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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.
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.
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.
Multiracial Identity as a Factor in Body Image and Disordered Eating
(North Dakota State University, 2022) Leonard, Kerrie
Emerging adulthood is a significant developmental stage where both ethnic-racial identitydevelopment and body dissatisfaction/disordered eating are salient. Past research suggests that there are links between identity development and body image/disordered eating (Palmeroni et al., 2020). Additionally, studies in the body image/disordered eating field have begun to examine differences among ethnic-racial groups (see Bucchianeri et al., 2016). However, there is limited research with Multiracial individuals (i.e., individuals with two or more ethnic-racial backgrounds). It is undetermined how Multiracial identity development influences body image and disordered eating behaviors. Thus, two studies were conducted to explore such connections. Participants included 174 Multiracial emerging adults (M = 21.8 years, SD = 2.08 years) in the U.S. Most participants were women (73.6%). The most common Multiracial identities were Asian-White (36.2%) and Black-White (23.0%). Study 1 was a mixed-method study that tested the racial identity-related factors of ethnic-racial identity achievement (i.e., feeling secure in one’s identity), racial ambiguity, racial incongruity, race esteem, and self-rated impact of identity and their associations with body dissatisfaction, body appreciation, and disordered eating. Furthermore, participants provided their overall thoughts and feelings on the impact of their Multiracial identity on their body image. Study 2 was a qualitative study that further explored Multiracial participants’ lived experiences with exoticization, racial ambiguity, and racial incongruity and how those experiences influenced their feelings towards their bodies. Quantitative results showed that ethnic-racial identity achievement and race esteem were positively associated with body appreciation. The qualitative findings provided mixed evidence, with an array of diverse appraisals and feelings ranging from positive to negative. Together, this research illuminates the ways in which being Multiracial plays a role in body image and disordered eating. The overall findings have implications for medical professionals, families, prevention and intervention programming, and Multiracial individuals themselves. Research with Multiracial participants is particularly important given that the U.S. Multiracial population is growing at a swift pace and that body image/disordered eating issues are prevalent for emerging adults.
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.
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.
Exploring the Concept of Prevescalation Through the Lens of Trauma: The Role of Students and Teachers
(North Dakota State University, 2021) Chinopfukutwa, Vimbayi Sandra
Numerous studies highlight that adolescence is the peak period of risk for trauma and its negative effects on physical and mental health. The current research focused on two studies examining whether training students and teachers in schools on effective strategies such as trauma-informed practices (TIPs) may help those who have experienced trauma build resilience and prevent the negative effects of trauma from progressing to adulthood. Study one examined the degree of trauma exposure, the role that students play in the implementation of TIPs, and the extent to which implementing TIPs impacts their lives. Participants were students (aged 15-18) participating in an elective Social Emotional Learning course in two rural high schools in the Midwest. Descriptive statistics showed that 46.2% of the students in the sample had at least one adverse childhood experience. Interview data also showed that students implemented Social Emotional Learning, Self-Care, and Restorative Circles in their schools. Results also showed that students trained younger students, same-age peers, and their teachers on these practices. Finally, results indicated that implementing TIPs promoted positive behaviors among students and teachers in the schools. Study two examined whether teachers’ professional quality of life and type of training received predicted their implementation of TIPs in schools. Participants were 324 teachers (aged 22-70) from three public school districts in the Midwest (different from the schools in study one). Hierarchical multiple regression analyses showed that compassion satisfaction positively predicted teachers’ implementation of TIPs while compassion fatigue negatively predicted teachers’ implementation of TIPs. In addition, teaching experience significantly moderated relations between compassion fatigue and teachers’ implementation of TIPs. Finally, training on Self-Care and Restorative Circles positively predicted teachers’ implementation of TIPs in schools. Discussion focuses on ways to provide support for students and teachers as they continue to promote the implementation of TIPs in schools.
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.
Does Mom Know Best? The Influence of Baby-led Weaning on Picky Eating and Sweetener Use
(North Dakota State University, 2021) Jellison, Savanna Elizabeth Jean Westrom
Baby-led weaning, the process of an infant feeding themselves at the introduction of solid foods as opposed to being spoon-fed by a caregiver, is an under-researched area of infant development. There is a significant gap in knowledge regarding how baby-led weaning influences aspects of this critical period of development including picky eating and parental use of sweeteners or additives. The purpose of this research was to better understand the influence that feeding method has on optimal infant development. The central hypotheses were (1) that infants who baby-led weaned would have greater food acceptance and be less likely to be labelled a picky eater than parent-led weaned infants, and (2) parents who utilize baby-led weaning will be less likely to utilize sweeteners or additives with their infants compared to parents who choose parent-led weaning. Participants (N = 412) were given a link to a single questionnaire through an online survey software. The survey consisted of a variety of question types including Likert-type scales, yes/no, and short answer. Results of our first study showed that infants in both groups accepted most foods at similar rates at first introduction, indicating that initially infants from the two groups were similar in their food preferences. However, infants who had experienced baby-led weaning were less likely to be considered to be picky eaters by their parents than those who were parent-led weaned. These results support the hypothesis that feeding method may influence rates of picky eating. The results of our second study showed that there were no differences between parents who baby-led weaned and those who parent-led weaned in willingness to give sugar to increase food acceptance. For most of the sweeteners and additives surveyed, parents in both groups did not differ significantly in utilization. The exceptions were ranch dressing and honey. Parents who baby-led weaned were more likely to use both ranch and honey compared to their parent-led counterparts. Together, these studies indicate that baby-led weaned infants differ from parent-led weaned infants in a variety of factors that contribute to the development of healthy eating habits.
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.

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