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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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.
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.
Exploring the Meaning of a Rural Mind-Body Medicine Group Curriculum from the Perspectives of Community-Based Participants
(North Dakota State University, 2020) Riegert, JoAnne Marie
The challenges and stress that are present in our daily lives can be consuming and are often associated with chronic illnesses and mental health concerns. In rural communities, residents may experience greater exposure to a range of potentially traumatic events at both a personal and community level (Handley et al., 2015). Additionally, in many rural areas, the availability of health services is a significant issue. One emerging approach utilized to treat the increasing numbers of chronic illnesses and trauma-related mental health problems in a rural population is the integration of meditation skills presented in a group setting, to counterbalance the effects. This phenomenological study explores seven individuals' perspectives on the impact of participation in a Mind-Body Medicine Group Curriculum, in a rural community. The findings illuminate etic clusters of the impact of worry, the importance of forgiveness, growth of self-love and self-compassion, the benefits of the therapeutic bond in the group experience, and micro and macro healing. Emic themes of self-actualization and the importance of relational connection were discovered. These outcomes suggest that healing in rural communities is obtained in group settings, as an additional alternative to individual therapy. Implications for integrating mindfulness into psychotherapy practice, the impact of group work in rural areas, as well as applications for counselor educators and graduate training programs, are additionally explored.
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.
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.
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.
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.
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.
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.

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