{"paper_id":"36d7f1c1-4fbd-4518-a6af-2c21c74c4bf2","body_text":"Relationships between in-person and remote religious attendance and loneliness, quality of life, stress and anxiety among older adults during covid-19 in ireland | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Relationships between in-person and remote religious attendance and loneliness, quality of life, stress and anxiety among older adults during covid-19 in ireland Brendan O'Maoileidigh, Mark Ward, Rose Anne Kenny, Siobhan Scarlett This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4631672/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Religious attendance has been shown to have a positive effect on psychological health among the older people [1]. Due to COVID-19 lockdown restrictions and precautionary health advice, many older adults struggled to attend service in-person. However, 87% of faith organisations provided a form of remote service between June and December 2020 [2]. Methods Data were from Wave 6 (2021) of The Irish Longitudinal Study on Ageing (TILDA). Data were collected via telephone interview and self-completion questionnaires. The analysis sample was made up of 3,961 community-dwelling adults living in Ireland aged 60 years and older. To assess religious attendance, participants were asked about how often they attended in-person and how often they attended remotely using radio, television, or internet streaming. Relationships between religious attendance, Quality of Life (QoL), Loneliness, Stress, and Anxiety were modelled using linear regressions. Results The sample was 44.1% male and 55.9% female, with a mean age of 72.0 years. In-person religious attendance was positively related to higher QoL [Beta=192.92, 95% Confidence Intervals (CI)=9.45, 376.39, p<0.05]. Remote religious attendance was positively related to higher anxiety [IRR=1.03, 95% CI=1.02, 1.04, p<0.001]. Conclusion Results show that in-person attendance was positively related to QoL, while remote attendance was positively related to higher anxiety. This may be a result of the lack of social connectedness felt when practicing religion remotely or the higher level of anxiety during the COVID-19 pandemic. Future research should focus on social connectedness felt during in-person religious practice and during remote practice. Introduction Traditionally, Roman Catholicism has permeated the culture in Ireland [ 3 ] with 81.6% of adults living in Ireland aged 60 and older identifying as Roman Catholic (CSO, 2022). In person religious attendance remains a highly prevalent activity among older people in Ireland, with over 50% of older adults reporting attending religious service at least once per week prior to the pandemic [ 4 ]. During the COVID-19 pandemic, older adults were advised to decrease social interaction, with those aged over 70 being advised to cocoon themselves, a form of extreme isolation (Health Service Executive, 2020). These restrictions combined with fear of contact with COVID made in person religious practice far less accessible during the pandemic period for older adults in Ireland. During the pandemic period, older adults in Ireland reported on average higher loneliness, depression, stress, as well as lower quality of life (QoL) [ 5 , 6 ]. In a study of 150 patients aged 70 and older who were in ambulatory hospital care, 40% reported lower mental health, 57% reported experiencing loneliness at least some of the time, and 50% reported a decline in QoL [ 7 ]. Religious participation has been shown to be associated with lower anxiety and stress and higher quality of life [ 1 , 8 , 9 ]. It is also associated with lower loneliness [ 10 ]. In-person religious attendance was associated with higher quality of life among older community dwelling adults [ 1 ]. It has also been shown to encourage healthy coping practice during times of adversity [ 8 , 9 , 11 ]. It is therefore likely that in a time of adversity such as the pandemic, barriers to access would have hindered these positive effects. At various points during the COVID-19 pandemic period, access to in person religious service was restricted by various levels of lockdown. Additionally, older adults were warned that they were at higher risk of complications from the virus and advised to practice extreme social isolation [ 12 ]These barriers to access may have led to an increase in remote religious attendance. Ganiel [ 2 ] surveyed 439 religious institutions in Ireland and found that 87% of them offered some form of online religious service during the pandemic. Kretzler [ 13 ], also found that those who use online religious services tend to be older. Bentzen [ 14 ] found that Google searches for prayer increased by 50% in 98 countries including Ireland. This suggests that, as barriers to in person participation increased due to the COVID-19 pandemic, remote religious practice became more popular. This research aims to assess the impact of both in-person and remote religious practice on loneliness, quality of life, anxiety, and stress. Specifically, we hypothesise that, because of the protective effect of religious practice and the healthy coping behaviours encouraged by religious practice, adults aged 60 and older who report higher in-person and remote religious attendance will have higher on average QoL, and lower on average stress, loneliness, and anxiety. Methods Criteria for inclusion in the sample were if participant completed the in person religious attendance and remote religious attendance questions as well as at least one of the measures for anxiety, stress, QoL, and loneliness. This left a sample made up of 3,223 people aged 60 or older living in Ireland. Data were from The Irish Longitudinal Study on Ageing (TILDA), a nationally representative, multidisciplinary, longitudinal study of the Irish population aged 50 and older and their partners of any age [ 15 ]. TILDA utilises a comprehensive nationally representative sampling frame system based on the Irish Geodirectory, a listing of all private residential addresses, allowing for a multi-stage sampling approach [ 15 ]. First, all residential addresses were grouped into clusters proportionate of socio-economic group, then a set of addresses within each cluster (n = 50) were selected with 10 in reserve [ 15 ]. A total of 25,600 addresses were visited with 8,178 participants agreeing to participate in the study, achieving a response rate of 62.0% [ 15 , 16 ]. Commencing in 2009, TILDA has collected data every two years, with a health assessment every four years [ 16 ]. A listwise deletion method was implemented whereby missing data were excluded from the model. As of 2022, TILDA has collected six waves of survey data; the first five using computer assisted personal interviews (CAPI). During Wave 6, TILDA used computer assisted telephone interviews (CATI) in line with COVID-19 guidelines. Ethical approval for TILDA was obtained from the College Ethics Committee, and informed consent was obtained from all participants prior to data collection. Data used for the present study were from Wave 6. Data collection took place via CATI from January 2021 to January 2022. Data collection began roughly ten months after the first COVID-19 lockdown in Ireland. The data collection period included various stages of lockdown restrictions. Key variables: Religious Participation: In-person religious attendance was assessed using a single item measure as part of a Computer Assisted Telephone Interview (CATI). Participants who were affiliated with a religion were asked “About how often do you go to religious services?” Response options ranged between 1 (more than once per week) and 6 (never/almost never). Remote religious participation was assessed with the following question: “How often do you participate in religion on radio, tv, or internet?” Response options ranged between 1 (more than once per week) and 6 (never/almost never). For ease of interpretation, both religious participation items were reverse coded. Participants who reported having no religious affiliation were routed past this question. These participants were added back during the analysis and coded as 0. This made for a range of 0 (non-religious) to 6 (More than once per week). Measurements of Anxiety, Stress, Loneliness, And QoL: Anxiety Anxiety was measured using the Generalized Anxiety Disorder (GAD-7) [ 17 ]. The GAD-7 uses a four-point Likert format and includes seven items. It is an accessible and relatively quick measurement of subjective anxiety. Possible responses are 0 “not at all” 1 “several days” 2 “more than half the days” and 3 “nearly every day”. Scores from each response are summed for a total possible score ranging from 0–21, with higher scores representing greater levels of anxiety. Loneliness : a modified version of the University of California Los Angeles (UCLA) Loneliness scale [ 18 ] was used to measure loneliness. This modified scale asks five questions: four positively framed, and one negatively framed question. The scale offers three response options: 0 (Hardly ever or never), 1 (Some of the time), and 2(Often). The scale is summed, ranging from 0–15, with higher scores representing higher levels of loneliness. Stress Stress was measured using The Perceived Stress Scale-4 (PSS-4) [ 19 ] [ 20 ]. The PSS-4 is a four item, five-point Likert scale that is designed to be a short, reliable, and accessible measure of subjective stress. The scale is summed, ranging from 0–16, with higher scores representing higher levels of stress. Quality of Life (QoL) The Control, Autonomy, Pleasure, and Self-Realization-12 (CASP-12) [ 21 ] was designed to measure subjective quality of life in older people. This 12 item Likert scale is a highly reliable and valid and has been used previously in examining the older adults living in Ireland [ 22 ]. The scale is summed, with scores ranging from zero to 36, and higher scores indicating higher levels of quality of life. Control variables: Several known covariates of the dependent variables were controlled for, including age, gender (male, female), education (primary, secondary, third), self-rated physical health (Excellent, Very Good, Good, Fair, Poor), marital status (Married, Widowed, Divorced, Never Married) and living alone (Alone/Not Alone) [ 23 – 25 ]. Concern about COVID and having a disability were controlled for because it was assumed that these participants would be more likely to attend remotely. To measure this, participants were asked whether illness or disability limit activities in any way. Response options were “Yes” or “No”. Concern about COVID was also controlled for by asking participants “Overall, how concerned are you about the COVID-19 pandemic?” Response options ranged from 1 (Least Concerned) to 10 (Most Concerned). Comorbidities were also controlled for. A variable was also derived from several variables asking about having any comorbidities. This new variable was coded 0 for no comorbidities and 1 for having a comorbidity. Analytic Strategy: Cross-sectional analytic framework was used to identify associations and test hypotheses. The choice of regression analysis was informed by the measurement type of each outcome variable. Ordinary Least Squares regression models were used to model the relationship between in-person and remote religious attendance and stress, and QoL. Prior to analysis model assumptions were tested using residual plots and histograms. Both the anxiety and loneliness variables were zero-inflated and approximated a Poisson distribution, and therefore, a Poisson regression was used for these two outcomes. The QoL variable was negatively skewed violating the assumption of normality so, prior to analysis, a cubic transformation was used to ensure the suitability of the variable. Missing data were dropped using a listwise deletion method; any case with a missing value in one or more of the religion or psychological health variables were dropped. Statistical analyses were performed using Stata version 15.1 (StataCorp. 2017, StataCorp LLC). Statistical significance was set at p < 0.05. For each of the Poisson models, results are presented with incidence rate ratios (IRR) and 95% confidence intervals (CI). This is a relative difference measure used to compare the incidence rates of an event and can be interpreted as plus or minus 1, with values below 1 indicating a negative relationship and values above 1 indicating a positive relationship. Results 44.1% identified as male and 55.9% identified as female. 42.4% reported having at least a third level education while 18.2% reported having a primary school or lower education. 69.9% of the sample reported being married. Table 1 Sample descriptive statistics Sample Characteristic Wave 6 Gender, % Female 55.9% Male 44.1% Marital Status, % Married 69.9% Never Married 8.5% Separated/Divorced 6.8% Widowed 14.8% Highest Level of Education % Primary/ None 18.2% Secondary 39.4% Third/Higher 42.4% Age (years), mean (SD) 72.0 (7.8) Lives Alone, % Alone 23.53% Not alone 76.47% Long Term Illness, % 44.1% Chronic Condition, % 60.3% COVID Concern, mean (SD) 6.9 (2.4) CASP Quality of Life Total Score, mean (SD) 27.7 (5.3) GAD-7 Anxiety Score, mean (SD) 2.4 (3.9) PSS Stress Score, mean (SD) 4.2 (3.0) UCLA Loneliness Score, mean (SD) 1.8 (2.1) Table 2 describes the sample by religious affiliation, frequency of in person religious attendance, and frequency of remote religious attendance. The sample was overwhelmingly Roman Catholic (85.2%). 46.1% of the sample reported attending religious service in person at least once per week, while 43.1% reported attending religious service remotely via radio, television, or internet streaming. Table 2 Sample broken down by religious affiliation and frequency of attendance. Variable % Religious Affiliation Roman Catholic 85.2 Anglican/ Church of Ireland 2.9 Other 2.8 Non-religious 8.3 Remote Attendance (Those who have religious affiliation) Never/ Almost Never 28.6 Once or Twice a Year 11.9 Every Few Months 6.6 Once or Twice a Month 6.6 Once a Week 36.1 More than Once Per Week 10.0 Remote Attendance (Those who have religious affiliation) Never/ Almost Never 44.2 Once or Twice a Year 3.4 Every Few Months 3.1 Once or Twice a Month 5.9 Once a Week 26.1 More than Once Per Week 17.0 Table 3 describes the results of the linear regression models. In-person attendance was positively associated with higher QoL [Beta(B) = 192.92, 95% CI = 9.45, 376.39, p < 0.05]. There was also a trend with in-person attendance being negatively related to Loneliness [IRR = 0.99, 95% CI = 0.99-1.00, p = 0.050], however this did not reach statistical significance. Remote attendance was not significantly associated with QoL, Stress, or Loneliness, but was significantly related to higher Anxiety [IRR = 1.03, 95% CIs = 1.02, 1.04, p < 0.001]. Prior to cubic transformation, in-person attendance was also significantly associated positively with QoL [B = 0.19, 95% CI = 0.10,0.29, p < 0.001]. Table 3 Results of multiple linear regression models QoL Anxiety Stress Loneliness B 95% CIs IRR 95% CIs B 95% CIs IRR 95% CIs In-person Attendance 192.92* 9.45, 376.39 1.01 0.99, 1.02 -0.01 -0.04, 0.06 0.99 0.97, 1.00 Remote Attendance 12.17 -161.44, 185.78 1.03*** 1.02, 1.04 0.04 -0.02, 0.08 1.00 0.99, 1.01 Models controlled for age education marital status sex self-rated physical health Covid Concern Limiting Disability, and comorbidity. *Indicates p value less than 0.05 **indicates p value less than 0.01 ***indicates p values less than 0.001 To further examine potential differences between in-person and remote religious attendance on psychological health, a sensitivity analysis was conducted to first model this relationship while excluding participants who reported never attending in-person, and subsequently model the relationship with participants excluding those who reported never using remote services. The results of the sensitivity analysis showed that in-person attendance was still associated with lower anxiety when participants who also reported using remote services at least once per month were removed [IRR = 0.98, 95% CI = 0.96, 0.99, p < 0.05]. Remote religious practice was also still found to be associated with higher anxiety when participants who had reported attending religious service in-person at least once per month were removed [IRR = 1.03, 95% CI = 1.01, 1.05, p < 0.001] (Table S1). Discussion This research examined the relationship between religious attendance and loneliness, QoL, stress, and anxiety during a period of great adversity and social isolation: the COVID-19 pandemic. Results provided evidence of a positive relationship between in-person attendance and QoL. Loneliness was also shown to trend downward despite not reaching statistical significance. In-person religious attendance has already been shown to have a beneficial effect on psychological health [ 1 , 8 , 9 ] and loneliness[ 10 ]. It has also been shown to encourage healthy coping behaviours [ 8 , 9 , 11 ]. Thus, during the COVID-19 pandemic, a time of uncertainty and adversity, those who were able to attend in-person may have been able to cope with anxiety better than those who could not. Remote religious practice, however, was found to be significantly associated with greater anxiety, even when concern over covid was controlled for. This result is similar to the results found in a study examining the relationship between religious involvement and anxiety among older adults in Ireland whereby frequency of prayer outside of religious service was found to be positively related to higher anxiety [ 26 ]. These results may be reflective of the social isolation experienced by older adults during the pandemic, meaning that anxiety was being driven by the social isolation that people who were using remote attendance experienced rather than the concern over the pandemic. Older adults were advised to avoid socialization and practice extreme isolation (Health Service Executive, 2020) which meant staying isolated from friends and family, restricted access to social activities and clubs, and even shopping at special times to avoid the general population. These results may also be indicative of the missing social benefit found from attending in person [ 4 , 10 ]. Older people experienced many barriers to in person social activities, including a religious community that could be interacted with in person. It should also be noted that the sensitivity analysis, which separated participants who only attend in person and those who only attend remotely, held the same result that remote religious attendance is significantly positively related to greater anxiety. In person religious attendance became significantly related to lower anxiety and lower loneliness when those who used remote attendance were removed. Data was also collected at various points throughout the pandemic, thus participants who were interviewed during higher levels of restrictions may have been feeling more anxious while at the same time being unable to attend in person religious service. Vaccinations were also not available for the entirety of data collection and participants who may not have had one when they were interviewed may have reported more anxiety. What’s more, when those who attended religious services online at all were dropped, in person religious participation predicted significantly lower anxiety. When those who had attended in person were dropped, remote attendance was still associated with higher anxiety. This study had several limitations. First, the use of cross-sectional survey data made measuring the change in religious practice and stress, loneliness, QoL, and anxiety over the COVID-19 pandemic impossible. Data was collected between January 2021 and January 2022, and while COVID was present through the entire time period, there were varying levels of lockdown restrictions throughout the year. Second, the use of single item responses to measure attendance rather than comprehensive scales. These items did not allow for the measurement of the complexities of religious participation such as spirituality, social benefit, or meaning and purpose. In addition, these measures fail to account for spirituality and intrinsic religious practice, which has been shown to have a positive effect on anxiety and stress [ 27 ]. This study also has several strengths. The use of a large nationally representative sample made for more accurate and generalizable results with smaller margin of error. Additionally, the use of data collected during a unique point in time; the COVID-19 pandemic period. Future research should include comprehensive spirituality measures as a dependent variable to capture the complex intrinsic facets of religious practice and spirituality as these facets of religious practice may be more protective against negative mental health outcomes than simple attendance alone. Future research should also focus on social connectedness felt during in-person and remote religious practice as this study could only measure social connectedness. Conclusion During the COVID-19 pandemic, older Irish adults were advised to socially isolate. This limited social participation in many ways, including in-person religious attendance. This study set out to examine whether religious attendance, both in-person and remotely, had a positive effect on stress, loneliness, QoL, and stress among older adults living in Ireland during the COVID-19 pandemic period. While in-person attendance was shown to have a beneficial effect on QoL, remote religious practice was shown to have a negative effect on anxiety. Declarations Author Contribution B.O. wrote the main manuscript text and prepared all tablesM.W. procured funding and supervisedR.A.K procured funding and supervisedS.S. Supervised and did main revisionsAll authors reviewed the manuscript Data Availability The publicly accessible dataset files are hosted by the Irish Social Science Data Archive based in University College Dublin.Researchers wishing to access the data must complete a request form available on the ISSDA website: References Moon YS, Kim DH (2013) Association between religiosity/spirituality and quality of life or depression among living-alone elderly in a South Korean city. Asia-Pac Psychiatry 5:293–300 Ganiel G (2021) Online Opportunities in Secularizing Societies? Clergy and the COVID-19 Pandemic in Ireland. Religions 12:437 Inglis T (2017) Church and Culture in Catholic Ireland. Stud Ir Q Rev 106:21–30 Orr J, Tobin K, Kenny RA et al (2019) Religious Attendance, Religious Importance, and the Pathways to Depressive Symptoms in Men and Women Aged 50 and Over Living in Ireland. 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Res Aging 41:891–911 Vitorino LM, Lucchetti G, Leão FC et al (2018) The association between spirituality and religiousness and mental health. Sci Rep 8:17233 Appendix Table S1: Sensitivity analysis results QoL Anxiety Stress Loneliness B 95% CIs IRR 95% CIs B 95% CIs IRR 95% CIs In-person Attendance Without Participants who Reported engaging in Remote Religion 590.99*** 242.07, 939.92 0.98* 0.96, 0.99 -0.10* -0.19, -0.00 0.96*** 0.94, 0.98 Remote Attendance Without Participants who Reported Attending in-person -76.25 -316.63, 164.12 1.03*** 1.01, 1.04 0.02 -0.04, 0.09 0.99 0.981.01 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-4631672\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":327019772,\"identity\":\"8cf7176a-00e2-465b-a6f7-003ce393d0db\",\"order_by\":0,\"name\":\"Brendan O'Maoileidigh\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAr0lEQVRIiWNgGAWjYBACAwhpwcAPpCSgXKK0SDBItpGmBaT4GIgkBpizdyd++FAgIWd8v/nhDYYCG8JaLHvObpacYSBhbHaMzdiCwSCNCIfdyN0gzWMgkbjtGA8b0HmHidKy+TdQS/3mNrCW/0Rp2QayJcGADazlAGEtQL9sswT6xXDGsTRjiwSDZMJazNl7N9/48MdGnr/58EMgw46wFlSQQKqGUTAKRsEoGAXYAQD6zjIMNxr3KwAAAABJRU5ErkJggg==\",\"orcid\":\"\",\"institution\":\"Trinity College Dublin\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Brendan\",\"middleName\":\"\",\"lastName\":\"O'Maoileidigh\",\"suffix\":\"\"},{\"id\":327019774,\"identity\":\"3f07c93c-711f-446a-abb4-67a2c27ab61e\",\"order_by\":1,\"name\":\"Mark Ward\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Trinity College Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Mark\",\"middleName\":\"\",\"lastName\":\"Ward\",\"suffix\":\"\"},{\"id\":327019775,\"identity\":\"da472962-3a2e-4a10-b88c-0e1fa7b376d7\",\"order_by\":2,\"name\":\"Rose Anne Kenny\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Trinity College Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Rose\",\"middleName\":\"Anne\",\"lastName\":\"Kenny\",\"suffix\":\"\"},{\"id\":327019776,\"identity\":\"19a4e369-e42e-47cb-a714-d4923bc3887f\",\"order_by\":3,\"name\":\"Siobhan Scarlett\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Trinity College Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Siobhan\",\"middleName\":\"\",\"lastName\":\"Scarlett\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2024-06-24 17:11:01\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-4631672/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-4631672/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":61173766,\"identity\":\"1f5a7768-be9f-468f-9aee-4bfe9bd39ad7\",\"added_by\":\"auto\",\"created_at\":\"2024-07-26 15:01:45\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":568819,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-4631672/v1/2711ef3b-0d9e-4683-b302-12e7e808081f.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Relationships between in-person and remote religious attendance and loneliness, quality of life, stress and anxiety among older adults during covid-19 in ireland\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eTraditionally, Roman Catholicism has permeated the culture in Ireland [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e] with 81.6% of adults living in Ireland aged 60 and older identifying as Roman Catholic (CSO, 2022). In person religious attendance remains a highly prevalent activity among older people in Ireland, with over 50% of older adults reporting attending religious service at least once per week prior to the pandemic [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. During the COVID-19 pandemic, older adults were advised to decrease social interaction, with those aged over 70 being advised to cocoon themselves, a form of extreme isolation (Health Service Executive, 2020). These restrictions combined with fear of contact with COVID made in person religious practice far less accessible during the pandemic period for older adults in Ireland. During the pandemic period, older adults in Ireland reported on average higher loneliness, depression, stress, as well as lower quality of life (QoL) [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. In a study of 150 patients aged 70 and older who were in ambulatory hospital care, 40% reported lower mental health, 57% reported experiencing loneliness at least some of the time, and 50% reported a decline in QoL [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eReligious participation has been shown to be associated with lower anxiety and stress and higher quality of life [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. It is also associated with lower loneliness [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. In-person religious attendance was associated with higher quality of life among older community dwelling adults [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. It has also been shown to encourage healthy coping practice during times of adversity [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. It is therefore likely that in a time of adversity such as the pandemic, barriers to access would have hindered these positive effects.\\u003c/p\\u003e \\u003cp\\u003eAt various points during the COVID-19 pandemic period, access to in person religious service was restricted by various levels of lockdown. Additionally, older adults were warned that they were at higher risk of complications from the virus and advised to practice extreme social isolation [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]These barriers to access may have led to an increase in remote religious attendance. Ganiel [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e] surveyed 439 religious institutions in Ireland and found that 87% of them offered some form of online religious service during the pandemic. Kretzler [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e], also found that those who use online religious services tend to be older. Bentzen [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e] found that Google searches for prayer increased by 50% in 98 countries including Ireland. This suggests that, as barriers to in person participation increased due to the COVID-19 pandemic, remote religious practice became more popular.\\u003c/p\\u003e \\u003cp\\u003eThis research aims to assess the impact of both in-person and remote religious practice on loneliness, quality of life, anxiety, and stress. Specifically, we hypothesise that, because of the protective effect of religious practice and the healthy coping behaviours encouraged by religious practice, adults aged 60 and older who report higher in-person and remote religious attendance will have higher on average QoL, and lower on average stress, loneliness, and anxiety.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cp\\u003eCriteria for inclusion in the sample were if participant completed the in person religious attendance and remote religious attendance questions as well as at least one of the measures for anxiety, stress, QoL, and loneliness. This left a sample made up of 3,223 people aged 60 or older living in Ireland. Data were from The Irish Longitudinal Study on Ageing (TILDA), a nationally representative, multidisciplinary, longitudinal study of the Irish population aged 50 and older and their partners of any age [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. TILDA utilises a comprehensive nationally representative sampling frame system based on the Irish Geodirectory, a listing of all private residential addresses, allowing for a multi-stage sampling approach [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. First, all residential addresses were grouped into clusters proportionate of socio-economic group, then a set of addresses within each cluster (n\\u0026thinsp;=\\u0026thinsp;50) were selected with 10 in reserve [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. A total of 25,600 addresses were visited with 8,178 participants agreeing to participate in the study, achieving a response rate of 62.0% [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. Commencing in 2009, TILDA has collected data every two years, with a health assessment every four years [\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. A listwise deletion method was implemented whereby missing data were excluded from the model.\\u003c/p\\u003e \\u003cp\\u003eAs of 2022, TILDA has collected six waves of survey data; the first five using computer assisted personal interviews (CAPI). During Wave 6, TILDA used computer assisted telephone interviews (CATI) in line with COVID-19 guidelines. Ethical approval for TILDA was obtained from the College Ethics Committee, and informed consent was obtained from all participants prior to data collection.\\u003c/p\\u003e \\u003cp\\u003eData used for the present study were from Wave 6. Data collection took place via CATI from January 2021 to January 2022. Data collection began roughly ten months after the first COVID-19 lockdown in Ireland. The data collection period included various stages of lockdown restrictions.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eKey variables:\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eReligious Participation:\\u003c/h2\\u003e \\u003cp\\u003eIn-person religious attendance was assessed using a single item measure as part of a Computer Assisted Telephone Interview (CATI). Participants who were affiliated with a religion were asked \\u0026ldquo;About how often do you go to religious services?\\u0026rdquo; Response options ranged between 1 (more than once per week) and 6 (never/almost never). Remote religious participation was assessed with the following question: \\u0026ldquo;How often do you participate in religion on radio, tv, or internet?\\u0026rdquo; Response options ranged between 1 (more than once per week) and 6 (never/almost never).\\u003c/p\\u003e \\u003cp\\u003eFor ease of interpretation, both religious participation items were reverse coded. Participants who reported having no religious affiliation were routed past this question. These participants were added back during the analysis and coded as 0. This made for a range of 0 (non-religious) to 6 (More than once per week).\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eMeasurements of Anxiety, Stress, Loneliness, And QoL:\\u003c/h2\\u003e \\u003cp\\u003e \\u003cstrong\\u003eAnxiety\\u003c/strong\\u003e \\u003cp\\u003eAnxiety was measured using the Generalized Anxiety Disorder (GAD-7) [\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e]. The GAD-7 uses a four-point Likert format and includes seven items. It is an accessible and relatively quick measurement of subjective anxiety. Possible responses are 0 \\u0026ldquo;not at all\\u0026rdquo; 1 \\u0026ldquo;several days\\u0026rdquo; 2 \\u0026ldquo;more than half the days\\u0026rdquo; and 3 \\u0026ldquo;nearly every day\\u0026rdquo;. Scores from each response are summed for a total possible score ranging from 0\\u0026ndash;21, with higher scores representing greater levels of anxiety.\\u003c/p\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cb\\u003eLoneliness\\u003c/b\\u003e: a modified version of the University of California Los Angeles (UCLA) Loneliness scale [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e] was used to measure loneliness. This modified scale asks five questions: four positively framed, and one negatively framed question. The scale offers three response options: 0 (Hardly ever or never), 1 (Some of the time), and 2(Often). The scale is summed, ranging from 0\\u0026ndash;15, with higher scores representing higher levels of loneliness.\\u003c/p\\u003e \\u003cp\\u003e \\u003cstrong\\u003eStress\\u003c/strong\\u003e \\u003cp\\u003eStress was measured using The Perceived Stress Scale-4 (PSS-4) [\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e] [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. The PSS-4 is a four item, five-point Likert scale that is designed to be a short, reliable, and accessible measure of subjective stress. The scale is summed, ranging from 0\\u0026ndash;16, with higher scores representing higher levels of stress.\\u003c/p\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cstrong\\u003eQuality of Life (QoL)\\u003c/strong\\u003e \\u003cp\\u003eThe Control, Autonomy, Pleasure, and Self-Realization-12 (CASP-12) [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e] was designed to measure subjective quality of life in older people. This 12 item Likert scale is a highly reliable and valid and has been used previously in examining the older adults living in Ireland [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e]. The scale is summed, with scores ranging from zero to 36, and higher scores indicating higher levels of quality of life.\\u003c/p\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eControl variables:\\u003c/h2\\u003e \\u003cp\\u003eSeveral known covariates of the dependent variables were controlled for, including age, gender (male, female), education (primary, secondary, third), self-rated physical health (Excellent, Very Good, Good, Fair, Poor), marital status (Married, Widowed, Divorced, Never Married) and living alone (Alone/Not Alone) [\\u003cspan additionalcitationids=\\\"CR24\\\" citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eConcern about COVID and having a disability were controlled for because it was assumed that these participants would be more likely to attend remotely. To measure this, participants were asked whether illness or disability limit activities in any way. Response options were \\u0026ldquo;Yes\\u0026rdquo; or \\u0026ldquo;No\\u0026rdquo;. Concern about COVID was also controlled for by asking participants \\u0026ldquo;Overall, how concerned are you about the COVID-19 pandemic?\\u0026rdquo; Response options ranged from 1 (Least Concerned) to 10 (Most Concerned). Comorbidities were also controlled for. A variable was also derived from several variables asking about having any comorbidities. This new variable was coded 0 for no comorbidities and 1 for having a comorbidity.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eAnalytic Strategy:\\u003c/h2\\u003e \\u003cp\\u003eCross-sectional analytic framework was used to identify associations and test hypotheses. The choice of regression analysis was informed by the measurement type of each outcome variable. Ordinary Least Squares regression models were used to model the relationship between in-person and remote religious attendance and stress, and QoL. Prior to analysis model assumptions were tested using residual plots and histograms. Both the anxiety and loneliness variables were zero-inflated and approximated a Poisson distribution, and therefore, a Poisson regression was used for these two outcomes. The QoL variable was negatively skewed violating the assumption of normality so, prior to analysis, a cubic transformation was used to ensure the suitability of the variable.\\u003c/p\\u003e \\u003cp\\u003eMissing data were dropped using a listwise deletion method; any case with a missing value in one or more of the religion or psychological health variables were dropped. Statistical analyses were performed using Stata version 15.1 (StataCorp. 2017, StataCorp LLC). Statistical significance was set at p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05.\\u003c/p\\u003e \\u003cp\\u003eFor each of the Poisson models, results are presented with incidence rate ratios (IRR) and 95% confidence intervals (CI). This is a relative difference measure used to compare the incidence rates of an event and can be interpreted as plus or minus 1, with values below 1 indicating a negative relationship and values above 1 indicating a positive relationship.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003e44.1% identified as male and 55.9% identified as female. 42.4% reported having at least a third level education while 18.2% reported having a primary school or lower education. 69.9% of the sample reported being married.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSample descriptive statistics\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"2\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSample Characteristic\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eWave 6\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGender, %\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e55.9%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44.1%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eMarital Status, %\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e69.9%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNever Married\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e8.5%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSeparated/Divorced\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6.8%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eWidowed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14.8%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eHighest Level of Education %\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePrimary/ None\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e18.2%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSecondary\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e39.4%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eThird/Higher\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e42.4%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge (years), mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e72.0 (7.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eLives Alone, %\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAlone\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23.53%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNot alone\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e76.47%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eLong Term Illness, %\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44.1%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eChronic Condition, %\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e60.3%\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCOVID Concern, mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6.9 (2.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCASP Quality of Life Total Score, mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e27.7 (5.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eGAD-7 Anxiety Score, mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.4 (3.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePSS Stress Score, mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4.2 (3.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eUCLA Loneliness Score, mean (SD)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1.8 (2.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e describes the sample by religious affiliation, frequency of in person religious attendance, and frequency of remote religious attendance. The sample was overwhelmingly Roman Catholic (85.2%). 46.1% of the sample reported attending religious service in person at least once per week, while 43.1% reported attending religious service remotely via radio, television, or internet streaming.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSample broken down by religious affiliation and frequency of attendance.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"2\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eVariable\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e%\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eReligious Affiliation\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRoman Catholic\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e85.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAnglican/ Church of Ireland\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOther\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNon-religious\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e8.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRemote Attendance (Those who have religious affiliation)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNever/ Almost Never\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e28.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce or Twice a Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEvery Few Months\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce or Twice a Month\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce a Week\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e36.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMore than Once Per Week\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRemote Attendance (Those who have religious affiliation)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNever/ Almost Never\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce or Twice a Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eEvery Few Months\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce or Twice a Month\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOnce a Week\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e26.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMore than Once Per Week\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e17.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e describes the results of the linear regression models. In-person attendance was positively associated with higher QoL [Beta(B)\\u0026thinsp;=\\u0026thinsp;192.92, 95% CI\\u0026thinsp;=\\u0026thinsp;9.45, 376.39, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05].\\u003c/p\\u003e \\u003cp\\u003eThere was also a trend with in-person attendance being negatively related to Loneliness [IRR\\u0026thinsp;=\\u0026thinsp;0.99, 95% CI\\u0026thinsp;=\\u0026thinsp;0.99-1.00, p\\u0026thinsp;=\\u0026thinsp;0.050], however this did not reach statistical significance. Remote attendance was not significantly associated with QoL, Stress, or Loneliness, but was significantly related to higher Anxiety [IRR\\u0026thinsp;=\\u0026thinsp;1.03, 95% CIs\\u0026thinsp;=\\u0026thinsp;1.02, 1.04, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001]. Prior to cubic transformation, in-person attendance was also significantly associated positively with QoL [B\\u0026thinsp;=\\u0026thinsp;0.19, 95% CI\\u0026thinsp;=\\u0026thinsp;0.10,0.29, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001].\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eResults of multiple linear regression models\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"9\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c3\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eQoL\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c5\\\" namest=\\\"c4\\\"\\u003e \\u003cp\\u003eAnxiety\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c7\\\" namest=\\\"c6\\\"\\u003e \\u003cp\\u003eStress\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c9\\\" namest=\\\"c8\\\"\\u003e \\u003cp\\u003eLoneliness\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eB\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e95% CIs\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eIRR\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e95% CIs\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eB\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e95% CIs\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eIRR\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e95% CIs\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eIn-person Attendance\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e192.92*\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.45, 376.39\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.01\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.99, 1.02\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e-0.01\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e-0.04, 0.06\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0.99\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.97, 1.00\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eRemote Attendance\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12.17\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-161.44, 185.78\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.03***\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1.02, 1.04\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0.04\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e-0.02, 0.08\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1.00\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.99, 1.01\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\\u003cp\\u003eModels controlled for age education marital status sex self-rated physical health Covid Concern Limiting Disability, and comorbidity.\\u003c/p\\u003e \\u003cp\\u003e*Indicates p value less than 0.05\\u003c/p\\u003e \\u003cp\\u003e**indicates p value less than 0.01\\u003c/p\\u003e \\u003cp\\u003e***indicates p values less than 0.001\\u003c/p\\u003e \\u003cp\\u003eTo further examine potential differences between in-person and remote religious attendance on psychological health, a sensitivity analysis was conducted to first model this relationship while excluding participants who reported never attending in-person, and subsequently model the relationship with participants excluding those who reported never using remote services. The results of the sensitivity analysis showed that in-person attendance was still associated with lower anxiety when participants who also reported using remote services at least once per month were removed [IRR\\u0026thinsp;=\\u0026thinsp;0.98, 95% CI\\u0026thinsp;=\\u0026thinsp;0.96, 0.99, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05]. Remote religious practice was also still found to be associated with higher anxiety when participants who had reported attending religious service in-person at least once per month were removed [IRR\\u0026thinsp;=\\u0026thinsp;1.03, 95% CI\\u0026thinsp;=\\u0026thinsp;1.01, 1.05, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001] (Table S1).\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis research examined the relationship between religious attendance and loneliness, QoL, stress, and anxiety during a period of great adversity and social isolation: the COVID-19 pandemic. Results provided evidence of a positive relationship between in-person attendance and QoL. Loneliness was also shown to trend downward despite not reaching statistical significance.\\u003c/p\\u003e \\u003cp\\u003eIn-person religious attendance has already been shown to have a beneficial effect on psychological health [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e] and loneliness[\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. It has also been shown to encourage healthy coping behaviours [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. Thus, during the COVID-19 pandemic, a time of uncertainty and adversity, those who were able to attend in-person may have been able to cope with anxiety better than those who could not.\\u003c/p\\u003e \\u003cp\\u003eRemote religious practice, however, was found to be significantly associated with greater anxiety, even when concern over covid was controlled for. This result is similar to the results found in a study examining the relationship between religious involvement and anxiety among older adults in Ireland whereby frequency of prayer outside of religious service was found to be positively related to higher anxiety [\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]. These results may be reflective of the social isolation experienced by older adults during the pandemic, meaning that anxiety was being driven by the social isolation that people who were using remote attendance experienced rather than the concern over the pandemic. Older adults were advised to avoid socialization and practice extreme isolation (Health Service Executive, 2020) which meant staying isolated from friends and family, restricted access to social activities and clubs, and even shopping at special times to avoid the general population.\\u003c/p\\u003e \\u003cp\\u003eThese results may also be indicative of the missing social benefit found from attending in person [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. Older people experienced many barriers to in person social activities, including a religious community that could be interacted with in person.\\u003c/p\\u003e \\u003cp\\u003eIt should also be noted that the sensitivity analysis, which separated participants who only attend in person and those who only attend remotely, held the same result that remote religious attendance is significantly positively related to greater anxiety. In person religious attendance became significantly related to lower anxiety and lower loneliness when those who used remote attendance were removed.\\u003c/p\\u003e \\u003cp\\u003eData was also collected at various points throughout the pandemic, thus participants who were interviewed during higher levels of restrictions may have been feeling more anxious while at the same time being unable to attend in person religious service. Vaccinations were also not available for the entirety of data collection and participants who may not have had one when they were interviewed may have reported more anxiety.\\u003c/p\\u003e \\u003cp\\u003eWhat\\u0026rsquo;s more, when those who attended religious services online at all were dropped, in person religious participation predicted significantly lower anxiety. When those who had attended in person were dropped, remote attendance was still associated with higher anxiety.\\u003c/p\\u003e \\u003cp\\u003eThis study had several limitations. First, the use of cross-sectional survey data made measuring the change in religious practice and stress, loneliness, QoL, and anxiety over the COVID-19 pandemic impossible. Data was collected between January 2021 and January 2022, and while COVID was present through the entire time period, there were varying levels of lockdown restrictions throughout the year. Second, the use of single item responses to measure attendance rather than comprehensive scales. These items did not allow for the measurement of the complexities of religious participation such as spirituality, social benefit, or meaning and purpose. In addition, these measures fail to account for spirituality and intrinsic religious practice, which has been shown to have a positive effect on anxiety and stress [\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThis study also has several strengths. The use of a large nationally representative sample made for more accurate and generalizable results with smaller margin of error. Additionally, the use of data collected during a unique point in time; the COVID-19 pandemic period.\\u003c/p\\u003e \\u003cp\\u003eFuture research should include comprehensive spirituality measures as a dependent variable to capture the complex intrinsic facets of religious practice and spirituality as these facets of religious practice may be more protective against negative mental health outcomes than simple attendance alone. Future research should also focus on social connectedness felt during in-person and remote religious practice as this study could only measure social connectedness.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eDuring the COVID-19 pandemic, older Irish adults were advised to socially isolate. This limited social participation in many ways, including in-person religious attendance. This study set out to examine whether religious attendance, both in-person and remotely, had a positive effect on stress, loneliness, QoL, and stress among older adults living in Ireland during the COVID-19 pandemic period. While in-person attendance was shown to have a beneficial effect on QoL, remote religious practice was shown to have a negative effect on anxiety.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eB.O. wrote the main manuscript text and prepared all tablesM.W. procured funding and supervisedR.A.K procured funding and supervisedS.S. Supervised and did main revisionsAll authors reviewed the manuscript\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eThe publicly accessible dataset files are hosted by the Irish Social Science Data Archive based in University College Dublin.Researchers wishing to access the data must complete a request form available on the ISSDA website:\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eMoon YS, Kim DH (2013) Association between religiosity/spirituality and quality of life or depression among living-alone elderly in a South Korean city. Asia-Pac Psychiatry 5:293\\u0026ndash;300\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGaniel G (2021) Online Opportunities in Secularizing Societies? Clergy and the COVID-19 Pandemic in Ireland. Religions 12:437\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eInglis T (2017) Church and Culture in Catholic Ireland. Stud Ir Q Rev 106:21\\u0026ndash;30\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eOrr J, Tobin K, Kenny RA et al (2019) Religious Attendance, Religious Importance, and the Pathways to Depressive Symptoms in Men and Women Aged 50 and Over Living in Ireland. Res Ageing 41:891\\u0026ndash;911\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePierce M, Hope H, Ford T et al (2020) Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. ;7\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWard M, May P, Normand C et al (2021) Mortality risk associated with combinations of loneliness and social isolation. Findings from The Irish Longitudinal Study on Ageing (TILDA). Age Ageing 50:1329\\u0026ndash;1335\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBailey L, Ward M, DiCosimo A et al (2021) Physical and mental health of older people while cocooning during the COVID-19 pandemic. QJM Int J Med 114:648\\u0026ndash;653\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFernando G, Berger D (2017) The role of religion in youth exposed to disasters in sri lanka. J Prev Interv Community 45. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1080/10852352.2016.1197751\\u003c/span\\u003e\\u003cspan address=\\\"10.1080/10852352.2016.1197751\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKidwai R, Mancha BE, Brown QL et al (2014) The effect of spirituality and religious attendance on the relationship between psychological distress and negative life events. Soc Psychiatry Psychiatr Epidemiol 49:487\\u0026ndash;497\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKrause N (2016) Assessing the Relationships Among Religiousness, Loneliness, and Health. Arch Psychol Relig 38:278\\u0026ndash;300\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHarris GM, Allen RS, Dunn L et al (2013) Trouble Won\\u0026rsquo;t Last Always: Religious Coping and Meaning in the Stress Process. Qual Health Res 23:773\\u0026ndash;781\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHSE. COVID-19 \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003eguidance-on-cocooning.https://www2.hse.ie/conditions/covid19/?referrer=http://www.gov.ie/en/publication/472f64-covid-19-coronavirus-guidance-and-advice\\u003c/span\\u003e\\u003cspan address=\\\"http://guidance-on-cocooning.https://www2.hse.ie/conditions/covid19/?referrer=http://www.gov.ie/en/publication/472f64-covid-19-coronavirus-guidance-and-advice\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. Published 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKretzler B, K\\u0026ouml;nig H-H, Hajek A (2023) Utilization of internet for religious purposes and psychosocial outcomes during the COVID-19 pandemic. Arch Gerontol Geriatr 108:104900\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBentzen JS (2021) In crisis, we pray: Religiosity and the COVID-19 pandemic. J Econ Behav Organ 192:541\\u0026ndash;583\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWhelan B, Savva G (2013) Design and Methodology of The Irish Longitudinal Study on Ageing. J Am Geriatr Soc 61. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1111/jgs.12199\\u003c/span\\u003e\\u003cspan address=\\\"10.1111/jgs.12199\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDonoghue O, Foley M, Kenny RA (2017) Cohort Maintenance Strategies Used by The Irish Longitudinal Study on Ageing (TILDA). The Irish Longitudinal Study on Ageing\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSpitzer R, Kroenke K, Williams J (2006) A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7. Arch Intern Med 166:1092\\u0026ndash;1097\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRussell DW (1996) UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure. J Pers Assess 66:20\\u0026ndash;40\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMitchell A, Crane P, Kim Y (2008) Perceived stress in survivors of suicide: Psychometric properties of the Perceived Stress Scale. Res Nurs Health 31:576\\u0026ndash;585\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCohen S, Kamarck T, Mermelstein R (1983) A Global Measure of Perceived Stress. J Health Soc Behav 24:385\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWiggins RD, Netuveli G, Hyde M et al (2008) The evaluation of a self-reported scale of quality of life (CASP-19) in the context of research on ageing: a combination of exploratory and confirmatory approaches. Soc Indic Res 89:61\\u0026ndash;77\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSexton E, King-Kallimanis BL, Layte R et al (2015) CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? Examining the WHO ICF disability domains as mediators of this relationship. Ageing Ment Health 19:622\\u0026ndash;633\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHerrera MS, Elgueta R, Fern\\u0026aacute;ndez MB et al (2021) A longitudinal study monitoring the quality of life in a national cohort of older adults in Chile before and during the COVID-19 outbreak. BMC Geriatr 21:143\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKalpana S, Srivastava SK (2014) Loneliness and Quality of Life Among Elderly People. J Psychosoc Res 9:11\\u0026ndash;18\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePurba FD, Kumalasari AD, Novianti LE et al (2021) Marriage and quality of life during COVID-19 pandemic. Cheung JC-S (ed.). \\u003cem\\u003ePLOS ONE\\u003c/em\\u003e ;16:e0256643\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eO\\u0026rsquo;Maoileidigh B, Kenny RA, Ward M et al (2022) P127 Religious involvement and psychological health among older irish adults during the COVID-19 pandemic: Findings from the irish longitudinal study on ageing. Res Aging 41:891\\u0026ndash;911\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eVitorino LM, Lucchetti G, Le\\u0026atilde;o FC et al (2018) The association between spirituality and religiousness and mental health. Sci Rep 8:17233\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"},{\"header\":\"Appendix\",\"content\":\"\\u003cp\\u003eTable S1: Sensitivity analysis results \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellspacing=\\\"0\\\" cellpadding=\\\"0\\\" width=\\\"662\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.350453172205437%\\\" valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"27.794561933534744%\\\" colspan=\\\"2\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eQoL\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"19.335347432024168%\\\" colspan=\\\"2\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAnxiety\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"18.580060422960724%\\\" colspan=\\\"2\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eStress\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"19.939577039274923%\\\" colspan=\\\"2\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eLoneliness\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.350453172205437%\\\" valign=\\\"top\\\"\\u003e\\u003cbr\\u003e\\u003c/td\\u003e\\n \\u003ctd width=\\\"12.83987915407855%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eB\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"14.954682779456194%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e95% CIs\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.365558912386707%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eIRR\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.969788519637461%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e95% CIs\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"7.099697885196375%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eB\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.48036253776435%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e95% CIs\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"8.761329305135952%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eIRR\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.178247734138973%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e95% CIs\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.350453172205437%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eIn-person Attendance \\u0026nbsp;Without Participants who Reported engaging in Remote Religion\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"12.83987915407855%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e590.99***\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"14.954682779456194%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e242.07, 939.92\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.365558912386707%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.98*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.969788519637461%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.96, 0.99\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"7.099697885196375%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-0.10*\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.48036253776435%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-0.19, -0.00\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"8.761329305135952%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.96***\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.178247734138973%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.94, 0.98\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd width=\\\"14.350453172205437%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eRemote Attendance Without Participants who Reported Attending in-person\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"12.83987915407855%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-76.25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"14.954682779456194%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-316.63, 164.12\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.365558912386707%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e1.03***\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"9.969788519637461%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e1.01, 1.04\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"7.099697885196375%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.02\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.48036253776435%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e-0.04, 0.09\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"8.761329305135952%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.99\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd width=\\\"11.178247734138973%\\\" valign=\\\"top\\\"\\u003e\\n \\u003cp\\u003e0.981.01\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-4631672/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-4631672/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackground\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eReligious attendance has been shown to have a positive effect on psychological health among the older people [1]. Due to COVID-19 lockdown restrictions and precautionary health advice, many older adults struggled to attend service in-person. However, 87% of faith organisations provided a form of remote service between June and December 2020 \\u0026nbsp;[2].\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethods\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eData were from Wave 6 (2021) of The Irish Longitudinal Study on Ageing (TILDA). Data were collected via telephone interview and self-completion questionnaires. The analysis sample was made up of 3,961 community-dwelling adults living in Ireland aged 60 years and older. To assess religious attendance, participants were asked about how often they attended in-person and how often they attended remotely using radio, television, or internet streaming. Relationships between religious attendance, Quality of Life (QoL), Loneliness, Stress, and Anxiety were modelled using linear regressions.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe sample was 44.1% male and 55.9% female, with a mean age of 72.0 years. In-person religious attendance was positively related to higher QoL [Beta=192.92, 95% Confidence Intervals (CI)=9.45, 376.39, p\\u0026lt;0.05].\\u003c/p\\u003e\\n\\u003cp\\u003eRemote religious attendance was positively related to higher anxiety [IRR=1.03, 95% CI=1.02, 1.04, p\\u0026lt;0.001].\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eResults show that in-person attendance was positively related to QoL, while remote attendance was positively related to higher anxiety. This may be a result of the lack of social connectedness felt when practicing religion remotely or the higher level of anxiety during the COVID-19 pandemic. Future research should focus on social connectedness felt during in-person religious practice and during remote practice.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Relationships between in-person and remote religious attendance and loneliness, quality of life, stress and anxiety among older adults during covid-19 in ireland\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-07-22 18:21:05\",\"doi\":\"10.21203/rs.3.rs-4631672/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"05f36aac-ec6b-4bfe-af8f-19757f8e762e\",\"owner\":[],\"postedDate\":\"July 22nd, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2024-07-26T14:53:39+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2024-07-22 18:21:05\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-4631672\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-4631672\",\"identity\":\"rs-4631672\",\"version\":[\"v1\"]},\"buildId\":\"qtupq5eGEP_6zYnWcrvyt\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}