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PURPOSE OF THE REVIEW. Recognition of the spiritual dimension as a vital component of human wellness has led to an increased interest in spirituality education, yet very little progress has been made in identifying possible intervention methods for enhancing spirituality. The purpose of this article is to review current definitions of spiritual health; provide an overview of several successful intervention methods that may enhance spiritual health; and outline potential relationships between spiritual health interventions and behavioral, emotional, and physical health outcomes. SEARCH METHOD USED. Research and review articles were identified through a CD-ROM computer search of ERIC (1966 to 1994), PSYCHLIT (1974 to 1994), and MEDLINE (1991 to 1994) databases using appropriate key words. Cumulative indexes from Advances (1984 to 1993) were manually searched, and reference lists from identified studies and literature reviews were analyzed. A total of 71 articles were identified and considered. Model interventions were chosen for presentation on the basis of soundness of research design, peer-review publication, clear description of intervention method, and relationship to spiritual health components. SUMMARY OF IMPORTANT FINDINGS. Imagery, meditation, and group support activities may address various components of spiritual health such as meaning and purpose in life; self-awareness; and connectedness with self, others, and a larger reality. In turn, positive changes in health behaviors such as communication, diet activity, and treatment compliance were noted, and a variety of beneficial physical and emotional health outcomes such as heart disease reversal, decreased cancer mortality, reduced anxiety, and improved mood states were reported. MAJOR CONCLUSIONS. Health educators are in a position to develop, implement, and evaluate spiritual health interventions within the context of comprehensive programs. There is a need for training in the theoretical and methodologic foundations of interventions like meditation, imagery, and group support and a need for more evaluation research in the impact of such interventions.

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Objectives: To identify the impact of body mass index (BMI) and Western advertising and media on the stage of the nutrition transition among Jordanian women, and to evaluate their impact on eating styles and body image. Design: A randomised cross-sectional survey that included a variety of culturally measured Likert-type scales and body size images. In addition, BMI was calculated based on measured height and weight. Setting: In the homes of the participants. The data were collected by female interviewers who worked for the Jordan Department of Statistics. Subjects: The sample was based on a random and representative selection of 800 mostly urban Jordanian women. A pre-test sample of 100 women was also used to validate the instruments. Results: Women tended to agree that they ate based on emotional cues. They had high levels of disordered eating attitudes and behaviours and 42.1% were considered restrained eaters. However, these women also had higher than expected body esteem levels and desired a healthy body size. As expected, being obese was associated with a desire to lose weight, being a restrained and emotional eater, and having more disordered eating attitudes and behaviours. Similarly, Western advertising and media were associated with restrained and emotional eating, desired weight loss, and disordered eating attitudes and behaviours. Conclusions: There is a need to develop health education materials that explain the influence of obesity on health and the negative psychological and physical consequences of restrained and emotional eating, building on the current cultural preferences of healthy body size. Further implications and suggestions for future research are discussed.

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