A Church Seeking Vision: A Study to Determine Which Stage of its Life Cycle the La Sierra Collegiate Church Is in, to Help the Church Clarify its Purpose and Goals and Grow Numerically

Problem Attendance at the La Sierra Collegiate Church worship services declined for several years, then membership began to decline. Programs, finances, and morale were negatively impacted. The church had lost any evangelistic fervor it may have had in the past. The Collegiate Church lacked a focus for ministry other than the education of the children of the members, in spite of efforts at worship renewal by a new senior pastor after his arrival in 1988. There was no mission or purpose. There was no vision and work for God’s redemption in the world. Method A questionnaire based on David Moberg’s church life-cycle model of five stages was used to survey the congregation, to determine why the Collegiate Church was not growing. Then a self-evaluation strategy was used to help the church focus on its purpose. The members through a congregational assessment evaluated the strengths and weaknesses of the Collegiate Church, and the Church Board devoted considerable time to studying the purpose of the church, taking special note of the results of the church life-cycle survey and the congregational assessment. Results The name of the church was changed to La Sierra University Church. Also, a plan for implementing change was adopted and put into action. That plan called on the department and committee leaders of the church to prepare plans for their area of responsibility, based on a revised Mission Statement and thirteen new goals adopted by the Church Board after its study of the purpose of the Collegiate Church. Follow-up called for periodic self-evaluation by the departments and committees, with periodic verbal or written reporting to the congregation, of the progress being made in meeting their goals and plans. Conclusions By 1990, the La Sierra Collegiate Church had evolved through its life cycle to the point where it was not growing because it had become institutionalized. The members were dissatisfied with the church and perceived it to be worldly. Work on clarifying the purpose of the church brought no significant change. No compelling vision or purpose surfaced which the leaders of the church and the congregation could identify with. Although a consensus on the mission and goals of the Collegiate (University) Church was developed, there was no renewal or revitalization of the church. To remain viable, the La Sierra University Church will need to continue seeking God’s vision for the church

Severity of Depressive Symptoms and Accuracy of Dietary Reporting among Obese Women with Major Depressive Disorder Seeking Weight Loss Treatment

An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 – 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms

The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time

Background Childhood obesity disproportionally affects children from low-income households. With the aim of informing interventions, this study examined pathways through which the physical and social home environment may promote childhood overweight/obesity in low-income households. Methods Data on health behaviors and the home environment were collected at home visits in low-income, urban households with either only normal weight (n = 48) or predominantly overweight/obese (n = 55) children aged 6–13 years. Research staff conducted comprehensive, in-person audits of the foods, media, and sports equipment in each household. Anthropometric measurements were collected, and children’s physical activity was assessed through accelerometry. Caregivers and children jointly reported on child sleep duration, screen time, and dietary intake of foods previously implicated in childhood obesity risk. Path analysis was used to test direct and indirect associations between the home environment and child weight status via the health behaviors assessed. Results Sleep duration was the only health behavior associated with child weight status (OR = 0.45, 95% CI: 0.27, 0.77), with normal weight children sleeping 33.3 minutes/day longer on average than overweight/obese children. The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children’s bedrooms to childhood overweight/obesity through effects on screen time and sleep duration. Conclusions This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households. Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep

Can Attention Control Conditions Have Detrimental Effects on Behavioral Medicine Randomized Trials

Objective: Attention control (AC) conditions are used to balance nonspecific attention in randomized trials of behavioral interventions. Very little guidance about which behavioral interventions and outcomes merit AC is available in the literature. The primary aim of the present study is to demonstrate a scenario in which use of AC in a behavioral randomized trial was unnecessary and possibly detrimental. Methods: Exploratory analyses were performed in a randomized controlled trial that tested whether a patient-centered counseling intervention reduced low-density lipoprotein cholesterol levels in 355 participants with peripheral arterial disease, compared with AC and usual care (UC) conditions. The patient-centered counseling intervention was designed to activate participants to ask their physician for lipid-lowering medication and/or increase dose intensity, increase medication adherence, and reduce fat intake. The AC condition involved attention-matched telephone-delivered health education, and the UC condition consisted of an educational pamphlet. Results: At 12-month follow-up, the mean low-density lipoprotein cholesterol changes were -11.1 and -6.8 mg/dL in the UC and AC conditions, respectively (p = .17). The proportion of participants who increased the use or dose intensity of medication was significantly lower in AC than in UC: 17.5% versus 30.5% (p = .03). No significant difference in other outcomes was observed between AC and UC. Conclusions: AC has significantly worse medication outcomes, and there is no indication of a therapeutic effect on other end points. Implications for the use of AC in behavioral randomized trials are discussed. Trial Registration:clinicaltrials.gov Identifier: NCT00217919