Midwestern Adults Research Articles

Multilevel correlates of domain-specific physical activity among rural adults – a cross-sectional study

BackgroundIncreasing physical activity (PA) in rural communities is a vital prevention tactic in multiple chronic diseases; however, little is known on the multilevel correlates of PA rural areas. A better understanding of domain-specific PA adds context for promoting PA in rural communities. The current study sought to determine factors associated with domain-specific and overall moderate-vigorous physical activity (MVPA) in rural communities.MethodsSurveys were conducted across 14 rural mid-Western communities, with the final analytical sample including 1241 adults (ages 19–96, M = 57.0 [SD = 16.7], 67.8% female, 83.8% white). Generalized linear models with negative binomial distributions examined the relation between demographics, trail use, and perceptions of the neighborhood environment, with domain-specific and overall MVPA, measured via the Global Physical Activity Questionnaire.ResultsRural residents reported an average of 617 total minutes of weekly MVPA (SD = 1141), with 58.5% meeting MVPA guidelines. Higher age, female gender, and higher educated individuals had lower levels of overall and occupational MVPA. Females, higher education, and perceived indoor recreational access were associated with lower levels of transportation-related MVPA, while trail use was associated with increased transportation MVPA. Higher age and female gender respondents had lower levels of recreational MVPA, while trail users and those who perceived favorable indoor recreational access had higher levels of recreational MVPA.ConclusionsPA primarily occurred in the occupational domain among this sample of rural mid-Western adults. Findings highlight the need for multilevel interventions to address PA across multiple domains in rural communities, especially among females and older adults.

Examining the Associations of and Interactions Between Intrapersonal and Perceived Environmental Factors With Objectively Assessed Physical Activity Among Rural Midwestern Adults, USA.

We investigated associations of intrapersonal and environmental factors with objectively assessed weekly moderate to vigorous physical activity (MVPA) minutes, and their interactions in rural adults. Cross-sectional. 14 rural towns participating in a multilevel intervention to promote physical activity. Baseline data from 241 rural community members (19% losses due to missing data). Self-reported demographics, behavioral factors, and neighborhood environment perceptions. Weekly MVPA minutes were assessed using accelerometry data. Generalized linear models using a negative binomial distribution examined associations of and interactions between intrapersonal and environmental correlates with weekly MVPA. Older age (β = -1.37; P= .025) and identifying as a woman (β = -.71; p= <.001) were inversely associated with MVPA. Self-efficacy (β = .34; p = <.001) and trail use (β = .44; P-value = .003) were directly associated with MVPA. Further, among women, perceived safety from traffic was inversely associated with MVPA (β = -.37; P = .003), while indoor recreational facility access was directly associated with MVPA (β = .24; P = .045). Rural residents, especially women, face disproportionately lower MVPA levels. Improving recreational access and self-efficacy may be effective strategies for increasing MVPA.

Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults.

Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455) completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010) scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02) and food-insecure (p < 0.0001) pantry clients. Mean energy intake (p = 0.0003), number of eating occasions (p = 0.004), and HEI-2010 component scores for total fruit (p < 0.001) and whole fruit (p < 0.0003) increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients.

Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis

ABSTRACTIncreasingly, social workers and behavioral health practitioners use assessment instruments to support service planning and to monitor progress. Following statewide implementation of the Adult Needs and Strengths Assessment (ANSA) to identify behavioral health symptoms, related functional challenges, risks, and strengths, this validation study explored the underlying structure of the instrument. An exploratory factor analysis used routinely collected information for Midwestern adults with diagnosed behavioral health disorders who participated in community-based services (N = 46,013). Five factors with adequate to good internal consistency (α = 0.733−0.880) emerged: personal recovery, trauma and stress related problems, substance use risks, self-sufficiency, and cultural-linguistic considerations. Validation of the ANSA supports use of the instrument to engage individuals and families, to plan services, to monitor progress, and to conduct research. Implications for social work education, supervision, and practice include the importance of understanding culture, holistic assessment, and services supporting personal recovery for individuals living with mental illness or substance use disorders. Confirmation of findings requires additional research.

Perceived Resources and Environmental Correlates of Domain-Specific Physical Activity in Rural Midwestern Adults.

Rural adults participate in lower levels of physical activity (PA) than urban or suburban adults. Due to known effects of the environment on PA participation, this study examined perceived ecological correlates (social, environmental, and policy) of domain- and intensity-specific PA in rural adults. A cross-sectional survey was completed by 143 individuals residing in the rural Midwest. PA was measured using the International Physical Activity Questionnaire; correlates of PA were measured using a modified version of the PA in Communities Questionnaire. Multiple regression analyses were conducted using general linear modeling. Predictors of PA included: employers providing time for exercise (P = .0003); available shopping malls (P = .0032); activity-friendly community aspects (P = .0048); favorable policy attitudes (P = .0018): participation in sports (P < .0001); encouragement from friends (P = .0136); awareness (P = .0015) and use (P = .0113) of community resources; and having hills (P = .0371). Correlates of PA in various domains and intensities in rural adults are multifactorial and occur at different levels of the environment. Findings from this study can be used to tailor PA interventions in rural adults, with respect to specific domains and intensity in which the PA occurs.

Environmental Influences on Physical Activity in Rural Midwestern Adults

Qualitative research can be used to examine multiple factors associated with physical activity and help practitioners identify language used by the rural adult population when discussing this behavior. Three focus groups were conducted among 19 residents of multiple towns in a rural Midwestern county to examine the language and influences on rural physical activity. Focus group members were asked to define physical activity, exercise, community, and neighborhood. They were asked about the activities they engaged in and facilitators and barriers to those activities. A guidebook was developed to capture major themes and common patterns that emerged in the responses to the topics discussed. The data were reviewed for repeated statements and points that were agreed on by multiple participants. Important factors associated with physical activity include the importance of social support and modeling physical activity behavior. Also, the influence of pets and children was important for engaging these adults in physical activity. The focus group members engaged in walking and bicycling in their neighborhood streets and community trails, and desired to see community buildings be open to the public for exercise. This study revealed contextual issues and culturally relevant language for practitioners to use in tailoring physical activity measurement tools or designing interventions for a rural adult population. Social support (specifically, seeing others being active and using pets as motivators for being active) and policy attitudes may be targeted for interventions to increase physical activity in rural adults.

Characteristics Associated With Awareness, Perceptions, and Use of Electronic Nicotine Delivery Systems Among Young US Midwestern Adults

We assessed the characteristics associated with the awareness, perceptions, and use of electronic nicotine delivery systems (e-cigarettes) among young adults. We collected data in 2010-2011 from a cohort of 2624 US Midwestern adults aged 20 to 28 years. We assessed awareness and use of e-cigarettes, perceptions of them as a smoking cessation aid, and beliefs about their harmfulness and addictiveness relative to cigarettes and estimated their associations with demographic characteristics, smoking status, and peer smoking. Overall, 69.9% of respondents were aware of e-cigarettes, 7.0% had ever used e-cigarettes, and 1.2% had used e-cigarettes in the past 30 days. Men, current and former smokers, and participants who had at least 1 close friend who smoked were more likely to be aware of and to have used e-cigarettes. Among those who were aware of e-cigarettes, 44.5% agreed e-cigarettes can help people quit smoking, 52.8% agreed e-cigarettes are less harmful than cigarettes, and 26.3% agreed e-cigarettes are less addictive than cigarettes. Health communication interventions to provide correct information about e-cigarettes and regulation of e-cigarette marketing may be effective in reducing young adults' experimentation with e-cigarettes.

Colorectal Cancer Screening Among Midwestern Community-Based Residents: Indicators Of Success

Screening reduces the rate of death and morbidity resulting from CRC. Although CRC screening rates are low relative to other cancer screening tests, rates appear to be increasing: In 2004, 57% of adults > or =50 years reported up-to-date CRC screening test use; 14 states and Washington DC showed rates in excess of 60%. Identification of indicators of success and challenges remaining are important for universal goal achievement. The purpose of this study was to identify system and individual-level indicators of up-to-date CRC screening in a geographic area that reports higher uptake rates. Random-digit-dialing methods were used to survey a population-based community sample (N = 1033) of Midwestern adults ages 50 to 79 for CRC screening uptake in spring 2005. Adjusted odds ratio estimates were obtained using multivariate logistic regression. In total, about 62.6% of the sample reported up-to-date CRC screening. Compliant attitudes toward physicians' screening recommendations were important indicators for up-to-date CRC screening; other individual-level psychosocial factors included beliefs about testing responsibility and testing safety. Non-current CRC screening was linked with testing anxiety and lack of perceived need for healthy people to test. System-level indicators associated with up-to-date CRC screening included reliance on physicians as the primary source for health information, family/personal history of bowel disease, regular physician visits, and participation in other cancer screening tests, controlling for age. Although population-based studies generally emphasize health system-level factors, individual-level attitudes such as feelings of responsibility to screen and adherence to physicians' screening recommendations are important contributors to up-to-date CRC screening patterns.

Frailty, morbidity and survival

Frailty, as a reflection of decreased physical reserve rather than disability, is assessed by various functional tests rather than by specific disease burden. We investigated association of measures of frailty to disease outcomes and survival in a population-based study of Midwestern adults. The markers of frailty we evaluated were: time to walk a measured course (gait-time), handgrip strength, peak respiratory flow rate, ability to stand from a sitting position without using arms, and best corrected visual acuity. A history of cardiovascular disease, cancer, and hypertension were obtained. Data were collected at the third examination (1998–2000) of the Beaver Dam Eye Study cohort ( n = 2962). Follow-up for mortality occurred up to 4 1 2 years after the 1998–2000 examinations. Markers of frailty were significantly associated with age. Values in the highest quartile (slowest) of gait-time, lowest quartile of peak expiratory flow rate, lowest quartile of handgrip strength, inability to stand from sitting in one try (those not in a wheelchair), and visual impairment were combined in an index to denote a general description of frailty. The range of the index was 0 (no frailty) to 5 (maximum frailty). Greater frailty was significantly associated with cardiovascular disease and hypertension. Frailty was associated with poorer survival over an interval of 4 1 2 years after adjusting for age, sex, hypertension, diabetes, and cardiovascular disease. Greater frailty was associated with greater likelihood of concurrent medical conditions and with decreased survival.

Learning by Viewing: Diversity Lessons on Videotape

Several recently produced videotapes may be used as resources for diversity training workshops and in classrooms where topics of diversity are addressed. Blue Eyed is a provocative, illuminating, in-your-face videotape that examines the impact of racial discrimination on people's lives. It is one of the strongest presentations on the subject I have witnessed. This 93minute experience is an opportunity to sit in on part of a full-length diversity workshop conducted by Jane Elliot. Elliot structures the workshop so that a group of 40 typical (white, middle-class) midwestern adults experience first-hand the impact of systematic discriminatory attitudes and behaviors. Her strategies are based on an experiment with her thirdgrade class in 1968 in the aftermath of the assassination of Dr. Martin Luther King, Jr. Negative stereotypes were assigned to the participants and they were deliberately exposed to negative behaviors and expectations based solely on their eye color. Elliot explained that she chose eye color as the criterion because it is genetically determined in the same way that skin color is determined. This video challenges traditional judgments that society makes on people who are different. There are several opportunities for learning through Elliot's direct teaching and incidental comments. Solid arguments are presented in both emotional and scholarly manners. It is obvious that she is invested in what she is striving to teach. Even though the viewer knows that the experiment shown in the videotape is staged, it is easy to become caught up in the emotional atmosphere and implications underlying the observed behavior. Less than an hour into the video, one blue-eyed subject is already crying. It is a very potent moment when a defiant white man breaks under the pressure and begins to cry. The primary emphasis of this video is racial discrimination but Elliot attempts to connect to class, gender, sexual orientation, and disability.

More Than Just Talk: Uses, Gratifications, and the Telephone

This study examines gratifications sought from telephones and variations in behavioral patterns of telephone use. Such research is increasingly important as telephones become a mixed mass-media, interpersonal communication channel. The results of a survey of Midwestern adults delineate social, entertainment, and instrumental dimensions of telephone use. Uses vary considerably across specific demographics.

The Gender Gap and Attitudes Towards Economic Development Strategies Among Midwestern Adults

Data and analysis are presented testing the argument that poverty and social position account for an important difference between men and women in political attitudes. The opening of the gender gap in politics coincided with the opening of the poverty gap. Gender politics are as much class as gender. Hypotheses are tested using 4-way ANOVA. One hypothesis is that income, gender, and age combine to explain voting in the 1988 presidential election where age is used in combination with income and gender to reflect social position. A second hypothesis tests attitudes on issues not apparently reflecting gender association to see whether gender divisions exist. Attitudes toward government subsidized economic development strategies are used as the issue area not obviously gender related.

The gender gap and attitudes towards economic development strategies among Midwestern adults

The gender gap and attitudes towards economic development strategies among Midwestern adults

Using the 1983 norms for the MMPI: Code type frequencies in four clinical samples

MMPI responses obtained from a large random sample of midwestern adults who were 18 through 99 years old and had no physically or mentally handicapping condition yielded a pattern significantly different from the pattern of the original norms. From these data, two new kinds of normative tables have been developed: Norms that reflect, for each sex, the response pattern of the general adult population, and a set of tables, separate for each sex, that allow comparisons to be based on age. In addition, the traditional scoring procedures based on a linear transformation that maintains any underlying skewness of the raw score distribution has been replaced by procedures that yield normalized T scores. The changes that are apparent at the item and scale level are also evident in the frequency with which certain 1- and 2-point codes occur in normal and clinical samples. These changes are apt to make our interpretive statements more meaningful because they are based on contemporary norms.