Human Development & Family Science Doctoral Work

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Weight-Related Health Behaviors and Body Mass: Associations between Young Adults and their Parents, Moderated by Parenting Styles
(North Dakota State University, 2011) Niemeier, Brandi Shea
The incidence of overweight conditions among children and adolescents is a growing national concern. Although current literature suggests that parental health behaviors could influence health behaviors of children, studies have not explored the actual predictive relationships of parents' and their children's weight statuses and weight-related behaviors. In addition, current studies have not tested the influence of parental authority, family communication, or demographic characteristics on the relationships. This study first examines factors that contribute to overweight conditions among children and adolescents and the associated costs. Studies of interventions that target children's and adolescents' weight-related health are then reviewed and provide evidence that parental involvement contributes to intervention success. The theory of planned behavior, social cognitive theory, social action theory, and systems theory are discussed and support the notion that parental influences contribute to the development of children's weight-related health behaviors. To test the relationships, 151 young adults and their parents were recruited and completed a series of questionnaires to describe their weight statuses, dietary behaviors, and physical activity behaviors. In addition, the young adult participants completed questionnaires to further describe their parents' parental authorities and their family communication environments during childhood and adolescence. Comparisons of body mass index, average daily energy consumption, average weekly energy expenditure, and physical activity enjoyment of young adult participants and their parents were conducted with correlation analyses and paired-samples t-tests. Further, multiple regression analyses were used to explore the influence of parental authority and family communication, and demographic characteristics were also considered. The empirical results of the current study indicate that, overall, parents' weight statuses and dietary behaviors help predict weight statuses and dietary behaviors of their young adult children. Further, parental authority scales interact with the relationships. At high levels of authoritarian and permissive parental authorities, young adults tend to have weight statuses that are opposite to those of their parents; at high levels of authoritarian parenting, young adults also tend to follow opposite dietary consumption patterns. The findings in this study have implications for professional practice, parenting practices, and the design of intervention activities. Recommendations for future research are provided.
Physical Activity of Preschool Aged Children during Childcare: Examination of Seasonal Changes and an Evaluation of a Dance-Based Intervention
(North Dakota State University, 2012) Schuna, John Micheal
The purpose of this dissertation was to prospectively track preschoolers' physical activity (PA) during childcare while investigating for seasonal differences in accelerometer measured PA between the fall and winter months in Fargo, North Dakota. This dissertation also evaluated the feasibility of a novel dance-based intervention for increasing PA and reducing sedentary (SED) time in childcare using short activity breaks (< 10 min) interspersed throughout the childcare day. Two studies were conducted as part of this dissertation. The first study (Paper 1) examined for seasonal differences in preschoolers' PA. The second study (Paper 2) evaluated the feasibility of a novel dance-based intervention for increasing PA and reducing SED time during childcare. Preschool aged children (3-5 years) were recruited from four childcare centers in Fargo, North Dakota, to participate in both studies. Children (N = 59) in study one wore an accelerometer during childcare for 5 days in October/November 2011 (fall) and for 5 days in January/February 2012 (winter). Significant decreases in all intensities of PA were observed from fall to winter. Levels of moderate-to-vigorous PA (MVPA) decreased by 17% (p < .01), while SED time increased by 3.2% (p < .01). Children averaged 6.1 min/hr of MVPA across the two assessment periods. Levels of MVPA among preschool children from this study fell within the range of estimates reported in the current literature. Findings from study one suggest that preschoolers' PA levels can substantially change across seasons. For study two, four childcare centers were randomly assigned (cluster randomized design) to take part in a novel dance-based PA intervention or to serve as a control site. Preschoolers (N = 61; intervention group [n = 30], control group [n = 31]) wore an accelerometer while at childcare for 5 days at baseline in January 2012 and for 5 days during the intervention in February 2012. No significant differences between groups in baseline to intervention period changes for MVPA or SED time were observed. Results from study two indicate that adding an additional 15-20 min of dance to preschoolers' childcare day did not significantly increase MVPA or reduce SED time.
The Association Between the Consumer Nutrition Environments and Free and Reduced School Lunch Rates
(North Dakota State University, 2012) Randles, Anthony Michael
This study examined the relationships between neighborhood socioeconomic status (SES), measured by free and reduced school lunch rates, the nutrition environment. In the first part of this study trained surveyors used the Nutrition Environment Measure Survey-Stores (NEMS-S) to document availability of healthy food items in sixty retail food stores (96% of total community retail food stores) categorized as `ethnic grocery', `supermarkets', and `convenience'. Community neighborhoods were divided by elementary school district, allowing neighborhood SES to be determined by the percentage of free and reduced price lunch provided to students and are thus grouped as high or low SES neighborhoods. Surveyors also used the NEMS-R to document nutritional availability and promotional signage in 187 restaurants categorized as being full service (n= 93) or fast food (n= 94). Restaurant locations were categorized as low SES, moderate SES, or high SES, based on the number of free and reduced lunch served in neighborhoods public elementary schools. In the second part of this study, Fargo, ND was subdivided by elementary school bounders and free and reduced school lunch rates were collected to categorize schools in to three SES categories. Census block groups were also used to subdivide Fargo and census poverty rates were used to classify SES categories for block groups. To determine access to healthful food choices data from the first part of this study was used to compare between SES indicators (free and reduced lunch rates; census poverty data) and also within groups. Take together; the results from both parts of this study emphasize the need to improve nutrition quality within all communities. This cannot be accomplished without a combination of government policies, consumer involvement, and a change in the food industry system; all are needed to address nutritional availability and access in communities. Governments can set policies to promote good nutrition, incentives to locate food outlets in low income areas and improving zoning laws. Most importantly, governments can work with food outlets to promote healthful eating and nutritional choice making, thereby encouraging the consumer to make the best choice possible for their health.
Structured Life Review and its Impact on Family Interactions
(North Dakota State University, 2013) Dahley, Laurie K.
Communication has been deemed by Nelson, Schrader, and Eidsness (2009) as critical to the ability to provide quality end-of-life care. While past research has focused on communication between healthcare professionals and the patient/family unit, this qualitative study explored the impact of a life review technique on family interactions. Structured life review interviews were conducted with fifteen residents of a skilled nursing facility in the presence of family members. Follow-up interviews were conducted with elders and family members to determine the impact of the intervention on family interactions as well as individual effects. Using qualitative methodology, open-ended questions were employed to enhance our understanding of the participant's experience through the life review process. Themes that emerged included: affirmation of prior knowledge, living legacy, new information, opened communication, enhanced understanding, affirmation of the older adult, testimonials, and bridging distant family relationships. Two articles for publication were produced as a result of the project. The first article defined and reviewed all of the themes identified in the study. Along with the discussion of themes, its potential as a tool to improve communication and family interactions was explored. The second article focused on the psychological impact of the life review process experienced by the individual as well as the family system. In addition, the implications for social work practice with older adults were examined and recommendations for implementation were reviewed. Possible direction of future research was also discussed.
Impact of a Wellness Coaching Program on Bariatric Surgery Candidates Following Weight Loss
(North Dakota State University, 2013) Gust, Anita Marie
A lifestyle approach toward weight loss, encompassing behavior modification strategies, education, and new coping skills may be most effective in adoption of the healthy behaviors necessary for achievement and maintenance of successful weight loss. Limited research exists on the effectiveness of pre-surgery wellness programs on post-surgical health behaviors for bariatric surgery candidates. The purpose of this study was to determine the impact of a pre-bariatric surgery wellness coaching program on health behaviors, quality of life (HRQoL), and psychosocial factors.A questionnaire containing measures of weight (self-report), dietary and physical activity (PA) (7-day IPAQ-short) behaviors, exercise motivation (BREQ-2), HRQoL (SF-12v2), and open-ended questions evaluating the wellness program, was sent out to all participants who engaged in a 12-week weight loss wellness coaching program and all bariatric surgery patients from 2009-2012 (n=782). From the 118 returned surveys (15.0%), participants (age = 51.46 years ± 12.98, BMI = 30.31 ± 7.70) were placed in either the wellness-coaching only group (n=16), surgery-only group (n=58), or surgery plus wellness coaching group (n=44) based on whether they participated in, and completed, the 12-week program and/or surgery. The wellness-coaching only group was excluded for the first set of analysis where weight loss, PA, dietary factors, exercise motivation and HRQoL were analyzed between a control (surgery only) group and intervention (surgery + wellness coaching) group. Compared to controls, participants in the wellness-coaching group had significantly more weekly vigorous PA, total minutes of MVPA, and total weekly PA. Significant differences were also found for two measures of exercise motivation and vitality scores. The second set of analysis excluded the surgery only group to analyze the impact of the wellness coaching program. Results indicate favorable results for health behaviors. A qualitative analysis found positive results for several psychosocial factors, motivation, and new skills learned. A comprehensive, wellness approach encompassing evidence based strategies toward weight loss had positive results towards health related behaviors and emotional and social well-being. Additionally, participants reported responses consistent with continued engagement in health behaviors and weight loss maintenance.
Evaluation of Osteoporosis Educational Interventions on Knowledge, Health Beliefs, Self-Efficacy, Dietary Calcium and Vitamin D Intakes
(North Dakota State University, 2013) Evenson, Alexa
Osteoporosis is a serious public health issue, which is growing in significance because of our aging population. It is estimated that 34 million individuals in the United States are at risk for osteoporosis. Education may be key to increasing preventative behaviors in younger adults to help prevent osteoporosis in later life. One purpose of this study was to determine the validity and reliability of three revised scales, which were revised to include vitamin D related items: Osteoporosis Knowledge Test -D, Osteoporosis Health Belief Scale-D, and the Osteoporosis Self-Efficacy Scale-D. These revised scales were then used to determine the effects of educational interventions (lecture versus hands-on activities) on osteoporosis knowledge, health beliefs, self-efficacy, dietary calcium, and dietary vitamin D intake in a sample of college age adults. A sample of 153 college age men and women completed online pre- and post-questionnaires to assess osteoporosis knowledge, health beliefs, and self-efficacy using the validated revised Osteoporosis Knowledge Test (OKT-D), revised Osteoporosis Health Belief Scale (OHBS-D), and revised Osteoporosis Self-Efficacy Scale (OSES-D) respectively. Pre and post three-day food diaries were used to assess dietary calcium, vitamin D, and kcalorie intake. In general, the college age adults in this sample were low in osteoporosis knowledge. Both intervention styles increased osteoporosis knowledge and health beliefs but not self-efficacy. Dietary calcium intakes at baseline met the recommendations while dietary vitamin D did not. No significant increases were found in dietary calcium or vitamin D intake after the educational interventions. Osteoporosis health beliefs were a significant predictor of dietary calcium intake (p<.044) and vitamin D intake (p<.047) accounting for approximately 11.2% and 10.1% of the variance respectively. Self-efficacy was a significant predictor of vitamin D intake (p<.01) only, accounting for approximately 7.3% of the variance. These findings suggest different types of osteoporosis educational interventions may increase knowledge and health beliefs in college-age adults but may not change behaviors. Perhaps tailored interventions towards specific health beliefs and self-efficacy are needed to warrant behavior change.
Changing Rural Communities: An Exploration of Older Adults' Experiences
(North Dakota State University, 2013) Strommen, Jane M.
This research was designed to better understand the perceptions and experiences of older adults who live in small towns and rural areas. In this qualitative study, 13 individuals were interviewed to gain an in-depth understanding of their experiences related to aging, community change, and well-being. Participants ranged in age from 69 to 90. Two articles report the results of this research in Chapters Three and Four. The first article presents the themes that reflect the participants' perceptions of living in changing communities. Data analysis revealed five themes: elders were saddened by losses in their community but were resigned to accept them; diversity among the rural communities affected views about community; dwindling social networks and opportunities left elders feeling isolated and lonely; attachment to place was strong, and commitment to stay on despite concerns for the future. The second article focuses on the daily life experiences, challenges, and strategies of older adults living in rural communities. Four key themes emerged from participants' responses about their lived experiences in communities that have undergone long-term changes: social interactions were limited; sense of social connectedness had weakened; daily life experiences depended on community and individual characteristics; and elders sought to manage challenges. Overall, there was a strong desire to remain in rural areas in spite of challenging conditions, with attachment to place being a factor contributing to the commitment to age in place. Daily experiences and challenges for participants were influenced by both community and individual characteristics. Person-environment relationships served as environmental comfort, maintenance, or distress for rural elders. Participants expressed disappointment in the deteriorating social interactions and social connections in their communities, resulting in feelings of isolation and loneliness. Future research should include a closer examination of the environmental characteristics that serve as resources or stressors for rural elders and of the personal competencies that help older adults adapt to changing environments and manage their lives effectively. These studies help identify specific environmental and personal characteristics that either promote or hinder well-being for elderly living in rural communities.
Anticipatory Guidance Provision Related to Driving Safety/Cessation for Older Drivers
(North Dakota State University, 2014) Huseth-Zosel, Andrea Lynn
Increasing numbers of older adults continue to drive. Aging-related physical and cognitive changes can impact driving ability. Health care providers (HCPs) are ideally placed in society to provide mobility counseling to older drivers. This research explored the frequency of HCP mobility counseling provision to older drivers; HCP demographic and practice predictors of mobility counseling provision; and rural-urban differences in HCP mobility counseling provision, HCP perceptions of mobility counseling provision, and HCP barriers to mobility counseling provision. Data were collected by surveying HCPs in several upper Midwest states. Two manuscripts were produced as a result of this research. The first article focuses on rural-urban differences in HCP mobility counseling. It was found that rural HCPs were less likely than urban HCPs to provide mobility counseling to patients aged 75 or older. Additionally, rural HCPs were less likely than urban HCPs to feel there are adequate resources, less likely to refer patients if they had questions related to driving issues, and less likely to know where to refer older drivers for driving fitness assessments. The second article focused on HCP demographic and practice predictors of mobility counseling provision. It was found that HCP predictors of mobility counseling provision differed by patient age. HCPs that had personal experience with a motor vehicle crash more often provided mobility counseling to patients aged 65 to 74. For older patients (aged 75 or older), HCPs who practice in rural areas, older HCPs, and HCPs with greater proportions of patients aged 65 or older were more likely to provide mobility counseling. This study is important in laying the groundwork for future research focusing on mobility counseling and older drivers, and emphasizing the significant role of HCPs in this process.
The Impact of Psychosocial Outcomes in Long-Term Bariatric Patients
(North Dakota State University, 2015) Geraci, Angela Ann
The disease of obesity is a serious and significant public health epidemic affecting more than 78 million Americans. The increase in human life expectancy also increases the chance of reduced quality of life and well-being by those suffering from obesity. Obesity–related factors may mean years of physical and psychosocial discomfort, lack of mobility, and chronic ill health. This study analyzed long-term bariatric patient outcomes, specifically, factors regarding postprocedure weight regain, surgeon follow-up, and psychosocial issues related to quality of life (i.e. self-concept and obesity discrimination). The overarching research design for this study employed survey methods, using a cross-sectional, self-reported questionnaire and enlisted both a combined quantitative and qualitative approach to analyze data. Participants over the age of 18 and at least 18-months post-procedure were recruited either from public bariatric support forums (n = 133) or through a regional weight management center in the Midwest (n = 534), which specializes in bariatric surgery. Results suggests that although some weight regain after surgery is likely, weight regain decreases as a patient continues to maintain adherence to the recommended post-operative diet, as well as the importance of bariatric follow-up and support. Additional results revealed that different aspects regarding the ‘self’ such as body image, the continued struggle to develop alternative coping strategies to eating, and obesity stigma have an impact for a multitude of years post-bariatric surgery, and therefore can overshadow the benefits of surgery. It is recommended that a critical key to success for long-term bariatric patients is having access and care of multidisciplinary teams including a bariatric surgeon, gastro-intestinal specialist, endocrinologist, nutritionist, and psychiatrist at minimum. Finally, there is also a significant need for long-term bariatric research in the future.
Understanding the Social Effects of Water Intervention Implementation in Sub-Saharan Africa: A Qualitative Study in Kitui, Kenya
(North Dakota State University, 2015) Zolnikov, Tara Rava
Global public health interventions focus on creating solutions to unaddressed humanitarian issues in developing countries; priority projects include providing communities with access to water, food, and healthcare. Nearby access to safe drinking water is a primary public health concern and a frequent public health intervention. Intervention success may depend on other factors in addition to health outcomes. However, previous research has focused solely on health effect outcomes and has not reviewed the impact of social effects from implemented water interventions. The purpose of this study was to understand the impacts of an implemented water intervention on social relationships among community members in Sub-Saharan Africa. A qualitative phenomenological approach with 52 semi-structured interviews was used to examine relationship experiences among primary water gatherers and their families after the implementation of water interventions in the community. This study took place throughout the historically semi-arid eastern region in Kitui, Kenya, where community members have been beneficiaries of various water interventions. Prior to the water intervention, family members experienced economic hardships, diminished community rapport, irregular meal times and food availability, infrequent family conversations, irritation with lack of bathing and cleanliness, and general discontent without the availability of one able-bodied family member. Participants’ experiences after implemented water interventions revealed enhanced relationships within household family units and within the community; additional personal time was gained and used to re-build relationships. The newly established relationships encouraged growth through family discussions and in conversations understanding and providing solutions to economic or individual challenges. This research provides evidence of an increased need for access to quality water for communities throughout the world in order to positively impact family relationships, which may ultimately contribute to the acceptance of the intervention. iv Clearly, the findings from this study are important to consider during the development phase of water interventions.
Graduate Counseling Students' Interest in Gerocounseling A Quantitative Study
(North Dakota State University, 2015) Nielsen, Twyla Ann
A growing population of older persons in the United States will require not only additional counselors but counselors who are trained to work with an aging adult population. Recent trends indicate that counselor education programs have moved away from gerocounseling as an academic track as well as eliminating units on aging from courses currently offered to counselors-in-training. Some graduate counselor education programs offer individual courses in aspects of gerontological counseling. If the counseling profession is to meet the rapidly increasing needs of a growing older population, more attention must be given to training counselors to meet the needs of this population. The purpose of this study was to assess graduate counseling students, from counselor education programs, regarding the students’ willingness to participate in gerocounseling training and identify specific topics of interest that the graduate counseling students would most be interested in counseling aging adults. Forty-four counselor education programs were contacted in the North Central Region of the Association of Counselor and Education Supervision (North Central ACES) and 211 students responded to the electronic survey through Survey Monkey. The results showed that graduate counseling students are very interested in gerocounseling and working with older adults. Students were willing to take additional coursework but not to the extent that it would delay graduation. Students indicated that they felt prepared to counsel older adults; however, none of the graduate counseling students surveyed had completed their field experience which could impact that sense of preparedness. As the aging population increases, so does the need for counselors who can help older adults with life transitions. It is important that counselor education programs have faculty that identify as gerontology specialists, that graduate counseling students have specialized coursework and are performing research specific to counseling older adults.
Older Adults Fighting Obesity with Bariatric Surgery: Benefits, Side Effects and Outcomes
(North Dakota State University, 2015) Marihart, Cindy Lou
The prevalence of obesity has increased at a rapid rate indicating that it is one of the fastest growing diseases in the older adult population. Since life expectancy has increased, some obese older adults are living longer; their quality of life may be compromised. Obese older adults may be facing years of discomfort, lack of mobility, and chronic ill health. This study compares bariatric surgery outcomes across four adult age groups, specifically comparing changes in body mass index (BMI), surgery side effects, existing disease outcomes and quality of life concerns. Satisfaction with the surgery and weight loss is also reviewed as well as the patients overall feelings about their health and future. The research design for this study was a survey method, using a cross-sectional, self-reported questionnaire. The 534 respondents who were 18 months or more post- surgery were divided into four age groups in years: 18-49 (n=171), 50-59 (n=148), 60-69 (n=138) and ≥ 70 (n=77). All age groups lost weight after bariatric surgery and all groups experienced some weight regain. The older and oldest age groups were as successful at losing weight and keeping it off as the young and midlife age groups. There were significant improvements in eight chronic diseases across all age groups. Older and oldest age groups had similar or better outcomes compared to the young and midlife groups on most diseases and had fewer side effects. Satisfaction with the weight loss since surgery was reported by over 79% of all the age groups, and there were significant improvements in quality of life among all age groups. While all the age groups improved greatly, the young age group (ages 18 – 49) perceptions seemed less positive than the other three age groups which were all 50 years old and older. In conclusion bariatric surgery should be considered for disease management for older adults as much as it is for younger adults.
Media Use, Body Image and Sexual Satisfaction in Emerging Adults
(North Dakota State University, 2016) Brennan, Alison Leigh
Emerging adults in America are avid users of media, including magazines and pornographic film. Use of this media is associated with body dissatisfaction and reduced sexual satisfaction. However, existing research has not examined media use, body dissatisfaction and sexual satisfaction within the same study. Additionally, the effects of pornographic film use on body image have not been extensively studied, and existing research does not adequately consider how reasons for use might relate to effects of viewing this type of media. The present study tests an integrated model of the relationships among media use, body dissatisfaction and sexual satisfaction and examines how reasons for use of pornographic film relate to emerging adults’ perceptions of their own bodies and sexual abilities. First, the proposed integrated model was tested separately by gender, using women’s magazine use as the media variable for women and pornographic film as the media variable for men. Pornographic film use was not a significant predictor in the men’s model. In the women’s model, magazine use had a positive, direct effect on sexual satisfaction. Second, chi-square tests were used to determine whether relationships existed between reasons for, and outcomes of, use of pornographic film. Regardless of gender, use of pornographic film for the purpose of “ideas, tips or instruction” was associated with engaging in body comparison. Reasons for use were not associated with reported reactions to engaging in comparison. T-tests were also used to determine if differences existed in BMI and body image among consumers who reported responding with negative self-evaluations versus those who did not respond negatively when comparing their bodies to the bodies of actors in pornographic film. When compared to those who did not respond negatively to body comparison, women who reported reacting negatively to body comparison were higher in drive for thinness and body dissatisfaction while men had higher BMIs, greater drive for low body fat, and greater body dissatisfaction. This study suggests that researchers must consider the possibility of positive effects and include consumer motivations and other dispositional factors as moderators of effects of viewing pornographic film and other media.
The Role of Music Among Healthy Older Performance Musicians
(North Dakota State University, 2016) Hutchison, Barbara
This qualitative study explored the role of music in the lives of 18 healthy older performance musicians (PMs). PMs began music education in early childhood and developed music competencies of advanced, expert, and virtuoso by voice, instruments, and composing music. The phenomenology approach to data consisted of a 7-item demographic questionnaire, and an 18-semi-structured interview questionnaire. From the themes of community music participation, wellness, and happiness emerged 11 subthemes. The role of participating in community music validated PMs’ music identity. First, values and beliefs explained music was life and a livelihood; second, music participation continued for decades because conductors chose complex repertoires that encouraged learning, and showcased music competencies. Third, camaraderie and enduring relationships sustained social connectedness, and fourth worldwide travel was inherent to performance and socialization. The role of music and wellness supported PMs’ healthy aging through the life course. First, emotional wellness explained sense of self to trust and share emotions with others and aligning views of aging to make adaptations to aging processes when needed. Second, intellectual wellness explained the relationship between complex music and brain health. Third, physical wellness explained personal benefits of physical fitness, nutrition, and intellectual energy to performing music. Fourth, sociological wellness explained PMs’ favorite music connected with family, friends, and community. The role of music and happiness clarified motivations to needing and wanting challenging repertoires. First, lifelong learning of music was resultant to happiness, and, second, happiness was resultant to performing repertoires expertly, and third, performing music was exhilarating and fun despite the countless hours of practice to perform expertly. This study found that music was critical to PMs’ health, happiness, and well-being. Future research should include audiology because hearing loss is endemic among musicians. Furthermore, establishment of regional U.S. research teams should gather data on yearly cycles, and longitudinal qualitative studies to help build a base of knowledge on PMs, and bridge the gap in literature to reverse the current empty trend. These efforts will help make seminal contributions for all generations and society.
Childhood Adversity and Successful Aging
(North Dakota State University, 2017) Danielson, Ramona Ann
Extant literature offers consensus regarding the long-term impacts of childhood adversity (CA) but its impact on successful aging is not well understood. The Midlife in the United States (MIDUS) study – a nationally representative sample including 1,017 adults 55-76 (Ryff et al., 2016) – did not include a measure of CA exposure for use in analyses. Two papers were developed for this dissertation. The first paper, An effective measure of childhood adversity for use with older adults, explored whether a cumulative CA measure that is effective for older adults could be developed using existing MIDUS questions. It provided a rationale for operationalization of CA for researchers and for creating a cumulative score of eight CA types. Distributions of individual items and the CA score were consistent with past studies using similar CA measures. The overall factor structure of the scale was consistent with previous research: 1) household dynamics (did not live with both biological parents until age 16, substance abuse in the home, financial distress, moved three or more times) and 2) child abuse and neglect (sexual assault, emotional abuse, physical abuse, emotional neglect). Consistent with the literature, CA score showed a significant negative association with life satisfaction and positive association with number of chronic conditions, and dose-response relationships with cumulative CA. This study demonstrated that CA score, created using existing MIDUS data, was an effective measure for use with older adults. The second paper, The impact of childhood adversity on successful aging for older adults, examined the impact of CA score on successful aging for older adults, operationalized using eight dimensions of wellness. Results showed that CA affected successful aging decades later. Controlling for age and gender, hierarchical multiple regression showed a significant negative association between CA score and emotional, physical, social, financial, environmental, and spiritual wellness as well as the cumulative wellness index, and no significant association with intellectual or occupational wellness. Prevention is the best way to address public health implications of CA. However, the present study provided insight into successful aging and can inform interventions that target adults for whom prevention of CA is not possible.
Summer Youth Work Programs: An Evaluation and Examination of Variables Contributing to Adolescent Career Development
(North Dakota State University, 2017) Wenner, Jennifer Rose
Adolescence is crucial for career development, as youth begin to engage in activities to prepare for their careers. However, at-risk and rural youth may face barriers to developing useful career traits like career adaptability and work hope. One barrier is insufficient parental support. Parental support is associated with the development of skills and characteristics that promote career success (Keller & Whiston, 2008). However, certain personal and social variables, including grit and mentoring relationships, may help youth succeed despite inadequate parental support. Additionally, programs that engage at-risk youth in work-related tasks and experiences may help youth develop positive career trajectories. Therefore, youth work programs must be evaluated, given their potential to impact career development. The research involved 106 youth ages 14-23 who participated in summer work-training programs. Participants took a pretest, posttest, and 3-month follow-up to examine change in program goals over time, and identify relationships and personal characteristics that can help youth develop career adaptability and work hope. Study one examined outcomes consistent with program goals to assess program effectiveness. Linear regression analyses showed that worksite performance only increased for those who had previously worked, such that those with more previous work experience had greater improvement in worksite performance. Multilevel models showed a significant or marginally significant increase in understanding the value of school and career adaptability over time. No significant increase was found for leadership and work hope. T-tests showed worksite supervisors scored the quality of their mentoring relationship with participants significantly higher than participants, and regression analyses showed participant perceptions of the mentoring relationship did not predict the continuity of the relationship three months later. The second study focused on personal characteristics and social relationships that are related to career adaptability and work hope. Multilevel models showed parental support and grit significantly positively predicted career adaptability and work hope. Grit moderated the relation between parent support and career adaptability, but not parent support and work hope. No findings were significant regarding perceived mentoring relationship or changes over time. The discussion focuses on program effectiveness, future directions, ways to improve programming, and ways to promote career traits.
Longitudinal Analyses of the Sexual and Reproductive Health Knowledge and Parent-Adolescent Communication of At-Risk Adolescents
(North Dakota State University, 2017) Mudzongo, Courage Chikomborero
Despite declining rates, unintended adolescent pregnancy remains a considerable public health challenge in the United States (Hamilton, Martin, & Osterman, 2015). Unintended pregnancy leads to a host of negative outcomes not only for adolescents, but also for their children who are more likely to get trapped in a cycle of poverty that is difficult to break (Rew & Wong, 2006). Factors such as poverty are difficult to address; nonetheless, sexual reproductive health (SRH) knowledge and parent-adolescent communication (PAC) have been identified as important tools for prevention, and potentially modifiable (Swenson et al., 2009; 2010). The goal of the current study was to examine change in SRH knowledge and PAC. Pretest, posttest, and three-month follow-up data were collected from 176 adolescents (M = 15.70 years, SD = 1.93) who participated in a comprehensive sexual health education program conducted in a Midwestern state with conservative adolescent SRH policies. Study one examined change in SRH knowledge over time, and assessed whether sexual experience, religiosity, cultural awareness, immigration status, and gender moderated change in SRH knowledge. Multi-level modeling analyses showed that SRH knowledge increased; however, the rate decreased over time. Immigrants had significantly lower initial SRH knowledge compared to American-born participants; however, neither group experienced change over time. Adolescents with high cultural awareness had lower initial SRH knowledge; however, their SRH knowledge increased over time whereas it declined for participants with low cultural awareness. Finally, girls had lower initial SRH knowledge; however, they experienced greater growth compared to boys over time. In the second study, we examined the relation between PAC and sexual experience, religiosity, cultural awareness, immigration status, and gender. Our results showed that only immigration status was associated with PAC. At pretest, American-born participants had higher PAC; however, there was no change over time. Discussion focuses on the implications of these findings for sexually transmitted infections and pregnancy prevention among at-risk adolescents living in states that are socially and politically conservative towards adolescent SRH.
Qualitative Research as a Creative Teaching Technique: A Phenomenological Study
(North Dakota State University, 2018) Hemming, Lynae Sue
Phenomenological inquiry was utilized to explore masters level counseling students’ experiences completing a qualitative research project as part of a Shame and Shame Resiliency course. Five of seven counseling students who participated in the Shame and Shame Resiliency course and completed the qualitative research project participated in an about their experience completing the assignment and the impact it had on their learning and growth. The qualitative research assignments were also analyzed by the researcher. The researcher identified themes and numerous subthemes using Moustakas (1994) method for data analysis. Four main themes were identified (Process of the Qualitative Research Project; Impact of the Qualitative Research Project; Learning Outcomes of the Qualitative Research Project and the Context of the Qualitative Research Project). Creative pedagogy was used as a framework for understanding student learning. Implications for counselor education and research are discussed.
Retraining the Brain to Prevent Disordered Eating: Approach Versus Avoidance
(North Dakota State University, 2019) Jones, Maegan Elizabeth
Emerging adult college women are at particular risk for developing unhealthy eating habits. Despite this, methods of intervention in this population are understudied. This study sought to test whether an implicit, cognitive retraining program could alter how women approach foods. Specifically, the researcher wanted to determine if the Behavioral Activation System (BAS), which encourages individuals to approach positive goals, and the Behavioral Inhibition System (BIS), which helps individuals avoid negative outcomes, could be manipulated. Thus, this study examined whether a dot-probe retraining program could significantly alter women’s approaches to healthy foods. Dot-probe programs present two pictures side-by-side; when the pictures disappear, a stimulus, in this case a “+”, appears where one of the pictures was previously located. In this project, participants assigned to an experimental training program would have the “+” located under healthy foods most of the time, in order to encourage BAS activation and approach behaviors. In addition, because it is imperative to understand how women’s families affect their thin ideal internalization (i.e., drive for thinness and restraint) and their approach/avoidance habits, the quality of past and current parent-daughter relationships were examined. Indeed, no known research has examined how the parent-child relationship may affect BAS/BIS usage. Forty emerging adult women were recruited; half were assigned to an experimental training group, while the other half completed a sham training group, in which they equally reacted to all foods. Participants were asked to complete five sessions on their own devices, in their chosen environment. By the final training sessions, those in the experimental group (n = 15) reacted to healthy foods two times faster than those in the sham group (n = 15). In addition, a series of moderation analyses found that, even when participants had high levels of thin ideal internalization, positive parenting characteristics such as a current high-quality mother-daughter relationship and past low paternal control improved participants’ reaction times to healthy foods. These findings suggest that a combination of both a biologically-based method of intervention and a family systems intervention may lead women to have healthier approaches to foods, thereby potentially preventing the development of unhealthy eating habits.
Longitudinal Associations among Personality, Perceived Control, and Health for American and Japanese Aging Adults
(North Dakota State University, 2019) Toyama, Masahiro
Perceived control is associated with health throughout adulthood, yet has also been found to decline with age possibly due to age-related experiences of increasing losses and limitations in life circumstances. Perceived control may also be affected by individual personality characteristics, which also predict health through late adulthood. Although previous studies have addressed these associations, research is lacking in examining nuanced associations among personality, perceived control, and health all together as well as age and gender differences in these associations. Moreover, perceived control may be related to individualistic values (e.g., autonomy, agency) that vary cross-culturally and the implications of perceived control as well as personality for health may differ in distinct cultures. However, cross-cultural research on longitudinal associations of personality, perceived control, and health is further limited. In order to address the gap in the literature, the present dissertation, consisting of three studies, focuses on investigating longitudinal associations among personality, perceived control, and health for American and Japanese middle-aged and older adults. The first two studies address longitudinal associations between personality and perceived control (Study 1) and the potential mediation of perceived control for longitudinal associations between personality and health (Study 2) for 4,611 American adults (aged 40 to 75 at baseline). Study 3 examines associations among personality, perceived control, and health for 827 Japanese adults (aged 40 to 79 at baseline) in contrast to Americans. The findings suggest that neuroticism and conscientiousness are consistent predictors for perceived control over time and that perceived control mediates longitudinal associations of neuroticism and conscientiousness with functional health for American adults. Such mediation was not found for Japanese adults despite overall similar tendencies except for associations between personality and perceived control. No age differences in associations among personality, perceived control, and health were found for both nationalities (who were in their 40s to 70s at baseline) while there were some gender differences in a limited few associations for Americans. The dissertation contributes to the literature by furthering the understanding of longitudinal associations of personality, perceived control, and health and indicating future directions for research including exploring potential avenues to promoting health through perceived control.

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