Kristen Fay

A Qualitative Study of Perceived Social Barriers to Care for Eating Disorders: Perspectives from Ethnically Diverse Health Care Consumers

Objective: The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample. Method: We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospective consumers of eating disorder treatment (n = 32). Transcripts were inputted into NVivo 8 for coding, sorting, and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants. We then examined the influence of key social barriers—including stigma and social stereotypes—on perceived impact on care. Results: The majority of respondents (78%) endorsed at least one social barrier to care for an eating or weight concern. Perceived stigma (or shame) and social stereotyping—identified both within social networks and among clinicians—had adversely impacted care for 59% and 19% of respondents, respectively. Discussion: Social barriers to care for eating and weight related concerns may be prevalent in the U.S. and impact both ethnic minority and non-minority health care consumers.

Is Spirituality Detrimental to Generativity

This article examines the relations between religiousness, spirituality, and generativity (concern for the welfare of future generations) in late adulthood using longitudinal life-course data. Religiousness and spirituality were operationalized as distinct but overlapping dimensions of individual difference measuring involvement in traditional and nontraditional religious practices, respectively. In late adulthood, both religiousness and spirituality correlated positively with overall scores on self-report and observer-based measures of generativity. However, whereas religiousness was significantly related to the communal facets of generativity, spirituality was significantly related to its self-expanding aspects. These differences were more pronounced after gender, cohort, social class, and the overlap between religiousness and spirituality were controlled. The respective relations among religiousness, spirituality, and generativity in late adulthood were also observed using religiousness scored in early, and spirituality scored in late-middle, adulthood.

Social network media exposure and adolescent eating pathology in Fiji.

BACKGROUND Mass media exposure has been associated with an increased risk of eating pathology. It is unknown whether indirect media exposure--such as the proliferation of media exposure in an individuals social network--is also associated with eating disorders. AIMS To test hypotheses that both individual (direct) and social network (indirect) mass media exposures were associated with eating pathology in Fiji. METHOD We assessed several kinds of mass media exposure, media influence, cultural orientation and eating pathology by self-report among adolescent female ethnic Fijians (n=523). We fitted a series of multiple regression models of eating pathology, assessed by the Eating Disorder Examination Questionnaire (EDE-Q), in which mass media exposures, sociodemographic characteristics and body mass index were entered as predictors. RESULTS Both direct and indirect mass media exposures were associated with eating pathology in unadjusted analyses, whereas in adjusted analyses only social network media exposure was associated with eating pathology. This result was similar when eating pathology was operationalised as either a continuous or a categorical dependent variable (e.g. odds ratio OR=1.60, 95% CI 1.15-2.23 relating social network media exposure to upper-quartile EDE-Q scores). Subsequent analyses pointed to individual media influence as an important explanatory variable in this association. CONCLUSIONS Social network media exposure was associated with eating pathology in this Fijian study sample, independent of direct media exposure and other cultural exposures. Findings warrant further investigation of its health impact in other populations.

Trajectories of Positive and Negative Behaviors from Early- to Middle-Adolescence

Although the positive youth development (PYD) model initially assumed inverse links between indicators of PYD and of risk/problem behaviors, empirical work in adolescence has suggested that more complex associations exist between trajectories of the two domains of functioning. To clarify the PYD model, this study assessed intraindividual change in positive and problematic indicators across Grades 5–10, and the links between these trajectories of development, among 2,516 participants from the 4-H Study of PYD (58.1% females; 64.9% European American, 7.0% African American, 12.3% Latino/a American, 2.6% Asian American or Pacific Islander, 1.8% Native American, 3.0% multiethnic-racial, and 8.4% with inconsistent race/ethnicity across waves). Results from person-centered analyses indicated that most youth clustered in the high trajectories of positive indicators and in the low trajectories of the negative ones. Consistent with past research, overlap between trajectories of positive and negative behaviors was found. These results suggest that theory and application need to accommodate to variation in the links between positive and problematic developmental trajectories.

Development of a Measure of “Acculturation” for Ethnic Fijians: Methodologic and Conceptual Considerations for Application to Eating Disorders Research

Acculturation has been examined as a risk factor for eating disorders, but interpretation of findings has been limited by inconsistent operationalization of this construct across studies. The study aim was to develop and evaluate a population-specific measure of acculturation for ethnic Fijian adolescent schoolgirls, to use in future analyses related to eating disorders. Our findings suggest that acculturation is a multidimensional construct characterized by distinct, though related, dimensions of orientation to ethnic Fijian and/or western/global culture with respect to a range of behaviors and attitudes. In contrast to theoretical models positing uni-dimensional, orthogonal, or oblique relations between cultural identities in individuals undergoing acculturation, our study findings support a heterogeneous pattern among correlations of dimensions across contrasting cultural identities. We suggest multidimensional measures of acculturation are optimal — and socio-demographic proxies inadequate — for characterization of this complex process for health research.

The association between sports participation and athletic identity with eating pathology among college-aged males and females

The current study examined associations among sports participation (SP), athletic identity (AI), weight status, and eating pathology, and whether these relations differed by gender. Data come from male and female first-year college students who participated in the Tufts Longitudinal Health Study (TLHS) between 1999–2007 (N=712). Relations among SP, AI, actual and perceived weight statuses, Eating Disorders Inventory (EDI) subscale scores, and indices of body shape concern and restrictive eating were examined with hierarchical ordinary least squares (OLS) regression. Associations between SP and eating pathology among females were moderated by perceived weight status. By contrast, relations between males’ EDI subscales scores and SP were moderated by ethnicity, as well as by actual weight status. Our findings support that sports participation alone neither promotes nor protects against eating pathology among males and females.