Discrimination and Religious Experiences of Adult Muslimahs in Salaat

This goal of this clinical trial is to examine the effects of the Muslim prayer (salaat) on physiological arousal among Muslim women. This study aims to measure EEG and HRV during the salaat performance among Muslim women. Using EEG as a measure of physiological relaxation, HRV will be utilized as a measure of stress experienced by Muslim women whose prayer have been understudied in research on the salaat. Thus, the main questions it aims to answer are 1) whether salaat performed by Muslim women influences physiological relaxation similar to what is seen by men, and 2) Evaluate health-related correlates of perceived discrimination among Muslim women.

Participants will complete 15 questionnaires. Participants will be connected to a Heart Rate Variability (HRV) monitor as well as a 32-electrode EEG cap. After the baseline data are obtained, all participants will complete both conditions (salaat and counting) but the order of participation in conditions will be randomly assigned. The resting period will again occur between conditions and at the end of the second condition.

All participants will pray the Duha prayer, an optional superogatory prayer that typically occurs in the early morning, to control for differences in timing and duration of prayer. The Duha is completed between the dawn and noon prayers and consists of four cycles of prayer as well as Qur'an recitation and supplication throughout the four positions. The salaat condition includes four cycles with four different positions during each cycle (standing with bowing at a 90-degree angle with both hands covering the knees, standing again briefly with arms at the sides, prostrating with forehead, hands, knees, and feet touching the ground, followed by sitting with knees bent under the torso, prostrating, and sitting again). The counting condition will include the same physical component as the salaat condition. This will include 4 cycles of movement through the four different positions (i.e., standing, bowing at a 90-degree angle with both hands covering the knees, standing again briefly with arms at the sides, prostrating with forehead, hands, knees, and feet touching the ground, followed by sitting with knees bent under the torso, prostrating, and a final sitting position in cycles two and four (see Figure 2)). Apart from not including the final sitting position, cycles one and three are identical to cycles two and four (see Figure 2). The counting condition will include replacing Qur'anic recitation and subsequent supplications throughout the prayer by counting "one one-thousand, two one-thousand, three one-thousand, etc." throughout the duration of time typically required to perform the full salaat. During the standing position, counting can last for approximately 30-60 seconds in line with the previous study by Doufesh and colleagues (2012). Thus, the first three cycles of prayer will require approximately 77 seconds each while the final cycle will require around 97 seconds based on the estimates by Doufesh and colleagues (2012), for a total of approximately five and a half minutes. To ensure that participant duration during the counting condition is, on average, equivalent to the salaat condition, an audio recording will be provided with counting aloud during each position. The duration of the counting in the audio recording will be an average of the duration of each position as found in Doufesh and colleagues (2012). A bell sound will be used to indicate when participants should change to the next position. After performance of each condition, participants will return to a comfortable seated position. Participants will complete a questionnaire to rate their mental focus in the condition. Blood pressure will be measured at the end of each condition. While at rest, assessment of blood pressure, HRV, and EEG will be obtained from participants for 5 minutes between each condition and at the end of the study.

Over the past 30 years, research has increasingly focused on the impact of religious practices on stress reduction. The Islamic prayer (salaat) is a mind-body practice consisting of a movement component and a meditative component. Although Weigand and colleagues (2004) and others (Archour \& Roslan, 2014; Archour, Muhamad, Syihab, Mohd, \& Mohd, 2021) have demonstrated robust negative associations between the practice of the Muslim prayer form (salaat) and anxiety. More recently, Doufesh and colleagues (2012; 2014; 2018) have examined the effect of salaat on central nervous system (CNS) and cardiovascular functioning. These studies have demonstrated improved physiological relaxation as reflected in increased alpha wave activity and high frequency heart rate variability (HF-HRV) among men. To date, existing studies that have focused on the relationships of salaat with anxiety and cardiovascular functioning have been mostly single group, observational designs. The only prior study with a control condition utilized a resting state comparison group rather than a true sham condition (Gao et al., 2019). Also, past studies have focused almost exclusively on Muslim men. Finally, research has documented the harmful effects of discrimination on automatic nervous system (ANS) functioning on racial and ethnic minorities (Nikolova, Tzacheva, \& Vodenitcharov, 2011). However, a paucity of research has examined the relationship of salaat and ANS functioning among Muslim women or Muslimahs reporting experiences of perceived discrimination. This is particularly important as discrimination reported by Muslim women is positively associated with their visibility, e.g., greater adherence to Islamic practices such as the traditional headscarf and wearing loose clothing in public spaces is associated with increased experience of discrimination (Ali, Elsayed, Elahi, Zia, \& Awaad, 2022). Thus, this study was designed to evaluate the influence of the recitation component of salaat on ANS functioning among visible Muslim women using a sham control condition. In addition, this study will explore the degree to which perceived discrimination is associated with physiological markers of stress and with health behaviors among Muslim women. Thus, this study aims to replicate and expand upon previous research demonstrating that alpha wave activity during EEG recordings can be found during the salaat.

Eligibility Criteria:
Inclusion Criteria:

* Adult Muslim women;
* Ages 18-55;
* Being ability to complete the salaat without assistance.

Exclusion Criteria:

* Being currently pregnant;
* Being post-menopausal or having a lack of regular menstrual cycles;
* Reporting a current neurological or psychological disorder;
* Receiving a score of greater than or equal to 9 on the Patient Health Questionnaire-9 (PHQ-9);
* Being unable or unwilling to follow the requirements of the study protocol;
* Being unwilling or unable to complete the morning salaat unassisted;
* Being unable or unwilling to provide written informed consent.