Lisa M. Soederberg Miller

Aging and self-regulated language processing.

An adult developmental model of self-regulated language processing (SRLP) is introduced, in which the allocation policy with which a reader engages text is driven by declines in processing capacity, growth in knowledge-based processes, and age-related shifts in reading goals. Evidence is presented to show that the individual readers allocation policy is consistent across time and across different types of text, can serve a compensatory function in relation to abilities, and is predictive of subsequent memory performance. As such, it is an important facet of language understanding and learning from text through the adult life span.

Online Health Information Seeking The Influence of Age, Information Trustworthiness, and Search Challenges

Objectives: The Internet holds great potential to support information gathering and decision making surrounding health education and self-care. Older adults, however, underutilize the Internet for health information searches relative to younger adults. The goal of the present study was to examine age differences in the role of trust and ease of search in predicting whether or not individuals use (adopters) or do notuse (nonadopters) the Internet to search for health information. Method: We used logistic regressions todetermine whether there were age differences in the extent to which trust and ease of search predicted online health information searches within a nationally-representative sample of 3796 adults from the Health Information National Trends Survey (HINTS). Results: Adopters were more trusting of Internet health informationthan nonadopters. However, a significant age by trust interaction indicated that this difference increased in magnitude with age, a pattern that held even after controlling for demographic and health variables. Conclusions: Older adults may benefit from special instructions designed to boost Internet trust, for example, learning how to distinguish between high and low quality health-related websites.

Self-regulated reading in adulthood.

Young and older adults read a series of passages of 3 different genres for an immediate assessment of text memory (measured by recall and true/false questions). Word-by-word reading times were measured and decomposed into components reflecting resource allocation to particular linguistic processes using regression. Allocation to word and textbase processes showed some consistency across the 3 text types and was predictive of memory performance. Older adults allocated more time to word and textbase processes than the young adults did but showed enhanced contextual facilitation. Structural equation modeling showed that greater resource allocation to word processes was required among readers with relatively low working memory spans and poorer verbal ability and that greater resource allocation to textbase processes was engendered by higher verbal ability. Results are discussed in terms of a model of self-regulated language processing suggesting that older readers may compensate for processing deficiencies through greater reliance on discourse context and on increases in resource allocation that are enabled through growth in crystallized ability.

The effects of nutrition knowledge on food label use. A review of the literature

Nutrition information on food labels is an important source of nutrition information but is typically underutilized by consumers. This review examined whether consumer nutrition knowledge is important for communication of nutrition information through labels on packaged foods. A cognitive processing model posits that consumers with prior knowledge are more likely to use label information effectively, that is, focus on salient information, understand information, and make healthful decisions based on this information. Consistent with this model, the review found that nutrition knowledge provides support for food label use. However, nutrition knowledge measures varied widely in terms of the dimensions they included and the extensiveness of the assessment. Relatively few studies investigated knowledge effects on the use of ingredient lists and claims, compared to nutrition facts labels. We also found an overreliance on convenience samples relying on younger adults, limiting our understanding of how knowledge supports food label use in later life. Future research should 1) investigate which dimensions, or forms, of nutrition knowledge are most critical to food label use and dietary decision making and 2) determine whether increases in nutrition knowledge can promote great use of nutrition information on food labels.

The eHealth Enhanced Chronic Care Model: A Theory Derivation Approach

Background Chronic illnesses are significant to individuals and costly to society. When systematically implemented, the well-established and tested Chronic Care Model (CCM) is shown to improve health outcomes for people with chronic conditions. Since the development of the original CCM, tremendous information management, communication, and technology advancements have been established. An opportunity exists to improve the time-honored CCM with clinically efficacious eHealth tools. Objective The first goal of this paper was to review research on eHealth tools that support self-management of chronic disease using the CCM. The second goal was to present a revised model, the eHealth Enhanced Chronic Care Model (eCCM), to show how eHealth tools can be used to increase efficiency of how patients manage their own chronic illnesses. Methods Using Theory Derivation processes, we identified a “parent theory”, the Chronic Care Model, and conducted a thorough review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct, as well as government reports, industry reports, legislation using search terms “CCM or Chronic Care Model” AND “eHealth” or the specific identified components of eHealth. Additionally, “Chronic Illness Self-management support” AND “Technology” AND several identified eHealth tools were also used as search terms. We then used a review of the literature and specific components of the CCM to create the eCCM. Results We identified 260 papers at the intersection of technology, chronic disease self-management support, the CCM, and eHealth and organized a high-quality subset (n=95) using the components of CCM, self-management support, delivery system design, clinical decision support, and clinical information systems. In general, results showed that eHealth tools make important contributions to chronic care and the CCM but that the model requires modification in several key areas. Specifically, (1) eHealth education is critical for self-care, (2) eHealth support needs to be placed within the context of community and enhanced with the benefits of the eCommunity or virtual communities, and (3) a complete feedback loop is needed to assure productive technology-based interactions between the patient and provider. Conclusions The revised model, eCCM, offers insight into the role of eHealth tools in self-management support for people with chronic conditions. Additional research and testing of the eCCM are the logical next steps.

Adult Age Differences in Knowledge-Driven Reading.

The authors investigated the effects of domain knowledge on online reading among younger and older adults. Individuals were randomly assigned to either a domain-relevant (i.e., high-knowledge) or domain-irrelevant (i.e., low-knowledge) training condition. Two days later, participants read target passages on a computer that drew on information presented in the high-knowledge training session. For both age groups, knowledge improved comprehension and recall and facilitated the processing of topic shifts during reading. In addition, domain knowledge had differential effects on processing across the 2 age groups. Among older (but not younger) readers, domain knowledge increased the time allocated to organization and integration processes (wrap-up) and increased the frequency of knowledge-based inferences during recall. These results suggest that among older readers, domain knowledge engenders an investment of processing resources during reading, which is used to create a more elaborated representation of the situation model.

The Sense of Control and Cognitive Aging: Toward a Model of Mediational Processes

Publisher Summary This chapter discusses the sense of control and cognitive aging. The chapter reviews the past research investigating the impact of control beliefs on cognitive performance as well as new findings that expand the understanding of control beliefs in relation to other predictors of performance. The chapter examines that cognitive performance has an impact on control beliefs. There is a significant relationship between control beliefs and cognitive performance. Evidence shows that the control beliefs predict changes in cognitive functioning. The nature of the relationship between beliefs and performance is somewhat complicated by whether background factors, which appear to have an impact on the magnitude of this association, are taken into consideration. Thus, future research is needed to investigate which domains of cognitive functioning are most closely linked to both background factors and control beliefs. This chapter presents the model which describes the complexity of the relationship and guides questions for future research. Finally the research of this nature can be used to identify which factors are more or less modifiable and thus can lend to interventions designed to improve the quality of life among older adults.

Making healthy food choices using nutrition facts panels. The roles of knowledge, motivation, dietary modifications goals, and age.

Nutrition facts panels (NFPs) contain a rich assortment of nutrition information and are available on most food packages. The importance of this information is potentially even greater among older adults due to their increased risk for diet-related diseases, as well as those with goals for dietary modifications that may impact food choice. Despite past work suggesting that knowledge and motivation impact attitudes surrounding and self-reported use of NFPs, we know little about how (i.e., strategies used) and how well (i.e., level of accuracy) younger and older individuals process NFP information when evaluating healthful qualities of foods. We manipulated the content of NFPs and, using eye tracking methodology, examined strategies associated with deciding which of two NFPs, presented side-by-side, was healthier. We examined associations among strategy use and accuracy as well as age, dietary modification status, knowledge, and motivation. Results showed that, across age groups, those with dietary modification goals made relatively more comparisons between NFPs with increasing knowledge and motivation; but that strategy effectiveness (relationship to accuracy) depended on age and motivation. Results also showed that knowledge and motivation may protect against declines in accuracy in later life and that, across age and dietary modification status, knowledge mediates the relationship between motivation and decision accuracy.

Contextual Knowledge Reduces Demands on Working Memory during Reading

An experiment is reported in which young, middle-aged, and older adults read and recalled ambiguous texts either with or without the topic title that supplied contextual knowledge. Within each of the age groups, the participants were divided into those with high or low working memory (WM) spans, with available WM capacity further manipulated by the presence or absence of an auditory target detection task concurrent with the reading task. Differences in reading efficiency (reading time per proposition recalled) between low WM span and high WM span groups were greater among readers who had access to contextual knowledge relative to those who did not, suggesting that contextual knowledge reduces demands on WM capacity. This position was further supported by the finding that increased age and attentional demands, two factors associated with reduced WM capacity, exaggerated the benefits of contextual knowledge on reading efficiency. The relative strengths of additional potential predictors of reading efficiency (e.g., interest, effort, and memory beliefs), along with knowledge, WM span, and age, are reported. Findings showed that contextual knowledge was the strongest predictor of reading efficiency even after controlling for the effects of all of the other predictors.

Physiological Reactivity to Cognitive Stressors: Variations by Age and Socioeconomic Status

The present study focused on age and SES differences in stress reactivity in response to cognitively challenging tasks. Specifically, we assessed within-person trajectories of cortisol, a steroid hormone released by the adrenal gland in response to stressors, before, during, and after exposure to cognitively challenging tasks. We extend the current literature by simultaneously examining age and SES differences in physiological reactivity. Findings suggest that age and SES both play an important role in reactivity, such that it was the older adults with higher SES who were the most physiologically reactive to cognitive stressors. Implications of these findings for cognitive aging research are discussed.