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Background and Objectives Behavioral expressions of dementia are often stressful for family caregivers to manage as they strive to ensure their relative's needs are met. Guided by Lazarus and Folkman's Transactional Model of Stress and Coping, we identified specific behaviors that disrupt daily routines and challenge the achievement of caregiving goals, and the approaches and strategies caregivers employ to address them. Research Design and Methods We conducted semistructured interviews with 30 family caregivers in rural Appalachia caring for a relative living with dementia. Analysis involved use of open and focused coding processes to identify the ways caregivers managed behaviors and bar graphs to examine management approaches relative to categories of behaviors and caregiver demographic and emotional well-being variables. Results Analyses revealed 10 types of behavioral expressions of dementia associated with confusion, irritability, and resistance to engaging in necessary activities of daily living. Caregiver approaches to managing behaviors included gentle persuasion, being harsh by yelling or threatening, being persistent in expecting the person with dementia to complete the tasks at hand, disengaging by postponing the activity, and employing a combination of strategies. Approaches differed across types of behavior and caregiver demographics and had varying effects on caregiver well-being. Discussion and Implications Uncovering specific behaviors family caregivers of persons living with dementia found bothersome, caregivers' adaptive strategies for managing behaviors, and the impact of those approaches provides new information to inform training on effective dementia caregiving practices and development of targeted intervention programs for dementia care. [ABSTRACT FROM AUTHOR]

In custodial grandfamilies, grandchildren often provide critical support and assistance to their grandparents. Less is known about the extent to which grandchildren may serve as caregivers to their custodial grandparents and how providing care may impact their well-being. Informed by the stress process model, the purpose of this study was to examine the nature of adolescent grandchildren's caregiving to their custodial grandmothers and the relationship of providing this care to grandchildren's perceived caregiving interference and internalizing and externalizing behavior problems. A survey was administered to 81 adolescents, aged 12 to 18, and their custodial grandmothers. Results suggest that grandchildren provide assistance with both instrumental activities of daily living (IADLs; e.g., housework, cooking) and activities of daily living (ADLs; walking, dressing). Results of a path analysis revealed that grandchildren's assistance with ADLs was associated with greater perceptions of caregiving interference in social and academic arenas, which was associated with increased externalizing behavior problems. Implications for practice, which underscore the necessity of interventions to support grandchild caregivers, and directions for future research, are addressed. Highlights: Grandchildren assisting grandmothers with instrumental activities of daily living, including household chores, was common. Grandchildren assist custodial grandmothers with activities of daily living (e.g., transferring, using stairs, and walking). When grandchildren assist with more activities of daily living, they report greater perceptions of caregiving interference. Grandchildren with greater perceived caregiving interference experienced more externalizing behavior problems. [ABSTRACT FROM AUTHOR]

Background and Objectives Coronavirus disease 2019 (COVID-19) created a "perfect storm" for financial fraud targeting older adults. Guided by the Contextual Theory of Elder Abuse, we focused on individual and systemic contexts to examine how older adults became prey to financial fraud. Research Design and Methods In July 2020, 998 adults who were 60–98 years of age (93% White; 64% female) completed an online survey about experiences with financial fraud. Participants were recruited from gerontology research registries at Florida State University, University of Pittsburg, Virginia Tech, and Wayne State University. Results Over half (65.9%) of the respondents experienced a COVID-19-related scam attempt, with charity contributions (49%) and COVID-19 treatments (42%) being the most common. Perpetrators commonly contacted older adults electronically (47%) two or more times (64%). Although most respondents ignored the request (i.e. hung up the phone and deleted text/e-mail), 11.3% sent a requested payment, and 5.3% provided personal information. Predictors of vulnerability included contentment with financial situation, concern about finances in the aftermath of the pandemic, and wishing to talk to someone about financial decisions. Respondents targeted for a non-COVID-19 scam attempt were less likely to be targets of a COVID-19-related scam. Discussion and Implications Older adults who were financially secure, worried about their financial situation, or wished they could speak with someone about their financial decisions appeared susceptible to falling victim to a fraud attempt. The high number of attempts indicates a need for a measurable and concerted effort to prevent the financial fraud of older adults. [ABSTRACT FROM AUTHOR]

Despite changes in the structure of contemporary families, little is known about extended family members—siblings, grandchildren, nieces/nephews, stepkin—who are primary caregivers for a relative living with dementia. Information about these caregivers is needed to help ensure their needs are understood by providers in health care and social service settings. The focus of this research was on the care situations of extended family caregivers and the impact of caregiving on their health and well-being. In Study 1, data from the National Study of Caregiving were used to describe the experiences of 107 extended family caregivers. In Study 2, case study techniques elicited additional information about the experiences of 10 extended family caregivers. Collectively, these caregivers provide care with little or no formal support and occasional help from a small informal network. Caregiving affected their physical and emotional health, depending on the strength of the relationship between the caregiver and the person living with dementia and the type of care provided. Findings contribute new knowledge about extended family caregivers and highlight the important role extended family dementia caregivers play and the challenges they face. [ABSTRACT FROM AUTHOR]

This study investigated perceived support received by partners and its association with quality of life (QOL) in older couples facing skin cancer. Thirty couples (n = 60; MAge = 70) in which one partner had a skin cancer diagnosis (PwSC) completed either online or paper surveys about their skin cancer diagnosis, perceived partner support, and overall QOL. Actor-partner interdependence models revealed that when PwSCs reported overprotection from their healthy partners (HPs), they were more likely to report lower QOL. Protective buffering received by HPs was negatively associated with their QOL as well as their PwSCs QOL. Active engagement support, however, was not associated with either partner's QOL. While couples may use all three styles of relationship-focused support, protective buffering and overprotection affected each partner's QOL. Implications of the study findings for interventions for couples facing illnesses like skin cancer are discussed. [ABSTRACT FROM AUTHOR]

The purpose of the present research was to develop questionnaires to assess outcome expectancy for resistance training (RT), behavioral expectation in the context of perceived barriers to RT, and self-regulation strategies for RT among young-old adults (50-69 years). Measurement development included (a) item generation through elicitation interviews (N = 14) and open-ended questionnaires (N = 56), (b) expert feedback on a preliminary draft of the questionnaires (N = 4), and (c) a quantitative longitudinal study for item-reduction and psychometric analyses (N = 94). Elicitation procedures, expert feedback, and item reduction yielded four questionnaires with a total of 33 items. Positive outcome expectancy (α = .809), negative outcome expectancy (α = .729), behavioral expectation (α = .925), and self-regulation (α = .761) had—with one exception—moderate bivariate associations with two different indicators of self-reported RT behavior at one-month follow-up (r = .298 to .506). The present research provides preliminary support for newly developed questionnaires to facilitate understanding of the psychosocial determinants of RT among young-old adults. [ABSTRACT FROM AUTHOR]

Objective Researchers have consistently shown that providing care in a gradually deteriorating situation, such as dementia, can be stressful and detrimental to the caregiver's (CG) health. Although stressor appraisal is important in understanding variability in CG outcomes, the role of personal mastery, a coping resource, in shaping CG's health outcomes has not been considered. The primary goal of this paper was to determine whether personal mastery is associated with a survival advantage for spousal CGs of persons with dementia. Methods This study assessed the association of CG burden and personal mastery with longevity over a 10-year period in 71 spousal CGs of persons initially diagnosed with mild cognitive impairment. Results Over the 10 years, 16 of 71 CGs (23%) died. Cox regression models with right censoring of CGs' time to death showed that after adjusting for the health of family CG, spousal CGs who reported high levels of burden had an 83% reduced risk of death when they also reported high personal mastery (hazard ratio [HR] = 0.17, 95% confidence interval [CI] 0.04, 0.65). Conclusions Findings have implications for support programs that help build personal mastery. [ABSTRACT FROM AUTHOR]

Objective: Despite overall improvements in the U.S. health care, older adults living in rural counties, such as Appalachian Virginia, continue to be underserved. Method: Multinomial regression models, including both individual and county data from 503 older adults aged 65+, were used to examine factors associated with informal and formal care use. Results: Older adults with stronger filial beliefs and less positive attitudes toward community services preferred informal help. If the county had more formal care services, however, older adults were more likely to use them, regardless of their filial beliefs. Disparities based on gender were observed, in that women who lived in counties with a higher percentage of older adults below the poverty line were more likely to receive no help than men. Discussion: Developing effective service promotion tactics, destigmatizing community services, and targeting services and support, especially to women, could decrease health disparities in rural Appalachia and similar geographic areas. [ABSTRACT FROM AUTHOR]

Objectives:Exposure to suffering of a relative or friend increases the risk for psychological and physical morbidity. However, little is known about the mechanisms that account for this effect. We test a theoretical model that identifies intrusive thoughts as a mediator of the relation between perceived physical and psychological suffering of the care recipient and caregiver depression. We also assess the role of compassion as a moderator of the relation between perceived suffering and intrusive thoughts. Methods:Hispanic and African American caregivers (N= 108) of persons with dementia were assessed three times within a one-year period. Using multilevel modeling, we assessed the mediating role of intrusive thoughts in the relation between perceived physical and psychological suffering and CG depression, and we tested moderated mediation to assess the role of caregiver compassion in the relation between perceived suffering and intrusive thoughts. Results:The effects of perceived physical suffering on depression were completely mediated through intrusive thoughts, and compassion moderated the relation between physical suffering and intrusive thoughts. Caregivers who had greater compassion reported more intrusive thoughts even when perceived physical suffering of the CR was low. For perceived psychological suffering, the effects of suffering on depression were partially mediated through intrusive thoughts. Discussion:Understanding the role of intrusive thoughts and compassion in familial relationships provides new insights into mechanisms driving caregiver well-being and presents new opportunities for intervention. [ABSTRACT FROM AUTHOR]

The article offers information on interpersonal neurobiology, an interdisciplinary theory being used by couple and family therapists. Topics discussed include National Longitudinal Study of Adolescent to Adult Health (Add Health), attachment theory and the connections between experiences in relationships and brain development. Also mentioned are exploring couple relationship quality, self-acceptance and neuroticism, a personality trait characterized by emotional reactivity.

Parental incarceration is often an adverse childhood experience that has been characterized as an enduring trauma that involves ongoing and repeated stressors. In this study we focus on the role of parental incarceration in predicting child trauma symptomology as well as key mediating family processes such as visitation and children's caregiving arrangement. We utilize a comparison group design of single caregiver and child dyads (N = 45) among similarly disadvantaged single caregiver families to first determine mean differences in child trauma symptomology. Findings revealed that both child and caregiver reports of child trauma symptomology were significantly higher in single caregiver families impacted by parental incarceration and these levels were in the clinical range (parent reports) or approached the clinical range (child reports). We then tested a mediational model examining family processes linked to child trauma symptomology. Parental incarceration was associated with more serious visitation problems (than other contexts of visitation to a nonresident parent) and children being raised by someone other than a biological parent. Parental incarceration also significantly predicted parent and child reports of child trauma symptoms. The effect of parental incarceration on parent reports of child trauma symptomology was fully mediated by the quality of children's visitation suggesting the importance of developing interventions aimed at alleviating child distress during visits in correctional settings. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Energy-containing beverages, specifically sugar-sweetened beverages, may contribute to weight gain and obesity development. Yet, no rapid assessment tools are available which quantify habitual beverage intake (grams, energy) in adults. Objective: Determine the factorial validity of a newly developed beverage intake questionnaire (BEVQ) and identify potential to reduce items. Methods: Participants from varying economic and educational backgrounds (n=1,596, age 43±12 years, body mass index [calculated as kg/m2] 31.5±0.2) completed a 19-item BEVQ (BEVQ-19). Beverages that contributed <10% to total beverage, or sugar-sweetened beverages, energy and grams were identified for potential removal. Factor analyses identified beverage categories that could potentially be combined. Regression analyses compared BEVQ-19 outcomes with the reduced version''s (BEVQ-15) variables. Inter-item reliability was assessed using Cronbach''s α. Following BEVQ-15 development, a subsequent study (n=70, age 37±2 years; body mass index 24.5±0.4) evaluated the relative validity of the BEVQ-15 through comparison of three 24-hour dietary recalls'' beverage intake. Results: Three beverage items were identified for elimination (vegetable juice, meal replacement drinks, and mixed alcoholic drinks); beer and light beer were combined into one category. Regression models using BEVQ-15 variables explained 91% to 99% of variance in the four major outcomes of the BEVQ-19 (all P<0.001). Cronbach''s α ranged .97 to .99 for all outcomes. In the follow-up study, BEVQ-15 and three 24-hour dietary recalls'' variables were significantly correlated with the exception of whole milk; BEVQ-15 sugar-sweetened beverages (R 2=0.69), and total beverage energy (R 2=0.59) were more highly correlated with three 24-hour dietary recalls'' than previously reported for the BEVQ-19. The BEVQ-15 produced a lower readability score of 4.8, which is appropriate for individuals with a fourth-grade education or greater. Conclusions: The BEVQ-19 can be reduced to a 15-item questionnaire. This brief dietary assessment tool will enable researchers and practitioners to rapidly (administration time of ∼2 minutes) assess habitual beverage intake, and to determine possible associations of beverage consumption with health-related outcomes, such as weight status. [Copyright &y& Elsevier]

Background Efforts to reduce unhealthy dietary intake behaviors in youth are urgently needed. Theory-based interventions can be effective in promoting behavior change; one promising model is the Theory of Planned Behavior (TPB). Purpose The aim of this study was to determine, using a systematic literature review, how the TPB has been applied to investigate dietary behaviors, and to evaluate which constructs are associated with dietary behavioral intentions and behaviors in youth. Methods Publications were identified by searching electronic databases, contacting experts in the field, and examining an evolving Internet-based TPB-specific bibliography. Studies including participants aged 2–18 years, all TPB constructs discernible and measured with a description of how the variables were assessed and analyzed, were published in English and peer-reviewed journals, and focused on nutrition-related behaviors in youth were identified. Accompanying a descriptive statistical analysis was the calculation of effect sizes where possible, a two-stage meta-analysis, and a quality assessment using tenants from the Consolidated Standards of Reporting Trials (CONSORT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statements. Results Thirty-four articles, including three intervention studies, were reviewed. The TPB was most often used to evaluate healthy eating and sugary snack and beverage consumption. Attitude had the strongest relationship with dietary behavioral intention (mean r = 0.52), while intention was the most common predictor of behavior performance (mean r = 0.38; both p < 0.001). All three interventions revealed beneficial outcomes when using the TPB (e.g. η 2 = 0.51 and d s = 0.91, 0.89, and 0.79); extending the Theory with implementation intentions may enhance its effectiveness (e.g. η 2 = 0.76). Conclusions Overall, the TPB may be an effective framework to identify and understand child and adolescent nutrition-related behaviors, allowing for the development of tailored initiatives targeting poor dietary practices in youth. However, support from the literature is primarily from observational studies and a greater effort towards examining these relationships within intervention studies is needed. [ABSTRACT FROM AUTHOR]

Abstract: Maintenance of weight loss remains a challenge for most individuals. Thus, practical and effective weight-loss maintenance (WTLM) strategies are needed. A two-group 12-month WTLM intervention trial was conducted from June 2007 to February 2010 to determine the feasibility and effectiveness of a WTLM intervention for older adults using daily self-monitoring of body weight, step count, fruit/vegetable (F/V) intake, and water consumption. Forty weight-reduced individuals (mean weight lost=6.7±0.6 kg; body mass index [calculated as kg/m2] 29.2±1.1), age 63±1 years, who had previously participated in a 12-week randomized controlled weight-loss intervention trial, were instructed to record daily body weight, step count, and F/V intake (WEV [defined as weight, exercise, and F/V]). Experimental group (WEV+) participants were also instructed to consume 16 fl oz of water before each main meal (ie, three times daily), and to record daily water intake. Outcome measures included weight change, diet/physical activity behaviors, theoretical constructs related to health behaviors, and other clinical measures. Statistical analyses included growth curve analyses and repeated measures analysis of variance. Over 12 months, there was a linear decrease in weight (β=−0.32, P<0.001) and a quadratic trend (β=0.02, P<0.01) over time, but no group difference (β=−0.23, P=0.08). Analysis of the 365 days of self-reported body weight for each participant determined that weight loss was greater over the study period in the WEV+ group than in the WEV group, corresponding to weight changes of −0.67 kg and 1.00 kg, respectively, and an 87% greater weight loss (β=−0.01, P<0.01). Overall compliance to daily tracking was 76%±5%. Daily self-monitoring of weight, physical activity, and F/V consumption is a feasible and effective approach for maintaining weight loss for 12 months, and daily self-monitoring of increased water consumption may provide additional WTLM benefits. [Copyright &y& Elsevier]

Background Added sugar intake, in the form of sugar-sweetened beverages (SSBs), may contribute to weight gain and obesity development in children and adolescents. A valid and reliable brief beverage intake assessment tool for children and adolescents could facilitate research in this area. Objective The purpose of this investigation was to evaluate the relative validity and test–retest reliability of a 15-item beverage intake questionnaire (BEVQ) for assessing usual beverage intake in children and adolescents. Design This cross-sectional investigation included four study visits within a 2- to 3-week time period. Participants/setting Participants (333 enrolled; 98% completion rate) were children aged 6 to 11 years and adolescents aged 12 to18 years recruited from the New River Valley, VA, region from January 2014 to September 2015. Study visits included assessment of height/weight, health history, and four 24-hour dietary recalls (24HRs). The BEVQ was completed at two visits (BEVQ 1, BEVQ 2). Main outcome measures To evaluate relative validity, BEVQ 1 was compared with habitual beverage intake determined by the averaged 24HR. To evaluate test–retest reliability, BEVQ 1 was compared with BEVQ 2. Statistical analyses performed Analyses included descriptive statistics, independent sample t tests, χ 2 tests, one-way analysis of variance, paired sample t tests, and correlational analyses. Results In the full sample, self-reported water and total SSB intake were not different between BEVQ 1 and 24HR (mean differences 0±1 fl oz and 0±1 fl oz, respectively; both P values >0.05). Reported intake across all beverage categories was significantly correlated between BEVQ 1 and BEVQ 2 ( P <0.001). In children (n=126), reported intake of milk and energy (in kilocalories) for total beverages was not different (all P values >0.05) between BEVQ 1 and 24HR (mean differences: whole milk=3±4 kcal, reduced-fat milk=9±5 kcal, and fat-free milk=7±6 kcal, which is 7±15 total beverage kilocalories). In adolescents (n=200), water and SSB kilocalories were not different (both P values >0.05) between BEVQ 1 and 24HR (mean differences: –1±1 fl oz and 12±9 kcal, respectively). Conclusions A 15-item BEVQ provides results that are similar relative to multiple 24HRs for determining habitual milk and total beverage intake in children, and water and SSB intake in adolescents. The 15-item BEVQ is a reliable indicator of habitual beverage intake in both children and adolescents. Future studies could explore whether adjustments to BEVQ beverage categories, portion size, and format could improve the tool’s ability to measure beverage intake in young populations. [ABSTRACT FROM AUTHOR]