Melissa M. Franks

Activities and well-being in older age: Effects of self-concept and educational attainment.

The positive effect of activities on well-being is proposed to be mediated by self-conceptualizations and facilitated by socioeconomic status. The hypothesized processes were estimated with LISREL VIII using data from a large cross-sectional survey with a sample of 679 adults aged 65 and older who were representative of older adults living in the Detroit area. Findings indicate that the frequency of performing both leisure and productive activities yields an effect on physical health and depression and that these effects are mediated in part by a sense of self as agentic, but less clearly by a sense of self as social. Furthermore, socioeconomic status, operationalized as formal educational attainment, facilitates the effect of leisure to a greater extent than that of productive activities.

Who Gets What and Why? Help Middle-Aged Adults Provide to Parents and Grown Children

OBJECTIVES Middle-aged adults engage in support exchanges with generations above and below. This study investigated (a) how support to one generation is associated with support to the other and (b) factors accounting for whether parents or offspring receive more support in a family. METHODS Middle-aged adults aged 40-60 years (N = 633) completed telephone interviews regarding their relationships and support exchanges with each grown child and living parent. RESULTS Multilevel models revealed that most participants provided more support to the average grown child than to the average parent. Yet, a proportion of the sample reversed this pattern, providing more support to parents. Mediation models revealed that middle-aged adults provided greater support to offspring because they viewed offspring as more important than parents and offspring had greater everyday needs (e.g., being a student, not married). Parental disability accounted for greater support to parents. DISCUSSION Discussion integrates solidarity theory, developmental stake, and contingency theory. Most middle-aged adults provide more to grown offspring than to parents, consistent with their greater stake in their progeny. Middle-aged adults also respond to crises (i.e., parental disability) and everyday needs (i.e., offspring student status) in providing intergenerational support, in accordance with contingency theory.

Influences of spousal support and control on diabetes management through physical activity.

OBJECTIVES Spouses may be involved in their partners diabetes management by providing social support to affirm healthy behaviors and social control to modify health behaviors. Yet, investigations of the influence of spousal involvement on daily patient health behaviors are limited. In daily diaries, we investigated how spousal support and control independently and jointly influence patient physical activity and efficacy to engage in physical exercise on a daily basis. METHODS Older adults (age 55 and older) with Type 2 diabetes and their spouses (N = 70 couples) completed electronic diaries for seven consecutive days that assessed spouse-reported involvement and patient-reported minutes of physical exercise and efficacy to engage in future physical exercise. A subset of patients (N = 53) also wore an activity monitoring device on the wrist that provided a measure of energy expenditure. RESULTS Multilevel analyses indicated that on a daily basis, spousal support was positively associated with physical activity, whereas spousal control was either unrelated or linked to less physical activity. On days in which spouses provided high levels of both support and control, however, patients felt more efficacious that day about exercising tomorrow and exhibited an increase in energy expenditure on the next day. CONCLUSIONS Findings suggest that spousal exercise support on its own or in conjunction with spousal exercise control may facilitate daily diabetes management through physical activity.

Caring for individuals with dementia and cognitive impairment, not dementia: findings from the aging, demographics, and memory study.

OBJECTIVES: To compare the characteristics and outcomes of caregivers of adults with dementia with those of caregivers of adults with cognitive impairment, not dementia (CIND).

It takes two: marriage and smoking cessation in the middle years.

Objectives: In this prospective study of smoking cessation among married individuals in midlife we examine correspondence in the change of each partner’s smoking status with that of the other, independent of established psychosocial correlates of smoking cessation. Methods: Using longitudinal data from the first two waves of the Health and Retirement Study, 1992-1994, hierarchical logistic regression models were estimated for married male and female smokers separately. Results: Findings support our hypothesis of correspondence in the smoking cessation of married male and female smokers net of other sociodemographic, health, and health behavior characteristics. Discussion: These findings suggest that initiation and maintenance of this positive lifestyle change may be more easily achieved when both marital partners are given information and support to quit smoking at the same time.

I Will If You Will Similarity in Married Partners’ Readiness to Change Health Risk Behaviors

Married men and women (N = 1,899 couples) reported readiness to eat a healthier diet, lose weight, and get more exercise (stage of change) and indicated whether they were confident to make these changes (self-efficacy). Husbands’ and wives’ reports of readiness to change each health behavior were positively associated. Furthermore, women who indicated readiness to eat a healthier diet and get more exercise (contemplation or preparation stages) were less likely to endorse confidence to change when their husbands were in a lower stage than they were relative to those whose husbands shared the same stage of change. Similarly, men who indicated readiness to lose weight were less likely to endorse being confident in their ability to lose weight when their wives were in a lower stage than they were relative to those who shared the same stage. Consideration of interpersonal factors in the behavior change process may enhance behavioral interventions that include married partners together rather than either individual alone.

Aid and Influence: Health-Promoting Exchanges of Older Married Partners

Dyadic exchanges of support and control were investigated in couples in which the husband was recently treated or assessed for heart disease. Each partner in 61 marital dyads (N = 122 participants) reported the frequency with which both social support and social control to promote a healthy lifestyle were provided to and received from one another. Multivariate findings demonstrated the influence of intrapersonal (or actor) and interpersonal (or partner) contributions of providing support and control to each spouse’s perception of receiving such exchanges from the other. These findings reveal that marital partners’ perspectives of receipt of health-related exchanges of support and control are associated not only with the behavior of the partner, but also with their own initiation of health-promoting exchanges on their partner’s behalf.

Are spouses of chronically ill partners burdened by exerting health-related social control?

Spouses often seek to influence the health behaviors of chronically ill partners, but little research has examined whether spouses find such involvement to be burdensome. The current study examined this question in a sample of 191 nondiabetic spouses whose partners had type 2 diabetes. Results revealed that spouses who attempted to exert more control over their partners’ dietary behavior experienced greater burden, particularly when their partners exhibited poor dietary adherence and reacted negatively to spouses’ involvement. The findings contribute to a sparse body of knowledge on how spouses are affected by efforts to influence their chronically ill partners’ disease management.

Spousal undermining of older diabetic patients' disease management.

Marriage can enhance health for individuals with a chronic disease, yet spouses may also undermine disease management. The current study investigated spousal undermining of dietary regimen in 129 patients with type 2 diabetes mellitus. A total of 40 patients reported that their spouses tempted them with forbidden foods, and 15 reported that their spouses conveyed disregard for their diabetic diet. Spousal tempting was associated with worse dietary adherence, and spousal disregard with worse nondietary adherence. Spousal undermining is relatively rare but is associated with patients’ disease management and warrants further investigation to better understand how spouses influence partners’ day-to-day management of chronic diseases.

When does spousal social control provoke negative reactions in the context of chronic illness? The pivotal role of patients’ expectations

Spouses often monitor and seek to alter each other’s health behavior, but such social control attempts can provoke behavioral resistance and emotional distress. Expectations regarding spouses’ roles in their partners’ health may influence reactions to spousal social control, with resistance and hostility less likely to occur among people who believe spouses should be involved in their partners’ health. Evidence consistent with this idea emerged in a study of 191 patients with type 2 diabetes. Patients with greater expectations for spousal involvement (particularly females) generally reacted less negatively to spousal control. The findings help to clarify when people with a chronic illness are likely to resist and resent, rather than appreciate, spousal control.