Catherine Coccia

Women in midlife: stress, health and life satisfaction.

Midlife is filled with challenges and unique stressors for women, which necessitate a greater understanding of the factors that influence their life satisfaction. This study examined the relationship of family strains/changes and weight to life satisfaction, as mediated by family coping, physical activity, sleep and health stress. The findings indicated that women in midlife, who experienced more stressful life changes and had higher body mass index scores, slept fewer hours and had greater health stress, which resulted in lower life satisfaction. These results have implications for family health professionals and programmes that deal with family and health problems, including sleep, weight and stress.

Adolescent Health, Stress and Life Satisfaction: The Paradox of Indulgent Parenting

A survey of adolescents aged 15 to 16 years was used to examine the relationship between their perceptions of indulgent parenting and adolescent weight status to overall satisfaction with life, as associated with adolescent perceptions of body image, health and stress. In addition, perceptions of parental indulgence were examined in terms of their association with adolescent eating behaviours and health. The results revealed a paradox related to indulgent parenting, with both positive and negative outcomes for adolescents. Structural equation analyses showed that parental indulgence was not only related to lower stress and higher life satisfaction, but also to unhealthy eating behaviours. Path analysis indicated that both positive and negative eating outcomes for adolescents were related to parental indulgence. This research has many implications for both parent and adolescent health education, focusing on parenting styles, stress and healthy lifestyles.

Reducing cardiovascular disease risk in mid-life and older African Americans: A church-based longitudinal intervention project at baseline

INTRODUCTION African Americans (AAs) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease (CVD). Church-based health programs can reduce risk factors for CVD, including elevated blood pressure [BP], excess body weight, sedentary lifestyle and diet. Yet few studies have incorporated older adults and longitudinal designs. PURPOSES The aims of this study are to: a) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs; b) compare selected dietary (fruit and vegetable servings/day, fat consumption), physical activity (PA) and clinical variables (BMI, girth circumferences, systolic and diastolic BP, LDL, HDL, total cholesterol [CHOL] and HDL/CHOL) between treatment and comparison churches at baseline; c) identify selected background characteristics (life satisfaction, social support, age, gender, educational level, marital status, living arrangement and medication use) at baseline that may confound results; and d) share the lessons learned. METHODS This study incorporated a longitudinal pre/post with comparison group quasi-experimental design. Community-based participatory research (CBPR) was used to discover ideas for the study, identify community advisors, recruit churches (three treatment, three comparison) in two-counties in North Florida, and randomly select 221 mid-life and older AAs (45+) (n=104 in clinical subsample), stratifying for age and gender. Data were collected through self-report questionnaires and clinical assessments. RESULTS AND CONCLUSIONS Dietary, PA and clinical results were similar to the literature. Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors. For the total sample, relationships were noted for most of the background characteristics. Lessons learned focused on community relationships and participant recruitment.

Life dissatisfaction and eating behaviors among older African Americans: The protective role of social support

ObjectivesTo examine (a) the influences of life dissatisfaction and dietary social support on eating behaviors (a high-fat diet and fruit/vegetable consumption) of older African Americans and (b) the moderating role of perceived dietary social support on the association between their life dissatisfaction and unhealthy eating behaviors.DesignBaseline data from a larger intervention study of mid-life and older African Americans. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.SettingSix churches in North Florida.ParticipantsOne hundred and seventy-eight (132 females and 46 males with a median age of 60) older African Americans.MeasurementsA structured questionnaire elicited personal data as well as information on eating behaviors, life dissatisfaction, and perceived dietary social support.ResultsOlder African Americans with more cumulative life adversity, as reflected by high life dissatisfaction, had significantly poorer eating behaviors including the consumption of a high-fat diet and low intake of fruits and vegetables. Older African Americans’ dietary choices were also associated with their perceived social support. More importantly, perceived social support acted as a buffer to mitigate the influence of life dissatisfaction on older African Americans’ eating behaviors.ConclusionLife dissatisfaction places older African Americans at risk for unhealthy eating behaviors. However, high levels of dietary social support can protect older African Americans from the influence of life dissatisfaction on unhealthy eating behaviors. There are practical implications of this research for health interventions and programming.

Indulgent Parenting and Life Satisfaction of College Students: Examination of Eating, Weight, and Body Image:

A cross-sectional design based on social cognitive theory was used to examine the association between mother and daughter perceptions of parental indulgence and family health discussions as they influenced eating motivations, health outcomes, and life satisfaction of college females. Results indicated that daughters perceived greater overall indulgence and overnurturance than mothers. Indulgence had both positive and negative associations with daughters’ life satisfaction. Daughters’ perceptions of parental overnurturance and giving too much had the greatest total effects on life satisfaction. Even as daughters began to transition away from their parents, mothers still played an integral role in their health behaviors and outcomes. Additional research was recommended, along with practice recommendations for family and health professionals.

The Development of Health for Hearts United: A Longitudinal Church-based Intervention to Reduce Cardiovascular Risk in Mid-life and Older African Americans

This article describes Health for Hearts United, a longitudinal church-based intervention to reduce cardiovascular disease (CVD) risk in mid-life and older African Americans. Using community-based participatory research (CBPR) approaches and undergirded by both the Socio-ecological Theory and the Transtheoretical Model of Behavior Change, the 18-month intervention was developed in six north Florida churches, randomly assigned as treatment or comparison. The intervention was framed around three conceptual components: awareness building (individual knowledge development); clinical learning (individual and small group educational sessions); and efficacy development (recognition and sustainability). We identified three lessons learned: providing consistency in programming even during participant absences; providing structured activities to assist health ministries in sustainability; and addressing changes at the church level. Recommendations include church-based approaches that reflect multi-level CBPR and the collaborative faith model.

Establishing health ministries: leaders' perceptions of process and effectiveness.

Church-based health interventions are one mechanism to address health issues of African Americans. This study determines the perceptions of health leaders regarding the development process for and the effectiveness of church health ministries, using the Precede/Proceed model. Ten health leaders from six medium-sized churches in a North Florida county participated in a 10-month breast health intervention. Data were collected using two methods. A brief questionnaire was administered that included items related to knowledge about breast health, perceptions of and processes for health ministry development, and perceptions of resources used during the intervention. In addition, a focus group was conducted with the health leaders, using a trained moderator, which included questions about their health behaviors prior to and after the project, biggest successes and challenges in establishing their health ministries, and plans for sustaining the health ministry after the project. Questionnaire data were analyzed using descriptive statistics and paired t-tests. Focus group data and open-ended questionnaire responses were transcribed and analyzed using code-based analytic procedures where data were organized into thinking units, categories, and then broader themes. Findings indicate that health leaders perceived that health ministry development focused on a series of steps, including: a) predisposing: health leaders background (personal characteristics, education/profession, health behaviors); b) enabling: support and participation from the pastor; and c) reinforcing: start-up processes (personal contact, public relations, materials and church member involvement) and outputs (activities and partnerships). This study demonstrates that health ministry development involves a sequential process that fits within a broad organizational framework for health behavior change.

Examining change in social support and fruit and vegetable consumption in African American adults

ObjectiveTo examine (a) inter-individual variation in African Americans’ fruit and vegetable social support, behavior, and consumption trajectories by estimating latent growth curves (LGCs) and (b) the associations between these trajectories over time.DesignAs part of a larger intervention study, data were collected from mid-life and older African Americans yearly for three years. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.SettingSix churches in North Florida.ParticipantsTwo hundred and thirty one (73% women; median age range of 57–63) older African Americans.MeasurementsA structured questionnaire elicited personal data as well as information on dietary social support, eating-related behaviors, and fruit and vegetable dietary intake.ResultsAge was positively associated with initial social support but negatively associated with the rate of change in social support. More important, the rate of change in dietary social support predicted eating-related behavior trajectories, which influenced the rate of change in fruit and vegetable consumption over time after controlling for the intervention.ConclusionThese findings illustrate the mediating role of eating-related behaviors and the inter-locking nature of social support, behavior and consumption trajectories. This research has implications for future research as well as community interventions and programs.

Linking Life Dissatisfaction to Health Behaviors of Older African Americans Through Psychological Competency and Vulnerability

The objective of this study was to examine the influence of life dissatisfaction on health behaviors of older African Americans and the linking role of psychological competency (e.g., control and agency) and psychological vulnerability (e.g., negative affect). A structural equation model using baseline data from a larger intervention study of older African Americans was examined. Respondents included 207 (153 females and 54 males with a median age of 60) older African Americans. Life dissatisfaction was directly associated with respondents’ daily fat consumption and sleep and indirectly associated with receiving regular physical exams, physical activity, and fruit and vegetable consumption through their psychological processes. The association between life dissatisfaction and respondents’ health behaviors varied depending on the behavior under consideration. Programs and services designed to improve older African Americans’ health behaviors should address their psychological processes, as this research suggests these psychological processes are associated with different health behaviors.

The Role of Parental Indulgence and Economic Stress in Life Satisfaction: Differential Perceptions of Parents and Adolescents

The purpose of this study was to determine if there were differences between adolescents and parents in their perceptions of parental indulgence, stress (economic and life), and life satisfaction. In addition, using the conceptual frameworks of family ecosystems and developmental theory, the relationships between the three types of parental indulgence (soft structure, overnurturance, and giving too much), economic stress, life stress, and life satisfaction were examined for parents and adolescent children. Findings indicated that adolescents perceived higher levels of stress and soft structure as compared to their parents, whereas parents perceived higher levels of economic stress. Additionally, each type of parental indulgence affected parent and adolescent life stress and life satisfaction differently. Implications for research and practice are discussed.