Human Development & Family Science

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Research from the Department of Human Development & Family Science. The department website may be found at https://www.ndsu.edu/hdfs/

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Adolescent Sibling Relationships and Disordered Eating
(North Dakota State University, 2012) Haugen, Emily Catherine
Researchers have begun to explore the role that family members play in maintaining or recovering from an eating disorder. However, little research has addressed the sibling relationship, including nurturance, quarreling, and favoritism. Self-report questionnaires were collected from 120 girls and 87 boys in middle school (N=161) or high school (N=46). Linear regressions, ANOVAs and mediation analyses were conducted to determine the effects of siblings on adolescents’ disordered eating. Sibling favoritism and modeling of bulimic behavior were the only variables significantly related to relationship quality. Our results indicate that family dynamics and structure may play a larger role in adolescent maladaptive behavior than sibling relationship quality. Additionally, sibling relationship quality, bulimic modeling and sibling favoritism may be part of a very complex process leading to disordered eating behavior. Future research should continue to utilize the sibling subsystem as a means of understanding the development of disordered eating behavior among adolescents.
Age and Gender Differences in Attitudes and Knowledge about Alzheimer's Disease
(North Dakota State University, 2014) Moreira, Rashidat Oladotun
The purpose of this study was to examine possible age and gender discrepancies in knowledge and attitudes towards individuals with Alzheimer's disease (AD). Data were taken from a Midwestern survey study of community-dwelling adults aged 18-88 (N=211). Participants were divided into two age groups: younger adults (ages 18-49), and older adults, encompassing the Baby Boom generation (ages 49+). The findings indicated that, relative to older adults, younger adults were: less likely to know someone with AD; less likely to make lifestyle changes to reduce their AD risk; and less factually knowledgeable about AD. However, younger adults reported more positive attitudes about AD. When demographic variables, knowing someone with AD, and knowledge of AD were examined simultaneously as predictors of attitudes, the following were significant: age, knowledge, and knowing someone with AD. Gender had no significant relationships with any of the outcome variables examined. Interpretations of these findings were discussed.
Aging Out of Place: Quality of Life and Successful Aging Among Aging Refugee Immigrants in the US
(North Dakota State University, 2021) Owino, Jonix Atieno
As individuals age, they experience physical, cognitive, and socioemotional changes that may impact their well-being. However, little is known about well-being among aging refugees. Thus, the present study explores factors associated with quality of life and perceptions of successful aging among refugees who are aged 50 years and above. This mixed methods dissertation included a quantitative and qualitative study. For the quantitative study, 108 refugee participants (from Bhutan, Burundi, and Somalia) living in the US were surveyed to assess quality of life. Hierarchical regression analyses showed that females, older individuals, individuals with lower education levels, and African refugees reported lower quality of life. When controlling for sociodemographic factors, social integration was positively and loneliness was negatively associated with quality of life. Furthermore, trauma related experiences and post-migration living difficulties did not predict well-being for all participants; however, moderating effects of place of origin, sex, level of education and length of residence were observed. Twenty-one aging, Burundian refugees were recruited for the qualitative study to explore perceptions and experiences of successful aging. Emergent themes showed that some of aging refugees’ perceptions of successful aging were consistent with perceptions among other aging populations, yet in many ways the unique background of aging refugees seemed to impact their aging perceptions, such as perceiving an earlier onset of aging. Cultural factors and the context of being a refugee led to unique experiences of successful aging, and apparent gender differences. In summary, perceptions of aging out of place among aging refugees indicated both protective factors and risk factors. The findings from the two studies of this dissertation suggest important future directions of inquiry and have potential implications for communities on how they can better support aging refugees as well as develop effective interventions to promote well-being.
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.
Assessing Child Care Standards and Rates of Expulsion for Problem Behaviors in Preschool Children
(North Dakota State University, 2014) Nicklay, Monica Alma
Quality in child care programs has been studied often and researchers search to find correlations between quality measures and positive child outcomes. Some studies also show that problem behaviors result in large numbers of child expulsions in preschool age programs. The question remains whether the quality of the program produces care that lends to a lower incidence of behavior problems leading to child expulsion. The current study investigated the correlations among quality standard levels, behavior problems, and expulsion rates in a variety of child care programs in one state. Results showed that programs that are documented as having achieved the high quality standard of NAEYC accreditation do not necessarily employ direct care staff with higher education and experience levels. Although higher quality programs in this study were not shown to experience a significantly lower occurrence of problem behaviors, higher quality programs did report lower child expulsion rates.
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.
Caregiver Stress : First Person Accounts of the Perception and Utilization of Support Services
(North Dakota State University, 2015) Shapiro, Debra Ann
The majority of care for older adults is provided in the home. Many studies show that the daily demands placed on informal care providers produce high degrees of strain and stress. In an effort to reduce the over-arching impact care provider burnout can have on the entire family system, a number of community organizations offer resources to informal caregivers in the form of support groups, respite care and skills-training. More research is needed regarding the extent to which informal caregivers utilize these services. The objective of this paper is to assimilate more information about how care providers learn about available resources, which ones are used, and how the care providers’ needs are being supported. Key themes from these data could provide service providers with insights regarding: the effectiveness of their marketing strategies; ways current services could better serve a larger, more diverse population; and potential new services.
Caregivers and Environments for People with Dementia
(North Dakota State University, 2014) Damme, Mary Jane
This paper is a report of a study to investigate the perceptions of caregivers regarding the effects of environments on the independence of a family member with dementia living in the home. The majority of persons with dementia are cared for by family members in the home. Caregiving can be stressful and rewarding to the caregiver. This study used a qualitative research design and a phenomenological approach to gather narrative information about caregiving and the home environment. Open-ended interview questions were used to gather information regarding the details of caregiver perceptions. The results of shared caregiving perceptions support previous research suggesting that resistance to change in the home is a barrier to home modifications to promote safety and enhance function. Caregivers need specific training by professionals in home modification in order to enhance functionality in the care recipient before environmental changes create confusion.
A Case Study on Assessing Quality of Life in a Resident of an Assisted Living Facility
(North Dakota State University, 2021) Peterson, A'shanti Mignona Kimera
Lorna (a pseudonym) is an 81-year-old African American female who resides in an assisted living facility in a small town in southern Kentucky, where she was born. She has some minor health issues, and her family alleges she has emotional issues going back to childhood. She is mentally competent, and until ten years ago resided independently in the home purchased by her deceased parents. Since leaving this home, Lorna has become increasingly withdrawn from family members and society; she has also lost weight and seems to have declined mentally. This case study used five different assessments to build a profile of Lorna’s current state and develop recommendations for her care. These tools could potentially form the basis of a standardized assessment protocol for other older adults who are not thriving in assisted-living facilities.
CFT Faculty: Self-Assessment of LGB-Affirming Stances and Programs
(North Dakota State University, 2016) Kellerman, Jared Daniel
The purpose of this study was to investigate the factors that Couple and Family Therapy (CFT) faculty were using to identify the extent to which their program was LGB-affirmative. The sample for this study included 71 faculty members from CFT training programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE). The online data collection for this study included one open-ended question and one Likert scale item. The thematic analysis revealed seven categories: (1) Coursework and Training, (2) Training Programs’ LGB Population, (3) Belief Systems, (4) Importance of Faculty, (5) Practical Implementation of Explicit LGB-affirmative Values, (6) Affirming Environment, and (7) Not LGB-affirming Environment. The findings of this study provided insights into how CFT faculty members are conceptualizing LGB affirmative training on an individual and program levels.
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.
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.
Confronting Prejudice: Identifying Factors of Nontarget Confrontation
(North Dakota State University, 2014) Boes, Lindsey Anne
The research question for this project sought to identify factors that encouraged people to stand up to people who were discriminating against others. Seventeen students who had previously stood up against other people participated in one of three semi-structured focus groups. The analysis produced four themes, each with multiple categories which highlight factors that encouraged the participants to confront prejudice and discrimination. Main findings include the importance of connection with the individual being discriminated against, being educated about systems of oppression, perceiving discrimination as potentially harmful, and emotions such as anger, guilt, and pride. Implications for clinical work and the development of bystander training programs are provided, as well as implications for previously existing models of bystander intervention are discussed.
Connections between Parental Eating Behaviors and Adolescents’ Disordered Eating Attitudes and Behaviors Optimal Parenting Style as a Mediator
(North Dakota State University, 2015) Raap, Sara
An optimal parenting style consists of high warmth and low overprotection, and can influence the development of adolescents’ eating attitudes and behaviors. Evidence suggests that parental eating behaviors influence their children’s eating attitudes and behaviors. In the current study, the link between parental eating behaviors and disordered eating attitudes and behaviors was assessed among 224 adolescent boys and girls in middle and high school via bivariate linear regression. Additionally, optimal parenting style as a mediator between parental eating behaviors and adolescents’ disordered eating attitudes and behaviors was assessed with a mediation model that used bivariate and multiple linear regression. I found significant associations between parental eating behaviors and adolescents’ disordered eating attitudes and behaviors for boys and girls, and partial mediation was found for girls. However, there was no mediation found for boys as optimal parenting was not significantly related to boys’ disordered eating attitudes and behaviors.
Contraception and Sexuality in Heterosexual Emerging Adult Women
(North Dakota State University, 2013) Erickson, Shauna Marie
Our study aimed to gain a comprehensive look into heterosexual emerging adult women's preferred type of contraception, who women identify as primarily responsible for contraception, and how sexual self schemas, sexual attitudes, and sexual satisfaction were associated with contraceptive responsibility and preference. Online, self-report surveys were used to collect data from 264 sexually active women between the ages of 18-25. Results indicated that single women preferred dual contraception, whereas committed women preferred hormonal methods, yet both groups primarily viewed both partners as responsible for providing contraception. There was also a significant relationship between contraceptive preference and feelings of responsibility. Finally, we found a relationship between single women's sexual attitudes and preferred contraception, suggesting that women who preferred non-hormonal methods had more conservative attitudes than women who preferred hormonal methods. Our study has important implications for health providers, therapists, and educators to promote women's sexuality and well-being.
Couple and Family Therapy Faculty Members' Level of Training in LGB Affirmative Therapy
(North Dakota State University, 2015) Corturillo, Emily Marie
This study sought to investigate the training that Couple and Family Therapy (CFT) faculty members have received on lesbian, gay, and bisexual (LGB) affirmative therapy. The sample for this study included 65 faculty members from CFT programs accredited by the Commission on Accreditation for Marriage and Family Therapy Education. The on-line data collection for this study included two Likert scale items and one open-ended question. In particular the results suggest that 45.6% of participants reported receiving some LGB affirmative therapy training. Additionally, the thematic analysis revealed six categories: (1) Negligible Training, (2) Informal Training, (3) Coursework, (4) Topic-Driven Training, (5) Tools for Training, and (6) Experience. The findings of this study provided crucial implications for both CFT graduate training programs as well as current CFT faculty members, such as including LGB topics throughout CFT program curricula and faculty members attending sessions at conferences or continuing education workshops on LGB topics.
Couple and Family Therapy Students' Attitudes Toward Bisexual Clients
(North Dakota State University, 2012) Nova, Elizabeth Ann
Few studies have focused on student therapists' beliefs about bisexual clients and the impact of affirmative training on these beliefs. The current study explored 1) the level of experience couple and family therapy (CFT) students have with gay, lesbian and bisexual clients; 2) whether CFT students' levels of biphobia and homophobia differ; and 3) whether LGB affirmative training had an impact on self-reported levels of biphobia. Secondary data were used from data collected through electronic and paper surveys. The results revealed that CFT students have similar levels of experience working with bisexual and lesbian clients, but report significantly lower levels of experience with gay male clients. Furthermore, CFT students reported nearly identical levels of biphobia and homophobia. Finally, the results of this study suggest that more LGB affirmative training was associated with lower levels of self-reported biphobia. The findings of this study support CFT training programs implementing LGB affirmative training.
Defining Feminism: A Phenomenological Exploration of the Meaning Women Assign to their Feminist Identities
(North Dakota State University, 2013) McDougall, Sarah Delaney
This study explored the meaning that women assign to their feminist identities. In particular, the study examined the lived experiences of fourteen women who were active in the women's movement during the 1970s. The definitions of feminism provided were organized into six categories: (1) Working Towards Justice, (2) Valuing Self and Other Women, (3) Women with Diverse Perspectives, (4) Relevancy in Personal Lives, (5) Future Orientation, and (6) Changing Understandings of Feminism. Major findings of the study included an understanding that women hold unique experiences as feminists in relation to the larger feminist movement, an insight into the centrality of equality to understanding feminist identities, and an awareness that the results of this study contrast with the leading model of feminist identity in the literature. The findings of this study provided important implications for family therapists as this study highlights the need to explore gender-based oppression with their clients.
Development of a Newsletter Series on the Parenting Concerns of Asian Indians in the United States
(North Dakota State University, 2013) Komarneni, Sirisha
The purpose of this paper was to review research on the parenting concerns faced by Asian Indian parents in the United States. This paper reviews issues such as the impact of cultural differences on Asian Indian parenting practices, dating norms that challenge the Asian Indian traditional practice of arranged marriages, autonomy and independence that affects the career choices of growing children, and the cultural stigma that is attached to seeking counseling services or support by Asian Indians. In addition, the paper proposes the development of a series of educational newsletters specifically designed to educate Asian Indian parents in the United States on these significant parenting concerns and offer recommendations for building positive parent-child relationships and lowering intergenerational conflicts. These newsletters will be provided to Asian Indian parents through the Indo American Great Plains (IAGP) organization in Fargo, North Dakota.
Diversity and Social Justice in Couple and Family Therapy Training: An Evaluation of Accredited Programs
(North Dakota State University, 2010) Ostrom, Angela Lynn
Over the past 15 years, the literature in the field of couple and family therapy (CFT) has called for training programs to make issues of social justice a central concern in the training of couple and family therapists (Guanipa, 2003; Laszloffy & Hardy, 2000; Leslie & McDowell, 2004; McGeorge, Carlson, Erickson, & Guttormson, 2006). During that time the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) made several changes to the accreditation standards that required programs to integrate social justice principles and practices into CFT training. Recently, however, the COAMFTE removed many of these social justice requirements from its most current accreditation standards. Most notably, programs are now able to create their own definitions of diversity in addition to their own benchmarks for achieving diversity. The purpose of this study was to examine how CFT programs are currently defining diversity and whether or not those definitions are consistent with the current feminist and social justice training literature. Nineteen participants from different accredited CFT programs participated in the study. The results demonstrated inconsistency in the ways that programs define diversity and an overall lack of measureable benchmarks for achieving diversity.

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