treatment. In fact, African Americans accounted for only 8.6% of mental health services consumers (SAMSHA, 2015). One explanation for these help-seeking disparities is religion. Religion has been and remains important and influential in the lives of African Americans and, in many cases, guides attitudes and beliefs about mental health (Avent, Cashwell, & Brown-Jeffy, 2015; Avent & Cahswell, 2015; Avent & Wong, in press; Morris & Robinson, 1996; Lincoln & Mimaya, 1990). The presenter will review findings from qualitative and quantitative inquiries that inform future research opportunities and provide direction for health care professionals to create interventions that are culturally responsive and that increase access and utilization of services for African Americans. “Shared Values between Faith-Based Agencies and Academic Public Health,” Ruth Little (Public Health, ECU) Background: Eastern North Carolina is a significant part of the “bible belt” that encompasses the deep south of the United States (Brunn, Webster, & Archer, 2011). The church plays a pivotal role in this population’s cultural and spiritual beliefs that influence their health (Giger, Appel, Davidhizar & Davis, 2008). Provider understanding of their patients’ culture and beliefs can reduce barriers to patient self-management (Nam, Chesla, Stotts, Kroon & Janson, 2011). Approaches recognizing the shared values of the population receiving intervention have been shown to be effective in fostering health status improvements (Joseph, Ainsworth, Mathis, Hooker & Keller, 2017). Method: Community participatory research was utilized in working with seventeen African American Churches comprised of diverse denominations in Edgecombe, Duplin, Pitt, and Lenoir counties with the goal of improving patient health literacy for chronic disease self-management by utilizing biblical principles interwoven with health messaging. The research team shared members’ spiritual values. Patients were taught fundamental chronic disease self -management and strategies to increase their communication with health care providers within the trusted framework of the church, supported by peer community health coaches. Principles of scripture was interwoven and taught in bible study format. Results: Every church contacted agreed to participate. Participants saw reductions in their blood pressure and weight. Congregational informal health policies were adopted offering water, unsweetened beverages and healthy food options at church food events.

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Conclusion: Shared values based on trust and authenticity, regardless of religious affiliation is of paramount importance. Shared values between researcher and participants are important for engagement with the faith community for promoting well-being.

“Shifting Birth Paradigms in Morocco and impacts on Women’s Experiences,” Hannah Potter (Maternal & Child Health, UNC Chapel Hill) Women who will give birth in Morocco are within a double bind in regard to their options for birth as country efforts emphasize medicalization of birth as part of a process that concurrently displaces traditional mechanisms of birth. Many women are left unsatisfied by the care afforded by the medical system, but without the options that communities depended on previously, which drew from larger, popular Sufi belief systems. Biomedicine and modernization place religious and traditional forms of knowledge as separate and in opposition to their methods and goals. The siloing of the religious knowledge from biomedical knowledge ignores the ways in which people approach these systems as integrated beings that approach, utilize, and refuse biomedical care through religious and cultural frameworks. Using options and practices for birth in Morocco, I will demonstrate the way that historical political, social, and religious changes impact and influence the options that women have for birth currently. I base this argument off the framework of Rachel Newcomb’s “Women and Reproductive Knowledge in the Mediterranean,” which demonstrates the double bind Moroccan women find themselves in regard to options for birth, and demonstrate the need for changes within the medical system which better integrate traditional beliefs and practices into the biomedical model. “‘So God Made A Farmer” –How Rural Masculinity Created (and Maintains) the Modern Hog Economy,” Christopher Neubert (PhD Candidate, Geography, UNC-Chapel Hill; Food Policy Leadership Fellow, George Washington University) The rural Midwestern United States has experienced a dramatic reformation of the agricultural landscape in the last thirty years. Driven by vertical integration and the implementation of modern, industrialized techniques for raising livestock and growing crops, there are now far fewer farmers and far more pigs raised for slaughter than ever before. Drawing on research in rural Iowa, I examine how this transition was driven by a particular formation of rural masculinity–one that positions men as protectors and providers of food for their families and the world–in response to the 1980s Farm Crisis. While certainly not fixed, discourses about masculinity as they circulate in everyday life at home, work, school, and church inform how agriculture is discussed and then practiced. I explore some of these discourses to demonstrate how deeply intertwined masculinity, religion, and capitalism are in everyday rural life–such as when Paul Harvey’s famous declaration that “God made a farmer” was used in a 2013 Super Bowl ad for Dodge Ram. “Working with Concrete: Lessons in Adapting the Memphis Model to the North Carolina Way,” Gary Gunderson (Baptist Medical Center, Wake Forest U.) & Teresa Cutts (Baptist Medical Center, Wake Forest U.) The Memphis Model, a partnership of 600+ mostly African American congregations and Methodist Le Bonheur Health System in Memphis, is cited as a best practice of care for vulnerable minority persons with supporting data. Since 2012, Wake Forest Baptist Medical Center (WFBMC) in North Carolina (NC), has adapted the model into the “North Carolina Way,” a network spanning twenty-five counties, 422 congregations and eight health systems. Based on the premise that “proactive mercy” is better than “reactive charity,” it helps health systems manage population health for the poor at the intersection of public health, healthcare, and the “socially complex systems” of faith and community networks. This work presents an overview of the efforts in both states, guiding principles for successful adaptation and mixed model findings. “You Do What? A Brief History of Learning and My Experience Training Students, the Art of the Pelvic Exam,” Molly Cashion (Clinical Skills, Brody School of Medicine, ECU) Students in the medical field often learn the female pelvic exam using a combination of methods. These include the use of pelvic models, task trainers, standardized patients (SPs), and gynecological training assistants

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(GTAs). In this study of medical school curricula, the 135 Liaison Committee for Medical Education (LCME) accredited allopathic United States medical schools were asked to complete a survey to identify methods and timing of teaching the pelvic exam. Results from this study indicated that 72% (n=68) used GTAs to teach the pelvic exam (Dugoff et al., 2016). This practice has not always been the case. Medical students in the past sometimes learned this skill on anesthetized patients, often without informing the patient that medical students would be performing a pelvic exam (Cohen et al., 1989). Walden (2012) indicates that, at that time, only four states in the U.S.—Virginia, Illinois, Hawaii and California—have laws making “unconsented” pelvic exams illegal. In a brief search of North Carolina Statutes, no such laws exist in this state. This presentation will explore a brief history of the practices and legislation related to teaching and learning the pelvic exam, as well as one GTA’s experience in teaching this sensitive, invasive exam. The hope being that by informing others of the current practices, evolution of best practices, and the state of the ethical and legal issues involved, that we can ensure that every woman is treated and cared for in the most respectful way possible. 12

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List of Participants Participants Institution Email Contact George Bailey Philosophy, East Carolina University gbailey@ecu.edu Ronnie Bell Public Health, East Carolina university bellr16@ecu.edu John Blevins Global Health, Emory University john.blevins@emory.edu Sarah Bowen Sociology/Anthropol., NC State University sarah_bowen@ncsu.edu Calvin Bradley Chaplaincy, Vidant Hospital calvinbradleyjr@gmail.com Molly Cashion Office of Clinical Skills, East Carolina Univ. cashionmo@ecu.edu Cherie Conley Nursing, Duke University cherie.conley@duke.edu Teresa Cutts Baptist Medical Center, Wake Forest Univ. cutts@wakehealth.edu Bob Edwards Sociology, East Carolina University edwardsr@ecu.edu Sinikka Elliott Sociology, University of British Columbia sinnikka.elliott@ubc.ca Mark Moss Eric East Carolina University markemoss@verizon.net Mary Glazer Community Member mkglazer@me.com Gary Gunderson Baptist Medical Center, Wake Forest ggunders@wakehealth.edu Annie Hardison-Moody Agricultural & Human Scis., NC State Univ. amhardis@ncsu.edu Chelsea Hargrove East Carolina University hargrovec18@ecu.edu Janée Rolanda Avent Harris Education, East Carolina University aventj16@ecu.edu Jarmichael Ross Harris Collegiate Recovery, East Carolina Univ. harrisja15@ecu.edu Joseph Hellweg Religion, East Carolina Univ./Florida State jhellweg@fsu.edu Ellen Idler Sociology, Emory University eidler@emory.edu Sitawa Kimuna Sociology, East Carolina University kimunas@ecu.edu Brenna Kirk Anatomy & Cell Biol., East Carolina Univ. owensa15@ecu.edu Ruth Little Public Health, East Carolina University littlena@ecu.edu Derek Maher Religious Studies, East Carolina University maherd@ecu.edu Jesse Miller Religion, Florida State University jcm14b@my.fsu.edu Samantha Miller Assoc’n of Mexicans in North Carolina samantham@amexcannc.org Naeema Muhammad NC Environmental Justice Network naeema1951@gmail.com Ari Mwachofi Public Health, East Carolina University mwanchofi@ecu.edu Christopher Neubert Geography, UNC Chapel Hill neubertc@live.unc.edu Mary Nyangweso Religious Studies, East Carolina Univ. wangilam@ecu.edu Hannah Porter University of North Carolina Wilmington hannahmportter@gmail.com Cristina Richie Bioethics, East Carolina University richiec17@ecu.edu Jill Laurich Rushing NC Dept. of Health & Human Services jlrushin@ncsu.edu Mona Russell History, East Carolina University russellm@ecu.edu Todd L. Savitt Bioethics, East Carolina University savittt@ecu.edu Mansi Trivedi Brody School of Med., East Carolina Univ. trivedim11@students.ecu.edu Josie Walker North Carolina Council of Churches josie@nccouncilofchurches.org Ayo Wilson NC Environmental Justice Network ayobwilson@yahoo.com Nadiya Yerich East Carolina University yerichn14@students.ecu.edu Stefanie Nicole Zapf University of North Carolina Wilmington snz822@uncw.edu

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