Internal locus of control and social support associated with some dietary changes by elderly participants in a diet intervention trial

Social Factors of Dietary Risk Behavior in Older German Adults: Results of a Multivariable Analysis

With this analysis, we aimed to examine the associations between social factors and dietary risk behavior in older adults. Data were collected through a full-population postal survey of German adults aged 65 years or older (n = 1687, 33% response proportion, 52% female, mean age = 76 years). Using principal component analysis (PCA), a data-driven Dietary Risk Behavior Index (DRB) was computed. Dietary risk behavior was defined as consumption frequencies of vegetables/fruit, whole grains, and dairy products below national dietary recommendations. By performing a multiple linear regression, we analyzed associations between sociodemographic, socioeconomic, psychosocial, and behavioral factors and dietary risk behavior. Physical activity, female gender, socioeconomic status, social support, and age (in the male sample) were negatively associated with dietary risk behavior. Alcohol consumption and smoking were positively associated with dietary risk behavior. A group-specific analysis revealed a higher goodness-of-fit for the low socioeconomic status group, older adults aged 65–79 years, and women. A comprehensive understanding of the relationships between social factors and dietary risk behavior in older adults assists the group-specific targeting of dietary-related interventions. Demand-oriented dietary interventions should account for underlying social conditions to reduce inequity in dietary risk behavior among older adults. The results of this work may be transferable to municipalities in high-income European countries.

M-LoCUS: A Scalable Intervention Enhances Growth Mindset and Internal Locus of Control in Undergraduate Students in STEM

Student self-beliefs regarding intelligence and ability have been shown to correspond to achievement and persistence in an academic domain. Specifically, previous research has suggested that a growth mindset-or the belief that intelligence is malleable and can increase with effort-is associated with student success. Locus of control is a related but distinct self-belief regarding personal agency over various academic and nonacademic outcomes and has also been associated with study skills and academic persistence. However, academic interventions targeting student mindsets and loci of control have remained relatively underexplored, specifically in the context of undergraduate STEM education. Here, we describe the development and assessment of an intervention encouraging students to adopt a growth mindset and internal locus of control. This five-part intervention is administered entirely online and is therefore independent of individual instructor variability. We administered the intervention in five introductory biology courses and show that the intervention was successful in impacting student mindsets and loci of control across various demographics.

Multidimensional Health Locus of Control: Comments on the Construct and its Measurement

In the present commentary, the theoretical construct of Multidimensional Health Locus of Control (MHLC) is described and evaluated in terms of its contributions to health psychology. This concept is compared to other control beliefs, in particular to perceived self-efficacy. It is argued that MHLC has supplied health psychology with essential insights and has offered a great deal of intellectual stimulation. Nevertheless, for some applications, different constructs might be more promising, in particular when it comes to predicting health behavior change. MHLC measurement, specifically its factorial structure, its proximity to health outcomes and health behaviors and its cultural sensitivity are addressed. Further refinement of the instrument is recommended, and the range of promising applications needs to be clearly defined.

Social Activities, Socioeconomic Factors, and Overweight Status Among Middle-Aged and Older Korean Adults: A Cross-Sectional Study

This study aims to investigate the relationship between social activities and overweight among middle-aged and older adults. This study used data from the 2008 Korean Longitudinal Study of Aging which included a total of 8157 adults. We divided body mass index into 2 groups: normal weight and overweight. Multivariable logistic regression analysis was used to identify the association between social activities and overweight. For males, frequency of meetings with neighbors (1-3 times a week) was associated with being less overweight. Middle-aged adults who met with neighbors 1 to 3 times a week were less likely being overweight than those with once a year meeting frequency. On the contrary, social activity participation is related with high risk of overweight especially in the female and older adults. Our results suggest that social activity participation and social support needs to be taken into consideration when dealing with being overweight.

Fruit and vegetable consumption in older individuals in Northern Ireland: levels and patterns

Low intakes of fruit and vegetables have previously been reported in the older population of Great Britain, particularly among certain socio-demographic groups. Levels and patterns of consumption in the older population of Northern Ireland, however, remain unknown. A representative sample of 1000 members of the older population of Northern Ireland were contacted by telephone to assess average intake of all fruits and vegetables and various demographic details. Data from 426 individuals (representative of the whole population) reported a mean consumption of 4.0 (sd 1.3) and 4.1 (sd 1.3) portions of fruit and vegetables per weekday and per weekend day respectively. Regression analyses revealed greater consumption on weekdays by females (B 0.53; P < 0.01), younger individuals (B - 0.02; P = 0.01) and those living in less deprived areas (B - 0.01; P = 0.04), and greater consumption at weekends by females (B 0.54; P < 0.01) and younger individuals (B - 0.03; P = 0.01). The amount of fruit and vegetables consumed is slightly higher than that reported in older populations in Great Britain, possibly as a result of differences in farming practices and rural activities, although levels of consumption remain below current recommendations for health. Patterns of consumption are similar across the UK, and suggest that strategies to increase fruit and vegetable consumption should target males, older individuals and those living in more deprived areas.

Poor social relations and adverse health behaviour: stronger associations in low socioeconomic groups?

OBJECTIVE

Poor social relations are supposed to contribute to adverse health behaviour. We examined this association and the role of low socio-economic position.

METHODS

We regressed health behaviour on composite variables of the two exposures of social relations and socio-economic position (SEP). Social relations included networks and support; health behaviour was analysed in terms of smoking, poor nutrition and physical inactivity; socio-economic position comprised of income and education. Cross sectional data from a population based epidemiological study in German (4,814 men and women aged 45-75) was analysed.

RESULTS

Among the indicators for social relations, social isolation was consistently associated with adverse health behaviour; social support showed modest effect. A combination of poor social relations and low SEP displayed stronger (additive) associations with adverse health behaviour than each factor alone. However, superadditivity was excluded.

CONCLUSION

Given the important role of health adverse behaviour in chronic disease development, results underline the relevance of social environment and socio-economic structure in Public Health interventions.

Predictors of dietary change and maintenance in the Women's Health Initiative Dietary Modification Trial

OBJECTIVE

To identify predictors of dietary change to and maintenance of a low-fat eating pattern (<20% energy from fat, > or = 5 servings fruits/vegetables daily, and > or = 6 servings grains daily) among a cohort of postmenopausal women. Candidate predictors included intrapersonal, interpersonal, intervention program characteristics, and clinical center.

DESIGN

Longitudinal study within the Women's Health Initiative Dietary Modification Trial. Dietary change was evaluated after 1 year of participation in the Women's Health Initiative Dietary Modification Trial, and dietary maintenance after 3 years.

SUBJECTS

Postmenopausal women aged 50 to 79 years at baseline who were randomized to the intervention arm of the Women's Health Initiative Dietary Modification Trial (n=19,541).

STATISTICAL ANALYSIS

Univariate and multivariate linear regression analysis was performed and associations evaluated between candidate predictors and each of the three dietary goals: percent energy from fat, fruit/vegetable servings, and grain servings.

RESULTS

Year 1 (change) predictors of percent energy from fat (P<0.005) included being younger (beta=2.12; 70 to 79 years vs 50 to 59 years), more educated (beta=-.69; college vs high school), more optimistic (beta=-.07), attending more sessions (beta=-.69), and submitting more self-monitoring records (beta=-.74). At year 3 (maintenance), the predictors of percent energy from fat (P<0.005) included attending more sessions (beta=-.65) and submitting more self-monitoring scores (beta=-.71). The analytic model predicted 22% of the variance in fat intake at year 1 and 27% at year 3 (P<0.01).

CONCLUSIONS

The strongest predictors of dietary change and maintenance were attending intervention sessions and self-monitoring dietary intake. Novel was the finding that optimism predicted dietary change.

THE EFFECTS OF LOCUS OF CONTROL, COMMUNICATION SKILLS AND SOCIAL SUPPORT ON ASSERTIVENESS IN FEMALE NURSING STUDENTS

In this study the interrelation of locus of control, social support and communication skills and their relation with assertiveness were investigated by means of a path model. Nursing students (N=105) participated in the study by completing questionnaires. Path analysis showed that the interrelation of locus of control, communication skills and perceived peer support and their relation with assertiveness are explained to a certain degree by the proposed model. The only variable that directly influenced assertiveness was communication skills. Perceived family support had no direct or indirect effect on assertiveness. The findings point to several considerations for nursing curricula including that faculties should plan and provide opportunities for learning activities that increase students' assertiveness.

Physician-assisted weight loss and maintenance in the elderly

Although commonly addressed in magazines, across airwaves, and within gyms nationwide, health care providers must now face the growing epidemic of obesity in their daily practice. With the graying of America, it is all the more important to realize that weight increases the risk for disease and mortality in the elderly. Despite overwhelming evidence that weight loss can reduce health risks, many patients who are overweight never receive needed advice from their primary care physicians. This article addresses the barriers to physician intervention, methods to assess obesity risk, and readiness to change. Effective approaches for assisting in successful weight loss and maintenance are discussed.

Religion, social support, fat intake and physical activity

OBJECTIVE

Most research on diet and exercise has focused on these health behaviours as proximate causes of disease, rather than examine the context of how diet and exercise are developed and maintained. This study examined religion and social support in relationship to fat intake and physical activity.

DESIGN, SETTING AND SUBJECTS

Data from surveys of 546 adults aged 17-91 years, residing in one upstate New York county, were analysed.

RESULTS

Most relationships between the multiple facets of religion, fat intake and physical activity were not statistically significant. After controlling for demographics and social support, Conservative Protestant women and women specifying an "Other" religious affiliation reported higher fat intakes than did Catholic women. There were no relationships between religion and fat intake in men. In women, religious commitment was associated with greater moderate and vigorous physical activity, whereas in men, divine social support was associated with greater moderate physical activity. Social support did not substantially change the magnitude of the relationships between religion, diet and physical activity.

CONCLUSION

Overall, there were few relationships between religion, fat intake and physical activity, suggesting that in contemporary US society religion may play a small role in the context of how diet and exercise are developed and maintained. The limited range of religiosity in the sample, however, may have underestimated the role of religion. Significant relationships between religion and physical activity in women suggest that further research is needed to more clearly delineate religion's relationship with health behaviours.

Concepts, Theories and Design Components for Nutrition Education Programs Aimed at Older Adults

This article examines characteristics of older adult learners and discusses adult education theory and empowerment concepts, along with nutrition education and behavioral change strategies for older adult nutrition education programs. Design components for older adult nutrition education programs are presented. Educational and behavioral change strategies should be selected based on characteristics of the intended audience, including their nutrition needs, wants and desires, and should be based on appropriate theory. Multi-disciplinary research is needed to develop behavioral and educational theoretical frameworks, as well as designs, intervention strategies, and evaluation methods for educational programs that lead to older adults adopting more healthful nutrition practices. This is one of a series of recent literature reviews on nutrition education for older adults.

Multipurpose senior centers: opportunities for community health nursing

Nationally, almost 10 million older Americans are served by approximately 12,000 multipurpose senior centers (MSCs). Among those over age 65, 15% attended an MSC in the previous year. We can expect that the number of older Americans attending MSCs will increase as our population ages. We conducted face-to-face interviews with 59 older adults at an MSC that provides programming to approximately 350 individuals aged 60 and older during the course of 1 year. We identified several areas in which senior center participants could benefit from the presence of community health nursing: loneliness and social support; diet and nutrition, oral health, and self-rated health and exercise. Community health nurses should play an integral role in MSCs by providing direct healthcare in the form of interventions and referrals and by providing preventative care and advice so that senior center participants may maintain and improve the prospects for their independence and quality of life.

The effects of physical and emotional status on adherence to a low-fat dietary pattern in the Women's Health Initiative

OBJECTIVE

To examine whether the effects of physical and emotional status on adherance to a low-fat (20% energy) dietary pattern are mediated by participation in an intervention program (attending sessions and self-monitoring).

DESIGN

The Baron and Kenny mediator model, a series of 4 regression analyses, was used to evaluate whether: a) physical and emotional status predicted program participation, b) program participation predicted dietary adherence, c) physical and emotional status factors predicted dietary adherence, and, ultimately d) the effects of physical and emotional status on dietary adherence were mediated by program participation.

SUBJECTS/SETTING

Data from 13,277 postmenopausal women randomly assigned to the low-fat intervention arm of the Women's Health Initiative Dietary Modification Trial.

INTERVENTION

The nutrition goals for women randomly assigned to the low-fat intervention were to reduce total fat intake to 20% or less of energy from fat and to consume 5 or more fruit/vegetable servings daily and 6 or more grain servings daily.

MAIN OUTCOME MEASURES

Year 1 program participation (degree of attending group sessions and submitting fat scores) and adherence to the low-fat dietary pattern (percent energy from fat) as predicted by baseline physical and emotional status (eight SF-36 Health Survey subscales).

RESULTS

Participating in the dietary intervention program reduced (mediated) the negative effect of poorer mental health on dietary adherence by 15%. Additional findings included that a 10% increase in physical functioning increased session attendance by 0.4% (P<.001) and a 10% increase in mental health predicted a decrease in percent energy from fat of 0.3% (P<.001). Program participation had a marked effect on dietary adherence: a 10% increase in session attendance predicted a 1.2% decrease in percent energy from fat (P<.001).

APPLICATIONS/CONCLUSIONS

Understanding and using instruments to assess the physical and emotional status of a target population will help dietetic professionals promote healthful dietary change and maintenance.