Bridget L. Hanson

Later life health optimism, pessimism and realism: Psychosocial contributors and health correlates

Prior research has established positive outcomes of health optimism (appraising ones health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over ones health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.

Perceived control as a longitudinal moderator of late-life stressors on depressive symptoms.

Objectives: This study examined perceived control as a moderator of the relationship between late-life stressors and depressive symptoms among a sample of older New Zealanders. Method: Data were drawn from a longitudinal study with two data collection periods, one year apart. The Time 1 sample consisted of 1489 participants ranging in age from 65 to 94 years and 72% percent participated at Time 2. Correlational and multiple regression procedures were used to examine study hypotheses. Results: Results showed that Time 1 perceived control beliefs were a unique predictor of depressive symptoms at Time 2 after controlling for Time 1 depressives symptoms and other relevant variables. Further, perceived control beliefs at Time 1 moderated the relationship between late-life stressors and depressive symptoms at Time 2. Those with low perceived control demonstrated a stronger relationship between late-life stressors and depressive symptoms than those with high perceived control. Conclusion: This study provides evidence that perceived control influences levels of depressive symptoms over time among older adults. Results also support the hypothesis that control beliefs moderate the relationship between late-life stressors and depressive symptoms among older adults. Implications include attributional retraining to promote perceived control and subsequent well-being in older adults.

The role of positive thinking in social perceptions of cancer outcomes

Pressure for ‘positive thinking’ (PT; i.e. focusing on positive thoughts/suppressing negative thoughts to ‘fight’ cancer) burdens cancer patients facing health deterioration. It was determined whether PT exposure enhanced effort, control and responsibility attributions assigned to an individual for his/her cancer trajectory. Within an online blog a hypothetical same-gender person describes a personal cancer experience. 482 participants were assigned to one of six experimental conditions in which we manipulated PT exposure (blogger learns about ‘power of PT’ but does not try it, blogger tries PT, control/no PT) and cancer outcome (successful/unsuccessful treatment). A 3 × 2 × 2 multivariate analysis of covariance (with personal cancer experience covariates) tested PT exposure × cancer outcome × gender effects on attributions for the bloggers cancer outcome. Results indicate that PT exposure enhanced effort and responsibility attributions assigned to individuals for their cancer outcomes and that responsibility attributions differed as a function of gender. Findings suggest that exposure to the idea of PT may lead to cancer patients being perceived as culpable if they do not recover from the disease.

The Unique Role of Sleep Quality in Older Adults’ Psychological Well-Being

Previous research has established a link between sleep quality and psychological well-being in older adults. However, no research to date has investigated this relationship in the context of other factors known to influence both sleep and psychological well-being. Among a sample of 489 independently living older adults (ages 60 to 98), the current study examined the association between sleep quality and psychological well-being (positive emotions, negative emotions, depression) while controlling for individual differences in factors known to affect sleep: physical health, stress, physical activity, functional ability, and demographics. Multiple linear regression models showed that both better current sleep quality and better comparative sleep quality (from middle to older adulthood) predicted better psychological well-being. Implications include interventions to improve sleep quality in older adults.

Key Stakeholders' Perceptions of Motivators for Research Participation among Individuals Who Are Incarcerated

Understanding motivations of research participants is crucial for developing ethical research protocols, especially for research with vulnerable populations. Through interviews with 92 institutional review board members, prison administrators, research ethicists, and researchers, we explored key stakeholders’ perceptions of what motivates incarcerated individuals to participate in research. Primary motivators identified were a desire to contribute to society, gaining knowledge and health care, acquiring incentives, and obtaining social support. The potential for undue influence or coercion were also identified as motivators. These results highlight the need for careful analysis of what motivates incarcerated individuals to participate in research as part of developing or reviewing ethically permissible and responsible research protocols. Future research should expand this line of inquiry to directly include perspectives of incarcerated individuals.

Changes in sexual activity following substance dependence treatment

Individuals who abuse alcohol and other drugs are at increased risk for HIV/AIDS, although time of greatest risk is unclear. Although many studies have documented decreased sexual risk behaviours following substance abuse treatment, some evidence indicates that sexual risk behaviours may actually increase with sobriety. In this study, individuals involved in a substance abuse treatment programme were asked about their sexual activity for the month prior to treatment and 6 months after treatment. Results showed higher levels of sexual activity, including risky sexual activity, 6 months after discharge from treatment. This increase was found for individuals regardless of whether they were abstaining from substance use at follow-up, with highest levels of sexual activity and risky sexual activity reported by those still consuming alcohol or other drugs. These findings support the need for inclusion of HIV/AIDS prevention and educational programmes during substance abuse treatment.

Fit and Feasibility: Adapting a Standardized Curriculum to Prepare Future Health Professionals to Address Alcohol Misuse

Standardized screening, brief intervention, and referral to treatment (SBIRT) is effective when used by health care professionals to assess, educate, and intervene to address risky alcohol use. To accelerate SBIRT training within academic settings, the Substance Abuse and Mental Health Services Administration funded implementation of its SBIRT curriculum to promote its use by future health care professionals. We report on how SBIRT content was implemented within nursing, social work, psychology, and family medicine residency programs at a state university. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) evaluation framework was used to compare delivery of SBIRT curriculum across health professions. Survey data measured changes in student knowledge, confidence, and responsibility to use SBIRT for alcohol and drugs, pre- and post-SBIRT training. Twelve months postgraduation follow-up surveys examined maintenance of outcomes and SBIRT use in practice. Observational data explored fidelity and adaptations made to curriculum content and delivery logistics. Results indicated that instructor adoption, fidelity, and format varied across health professional training programs, with adaptations made to improve fit, role alignment, and cultural relevance. Despite variation in curriculum delivery, students demonstrated significant gains in knowledge and confidence, (p < .001). Key implementation and maintenance challenges included time constraints, instructor buy-in, competing accreditation requirements, and costs for using the university simulation laboratory to practice SBIRT. Strengths supporting maintenance included flexibility to adapt curriculum, department champions, and electronic resources to support curriculum delivery. Results suggest that adaptations maximizing the feasibility and fit of SBIRT within existing courses enhanced its adoption and maintenance potential without sacrificing effectiveness.

The Relationship Between Mixed Race/Ethnicity, Developmental Assets, and Mental Health Among Youth

This study assessed whether high school youth with mixed race/ethnicity are at greater risk for poor mental health conditions compared to their single race/ethnic counterparts and whether this mental health risk can be mitigated by youth developmental assets regardless of one’s race/ethnicity. Methods involved secondary data analysis of the 2009–2013 Youth Risk Behavioral Survey—Anchorage, Alaska subsample. Difference in rates of mental health conditions and mean number of developmental assets (protective factors) were assessed among three racial/ethnic groups. Logistic regression models tested whether race/ethnicity has an independent association with mental health conditions and whether there is an interaction effect between race/ethnicity and protective factors. Results show that, compared to white students, mixed race/ethnic students have significantly higher rates of poor mental health condition and significantly fewer protective factors. A significant interaction effect between race/ethnicity and protective factors was also found, showing decreasing likelihood of poor mental health condition with increasing number of protective factors among all racial/ethnic groups. However, this effect was more pronounced among white students compared to both mixed and single race/ethnicity minority students. Study findings indicate that youth of mixed race/ethnicity are more likely to be at risk for poor mental health outcomes, yet less likely to mitigate this risk even with similar number of external developmental assets as their single race/ethnic counterparts. More research is needed to further understand the differential effect of certain developmental assets among different racial/ethnic groups.

The Feasibility of Adopting an Evidence-Informed Tailored Exercise Program within Adult Day Services: The Enhance Mobility Program

ABSTRACT This article uses the RE-AIM framework to evaluate the feasibility of implementing Enhance Mobility (EM), a tailored, evidence-informed group exercise and walking program for older adults with dementia, into an adult day services center. Participant physical performance outcomes were measured at baseline and 8 months. Program staff were interviewed to understand implementation challenges. Participant outcomes did not change significantly, though gait speed improved from limited to community ambulation levels. Implementation challenges included space reallocation and adequate staffing. Adopting EM in adult day services is feasible, and has potential to reach older adults who could benefit from tailored exercise.

The role of change facilitators in the implementation of alcohol SBI with public health nurses

Background The University of Alaska Anchorage partnered with the State of Alaska, Section of Public Health Nursing (PHN) to pilot routine alcohol screening and brief intervention (aSBI) in three of their 22 public health centers (PHCs) prior to system-wide dissemination. During this two-year project funded by the Centers for Disease Control and Prevention, the university research team facilitated aSBI implementation through collaborative planning with PHN leadership, providing training for nurses to conduct aSBI, and maintaining contact with PHN staff. Nurses at the pilot sites participated in regular phone calls with members of the research team acting as change facilitators. A Plan-Do-Study-Act approach was used to refine implementation protocols throughout the pilot.