Coping With Uncertainty Use of Contemplative.5

F E AT U R E S
Coping With Uncertainty

Use of Contemplative Practices Amid the COVID-19
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Pandemic in the United States

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■ Nirmala Lekhak, PhD, RN ■ Tirth R. Bhatta, PhD ■ Timothy D. Goler, PhD ■ Eva Kahana, PhD
■ Sfurti Rathi, MPH
Scant research has attempted to understand the use and frequency of contemplative practices across social
groups of older adults in the context of uniquely uncertain and stressful circumstances, such as the COVID-19
pandemic. Using data from a nationwide web-based survey (n = 1861), we examined the change in the frequency
of contemplative practices and variation across sociodemographic, health, and psychological status and we
documented a significant increase in the use of prayer and meditation since the beginning of the pandemic.
Minority groups and those with lower income reported praying longer than their counterparts. Respondents who
were unmarried, women, and more educated were more likely to meditate, whereas lower-educated respondents
were more likely to pray during the pandemic. Greater use of these practices was found among participants with
higher anxiety. Our study offers much-needed guidance for future intervention studies to improve psychological
well-being among diverse groups of older adults facing stressful circumstances. KEY WORDS: anxiety, meditation,
prayer, sociodemographic characteristics Holist Nurs Pract 2024;38(6):341–350
older adults with regard to sociodemographic, health,

INTRODUCTION and psychological statuses is limited. Scholarship on
Contemplative practices, such as meditation and the use of contemplative practices during the
prayer, have been used as coping resources to pandemic is warranted because of the pandemic’s
counteract the adverse influences of stressful life varying impacts on already disadvantaged social
situations on psychological health.1-5 These practices groups. Understanding the sociodemographic
are often used to develop awareness and characteristics of older adults engaged in
connectedness to God (eg, prayer), the higher power contemplative practices will help design and
or inner-self (eg, meditation).6 Our understanding of implement targeted, culturally appropriate
how contemplative practices are distributed among contemplative interventions (eg, meditation) to
ameliorate the short- or long-term effects of
coronavirus disease-2019 (COVID-19) on their
Author Affiliations: School of Nursing, University of Nevada, Las Vegas, psychological well-being.3
Las Vegas (Dr Lekhak); Department of Sociology, University of Nevada,
Las Vegas, Las Vegas (Dr Bhatta); Department of Sociology, Norfolk State The COVID-19 pandemic has exacerbated existing
University, Norfolk, Virginia (Dr Goler); Department of Sociology, Case physical and mental health challenges, but it has had
Western Reserve University, Cleveland, Ohio (Dr Kahana); and School of
Public Health, University of Nevada, Las Vegas, Las Vegas (Ms Rathi). disproportionate, adverse effects on older adults,
This work was supported by the STTI Honor Society of Nursing Zeta
especially those with preexisting health conditions and
Kappa-At-Large Chapter. from lower socioeconomic or minority groups.7,8
We are also thankful to Sarah Lyons for her editorial assistance. Physical distancing and lockdown measures to curb
The authors have disclosed that they have no significant relationships with,
the spread of the novel coronavirus socially isolated
or financial interest in, any commercial companies pertaining to this article. older adults who were already living alone.9 Thus, the
Correspondence: Nirmala Lekhak, PhD, RN, School of Nursing, Univer- current pandemic could have increased their
sity of Nevada, Las Vegas, 4505 S. Maryland Pkwy, Box 455033, Las Vegas, vulnerability to loneliness, psychological distress,
NV 89154 (nirmala.lekhak@unlv.edu).
morbidity, and mortality.10,11 Moreover, these
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. experiences are likely to vary among
DOI: 10.1097/HNP.0000000000000507 sociodemographic groups. The pandemic adversely
341
Copyright © 2024 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
342 HOLISTIC NURSING PRACTICE ● NOVEMBER/DECEMBER 2024
and disproportionately affected Blacks and Latinx during the pandemic. Our study offers insight into the
compared with Whites.7,12 In terms of socioeconomic use and frequency of meditation and prayer before and
status (SES), individuals with a lower SES were more during the pandemic based on the sociodemographic,
likely to work jobs that did not offer the flexibility to health, and psychological characteristics of these users.
work from home, putting them at higher risk of Previous studies on adults 18 years and older
getting COVID-19.13 Although men have experienced consistently found meditation and prayer to be more
more severe symptoms associated with COVID-19,14 prevalent among women and those experiencing one
women have reportedly experienced greater or more chronic conditions, functional limitation, or
psychological strain as a result of the pandemic.15,16 emotional distress.5,29-33 Greater use of meditative
practices has been reported among non-Hispanic
Contemplative practices and adversity Whites, middle-aged adults, and individuals of a
higher SES29,32,33 as well as those who are not
Scholars have recognized the benefits of married.33 In contrast to meditative practices, prayer is
contemplative practices for psychological health more prevalent among older adults compared with
during the pandemic,17,18 especially as these practices their younger counterparts—especially those of a
can effectively reduce stress and anxiety.19-22 One lower SES—and minorities (ie, Hispanics and Blacks)
study found a record increase in Google searches for relative to Whites.4,5,30
prayer during the pandemic in 95 countries.23 A few
studies looked at the use of prayer during the Purpose of the study
pandemic and found Polish younger adults24 and
Tanzanian women25 used prayer to cope. Further, The theory of self-transcendence,34 a middle-range
findings from the natural disaster literature indicate nursing theory, provides a framework for
that people rely more on their religion, religious understanding an individual’s capacity, usually by the
practices (eg, prayer), and community (eg, church) use of practices such as meditation, to transcend the
during and after traumatic events to cope with difficult life situations to promote well-being. We
adversity.26,27 However, besides scholarly, and expert draw from this theory to understand how older adults
opinions, research on the prevalence of meditation cope with difficult circumstances (eg, the pandemic)
during the pandemic or other adverse events was through use of contemplative practices and how their
largely absent. traits and contextual factors affect the use of these
practices. Our study offers insights into the use of
contemplative practices in the context of the uniquely
Contemplative practices use and frequency
uncertain and stressful circumstances induced by the
Studies on the frequency of contemplative practices COVID-19 pandemic (Figure 1). Specifically, we
and variation across social groups before and during addressed the following research questions:
the pandemic are lacking. A survey conducted among
1. How do the use and frequency of meditation and
adults 18 years and older before the pandemic found
prayer during the pandemic differ across
that 55% of adult respondents prayed daily, and 40%
meditated at least once a week.28 Fifty-two percent
of those who meditated weekly and 50% of those
who prayed daily were adults 50 years and older.
Thus, the extreme stress and uncertainly induced
by the pandemic are likely to necessitate greater use
of these practices. Of note, research conducted prior
to the pandemic focused on adults 18 years and older
or middle-aged adults, yet virtually no attempt has
been made to understand these dynamics specifically
among older adults before or amid the pandemic.
Given the widespread social isolation and increased
vulnerability to coronavirus, it is unclear whether the
sociodemographic characteristics observed by prior FIGURE 1. Conceptual framework based on Reed’s
studies among adults will be similar for older adults transcendence theory.
Coping With Uncertainty 343
sociodemographic, health, and psychological any of the following to cope with the coronavirus
statuses? pandemic?” The responses were coded as 1 = yes and
2. Has the context of the pandemic increased the 0 = no. If participants chose meditation or prayer,
frequency of meditation and prayer? Does the they were prompted to answer the frequency of their
change in the frequency (before and during the use (from once a week or less to twice a day; reported
pandemic) of these practices differ across as amount) and length of each practice (from 5
sociodemographic, health, and psychological minutes or less to 30 minutes or more; reported as

statuses? duration). We also collected the same frequency data
on whether participants used meditation and prayer

before the pandemic.
METHODS
Data for this study came from our Chronic conditions
cross-sectional, national web-based survey of adults The chronic conditions index was created by
50 years and older, conducted from April to June combining binary responses on 15 diagnosed chronic
2020. We administered the survey to understand how illnesses (eg, arthritis, diabetes, and hypertension).
older adults in the United States were affected by and
coped with the COVID-19 pandemic. We employed
Functional limitation
a nonprobability sampling approach to recruit our
A 4-item PROMIS physical function scale35,36 was
sample participants. The inclusion criteria were aimed
used to assess the participant’s functional health
to sample adults 50 years and older living in the United
status. Participants were asked to evaluate their ability
States who could read and write English. Participants
to perform activities of daily living (eg, “Are you able
were recruited using email communication and social
to run errands and shop?”) on a 5-point scale. Their
media advertisements. The study information, flyer,
responses ranged from 1 = without any difficulty to 5
and survey link were sent to various agencies serving
= unable to do. A functional limitation scale was
older adults with a request to forward the information
created by combining these items for each participant.
to or share it with their members. We created a study
account and group page on Twitter and Facebook,
respectively, to share/advertise the study information Concerns about COVID-19
and recruit participants. The brief study information This 7-item scale measured a participant’s appraisal
with a survey link and flyer were shared through of the personal implications of the pandemic on a
tweets and boosted Facebook posts that targeted 5-point Likert scale from 1 (not at all) to 5 (very
potential participants. The study was exempted much). Some of the questions asked were, “To what
by the (blinded for review) institutional review board. extent are you concerned about coronavirus affecting
you personally? Are you concerned about dying from
Measures
coronavirus?” These items had high internal
Sociodemographic characteristics consistency as indicated by high Cronbach’s α of
Age was measured in years. Other demographic 0.82. A concerns about COVID-19 scale was created
characteristics were race (White, Black, and other by summing the 7-item responses for each participant.
races), gender (1 = female, 0 = male), and marital
status (1 = married, 0 = not married). Income was
divided into 11 ordinal categories, from 1= less than Anxiety
$10 000 to 11 = $100 000 and above. Education was We used a 6-item PROMIS emotional distress-
coded into 6 ordinal categories: 1 = no high school or anxiety scale37,38 to measure a participant’s anxiety
GED, 2 = high school graduate, 3 = some college, 4 during the pandemic by asking questions like “I felt
= bachelor’s degree, 5 = master’s degree, and 6 = fearful.” Each item response was recorded on a
doctorate degree. 5-point scale, ranging from 1 (never) to 5 (very often).
These items had high internal consistency as indicated
Contemplative practices (meditation and prayer) by high Cronbach’s α of 0.93. An anxiety scale was
The use of contemplative practices during the created by summing the 6-item responses for each
pandemic was measured by asking, “Are you doing participant.
Analytic plan TABLE 1. Demographic Characteristics of Study

Respondents
We used SAS 9.4 software to conduct our statistical
analyses, which proceeded in multiple steps. First, we Mean (SD) or
Percentage
calculated descriptive statistics to examine the
(n = 1861)
distribution of study participants’ sociodemographic,
health, and psychological statuses. Second, we Age (range: 50-93 y) 64.82 (8.45)
examined the distribution of prayer and meditation use Gender (1 = female) 74%
Marital status (1 = married)
based on frequency before and during the pandemic. 65%

Race
Third, we performed binary logistic regression
White 88%
analyses to explore the relationship between the use of Black 7%
these practices during the pandemic and Other racial/ethnic groups 5%
sociodemographic, health, and psychological statuses. Education
We fitted ordinal logistic regression models to assess No high school or GED 1%
the relationship between the use of contemplative High school 5%
Some college 21%
practices and sociodemographic, health, and Bachelor’s degree 28%
psychological statuses. We fitted 3 models, the first of Master’s degree 31%
which included age, gender, marital status, race, Doctorate degree 14%
education, and income as predictors for the use and Household income (range: 1-11) 7.81 (3.09)
frequency of contemplative practices. We added Users of meditation during pandemic 23%
Users of prayer during pandemic 43%
health characteristics (ie, chronic diseases and
Chronic diseases (range: 0-15) 1.74 (1.52)
functional limitations) in model 2. In model 3, we Functional limitations (range: 4-20) 6.00 (3.15)
further included concerns about COVID-19 and Concerns about COVID-19 (range: 7-35) 22.03 (5.88)
anxiety variables to assess their role in predicting the Anxiety (range: 6-30 ) 14.20 (5.34)
use and frequency of contemplative practices during
the pandemic. Finally, we employed generalized
estimating equation (GEE) approach to assess changes pandemic. The percentage of participants who
in the frequency of meditation and prayer before and reported meditating daily or twice a day increased
during the pandemic using ordinal logistic models. from 41% before the pandemic to 56% during the
Those models were also used to examine whether pandemic. We documented a similar reported increase
such changes differed across sociodemographic, in the percentage of participants praying daily or twice
health, and psychological statuses (findings are not a day (ie, from 72% before the pandemic to 85%
reported in tables). during the pandemic). In terms of duration, the
percentage of participants who reported meditating for
more than 20 minutes increased from 39% before the
RESULTS pandemic to 43% during the pandemic; for prayer, this
duration increased from 17% before the pandemic to
The average age of our study participants was 65 21% during the pandemic.
years. Most participants were female (74%), were
White (88%), had a bachelor’s degree or higher (73%), Use of meditation and prayer during
and earned more than $50 000 (74%). On average, the pandemic
participants had 2 chronic conditions. Their average
functional limitation score was 6 on a range from 4 to Tables 2 and 3 present the results of binary logistic
20, with 20 being the most limited. Most participants regression models that examined the influence of
were concerned about the personal impacts of sociodemographic, health, and psychological status on
COVID-19 and had an average anxiety score of 14. the use of meditation (Table 2) and prayer (Table 3).
Twenty-three percent of participants meditated, and Model 1 shows that women have 40% (odds ratio
43% prayed during the pandemic (see Table 1). As [OR] = 1.40, confidence interval [95% CI] =
illustrated by 2 bar graphs (see Figures 2 and 3), there 1.06-1.84) and 83% (OR = 1.83, 95% CI =
was an increase in the frequency of prayer and 1.45-2.31) higher odds of using meditation and prayer,
meditation in terms of amount and duration during the respectively, during the pandemic than men. The
FIGURE 2. Frequency of meditation and prayer use before and during the pandemic.
gender differences associated with meditation became education had significantly greater odds of using
statistically not significant when concerns about meditation (OR = 1.46, 95% CI = 1.30-1.64) but
COVID-19 and anxiety variables were included in lower odds of using prayer (OR = 0.91, 95% CI =
model 3. However, the statistical significance was 0.83-0.99) than those with lower levels of education.
maintained when it pertained to gender differences in The odds of using prayer and meditation were lower
the use of prayer. Compared with unmarried among individuals with higher income, but the
participants, married participants were 25% less likely estimates were not statistically significant. However,
to meditate (OR = 0.75, 95% CI = 0.57-0.99). While before the influence of education was adjusted, the
married participants had higher odds of using prayer, odds for meditating were greater among individuals
the estimates were not statistically significant. With with higher income (OR = 1.03, 95% CI = 0.99-1.07;
regard to race, Blacks and other race/ethnic groups not reported in Table 2).
had significantly higher odds of using meditation (OR With regard to health status, only chronic disease
for Blacks = 1.78, 95% CI = 1.17-2.68; OR for other was significantly associated with the odds of prayer
race groups = 1.61, 95% CI = 1.00- 2.59) and prayer (OR = 1.08, 95% CI = 1.02-1.16; not reported in
(OR for Blacks = 7.29, 95% CI = 4.54-11.70; OR for Table 3), with greater use reported by participants
other race groups = 1.50, 95% CI = 0.98-2.30) than with a higher number of chronic diseases. Due to a
Whites. We documented significant racial differences significant association between chronic disease and
in the use of meditation and prayer, even after functional limitations, the relationship between
accounting for socioeconomic, health, and chronic disease and prayer was rendered statistically
psychological status. Participants with higher levels of not significant when the latter was included in a model
FIGURE 3. Frequency of prayer use before and during the pandemic.
TABLE 2. Logistic Regression Models Representing the Influence of Sociodemographic and Health
Characteristics on Use of Meditation During the Pandemic
Model 1 (n = 1731) Model 2 (n = 1730) Model 3 (n = 1729)
Odds Ratio (SE) 95% CI Odds Ratio (SE) 95% CI Odds Ratio (SE) 95% CI
0.05 (0.54)a 0.05 (0.55)a 0.01 (0.65)a

Intercept
Age 1.00 (0.01) 0.99-1.02 1.00 (0.01) 0.99-1.02 1.01 (0.01) 0.99-1.03
Gender 1.40 (0.14)b 1.06-1.84 1.40 (0.14)b 1.06-1.84 1.26 (0.14) 0.95-1.67
Marital status 0.75 (0.14)b 0.57-0.99 0.75 (0.14)b 0.57-0.98 0.76 (0.14)b 0.57-0.99
Blackc 1.78 (0.21)d 1.17-2.68 1.77 (0.21)d 1.17-2.68 1.94 (0.22)d 1.27-2.96
Other racial groupsc 1.61 (0.24)b 1.00-2.59 1.65 (0.24)b 1.02-2.66 1.66 (0.25)b 1.02-2.68
Education 1.46 (0.06)a 1.30, 1.64 1.46 (0.06)a 1.30-1.64 1.46 (0.06)a 1.29-1.63
Income 0.97 (0.02) 0.93-1.02 0.97 (0.02) 0.93-1.02 0.98 (0.02) 0.94-1.03
Chronic diseases ... ... 1.00 (0.04) 0.92-1.09 0.99 (0.05) 0.91-1.08
Functional limitations ... ... 1.01 (0.02) 0.97-1.05 0.99 (0.02) 0.95-1.03
COVID concerns ... ... ... ... 1.01 (0.01) 0.99-1.04
Anxiety ... ... ... ... 1.06 (0.01)a 1.03-1.09
Model fit −2 log likelihood 1793.47 1792.32 1761.11
Abbreviations: CI, confidence interval; SE, standard error.

a
P < .001.
b
P < .05.
c
Reference group = White.
d
P < .01.
(see model 2 in Table 3). Both chronic disease and prayer and meditation. The odds of using meditation
functional limitations were not significantly related to were significantly higher among participants with
meditation. Concerns about the COVID-19 pandemic greater concerns about COVID. Given the significant
and anxiety variables were added to Model 3. Anxiety association between concerns about COVID-19 and
was significantly associated with greater use of both anxiety, the relationship between COVID-19 concerns
TABLE 3. Logistic Regression Models Representing the Influence of Sociodemographic and Health
Characteristics on Use of Prayer During Pandemic
Model 1 (n = 1745) Model 2 (n = 1744) Model 3 (n = 1743)
Odds Ratio (SE) 95% CI Odds Ratio (SE) 95% CI Odds Ratio (SE) 95% CI
Intercept 0.72 (0.46) 0.57 (0.47) 0.46 (0.53)

Age 0.99 (0.01) 0.99-1.01 0.99 (0.01) 0.99-1.01 1.00 (0.01) 0.99-1.02
Gender 1.83 (0.12)a 1.45-2.31 1.80 (0.12)a 1.42-2.28 1.73 (0.12)a 1.37-2.21
Marital status 1.13 (0.12) 0.89-1.43 1.11 (0.12) 0.88-1.41 1.12 (0.12) 0.90-1.44
Blackb 7.29 (0.24)a 4.54-11.70 7.31 (0.24)a 4.55-11.74 8.27 (0.25)a 4.99-13.22
Other racial groupsb 1.50 (0.22) 0.98-2.30 1.56 (0.22)c 1.01-2.40 1.58 (0.22)c 0.99-2.33
Education 0.91 (0.05)c 0.83-0.99 0.91 (0.05) 0.83-1.00 0.91 (0.05)c 0.82-0.99
Income 0.97 (0.02) 0.94-1.01 0.99 (0.02) 0.95-1.03 0.99 (0.02) 0.94-1.02
Chronic diseases ... ... 1.06 (0.04) 0.98-1.14 1.07 (0.04) 0.99-1.15
Functional limitations ... ... 1.03 (0.02) 0.99-1.07 1.03 (0.02) 0.99-1.07
COVID concerns ... ... ... ... 0.98 (0.01) 0.97-1.01
Anxiety ... ... ... ... 1.03 (0.01)c 1.01-1.05
Model fit −2 log likelihood 2271.11 2260.74 2252.44
Abbreviations: CI, confidence interval; SE, standard error.

a
P < .001.
b
Reference group = White.
c
P < .05.
and meditation was rendered statistically not had higher odds of using meditation during the
significant when anxiety was included in the model pandemic than their counterparts.29,39 The odds of
(see model 3 in Table 2). using prayer and meditation, which were greater
among lower-income individuals, were not
Frequencies of meditation and prayer during statistically significant. Previous research has reported
the pandemic greater use of meditation among respondents with
higher incomes29,32,33 and greater rates of prayer

In examining predictors of meditation and prayer among respondents with lower incomes.4,5,30 The
frequencies (amount), a significant relationship effect of income may be explained by education, as

existed only between income and prayer. The odds of participants who reported higher education had higher
higher prayer frequency (OR = 0.93, 95% CI = incomes. In fact, although not statistically significant,
0.88-0.98) decreased with increased income. With the odds of using meditation were greater among
respect to the duration of contemplative practices, individuals with higher income before the influence of
significantly less time was devoted to prayer (OR = education was adjusted.
0.91, 95% CI = 0.86-0.96) and meditation (OR = Unlike meditation, use of prayer was higher among
0.91, 95% CI = 0.84-0.99) among participants with individuals with lower levels of education. This
higher incomes. Participants from older age groups finding aligns with the research conducted before the
had significantly greater odds of meditating longer pandemic.4,5,30 Older adults from minority groups
(OR = 1.03, 95% CI = 1.01-1.06) than those in reported using prayer more than Whites during the
younger age groups. We also documented significantly pandemic. Surprisingly, we found higher odds of
greater odds of praying for a longer duration (OR = meditation among minority groups (eg, Blacks) than
2.09, 95% CI = 1.22-3.62) among other racial groups Whites. Previous studies have documented greater use
relative to Whites (not presented in the table). of meditation among Whites compared with Blacks
across all ages. Our study may be different in that we
Change in frequencies of meditation and prayer only look at older adults, for whom racial
characteristics of individuals engaged in
Our GEE models show a significant increase in the contemplative practices may be different. Moreover,
amount of meditation (OR = 2.10, 95% CI = older minorities may have increased their reliance on
1.79-2.48) and prayer (OR = 2.15, 95% CI = meditation to cope with increasing adversities during
1.92-2.40) between before and during the pandemic. the pandemic.40,41 This difference could also reflect
A statistically significant increase was also observed higher levels of education and income among minority
in the duration of meditation (OR = 1.27, 95% CI = races in our sample than the general population.42 Our
1.11-1.46) and prayer (OR = 1.20, 95% CI = findings on the influence of SES on meditation align
1.09-1.31). The changes in the amount and duration of with previous studies that show greater rates of
meditation and prayer sessions did not differ meditation among individuals with higher levels of
significantly across sociodemographic, health, and education and income.29
psychological statuses (not shown in the table). Gender differences in meditation became
statistically not significant after the inclusion of
concerns regarding COVID-19 and anxiety variables;
DISCUSSION this could be due to women experiencing more anxiety
during the pandemic.15,16 The odds of meditating were
Our study contributes to the scant research on the role high among those with higher concerns regarding
the COVID-19 pandemic played in affecting the use COVID-19, which became nonsignificant after
and frequency of contemplative practices, such as adjusting for anxiety. Those who meditated or prayed
meditation and prayer. We also examined the had higher anxiety levels compared with those who
influences of sociodemographic and health statuses on did not meditate or pray, suggesting these practices
such contemplative practice among older adults in the were used to reduce anxiety during the pandemic. A
United States during the pandemic. Consistent with previous intervention study has suggested that
studies among adults 18 years and older prior to the meditation-based therapies and faith-based practices
pandemic, our findings show that women, the help reduce anxiety in older adults.19-22 The growing
unmarried, and people with higher education levels evidence of meditative practices being helpful to
reduce stress and anxiety43,44 could have prompted indicating increased reliance on contemplative
older adults with a higher level of anxiety to meditate. practices among groups who have been
Studies have found that adults leverage these practices disproportionately affected by the pandemic.48
primarily for stress management, emotional
well-being, and health concerns.4,29,31,33 Prayer was Limitations
significantly associated with a higher number of
chronic conditions before functional limitation was As with any web-based study, our study is not without
added to the model. Although statistically limitations. Online data collection with nonprobability
nonsignificant, higher numbers of chronic conditions sampling makes it difficult to avoid self-selection bias.
and functional limitations were associated with greater We had fewer men, minority races, and individuals
use of meditation. These findings are consistent with with less than a high school education participate in
prior studies that show significantly greater use of this study, making it hard to generalize our sample to
contemplative practices among adults with more the larger population. Our finding on the differences in
chronic conditions and functional limitations.1,29 meditation use between minority groups and Whites
Some of our nonsignificant findings concerning the could reflect our relatively well-educated sample, as
influence of health status on contemplative practices individuals with higher levels of education are more
could indicate increased use of such practices, likely to meditate than lower-educated older adults.
regardless of health status, due to greater concerns for Given the unexpected results regarding race
the pandemic and higher anxiety. Indeed, we differences in the use of meditation, future studies
documented the latter to be significantly associated should glean more details about potential race
with increased use of contemplative practices. differences in how various race and ethnic groups
The findings offered unique insights into the effect define meditative practices.
of the pandemic on the frequency of prayer and
meditation among adults. Overall, participants Implications
meditated and prayed more often and for longer per
week during the pandemic than before. These changes Limitation aside, our study offers important insight
did not differ significantly across sociodemographic, into the frequency of contemplative practice among
health, and psychological statuses, which indicates older adults during the pandemic. It corroborates
that the increase in the frequency of prayer and Reed’s theory of self-transcendence, which states that
meditation was similar across social and health when confronted with adversity (eg, pandemic),
groups. Previous studies conducted outside the United individuals possess the capacity for self-transcendence
States focused only on the use of prayer to cope during by utilizing intrapersonal (eg, meditation) or
the pandemic,24,25 with minimal insight into whether transpersonal (eg, prayer) resources.34 During the
the pandemic changed such practices. With regard to pandemic, participants in our study increased their use
baseline differences in the frequency of contemplative of contemplative practices. Those with a higher level
practices, individuals with lower income status prayed of anxiety made greater use of these resources,
more often and for longer. For meditation practice, indicating that they were aware of their situation and
those with higher incomes meditated for shorter made an effort to mitigate its impact on their overall
durations compared with those with lower incomes; well-being. When sociodemographic characteristics
this could be due to the protective factor that financial are considered, women and minorities face greater
security offered those with higher incomes during the adversity than their counterparts. The increased
pandemic. Those who were financially secure were likelihood of these groups engaging in contemplative
less anxious and had better health status,45 hence less practices suggests that when faced with adversity,
likely to need contemplative practices for long people cope by engaging in activities like meditation
periods. Older participants also engaged in meditation and prayer. It is critical for health care providers and
longer than their younger counterparts, which could researchers to encourage the use of contemplative
relate to their social isolation (ie, more time at home), practices as a means of mitigating the negative effects
worry for family members, and decreased household of adverse events on the psychological well-being of
responsibilities compared with younger adults (eg, older adults.
parenting and regular job).46,47 Black and other racial Our findings also inform the design of future
groups prayed for more extended periods than Whites, interventions to reduce the adverse impacts of
stressful events on psychological well-being among 14. Lakbar I, Luque-Paz D, Mege J-L, Einav S, Leone M. COVID-19 gen-
diverse older adults. Meditation and prayer are der susceptibility and outcomes: a systematic review. PLoS One. 2020;
15(11):e0241827. doi:10.1371/journal.pone.0241827.
inexpensive and accessible self-care personal/spiritual 15. Ausín B, González-Sanguino C, Castellanos MÁ, Muñoz M. Gender-
resources, and they are used more frequently during related differences in the psychological impact of confinement as a
adverse events, such as the pandemic. Providing consequence of COVID-19 in Spain. J Gend Stud. 2021;30(1):29-38.
doi:10.1080/09589236.2020.1799768.
proper and culturally appropriate training to use these 16. Breslau J, Finucane ML, Locker AR, Baird MD, Roth EA, Collins RL.
resources when applicable among diverse older adults A longitudinal study of psychological distress in the United States be-
is critical to reducing psychological distress such as fore and during the COVID-19 pandemic. Prev Med (Baltim). 2021;
143:106362. doi:10.1016/j.ypmed.2020.106362.
anxiety and loneliness in the post-COVID world.
17. Behan C. The benefits of Meditation and Mindfulness practices dur-
Given the long-term impact of the pandemic, health ing times of crisis such as COVID-19. Ir J Psychol Med. 2020:1-3.
care providers must be aware of the increased use of doi:10.1017/ipm.2020.38.
contemplative practices among older adults and 18. Bushell W, Castle R, Williams MA, et al. Meditation and yoga prac-
tices as potential adjunctive treatment of SARS-CoV-2 infection and
initiate discussions about employing such practices to COVID-19: a brief overview of key subjects. J Altern Complement
improve their psychological well-being.4 Med. 2020;26(7):547-556. doi:10.1089/acm.2020.0177.
19. Ai AL, Peterson C, Tice TN, Huang B, Rodgers W, Bolling SF. The
influence of prayer coping on mental health among cardiac surgery pa-
tients: the role of optimism and acute distress. J Health Psychol. 2007;
12(4):580-596. doi:10.1177/1359105307078164.
REFERENCES 20. Dalmida SG, Holstad MM, Diiorio C, Laderman G. Spiri-
tual well-being, depressive symptoms, and immune status among
1. Anderson JW, Nunnelley PA. Private prayer associations with de- women living with HIV/AIDS. Women Health. 2009;49(2/3):119-143.
pression, anxiety and other health conditions: an analytical review doi:10.1080/03630240902915036.
of clinical studies. Postgrad Med. 2016;128(7):635-641. doi:10.1080/ 21. Foulk MA, Ingersoll-Dayton B, Kavanagh J, Robinson E, Kales HC.
00325481.2016.1209962. Mindfulness-based cognitive therapy with older adults: an exploratory
2. Gillum F, Griffith DM. Prayer and spiritual practices for health reasons study. J Gerontol Soc Work. 2014;57(5):498-520. doi:10.1080/
among American adults: the role of race and ethnicity. J Relig Health. 01634372.2013.869787.
2010;49(3):283-295. doi:10.1007/s10943-009-9249-7. 22. Linardakis M, Papadaki A, Smpokos E, Sarri K, Vozikaki M, Philalithis
3. Kok BE, Coffey KA, Cohn MA, et al. How positive emotions build A. Are religiosity and prayer use related with multiple behavioural risk
physical health: perceived positive social connections account for the factors for chronic diseases in European adults aged 50+ years? Public
upward spiral between positive emotions and vagal tone. Psychol Sci. Health. 2015;129(5):436-443. doi:10.1016/j.puhe.2015.02.006.
2013;24(7):1123-1132. doi:10.1177/0956797612470827. 23. Bentzen J. In crisis, we pray: religiosity and the COVID-19 pandemic.
4. McCaffrey AM, Eisenberg DM, Legedza ATR, Davis RB, Phillips RS. Cent Econ Policy Res. 2020:DP14824. https://ssrn.com/abstract=
Prayer for health concerns: results of a National Survey on Preva- 3615587.
lence and Patterns of Use. Arch Intern Med. 2004;164(8):858-862. 24. Kowalczyk O, Roszkowski K, Montane X, Pawliszak W, Tylkowski
doi:10.1001/archinte.164.8.858. B, Bajek A. Religion and faith perception in a pandemic of COVID-
5. Wachholtz AB, Sambamthoori U. National trends in prayer use as a 19. J Relig Health. 2020;59(6):2671-2677. doi:10.1007/s10943-020-
coping mechanism for depression: changes from 2002 to 2007. J Relig 01088-3.
Health. 2013;52(4):1356-1368. doi:10.1007/s10943-012-9649-y. 25. Mshana G, Mchome Z, Aloyce D, Peter E, Kapiga S, Stöckl H. Con-
6. CMind. The Tree of Contemplative Practices [Illustration]. The Center tested or complementary healing paradigms? Women’s narratives of
for Contemplative Mind in Society. https://www.contemplativemind. COVID-19 remedies in Mwanza, Tanzania. J Ethnobiol Ethnomed.
org/practices/tree. Published 2021. Accessed June 18, 2021. 2021;17(1):30. doi:10.1186/s13002-021-00457-w.
7. Centers for Disease Control and Prevention. Risk for COVID-19 Infec- 26. O’Grady KA, Rollison DG, Hanna TS, Schreiber-Pan H, Ruiz
tion, Hospitalization, and Death by Race/Ethnicity. https://www.cdc. MA. Earthquake in Haiti: relationship with the sacred in times
gov/coronavirus/2019-ncov/covid-data/investigations-discovery/ of trauma. J Psychol Theol. 2012;40(4):289-301. doi:10.1177/
hospitalization-death-by-race-ethnicity.html. Published 2021. 009164711204000404.
8. NCOA. Healthy Aging. Arlington, VA: NCOA; 2018. doi:10.4324/ 27. Shaw A, Joseph S, Linley PA. Religion, spirituality, and posttraumatic
9781351204996-4. growth: a systematic review. Ment Health Relig Cult. 2005;8(1):1-11.
9. Lee SM, Edmonston B. Living alone among older adults in Canada doi:10.1080/1367467032000157981.
and the U.S. Healthc (Basel, Switzerland). 2019;7(2):68. doi:10.3390/ 28. Pew Research Center. Religious Landscape Study. https://www.
healthcare7020068. pewforum.org/religious-landscape-study/ Published 2015.
10. Armitage R, Nellums LB. COVID-19 and the consequences of isolating 29. Burke A, Lam CN, Stussman B, Yang H. Prevalence and patterns
the elderly. Lancet Public Heal. 2020;5(5):e256. doi:10.1016/S2468- of use of mantra, mindfulness and spiritual meditation among adults
2667(20)30061-X. in the United States. BMC Complement Altern Med. 2017;17(1):316.
11. D’Adamo H, Yoshikawa T, Ouslander JG. Coronavirus disease 2019 in doi:10.1186/s12906-017-1827-8.
geriatrics and long-term care: the ABCDs of COVID-19. J Am Geriatr 30. Graham RE, Ahn AC, Davis RB, O’Connor BB, Eisenberg DM,
Soc. 2020;68(5):912-917. doi:10.1111/jgs.16445. Phillips RS. Use of complementary and alternative medical thera-
12. Jacobs M, Burch AE. Anxiety during the pandemic: racial and ethnic pies among racial and ethnic minority adults: results from the 2002
differences in the trajectory of fear. J Affect Disord. 2021;292:58-66. National Health Interview Survey. J Natl Med Assoc. 2005;97(4):
doi:10.1016/j.jad.2021.05.027. 535-545.
13. Patel JA, Nielsen FBH, Badiani AA, et al. Poverty, inequality and 31. Harrigan JT. Health promoting habits of people who pray for their
COVID-19: the forgotten vulnerable. Public Health. 2020;183:110- health. J Relig Health. 2011;50(3):602-607. doi:10.1007/s10943-009-
111. doi:10.1016/j.puhe.2020.05.006. 9293-3.
32. Olano HA, Kachan D, Tannenbaum SL, Mehta A, Annane D, Lee Work Soc Thought. 2011;30(3):294-319. doi:10.1080/15426432.2011.
DJ. Engagement in mindfulness practices by U.S. adults: sociode- 587388.
mographic barriers. J Altern Complement Med. 2015;21(2):100-102. 41. Novacek DM, Hampton-Anderson JN, Ebor MT, Loeb TB, Wyatt GE.
doi:10.1089/acm.2014.0269. Mental health ramifications of the COVID-19 pandemic for Black
33. Upchurch DM, Johnson PJ. Gender differences in prevalence, pat- Americans: clinical and research recommendations. Psychol Trauma.
terns, purposes, and perceived benefits of meditation practices in 2020;12(5):449-451. doi:10.1037/tra0000796.
the United States. J Womens Health (Larchmt). 2018;28(2):135-142. 42. de Brey C, Musu L, McFarland J, et al. Status and Trends in the Ed-
doi:10.1089/jwh.2018.7178. ucation of Racial and Ethnic Groups 2018 (NCES 2019-038). Wash-
34. Reed PG. Theory of self-transcendence. In: Middle Range Theory for ington, DC: US Department of Education; 2019. https://nces.ed.gov/
Nursing. 4th ed. New York, NY: Springer Publishing Company; 2018: pubsearch/
119-145. doi:10.1891/9780826159922.0007. 43. Bertisch SM, Wee CC, Phillips RS, McCarthy EP. Alternative mind-
35. Health Measures. PROMIS Physical Function-Short Form 4a. https:// body therapies used by adults with medical conditions. J Psychosom
www.healthmeasures.net/index.php?option=com_instruments&view= Res. 2009;66(6):511-519. doi:10.1016/j.jpsychores.2008.12.003.
measure&id=796&Itemid=992. Published 2016. 44. Sorrell JM. Meditation for older adults: a new look at an ancient inter-
36. Jensen RE, Potosky AL, Reeve BB, et al. Validation of the PROMIS vention for mental health. J Psychosoc Nurs Ment Health Serv. 2015;
physical function measures in a diverse US population-based cohort 53(5):15-19. doi:10.3928/02793695-20150330-01.
of cancer patients. Qual life Res. 2015;24(10):2333-2344. doi:10.1007/ 45. Sams N, Fisher DM, Mata-Greve F, et al. Understanding psycholog-
s11136-015-0992-9. ical distress and protective factors amongst older adults during the
37. PROMIS Health Organization. Emotional Distress-Anxiety-Short COVID-19 pandemic. Am J Geriatr Psychiatry. 2021;29(9):881-894.
Form 6a. https://www.healthmeasures.net/index.php?option=com_ doi:10.1016/j.jagp.2021.03.005.
instruments&view=measure&id=145&Itemid=992. Published 2020. 46. Gonçalves AR, Barcelos JLM, Duarte AP, et al. Perceptions, feelings,
38. Liu W, Dindo L, Hadlandsmyth K, et al. Item response theory analy- and the routine of older adults during the isolation period caused by the
sis: PROMIS® Anxiety Form and Generalized Anxiety Disorder Scale COVID-19 pandemic: a qualitative study in four countries. Aging Ment
[published online ahead of print May 17, 2021]. West J Nurs Res. Health. 2021:1-8. doi:10.1080/13607863.2021.1891198.
doi:10.1177/01939459211015985. 47. Finlay JM, Kler JS, O’Shea BQ, Eastman MR, Vinson YR, Kobayashi
39. Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends LC. Coping during the COVID-19 pandemic: a qualitative study of
in the use of complementary health approaches among adults: United older adults across the United States. Front Public Health. 2021;9:
States, 2002-2012. Natl Health Stat Report. 2015;(79):1-16. https:// 643807. doi:10.3389/fpubh.2021.643807.
pubmed.ncbi.nlm.nih.gov/25671660. 48. Lee FC, Adams L, Graves SJ, et al. Counties with high COVID-19
40. Alawiyah T, Bell H, Pyles L, Runnels RC. Spirituality and faith- incidence and relatively large racial and ethnic minority populations—
based interventions: pathways to disaster resilience for African United States, April 1-December 22, 2020. MMWR Morb Mortal Wkly
American Hurricane Katrina survivors. J Relig Spiritual Soc Rep. 2021;70(13):483-489. doi:10.15585/mmwr.mm7013e1.

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F E AT U R E S

Coping With Uncertainty

Pandemic in the United States

older adults with regard to sociodemographic, health,

sociodemographic, health, and psychological minutes or less to 30 minutes or more; reported as

on whether participants used meditation and prayer

Analytic plan TABLE 1. Demographic Characteristics of Study

based on frequency before and during the pandemic. 65%

FIGURE 3. Frequency of prayer use before and during the pandemic.

0.05 (0.54)a 0.05 (0.55)a 0.01 (0.65)a

Abbreviations: CI, conﬁdence interval; SE, standard error.

Intercept 0.72 (0.46) 0.57 (0.47) 0.46 (0.53)

Abbreviations: CI, conﬁdence interval; SE, standard error.

higher incomes29,32,33 and greater rates of prayer

frequencies (amount), a significant relationship effect of income may be explained by education, as

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