VTechWorks Repository :: Browsing by Author "Savla, Jyoti S."

Browsing by Author "Savla, Jyoti S."

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Are the Initiation and Maintenance of a Resistance Training Program Associated with Changes to Dietary Intake and Non-Resistance Training Physical Activity in Adults with Prediabetes?
Halliday, Tanya M. (Virginia Tech, 2016-05-02)
Prediabetes is associated with an elevated risk for developing type 2 diabetes (T2DM) and associated cardiovascular complications. Lifestyle factors such as physical activity (PA) and dietary intake are strongly implicated in the development of metabolic disease, yet few Americans meet PA and dietary recommendations. Middle-aged and older adults are at increased risk for developing prediabetes and T2DM due to age-related muscle loss, increased fat mass, and alterations in glucose handling. In addition, this segment of the population is least likely to meet PA guidelines, particularly the resistance training (RT) recommendation of completing a whole body routine 2x/week. Ideally, individuals would alter their lifestyle in order to meet PA guidelines and habitually consume a healthy diet, to decrease disease risk. However, behavior change is difficult and optimal strategies to promote and maintain changes have yet to be determined. Furthermore, behavior change interventions tend to be time-, cost-, and resource-intensive, limiting the ability for efficacious programs to be translated into community settings and broadly disseminated. Evidence suggests that health-related behaviors, particularly diet and exercise habits, tend to cluster together. Thus, intervening on one behavior (e.g. PA) may elicit a spillover effect, promoting alterations in other behaviors (e.g. diet), though findings to date are conflicting. The purpose of this dissertation was to determine if participation in a social cognitive theory-based RT program targeting the initiation and maintenance of RT exerts a spillover effect and is associated with alterations in dietary intake and/or non-RT PA in a population at risk for T2DM. Data from the 15-month Resist Diabetes study was analyzed to evaluate this possibility. Sedentary, overweight/obese (BMI 25-39.9 kg/m2 ), middle-aged and older (50 -69 years) adults with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a 3 month initiation phase where they RT 2x/week in a lab-gym with an ACSM-certified personal trainer. Participants then completed a 6-month faded contact maintenance phase, and a 6-month no-contact phase during which they were to continue RT on their own in a public facility. No advice or encouragement was given to participants to alter dietary intake or non-RT PA habits. At baseline, and months 3, 9, and 15, three non-consecutive 24-hour diet recalls were collected to evaluate dietary intake and quality, the Aerobics Institute Longitudinal Study Questionnaire was completed to evaluate non-RT PA, and body mass, body composition, and strength (3 repetition maximum on leg and chest press) were measured. At months 3, 9, and 15 social cognitive theory (SCT) constructs were assessed with a RT Health Beliefs Questionnaire. In the first study, dietary intake was assessed at baseline and after 3 months of RT. Using paired sample t-tests, reductions in intake of energy (1914 ± 40 kcal vs. 1834 ± 427 kcal, p = 0.010), carbohydrate (211.6 ± 4.9 g vs. 201.7 ± 5.2 g, p = 0.015), total sugar (87.4 ± 2.7 g vs. 81.5 ± 3.1 g, p = 0.030), glycemic load (113.4 ± 3.0 vs. 108.1 ±3.2, p= 0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p= 0.018), and sweets and desserts (1.1 ± 0.07 servings vs. 0.89 ± 0.07 servings, p = 0.023) were detected from baseline to month 3. No changes in other dietary intake variables were observed. These findings supported additional investigation in this area. The second study assessed changes in overall diet quality (Healthy Eating Index [HEI]-2010 scores) and non-RT PA over the initiation, maintenance, and no-contact phases using mixed effects models. Demographic, physiological, and psychosocial factors that may predict alterations to diet quality and non-RT PA were also explored. Energy and carbohydrate intake decreased with RT (β= -87.9, p=.015 and β= -16.3, p<.001, respectively). No change in overall dietary quality (HEI-2010 score: β= -0.13, p=.722) occurred, but alterations in HEI-2010 sub-scores were detected. Maintenance of RT was accompanied by an increase in MET-min/week of total non-RT PA (β=153.5, p=0.01), which was predicted by increased self-regulation for RT (β=78.1, p=0.03). RT may be a gateway behavior leading to improvements in other health-related behaviors among adults with prediabetes. These results support the use of singlecomponent vs. multi-component interventions. This may have broad translational potential for the development of time-, resource-, and cost-efficient lifestyle interventions which can improve multiple health-related behaviors and decrease disease risk.
Are There Sex Differences in Behavioral Predictors of Successful Weight Loss Maintenance?
Baugh, Mary Elizabeth (Virginia Tech, 2013-10-16)
Current literature emphasizes poor long-term weight loss maintenance (WTLM) outcomes, and the need for inexpensive, practical solutions for effective WTLM is evident. Individuals successful at WTLM utilize similar behaviors but in varying amounts and combinations, seemingly choosing behaviors that best fit their preferences. Researchers have attempted to identify characteristics of individuals that may predict successful WTLM in order to develop flexible WTLM treatments based on individuals' lifestyle and preferences. The purpose of this analysis was to examine sex differences in WTLM outcomes and to identify potential behaviors related to WTLM success. In a 12-month study targeting WTLM, weight-reduced middle-aged and older men and women (n=39) were assigned behavioral goals for body weight, fruit and vegetable intake, water consumption, and physical activity and were asked to daily self-monitor body weight and these behaviors. Sex difference in clinically significant WL ≥5% WL) at 12 months was determined. A growth curve model assessed interactions of sex and WTLM predictors, and a crisp set qualitative comparative analysis (QCA) characterized individuals' weight changes and behaviors. No sex difference was found in clinically significant WL or in the interaction of sex and behaviors on weight change; however, QCA evidence suggests men and women may approach WTLM with different behaviors. Additionally, QCA findings suggest weight change in the first 3 months of WTLM may determine success at 12-months. WTLM treatments should provide more intensive support during the transition period from WL to WTLM. Future research in predictors of WTLM, particularly within the context of sex, is essential.
Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach
Liu, Sarah Victoria (Virginia Tech, 2017-05-22)
An estimated 20.5% of adolescents ages 12 – 19 years were obese (≥95th percentile of BMI-for-age) in 2011 – 2014. Consumption of added sugars (AS) has been linked with adverse effects on weight and cardiovascular disease risk factors. Approximately 16% of adolescents’ calories come from AS, of which sugar-sweetened beverages (SSB) are a major contributor. However, the relationship between AS/SSB intake and obesity is controversial, partly due to limitations in self-reported dietary data. Objective dietary intake biomarkers may circumvent this problem. The δ13C biomarker for AS intake is based upon the fact that C4 plants– major source for sugar production in the United States – have elevated δ¹³C values compared to C3 plants, which includes most fruits and vegetables. The δ¹³C value of blood, which is influenced by diet, has been established as a valid, reliable, and sensitive biomarker, but when compared to selfreported AS intake. This investigation evaluated the sensitivity and reliability of the δ13C biomarker, assessed with fingerstick blood samples, in adolescents using a controlled feeding, crossover design. Fingerstick δ¹³C values significantly changed by -0.05‰ and +0.03‰ after subjects completed the 5% and 25% AS diets, respectively (F(1, 30) = 18.828, p < 0.001). High reliability was found between two consecutive fingerstick δ¹³C values on the low (ICC = 0.996) and high (ICC = 0.997) AS diets. Thus, fingerstick δ¹³C may be a sensitive and reliable indicator of AS intake in adolescents. Future investigations should develop an equation to estimate AS intake based on fingerstick δ¹³C
Community Characteristics and Trajectories of Adolescent Internalizing and Externalizing Behaviors: The Cumulative Advantage/Disadvantage and Subjective Appraisals of Social Support as Mechanisms
Zhang, Jing (Virginia Tech, 2012-09-05)
Studies examining neighborhood effects on adolescent outcomes have indicated that adolescents growing up in low-income neighborhoods are at higher risk of developing internalizing and externalizing behaviors. However, knowledge of the long-term effects of neighborhood disadvantages on internalizing and externalizing behaviors and the involved mechanisms across adolescence is limited. Using family life course theory and the cumulative advantage/disadvantage perspective, this study examined how community disadvantages in early adolescence accumulate over time to influence later internalizing and externalizing behaviors and the protective effects of subjective appraisals of social support by adolescents and their primary caregivers. I estimated a two-level growth curve model using three waves of data from the Project on Human Development in Chicago Neighborhoods (PHDCN). Results indicated subjective appraisals of social support by both adolescents and caregivers played a protective role to buffer the negative effects of community disadvantages on internalizing and externalizing behaviors across adolescence. These results provide insight for the development of intervention programs at both family and government levels to improve adolescent outcomes.
Comorbid ADHD: Implications for Cognitive-Behavioral Therapy of Youth with a Specific Phobia
Halldorsdottir, Thorhildur (Virginia Tech, 2014-03-04)
Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed.
Consumer Evaluation of a Vertical Brand Extension in the Lodging Industry: Relationships among Brand Trust, Band Loyalty, Brand Distance, and Brand Extension
Lim, Yu Mi (Virginia Tech, 2013-04-24)
Vertical brand extensions have been used as popular strategies in the lodging industry. Research on brand extension that is related with brand trust and brand loyalty has been useful in making brand extensions successful. However, previous research focused on aggregated relationships among brand trust, brand loyalty, and brand extension. In addition, it has been found that quality and price distance from a core brand of the brand extension has an impact on the success of the brand extension. Therefore, this dissertation proposes a theoretical model with six hypotheses investigating relationships among brand trust, brand loyalty and brand extension simultaneously. Further, the impact of distance from a core brand (brand distance) on the brand extension was examined. Data was collected using an online panel. A final sample of 396 was used for the data analysis. Structural equation modeling (SEM), a Chi-square difference test, and independent t-tests were utilized to test the hypotheses. The data was randomly split in two. One half of the dataset was used to test a measurement model and the other half of the dataset was used to test a structural equation model. The findings suggested there were positive relationships between brand trust and brand loyalty, brand trust and brand extension, and brand loyalty and brand extension. Furthermore, it was found that brand distance plays a significant role not only on brand extension, but also on the relationship between brand trust and brand extension and the relationship between brand loyalty and brand extension. This study contributes to vertical brand extension literature by providing a theoretical model by which simultaneous relationships among brand trust, brand loyalty and brand extension were investigated with a moderating factor: brand distance. The findings of this dissertation have important managerial implications for lodging industry brand managers.
The Contribution of Common Factors to Therapeutic Outcomes from the Clinician's Perspective: A Mixed Method Study to Explore Common Mechanisms of Change
Karimi, Hassan (Virginia Tech, 2015-11-23)
While the Common Factors (CFs) model is becoming more popular it has been criticized for the lack of empirical evidence compared to empirically supported treatments and the lack of capacity to guide clinicians on what to do and when to do it in the course of therapy. This parallel mixed methods study addressed both of these critiques. In phase one, a Common Factors Questionnaire (Karimi-CFQ) was developed to collect empirical data of CFs. In phase two, the Karimi-CFQ was administered to 391 clinicians in the United States to survey the therapists' perspective regarding the contribution of common factors to therapy outcomes. In this phase data was also collected to assess the relationship between clinicians' demographic characteristics and their perceived contribution of common factors to therapeutic change. The CFQ Cronbach's Alpha and Split-half reliability were .84 and .87, respectively. Content Validity Index by expert panel, concurrent validity, and construct validity including Exploratory Factors Analysis (EFA) and Confirmatory Factor Analysis (CFA, χ²=797.96, df=326; RMSEA=.06; CFI=.83) evaluated the validity of the scale. Clinicians across five clinical orientations (Integrative, Cognitive Behavior Therapy, Humanistic, Psychodynamic, Postmodern) and three mental health disciplines (marriage and family therapy, psychology, counseling) attributed 69% of therapeutic change to common factors versus 31% to model-specific factors. Clinicians attributed different contributions to specific components of the CFs model: client (25%), therapist (20%), relationship (23%), hope (12%), non-theory specific (11%), and systemic (9%). Particular clinicians' characteristics (e.g., gender, year of experience) were found to be associated with contributions of specific components of CFs. In phase three, six CF experts were invited to respond to open-ended questions via Wiki that explored how and when experienced therapists use specific common factors in the course of therapy to reach to their therapy goals. Thematic Analysis (TA) generated a chronological map with specific themes that can guide clinicians on how and when specific CFs can be used in each of the three stages of therapy (i.e. Initial, Intermediate, Termination). Findings further indicated that CFs and model-specific factors can be operationally defined and empirically studied within the same evidence-based practice framework. Clinical and research implications of the results are also discussed.
A Cross-Cultural Study of Never-Married Chinese and American Adults' Mate Selection Perceptions and Criteria
Chen, Ruoxi (Virginia Tech, 2013-11-26)
Mate selection has garnered much attention in the existing literature. However, most mate selection research has reviewed mate selection preferences and criteria individually. In this study, the researcher attempted to illustrate mate selection as an interactive process in which individuals are affected by external influences, and their mate selection criteria are influenced by their self-appraisals and their perceptions of others' mate selection criteria. Two studies were conducted. Study 1 was based on social exchange theory, sexual strategies theory, and social context frameworks, and used multiple-group structural equation modeling to describe the relationships among gender, receptivity to external influences on mate selection, self-perceived relative mate selection position, and relative mate selection demand, between Chinese and American never-married heterosexual adults. The results indicated that the model fit the data well. Self-perceived relative mate selection position and relative mate selection demand were negatively correlated. Women had a higher relative mate selection demand than men did. Self-perceived relative mate selection position fully mediated the effect of receptivity to external influences on relative mate selection, though the indirect effect was not significant. Path values did not differ between Chinese participants and American participants. Study 2 confirmed that the model fit the data well and replicated all significant correlations among latent variables found in Study 1. Additionally, Study 2 found that receptivity to external influences and self-perceived relative mate selection position were positively correlated, and that receptivity to external influences had a negative indirect effect on relative mate selection demand, fully mediated by relative mate selection position. Lastly, the researcher discussed findings, implications, strengths, limitations, and future directions of the present study.
A Daily Diary Investigation of the Impact of Flexible Work Arrangements on Physical Activity Among University Staff
Borowski, Shelby (Virginia Tech, 2019-06-07)
The goal of this investigation was to examine personal and environmental factors that may influence levels of daily physical activity in a sample of university staff employees who use flexible work arrangements (flextime or telework). Our first aim was to investigate the link between self-efficacy, perceived barriers, and flexible work arrangements on daily physical activity. Our second aim was to investigate the link between work stress, job burnout, work-to-family conflict and flexible work arrangements on physical activity. Lastly, we investigated if the use of flexible work arrangements buffered the relationship between barriers, as well as job burnout, on physical activity. University staff employees who worked full-time, currently used a flexible work arrangement, lived with at least one family member were eligible to participate. Using a daily diary design, data were collected from 61 university staff employees. Participants completed an initial survey followed by daily diaries over the course of one workweek, resulting in 281 diary days. Data were analyzed with multilevel negative binomial models. Daily barriers and use of flextime were associated with lower physical activity. Self-efficacy, telework, work stress, and work-to-family conflict were not significantly associated with daily physical activity. Flexible work arrangements did not moderate the association between barriers and physical activity. However, flextime moderated the association between job burnout and physical activity. Individuals with high job burnout engaged in more physical activity on flextime days compared to non-flexible workdays. Implications regarding physical activity, flexible work arrangements, and workplace wellness programs are discussed.
Daily Self-Monitoring During the Winter Holiday Period: A Strategy for Holiday Weight Maintenance in Reduced-Obese Older Adults?
Cornett, Rachel Ann (Virginia Tech, 2011-02-23)
Weight management is problematic among Americans, as the number of overweight adults has risen to two-thirds of the population (1). Without the identification of successful approaches to promote weight stability, it is predicted that 86% of American adults will be overweight or obese by 2030 (2). Body-weight influenced diseases, such as diabetes and cardiovascular disease, are now leading causes of death (3). Annually, adult Americans are thought to increase their body weight by 0.5-0.9 kg (4). Of this gain, 52% is believed to occur during the winter holiday period of mid-late November to early January (5). Unfortunately, obesity research specific to this high-risk period is limited. Older adults and weight-reduced individuals are thought to be highly susceptible to significant holiday body weight gains (1, 6). To date, little research has investigated effective interventions that may be used to assist in successful body weight maintenance during the winter holiday period. Therefore, our purpose was to determine if daily self-monitoring of body weight, physical activity, and step counts is a feasible and effective tool to prevent weight gain in older, weight-reduced adults during the winter holiday period. This intervention represents a holiday weight maintenance approach that may be translatable to larger, more diverse populations.
Daily Stressors and Marital Interactions Affect Diurnal Cortisol and Alpha-Amylase Rhythm in Spouses of Persons with Mild Cognitive Impairment
Savla, Jyoti S.; Roberto, Karen A.; Blieszner, Rosemary (Virginia Tech, 2011)
Research aims: 1. To document daily symptoms and behaviors of persons with MCI 2. To assess how MCI-related symptoms, care needs and other stressors influence psychological well-being of care partners 3. To examine effects of MCI-related symptoms, care needs and other stressors on spouse care partner’s physiological indicators of health (Diurnal Rhythm of Coritsol and Alpha-Amylase)
Development and Evaluation of a Brief Questionnaire to Assess Habitual Beverage Intake (BEVQ-15): Sugar-Sweetened Beverages and Total Beverage Energy Intake
Hedrick, Valisa E. (Virginia Tech, 2011-09-23)
Attention on beverage intake, specifically sugar-sweetened beverages (SSB), has increased in recent years (1). Energy-containing beverages do not provide the same satiety as solid foods, and intake of solid food is not spontaneously reduced when energy-containing beverages are consumed (2,3). This may contribute to positive energy balance (1). Conversely, a reduction in energy intake occurs by replacing SSB with water and may facilitate weight loss (4,5). A valid, reliable and sensitive assessment tool for quantifying beverage consumption and determining its influence on weight status could help advance research on this topic. Three studies were conducted to develop the BEVQ, a self-administered quantitative beverage intake questionnaire. First study (n=105): the 19-item BEVQ's validity was examined by comparing participant's beverage intake to the "gold standard" of dietary intake assessment, food intake records; reliability was assessed by comparing two BEVQ's, administered two weeks apart. The BEVQ demonstrated acceptable validity (R2=0.53, water g; 0.46, 0.61 total beverage g, kcal; 0.49, 0.59 SSB g, kcal) as well as reliability (all correlations P<0.001) (6). Second study (n=1,596): the BEVQ underwent exploratory factor analyses (EFA) to identify the potential to reduce items. Three beverage items, which contributed <10% to total beverage intake g, kcal, were eliminated; EFA identified beer and light beer as a combined category. The refinement led to the 15-item BEVQ, which produced a lower readability score of 4.8 and shorter administration time (~2 min) (7). Third study (n=70): the ability of the BEVQ-15 to detect changes in beverage intake was evaluated by increasing participant water and fruit juice consumption and evaluating BEVQ-15 outcomes before and after the feeding period. Increases in water, juice and total beverage (g) were detected during the intervention period (P<0.001) (8). This rapid, valid, reliable and sensitive beverage intake assessment tool may determine the habitual intake of SSB and other beverages, and evaluate the effectiveness of clinical and public health interventions which aim to address national SSB recommendations. Future work is needed to evaluate the validity and reliability of the BEVQ-15 in children, as well as develop cost-effective noninvasive biomarkers that can objectively estimate intake of specific foods/dietary components (9).
Development of Neuroconnectivity and Inhibitory Control: Relation to Social Cognition in Late Childhood
Broomell, Alleyne Patricia Ross (Virginia Tech, 2019-05-03)
Social cognition is a set of complex processes that mediate much of human behavior. The development of these skills is related to and interdependent on other cognitive processes, particularly inhibitory control, which allows for willful suppression of dominant responses. Many aspects of social behavior rely on inhibitory control to moderate impulsive or socially inappropriate behaviors and process complex perspective-taking. Furthermore, the brain regions associated with inhibitory control and social cognition overlap functionally and structurally. I review neurodevelopmental literature to suggest that social cognition is developmentally dependent on inhibitory control and that the neural foundations of both these skills are measurable in infancy. I tested this model using growth curve and structural equation modeling and show that 10-month, but not 5-month, frontotemporal coherence predicts social cognition in late childhood through preschool inhibitory control. These findings provide insight into the neurodevelopmental trajectory of cognition and suggest that connectivity from frontal regions to other parts of the brain is a foundation for the development of these skills.
Dietary biomarkers: advances, limitations and future directions
Hedrick, Valisa E.; Dietrich, Andrea M.; Estabrooks, Paul A.; Savla, Jyoti S.; Serrano, Elena L.; Davy, Brenda M. (Biomed Central, 2012-12-14)
The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.
Dual Caregivers of Persons Living with Dementia: The Added Stress of COVID-19 Pandemic
Atkinson, Emily; Savla, Jyoti S.; Roberto, Karen A.; Blieszner, Rosemary; McCann, Brandy R.; Knight, Aubrey L. (SAGE, 2022-02-17)
Serving in dual caregiving roles presents challenges and has consequences for caregivers’ physical and mental health. Forty-six dual caregivers in rural southwest Virginia participated in one semi-structured telephone interview pre-pandemic. Of these caregivers, nine dual caregivers of multiple older adults (MOA) and six caregivers of multiple generations (MG) participated in two telephone interviews during the COVID-19 pandemic. Pre-pandemic health, stress, and support data were used to compare dual caregivers of MOA and MG; differences were minimal. Responses to interviews conducted during the pandemic highlighted the effects of social restrictions on MOA and MG caregivers, revealing five themes (1) Increased isolation, (2) Increased need for vigilance, (3) Negative impact on mental health, (4) Tendency to “do it all,” and (5) Increased informal help. MOA and MG caregivers differed on managing care responsibilities and ensuring the health of care recipients. In general, dual caregivers experienced decreased mental health, increased social isolation, and increased caregiving responsibilities. Antecedents of the pandemic experiences differentiated MOA and MG caregiver. Findings suggest that programs and services should target dual caregivers’ unique needs.
Extended Family Caregivers for Persons Living With Dementia
Roberto, Karen A.; Savla, Jyoti S. (SAGE, 2022-11-01)
Despite changes in the structure of contemporary families, little is known about extended family members—siblings, grandchildren, nieces/nephews, stepkin—who are primary caregivers for a relative living with dementia. Information about these caregivers is needed to help ensure their needs are understood by providers in health care and social service settings. The focus of this research was on the care situations of extended family caregivers and the impact of caregiving on their health and well-being. In Study 1, data from the National Study of Caregiving were used to describe the experiences of 107 extended family caregivers. In Study 2, case study techniques elicited additional information about the experiences of 10 extended family caregivers. Collectively, these caregivers provide care with little or no formal support and occasional help from a small informal network. Caregiving affected their physical and emotional health, depending on the strength of the relationship between the caregiver and the person living with dementia and the type of care provided. Findings contribute new knowledge about extended family caregivers and highlight the important role extended family dementia caregivers play and the challenges they face.
Family Caregivers in Rural Appalachia Caring for Older Relatives With Dementia: Predictors of Service Use
Savla, Jyoti S.; Roberto, Karen A.; Blieszner, Rosemary; Knight, Aubrey L. (Oxford University Press, 2022-01-01)
Background and Objectives Residents of rural Appalachia tend to experience poorer health and greater economic distress than rural dwellers elsewhere in the United States. Although family is the first line of support for older adults needing care, it is unclear whether dementia caregivers in Appalachia assume these care responsibilities because of strong informal networks that support them in their caregiving role, underresourced formal services for persons with dementia, or culture-based reluctance to accept help from outsiders. This research examines how rural residents of Appalachia manage the care of relatives with dementia. Research Design and Methods The study was grounded in the Andersen Behavioral Model, supplemented with culturally relevant variables. Family caregivers from rural Appalachian counties in Virginia caring for community-dwelling relatives with dementia participated in a structured phone interview (N = 163). Generalized structural equation models were estimated, with predisposing, need, and enabling variables as predictors. Use of support services (e.g., meal delivery) and personal services (e.g., home health nurse) by family caregivers to care for the person with dementia were the dependent variables, and caregiver's rural community identity and attitude toward services were moderators. Results Approximately half the sample utilized at least one support service and one personal service. Predisposing and need factors predicted the use of support services, whereas predisposing, need, and enabling factors predicted personal services. Caregivers who strongly identified with their cultural roots were less likely to use personal services unless they held a generally positive view of formal services. Discussion and Implications Although the extent of needs and the caregiver's economic situation were essential influences on formal service utilization, the main drivers were the caregiver's identification with rural Appalachian culture and attitude toward services. Findings point to within-group heterogeneity that requires differential approaches to delivery of community-based services accounting for varying attitudes, preferences, and family resources.
The Feasibility of Ecological Momentary Assessment of Pain Intensity, Affect and Self-Efficacy Associated with Exercise in Women with Chronic Pain
Johnson, Elizabeth (Virginia Tech, 2010-04-30)
Objective: The purpose of the following study was to test the feasibility of using an ecological momentary assessment strategy during participation in water exercise. This assessment strategy was used to collect ratings of pain intensity level, affective status and self-efficacy for engaging in regular exercise prior to, during and following participation in water exercise for women with chronic pain. Design: Participants (N=15) completed six measures assessing physical activity level and reactions to physical activity and exercise participation and participated in elicitation interviews focused on their experiences with chronic pain and physical activity and exercise. Participants reported daily pain intensity levels, affect and self-efficacy each morning by phone and used cellular phones to report momentary ratings immediately following participation in water exercise for 6 weeks. Results: Participant profiles were developed to display patterns of pain intensity, affect and self-efficacy over the course of 6 weeks. Profiles indicated a variety of levels of exercise consistency in participants. Pain intensity, affect and self-efficacy varied over the course of an exercise event and revealed varied patterns across participants. Overall, momentary self-efficacy (MÂ¹= 7.98, SD=1.65; MÂ²= 8.29, SD=1.62; MÂ³=8.45, SD=1.45) and affect mean ratings (MÂ¹= 2.05, SD=1.42; MÂ²= 2.76, SD=1.22; MÂ³=3.02, SD=1.06) increased over the course of the exercise events while pain levels decreased from pre-exercise levels (MÂ¹= 2.67, SD=2.30; MÂ²= 1.85, SD=1.86; MÂ³=1.95, SD=2.05). Elicitation interviews indicated themes related to the importance of enjoyment of exercise, social factors, and impact on pain level and overall physical condition. Final interviews provided information about the reactions of participants to the assessment strategy and offered insight into the acceptance of this approach for future studies of exercise behaviors. Conclusion: Overall, this approach to ecological momentary assessment of variables associated with exercise was acceptable to participants and revealed variable patterns of pain intensity, self-efficacy and affective state in relation to water-exercise engagement.
From Terrible Twos to Sassy Sixes: The Development of Vocabulary and Executive Functioning Across Early Childhood
Bruce, Madeleine D. (Virginia Tech, 2022-05-09)
Early childhood marks a time when word learning is accompanied by rapid growth in the cognitive processes that underlie self-modulated and goal-directed behavior (i.e., executive functions (EF)). Although there is empirical evidence to support the association between EF and vocabulary development in childhood, inconsistent findings have been reported regarding the extent to which early EF abilities predict later vocabulary outcomes and vice versa. Thus, the first aim of the present study was to employ a stringent analytic approach to examining the longitudinal relations between EF and vocabulary across multiple waves in early childhood (i.e., at ages 2, 3, 4, and 6). Among the studies that have documented a link between children's early and later EF/vocabulary skills, the underlying mechanism(s) that can account for this association have yet to be identified. As such, the second and third aims of this study were to investigate children's private speech and visual attention skills as potential mediators of the hypothesized link between early and later EF/vocabulary. The results indicate that after controlling for maternal education, a unidirectional cross-lagged panel model best fit the data. That is, across all measurement waves, children's vocabulary scores at one timepoint were positively predictive of their EF performance at the following timepoint. Although no evidence of mediation was detected, a significant and novel association emerged between children's early vocabulary scores and their later private speech production. Moreover, this study was able to replicate the well-established link between visual attention and receptive vocabulary among a sample of older children.
Health of the Adult Children Caregivers for Older Adults in Mainland China
Liu, Yujun (Virginia Tech, 2017-06-07)
Objective. Guided by Pearlin's stress process model, this study explored the health of the adult children caregivers for older adults in mainland China. Methods. Data were from a nationally representative sample of respondents aged 45+ (N=13,204) who participated in the China Health and Retirement Longitudinal Study Wave 2 (2013). Using logistic regression techniques, the first analysis focused on the relationship between caregiver status and social determinants of health and health disparities. For the second analysis, the moderating effect of employment status on caregiving time and depressive symptoms among 1,082 adult children caregivers was examined using multiple linear regression. Results. Adult children who were women, urban residents, younger, married, and had high school or more education were more likely to be caregivers than non-caregivers. Caregivers were more likely to live alone or live in three generation households and report fewer difficulties with physical functions compared to non-caregivers. Among caregivers, adult children who spent more hours providing care were more likely to experience more depressive symptoms as were adult children who were working outside of the home. The effect of caregiving time on depressive symptoms was moderated by employment status and gender. Unemployed men caregivers who spent more hours providing care reported the most depressive symptoms. Conversely, unemployed men caregivers who spent fewer hours providing care reported lowest level of depressive symptoms.

Browsing by Author "Savla, Jyoti S."

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