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Jang Y, Hepburn K, Park J, Haley WE, Kim MT. Changes in Depressive Symptoms of Korean American Dementia Caregivers After Attending the Savvy Caregiver Program: Preliminary Findings with a Pilot Sample. Clin Gerontol 2023:1-8. [PMID: 37724817 PMCID: PMC10948376 DOI: 10.1080/07317115.2023.2260815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVES Language accommodation is indispensable in making evidence-based interventions available and accessible to ethnic minorities with limited English proficiency. As part of the larger effort to culturally adapt the Savvy Caregiver Program for Korean American dementia caregivers, we first conducted linguistic adaptation, and the present study reports the preliminary findings on participants' changes in depressive Symptoms. METHODS The linguistically adapted program was delivered to two small groups of Korean American dementia caregivers (total n = 13) by two Savvy-certified Korean-speaking trainers. Participants' depressive symptoms were assessed at three time points (pre-intervention, immediate post-intervention, and 6-month follow-up). RESULTS Following the intervention, participants exhibited lowered depressive symptoms (t = 8.64, p < .001, Cohen's d = .89). This benefit was sustained at 6-month follow-up. CONCLUSIONS Findings suggest that the therapeutic benefit of the Savvy Caregiver Program could potentially be shared with linguistic minorities when delivered in their native language. CLINICAL IMPLICATIONS Although limited in its scope and nature, the pilot study with linguistic adaptation sheds light on efforts to close the gap in the evidence-based intervention delivery.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
- Department of Social Welfare, Ewha Womans University, Republic of Korea
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
| | | | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, USA
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Jang Y, Hepburn K, Park J, Haley WE, Kim MT. Cultural adaptation of the savvy caregiver program for Korean Americans with limited English proficiency: a feasibility and acceptability study. BMC Geriatr 2022; 22:875. [PMCID: PMC9673327 DOI: 10.1186/s12877-022-03611-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Limited English proficiency (LEP) of dementia caregivers poses a critical barrier to these caregivers’ access to evidence-based interventions. In an effort to make such interventions available and accessible to dementia caregivers with LEP, in the present study we use Barrera and colleagues’ (2011) three-step model of cultural adaptation: (1) information gathering, (2) preliminary adaptation, and (3) full adaptation. Selecting Korean Americans as a target group and the Savvy Caregiver Program (SCP) as a target intervention, we demonstrate the sequential process of cultural adaption and report the outcomes on feasibility and acceptability. Methods Preliminary adaptation with linguistic attunement was conducted by translating the SCP manual into Korean and certifying two lay individuals who were bilingual in English and Korean as Savvy trainers. The 6-week online SCP program was delivered by the two trainers in Korean with six to seven caregiver participants per trainer (N = 13). Feasibility and acceptability of the SCP for both caregiver participants and trainers were assessed using mixed methods, and their data then informed full adaptation. Results Findings not only showed the initial efficacy of the linguistically attuned SCP but also suggested areas for further modification. Data-driven assessment yielded a list of recommended changes for full adaptation, which was reviewed by the SCP developer to ensure fidelity and by community and research partners to confirm contextual and cultural relevance. Conclusions The adopted changes are broadly summarized as representing logistical, technical, and cultural issues. Given our refined set of educational materials and implementation guidelines, we discuss future directions for research and development.
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Affiliation(s)
- Yuri Jang
- grid.42505.360000 0001 2156 6853Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411 USA ,grid.255649.90000 0001 2171 7754Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Kenneth Hepburn
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, USA
| | - Juyoung Park
- grid.42505.360000 0001 2156 6853Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411 USA
| | - William E. Haley
- grid.170693.a0000 0001 2353 285XSchool of Aging Studies, University of South Florida, Tampa, USA
| | - Miyong T. Kim
- grid.89336.370000 0004 1936 9924School of Nursing, University of Texas at Austin, Austin, USA
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Guo M, Sabbagh Steinberg N, Dong X, Tiwari A. A cross-sectional study of coping resources and mental health of Chinese older adults in the United States. Aging Ment Health 2018; 22:1448-1455. [PMID: 28812377 PMCID: PMC6123276 DOI: 10.1080/13607863.2017.1364345] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study examined the potential influence of coping resources at individual (sense of mastery), family (spousal and family support, children's filial piety), and community levels (community cohesion) on the mental health (depression, anxiety) of U.S. Chinese older adults. METHODS The data were derived from the Population Study of Chinese Elderly in Chicago (N= 3,159). Negative binomial regressions were performed to predict depression and anxiety, respectively, by entering the three sets of coping resources separately and jointly, controlling for socio-demographic and acculturation variables. RESULTS Stronger sense of mastery and greater perception of children's filial piety were associated with better mental health outcomes. Spousal support was not associated with any mental health outomes, and family support was actually assciated with greater depression and anxiety. Stronger community cohesion was associated with fewer depressive symptoms but greater anxiety. CONCLUSION Older immigrants' sense of control and perception that children adhere to traditional family norms are important mental health protective factors. Whereas depending on families for support may compromise their well-being, community cohesion could be a double-edged sword for their mental health. Future studies shall further disentangle the associations among sense of mastery, reliance on family and ethnic enclaves for support, and older immigrants' well-being.
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Affiliation(s)
- Man Guo
- University of Iowa, School of Social Work, 308 North Hall, Iowa City, IA, USA, 52242. Tel: (1)319-335-0513.
| | | | - Xinqi Dong
- Rush University Medical Center, Rush Institute for Healthy Aging, 1645 W. Jackson Blvd, Suite 675, Chicago, IL, USA, 60612. Tel: (1)319-942-3237.
| | - Agnes Tiwari
- University of Hong Kong, School of Nursing, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China. Tel: (852) 3917-6629.
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Guo M, Dong X, Tiwari A. Family and Marital Conflict Among Chinese Older Adults in the United States: The Influence of Personal Coping Resources. J Gerontol A Biol Sci Med Sci 2017; 72:S50-S55. [PMID: 28575252 PMCID: PMC5458423 DOI: 10.1093/gerona/glw129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/16/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Conflict in the family is a major risk factor for the well-being of older immigrants, whose lives are centered around their families. This study examined the potential linkage between personal coping resources and family and marital conflict among U.S. Chinese older adults. METHODS Data were derived from the PINE study, a population-based study of Chinese elders in Chicago (N = 3,157). Logistic regressions were carried out to predict the likelihood of having conflict with family members and with the spouse, respectively, using indicators of personal coping resources (ie, socioeconomic status, physical health, acculturation level, perceived children's filial piety, number of friends, and sense of mastery). RESULTS The results showed that older adults with higher education (odds ratio [OR] = 1.03, confidence interval [CI] = 1.01-1.06; OR = 1.09, CI = 1.06-1.11, respectively), lower perception of children being filial (OR = 0.95, CI = 0.93-0.97; OR = 0.96, CI = 0.94-0.98], respectively), and lower sense of mastery (OR = 0.95, CI = 0.94-0.96; OR = 0.98, CI = 0.97-0.99, respectively) were more likely to report both family and marital conflict. Older adults who had more friends were less likely to report marital conflict (OR = 0.61, CI = 0.43-0.86). CONCLUSIONS Overall, older immigrants with greater coping resources seemed to have less family and marital conflict. Particularly important are their own sense of control and available support from children and friends in the new society. Higher education could be a risk factor for these conflicts. Future studies are needed to distinguish everyday life conflict from acculturation-related conflict in this population.
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Affiliation(s)
- Man Guo
- School of Social Work, University of Iowa
| | - Xinqi Dong
- Rush University Medical Center, Chicago, Illinois
| | - Agnes Tiwari
- School of Nursing, University of Hong Kong, China
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Jang Y, Kim K, Park NS, Chiriboga DA. Emotional Confidants in Ethnic Communities: Social Network Analysis of Korean American Older Adults. J Aging Health 2015; 28:324-40. [PMID: 26082133 DOI: 10.1177/0898264315591002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Ethnic communities often serve as the primary source of emotional support for older immigrants. This study aims to identify individuals who are more likely to be nominated as emotional confidants by age peers in the ethnic community and to examine factors contributing to the likelihood of being a more frequently endorsed confidant. METHOD Data were drawn from a survey with 675 older Korean Americans. Using the name-generator approach in Social Network Analysis (SNA), participants were asked to list the names of three emotional confidants among age peers in the community. RESULTS A higher level of popularity (i.e., in-degree centrality) was predicted by male gender, advanced education, lower functional disability, fewer symptoms of depression, and higher levels of participation in social activities. DISCUSSION Our findings suggest the value of SNA as a means of identifying the key emotional confidants in the community and utilizing them in community-based interventions.
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Affiliation(s)
- Yuri Jang
- The University of Texas at Austin, USA
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Lee KH, GlenMaye LF. Stressors, coping resources, functioning, and role limitations among older korean immigrants: gender differences. J Women Aging 2014; 26:66-83. [PMID: 24483283 DOI: 10.1080/08952841.2014.858578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.
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Affiliation(s)
- Kyoung Hag Lee
- a School of Social Work , Wichita State University , Wichita , KS
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Lee KH, Hwang MJ. Private religious practice, spiritual coping, social support, and health status among older Korean adult immigrants. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:428-443. [PMID: 25068608 DOI: 10.1080/19371918.2013.858234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study explored the role of spiritual factors and social support on the health status of 246 older Korean adult immigrants age 65 years or older. Ordinary least squares regression results revealed that private religious practice, spiritual coping, and social support were significantly associated with improved health status. However, stressors such as the lack of English proficiency and transportation, longer residency in the United States, and financial problems were significantly associated with lower health status. Social workers need to consider providing appropriate spiritual interventions and social support programs for older Korean adult immigrants so that they may better handle their stressors and health problems.
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Affiliation(s)
- Kyoung Hag Lee
- a School of Social Work, Wichita State University , Wichita , Kansas , USA
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Lee KH, Woo H. Stressors, social support, religious practice, and general well-being among Korean adult immigrants. JOURNAL OF EVIDENCE-BASED SOCIAL WORK 2013; 10:421-434. [PMID: 24066632 DOI: 10.1080/15433714.2012.759483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Through this cross-sectional study the authors explore how stressors, social support, and religious practice are associated with the general well-being of 147 Korean adult immigrants through interviews. Hierarchical regression analysis reveals that low English proficiency and financial hardship are significantly related to low general well-being. However, high social support and religious practice are significantly associated with high general well-being. Social service and health care providers need to carefully assess stressors, social support systems, and spiritual issues for providing appropriate services/programs for English, culture, or social activities as well as spiritual intervention to maximize the strengths of Korean immigrants coping with health issues.
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Affiliation(s)
- Kyoung Hag Lee
- a School of Social Work, Wichita State University , Wichita , Kansas , USA
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Park J, Roh S. Daily spiritual experiences, social support, and depression among elderly Korean immigrants. Aging Ment Health 2013; 17:102-8. [PMID: 22881195 DOI: 10.1080/13607863.2012.715138] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study examined the associations of daily spiritual experiences (DSE) and social support with depression to find viable coping resources and enhance the quality of life among elderly Korean immigrants. METHOD We used Smith's (2003) theory of religious effects and Baron and Kenny's (1986) approach for mediation analysis to explain the mediating role of social support between DSE and depression. The sample consisted of 200 elderly Korean immigrants who were aged 65 or older (mean age = 72.5, range = 65-89) living in the New York City Metropolitan area. Hierarchical regression model was used with SPSS version 17.0 to analyze cross-sectional data. RESULTS Elderly Korean immigrants in the present sample were found to be moderately engaged in DSE but not experiencing a fair level of social support. Respondents reported no depression on the average but 30% of them (60 out of 200 respondents) were experiencing mild to severe depression. Both DSE and social support were inversely related with depression, and the relationship between DSE and depression was mediated by social support. CONCLUSION These findings are only suggestive and should not be generalized to a larger population. However, this study supports the importance of DSE and social support in the life of elderly Korean immigrants as a way to alleviate depression. Mental health professionals may consider facilitating social network when elderly Korean immigrants suffer from depression.
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Affiliation(s)
- Jisung Park
- Samsung Life Retirement Research Center, Seoul, South Korea.
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Kim W, Chen YL. The social determinants of depression in elderly Korean immigrants in Canada: does acculturation matter? Int J Aging Hum Dev 2012; 73:283-98. [PMID: 22474912 DOI: 10.2190/ag.73.4.a] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Depression in old age significantly decreases the quality of life and may lead to serious consequences, such as suicide. Existing literature indicates that elderly Korean immigrants may experience higher levels of depression than other racial ethnic group elders. The purpose of this exploratory study was to investigate factors that influence depression among older Korean immigrants in Toronto. A total of 148 participants, ages 60 years or older (mean age = 74.01, SD = 8.24), completed face-to-face interviews in Korean language. Hierarchical regression analyses were conducted by adding variables in three steps: (1) demographic variables; (2) acculturation variables (years of immigration and English proficiency); and (3) social determinants (social integration variables, physical health, and financial satisfaction). Results showed that acculturation factors were not associated with depression. Instead, social determinants variables, including lower physical health status and lower financial status, living alone, and lower level of social activity, predicted higher level of depressive symptoms, along with lower education. The final regression model explained about 37% of variance of depression in the sample. These results suggest that social determinants, not acculturation, are important factors explaining the levels of depression in Korean immigrant elders living in a metropolitan city in Canada. Implications for practice are discussed.
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Affiliation(s)
- Wooksoo Kim
- School of Social Work, University at Buffalo, The State University of New York, 14260-1050, USA.
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Lee KH. The Role of Spiritual Experience, Forgiveness, and Religious Support on the General Well-Being of Older Adults. JOURNAL OF RELIGION SPIRITUALITY & AGING 2011. [DOI: 10.1080/15528030.2011.533398] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Challenges and barriers to services for immigrant seniors in Canada: “you are among others but you feel alone”. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2011. [DOI: 10.1108/17479891111176278] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lear SA, Humphries KH, Hage-Moussa S, Chockalingam A, Mancini GBJ. Immigration presents a potential increased risk for atherosclerosis. Atherosclerosis 2009; 205:584-9. [PMID: 19181317 DOI: 10.1016/j.atherosclerosis.2008.12.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 12/17/2008] [Accepted: 12/23/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Immigrants in Western countries tend to have a greater risk for cardiovascular disease (CVD) than those in their home country, but it is unclear if immigrants are at increased risk for CVD compared to non-immigrants in their new country. The purpose of this study was to determine the independent association of time since immigration with sub-clinical atherosclerosis in immigrants of Chinese, European and South Asian origin. METHODS A total of 460 immigrants and 158 non-immigrants of Chinese, European and South Asian origin without pre-diagnosed CVD were assessed for sub-clinical atherosclerosis by carotid artery ultrasound scan, socio-demographics, CVD risk factors and lifestyle factors. Time since immigration in years was used as a measure of exposure. RESULTS Participants who immigrated > or =30 years ago had a greater intima-media thickness (IMT) of the carotid artery compared to non-immigrants, and immigrants of < or =20 years. Time since immigration was associated with IMT, plaque area and IMT+plaque area. After adjustment for age, sex, ethnicity, income, education, family history of CVD and diabetes, smoking, physical activity, body mass index, visceral adipose tissue, lipids, insulin, glucose and blood pressure, time since immigration was significantly associated with IMT. For every ten years since immigration there was a 2% increase in IMT in addition to the 7% increase for every 10 years of age. CONCLUSIONS Immigration was associated with an increased burden of sub-clinical atherosclerosis that surpassed that of non-immigrants. This burden increased over time independent of other risk factors. Immigrants represent a high-risk group for which targeted interventions are needed.
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Affiliation(s)
- Scott A Lear
- Simon Fraser University, British Columbia, Canada.
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Abstract
Healthy People 2010 breastfeeding goals include 50% exclusive breastfeeding at 6 months. In California, US, Santa Clara County Women, Infants, and Children (SCCWIC) data indicated Asian participants had low (5.6%) 6-month breastfeeding rates. To examine infant-feeding practices, Vietnamese breastfeeding peer counselors surveyed 133 Vietnamese SCCWIC participants (> or= 18 years old, nonpregnant, < 28 months postpartum) using a structured questionnaire regarding intentions, attitudes, and subjective norms toward breastfeeding. Results indicated that 75% initiated breastfeeding in the hospital (33% exclusively, 42% partially), and 25% exclusively formula fed. At survey time, 49% had terminated breastfeeding (average duration 4.4 months). Feeding intentions during pregnancy predicted feeding method used (P < .001). Most prenatal advice was from SCCWIC employees, friends, and doctors who supported breastfeeding. Most postnatal advice was from nurses who supported breastfeeding and bottle-feeding equally. Stronger control beliefs, peer counseling, and education were correlated with breastfeeding (P < .001). Improved postdelivery hospital advice may further increase breastfeeding initiation and duration.
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Affiliation(s)
- Yashmi Mistry
- Ryerson Polytechnic University, Toronto, Ontario, Canada
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Slagsvold B, SØrensen A. Age, Education, and the Gender Gap in the Sense of Control. Int J Aging Hum Dev 2008; 67:25-42. [DOI: 10.2190/ag.67.1.b] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High sense of control is related to benefits in many aspects of life, and education is known to be strongly related to sense of control. In this article we explore why women tend to feel a lower sense of control than men, and why the sense of control tends to be lower among the elderly than among younger people. In particular we explore the role played by education in explaining age- and gender differences in sense of control. The analysis is based on data from the first wave of the Norwegian NorLAG study, with a representative sample of adults aged 40–79 in 30 municipalities. We find that education accounts for some of the age and gender differences in sense of control, but the mediating effects of education are rather modest. We find an increasing gender gap in sense of control with age, and this increasing gap is completely explained by differences in education. Gender differences in sense of control is explained completely by four factors, which are related to resources and power; physical health, education, living with a partner, and leadership experience. Age differences in sense of control are only partially explained. Education, physical health and employment status cuts the age effect on sense of control to half. The effect of education on sense of control is partly mediated through what we suggest are tangible benefits of education, namely health, employment, and leadership experience. Education also influences individuals through socialization mechanisms. We view agentive orientation as a psychological benefit of education, and measure this characteristic with Bem's (1981) sex-role scale on masculinity. Agentive orientation completely explains the remaining effect of education on sense of control.
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