Doctor of Philosophy in Urban Education, Cleveland State University, 2015, College of Education and Human Services

The aim of this qualitative study was to examine contextualized experiences of African-American Third Agers (AATA). Current literature conceptualizes Third Agers as individuals who are societally positioned to experience meaningful and purposeful periods of self-discovery and adult development later in life. However, among Third Age theorists, adult educators, educational gerontologists (a sub-field of adult education), psychologists, sociologists, and diversity theorists, there are comparatively few research studies of the experiences of AATA. As a result, we do not know much about AATA; this poses a significant problem. Therefore, this investigation of AATA's experiences simultaneously reduced the related literature gap, added to the academic body of knowledge on older adults, and strengthened the emerging study of the third age. The goals of the study were to understand who these individuals are, what their experiences were as adult learners, and what learning meant to them at this stage in life. The overarching research question that guided this inquiry are the following: what does it mean to be an AATA adult learner? Within this question are two related questions: (1) What is the experience of lifelong learning as narrated by AATA, (2) What meaning do AATA give to this phase of life as it relates to lifelong learning? Narrative research was used to capture the stories of a small group of participants, with the intent of collecting rich, in-depth narratives on the topic. The data was collected through semi-structured interviews. Data analysis was guided by the narrative inquiry approach. This study produced an understanding of how AATA perceive of themselves as learners and investigated their attitudes towards lifelong learning for assisting institutions in the delivery of quality educational experiences for an aging population.

Committee: Elice Rogers Ed.D. (Committee Chair); Anne Galletta Ph.D. (Committee Co-Chair); Catherine Hansman Ed.D. (Committee Member); Jonathan Messemer Ed.D. (Committee Member); Regennia Williams Ph.D. (Committee Member); Ovella Roulette-McIntyre Ph.D. (Committee Member) Subjects: Adult Education; African Americans; Aging; Community College Education; Continuing Education; Curriculum Development; Educational Leadership; Educational Sociology; Gerontology; Minority and Ethnic Groups; Spirituality

MA, Kent State University, 2013, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

The following research examines adult children's patterns of parental support. However, the majority of current research on adult children's patterns of parental support is examined using a time period of 6 months or longer. This research addresses the issues with using global data when examining the associations between adult children's patterns of parental support and demographic variables by using daily data. Specifically, this research examines how these patterns of support vary by demographics variables, including gender, race, parental marital status, and adult child's marital status, on a daily level, which has revealed previous misconceptions using global data. This research has found that patterns of support vary more by interactions between variables such as, gender, adult child's marital, and parents' marital status by race and gender, adult child's marital, and parents' marital status by emotional support. Also, this research has found no direct associations between support and affect.

Committee: Kelly Cichy (Committee Chair); Kelly Cichy (Advisor); Maureen Blankemeyer (Committee Member); Rhonda Richardson (Committee Member) Subjects: African Americans; Aging; Families and Family Life; Gender; Gerontology; Individual and Family Studies

Doctor of Philosophy (PhD), Ohio University, 2024, Translational Biomedical Sciences

The global population is rapidly aging, creating a significant public health challenge as aging is associated with a myriad of health concerns, including an increased prevalence of osteoporosis, cardiovascular disease, and neurodegenerative conditions such as Alzheimer's and Parkinson's disease. Additionally, aging often threatens independent living, as adults over age 60 are more likely to experience muscle weakness, reduced mobility, difficulties with activities of daily living, and a higher incidence of falls. To address these aging-related health crises, the field of geroscience has shifted focus toward capturing the hallmarks of biological aging, with the goal of mitigating physiological processes that contribute to functional decline. Among the emerging biomarkers of aging, biological brain age—derived from neuroimaging techniques and machine learning models—has shown great promise as an indicator of global brain health. By comparing brain age to chronological age, one can assess the rate of brain aging, with accelerated brain aging (brain age > chronological age) linked to several conditions, including Alzheimer's disease, schizophrenia, cognitive impairments, and slower gait speed. I conducted preliminary cross-sectional analyses and leveraged data from the Baltimore Longitudinal Study of Aging (BLSA), a large, well-characterized longitudinal dataset, to examine the complex relationships between brain aging, muscle strength, and physical function. I found that accelerated brain aging was associated with slower gait speed, longer time to complete five consecutive chair stands, and difficulty completing a narrow walking task, demonstrating brain age's predictive value for physical function. Moreover, I identified a relationship between an accelerated rate of brain aging and elevated levels of interleukin-6 (IL-6), a pro-inflammatory cytokine implicated in inflammaging—the chronic, low-grade systemic inflammation observed in older adults. To further explore the (open full item for complete abstract)

Committee: Brian Clark (Advisor); Dustin Grooms (Committee Member); Julie Suhr (Committee Member); Janet Simon (Committee Chair); Graciela Muniz-Terrera (Committee Member) Subjects: Aging; Epidemiology; Neurosciences

Doctor of Philosophy, Miami University, 2024, Psychology

Introduction: This study aims to better understand the psychosocial mechanisms by which individuals who report subjective concerns about their memory (SCI) are at a higher risk for objective cognitive impairments (OCI) over time. It also aims to identify modifiable risk factors that may disrupt this progression. Aim 1 tests if symptoms of affective disorders mediate the relationship between SCI and OCI over time. Aim 2 tests if self-perceptions of aging moderate the relationship between SCI and symptoms of affective disorders over time. Aim 3 tests if self-perceptions of aging moderate the indirect effect of symptoms of affective disorders on the relationship between SCI and OCI over time. Method: Data was sourced from the Health and Retirement Study, a national longitudinal dataset, across 8 years. 4,002 adults, 65 and older, were included in the sample. The moderation, mediation, and moderated mediation analyses were conducted using a path model in Mplus (Version 8 Plus). Relevant covariates including demographic and health variables were controlled for. Results: Analyses confirmed that symptoms of affective disorders partially mediated the relationship between SCI and OCI. For individuals with negative self-perceptions of aging, the relationship between SCI and symptoms of affective disorders strengthened over time, while for individuals with positive self-perceptions of aging, the relationship ceased to exist. Finally, positive self-perceptions of aging weakened, while negative self-perceptions of aging strengthened the indirect effect of symptoms of affective disorders on the relationship between SCI and OCI. Conclusion: Results of the current study clarify the psychosocial mechanisms involved in the progression from SCI to OCI, and add support to literature identifying positive beliefs about aging and mental health as protective factors against cognitive impairment among older adults. This study implicates the need for more interdisciplinary research studying (open full item for complete abstract)

Committee: Katherine Abbott (Committee Co-Chair); Aaron Luebbe (Committee Co-Chair); Vaishali Raval (Committee Member); Angela Curl (Committee Member) Subjects: Aging; Clinical Psychology; Psychology

Doctor of Philosophy, The Ohio State University, 2022, Kinesiology

Knee osteoarthritis (OA) progression represents a leading cause of mobility disability for older adults in the U.S. Being overweight or obese is a primary modifiable risk factor. It is recognized that lifestyle intervention represents an integral component of disease management efforts. However, following primary intervention, significant weight regain and behavioral recidivism is common. The overarching purpose of this dissertation was to explore the temporal relationships between key social cognitive determinants of lifestyle behavior and determine the feasibility and preliminary efficacy of virtually- delivered extended care contacts for improving weight loss and behavioral maintenance. Study I: Dynamics of Self-Efficacy, Goal Commitment, and Self-Regulation was a mediation analysis of extant data from the 18-month, Collaborative Lifestyle Intervention Program in knee OA patients (CLIP-OA) trial (M [SD] age = 65.4 [7.3]; M [SD] BMI = 35.1 [6.5] kg/m2). Self-efficacy (SE), goal commitment (GC), and self-regulation (SR) for PA were measured at 6, 12, and 18-month follow-up. Path analysis using bias- corrected bootstrapped 95% confidence intervals (CI) revealed the effect of 6-month SE on 18-month SR was partially mediated by level of GC at 12 months (β = 0.053, 95% CI = 0.028, 0.085), controlling for age, explaining 32.4% of the total effect. Study I provides evidence supporting hypothesized temporal relationships among key determinants of PA adoption and adherence in overweight and obese knee OA patients. Study II: The CLIP-OA Expansion Pilot Trial was a 6-month, two-arm, randomized, controlled pilot trial examining two schedules of virtually-delivered, group- mediated cognitive behavioral (GMCB) extended care contacts in a subsample of participants from CLIP-OA (n = 32; M [SD] age = 66.2 [6.1]). Upon completing 18 months of CLIP-OA, participants were allocated to receive either traditional (i.e., monthly; TRAD; n = 16), or 2, 3-week clusters of contacts (CL (open full item for complete abstract)

Committee: Brian Focht (Advisor); Carla Miller (Committee Member); Jeff Volek (Committee Member); Jerome D'Agostino (Committee Member) Subjects: Aging; Behavioral Sciences; Cognitive Psychology; Experiments; Health Sciences; Kinesiology; Social Psychology

Doctor of Philosophy (PhD), Ohio University, 2021, Counselor Education (Education)

As the older adult community increases, there will be a higher demand for counselor professionals who are prepared to serve the needs of the population. Within that cohort, the population of older adult Black women is rapidly increasing. In efforts to serve the unique cultural needs of the population, it will be imperative that counselor professionals are able to provide treatment and support that acknowledges the dense cultural history that shapes their identity. By exploring the cultural framework through the lens of Black feminist theory, counselor educators and professionals can glean greater awareness of how to accommodate older adult Black women in ways that promote mental health, wellness, and healthy aging within the population. This interpretative phenomenological analysis study will explore ways older adult Black women who identify with the Strong Black Woman schema make sense of the aging process while promoting their mental health and wellbeing.

Committee: Mona Robinson (Committee Chair); Christine Bhat (Committee Co-Chair); Theda Gibbs-Grey (Committee Member); Adah Ward-Randolph (Committee Member); Adrienne Erby (Committee Member) Subjects: Counseling Education

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2021, Psychology/Clinical

Life expectancy rates for adults living with serious mental illness (SMI) continue to rise, but relatively little is known about how best to help older adults with SMI live meaningful lives in the community. Using a participatory action research framework, the present study examined social and community experiences of older adults living with SMI in a mid-sized urban city. A total of nine older adults (M = 60.22 years; SD = 3.15) diagnosed with depression, schizophrenia, or bipolar disorder engaged in a six-week photovoice study. Each week, participants photographed different aspects of their community and shared them with other participants at weekly group meetings. A final session consisted of a public display where photos and descriptions were shared with the community. After project completion, participants engaged in individual project evaluation interviews. Data for the research consisted of participants' photographs, captions, and verbatim transcripts of discussions from group meetings. A total of 11 themes were identified using content analysis to describe participants' photos and group discussions of their experiences. These overarching themes included: Physical Space, Interpersonal Relationships, and Accessing Resources, and these themes were further categorized into descriptive subthemes. Overall, participants spoke about salient experiences with community integration, significant relationships with other people, and impact of needed resources in their lives. In particular, photovoice participants described challenges of navigating public transportation, importance of the psychosocial clubhouse where they all hold membership, and appreciation for positive evolution of social relationships with friends and family. Participant accounts were further characterized by the degree to which their experiences remained consistent or changed over time. These older adults also provided recommendations for future changes in their local community. Project evaluation re (open full item for complete abstract)

Committee: Catherine Stein PhD (Advisor); John Dowd PhD (Committee Member); Dryw Dworsky PhD (Committee Member); Dale Klopfer PhD (Committee Member) Subjects: Clinical Psychology

MDES, University of Cincinnati, 2020, Design, Architecture, Art and Planning: Design

With the advent of technology, digital applications and digital devices have permeated our day to day life. While technologies are widely adopted, use and acceptance may vary across groups. Recently, studies have been conducted to monitor and assess the use of these digital technologies within the older population, specifically adults 62+ years or older. Although the studies indicate a growing increase in the usage of these, there is ambiguity around the actual usage of these technologies within this population cohort. This thesis research aims to investigate the use of digital devices and applications within the older population specifically looking at the actual usage of email, cellphones, tablets etc. The research further delves in to understand the number, type and preference of technologies older adults 62+ possess, and understand how they are used at retirement communities.

Committee: Claudia Rebola Ph.D. (Committee Chair); Craig Vogel M.I.D. (Committee Member) Subjects: Design

Doctor of Philosophy, University of Akron, 2019, Psychology-Adult Development and Aging

Older adults often report better well-being than young adults, despite physical and cognitive declines that accompany aging. This paradox may be explained by older adults' better emotion regulation abilities and social support. Together, Selection, Optimization, and Compensation with Emotion Regulation Theory and Interdependence Theory offer a potential mechanism for how older adults are able to maintain emotion regulation success and suggest older adults might be more likely to shift their emotion regulation strategies to rely on and help manage the emotions of a romantic partner by using interpersonal emotion regulation strategies. However, extant emotion regulation research has mainly focused on individual regulation strategies even though the majority of situations requiring regulation involve a close social partner. The main goal of the present study was to understand what personal and social characteristics influence the use of interpersonal emotion regulation (IER) in general and throughout an interaction. Data were collected using an online survey and an in-person, videotaped session. Emotion regulation preferences, frequency of emotion regulation use, relationship quality, and interpersonal skills were assessed. Researchers coded and participants self-identified their IER strategy use by viewing their videotaped interaction with their partner. Young adults, compared to middle-aged and older adults, preferred all emotion regulation strategies and those with better interpersonal skills and longer relationship durations, on average, used interpersonal strategies more frequently on a weekly basis. Participants expressed negative affect and withdrawal, and females expressed conflict as cues for intrinsic IER. Participants expressed positive affect, problem solving, support/validation, effective communication, and physical touch of the female partner as extrinsic IER. Couples interdependently helped each other regulate their emotions; specifically, older couples (open full item for complete abstract)

Committee: Jennifer Stanley PhD (Advisor); Toni Bisconti PhD (Committee Member); Eric Allard PhD (Committee Member); Ingrid Weigold PhD (Committee Member); Shannon Zentall PhD (Committee Member); Christiane Hoppman PhD (Committee Member) Subjects: Aging; Psychology

Master of Gerontological Studies, Miami University, 2018, Gerontology

An estimated 41.1 million adults in Latin America have diabetes, a condition with potentially serious complications. Fortunately, optimal self-care behaviors such as healthy eating can reduce the risk of complications. Diabetes self-care is influenced by many factors. One unexplored factor is the educational level of one's adult children. Using data from the 2012 Mexican Health and Aging Study, I examined the association between adult children's education and two diabetes self-care behaviors (following a special diet and blood sugar monitoring) in adults aged 65 years and over. A total of 1,386 older adults reported having diabetes and had data on all study variables. Logistic regression was used to test the association between adult children's education and diabetes self-care behaviors. Although following a special diet reached only borderline statistical significance, the odds of weekly blood sugar monitoring (OR: 2.41; 95% CI: 1.30, 4.43) were significantly higher among older adults with higher educated children compared to those with less educated adult children. While more research is needed, findings suggest that older Mexican adults with diabetes benefit from having children with higher education.

Committee: Sara McLaughlin (Committee Chair); Katherine Abbott (Committee Member); Jonathon Vivoda (Committee Member) Subjects: Gerontology

Doctor of Nursing Practice , Case Western Reserve University, 2018, School of Nursing

Background and Purpose: Falls and fall-related injuries are an ongoing public health concern since one in three adults over 65 years of age is expected to fall each year and, of those who fall, an estimated 33 % will require a medical intervention. Despite the evidence that most older-adult falls are preventable and that evidence-based clinical practice guidelines for identifying and managing risk are widely available, often a gap between scientific evidence and clinical practice exists. This study examined, within the context of Indian healthcare organizations, health care providers' knowledge of, attitudes toward, and practice (KAP) of evidence-based, older adult fall prevention and the potential relationships among these concepts. The Promoting Action on Research in Health Services framework was selected to guide the study and interpretation of findings since knowledge, attitude, and behavior may influence fall prevention practice and are, for the purpose of this study, considered sub-factors in terms of the framework. Methods: A self-administered, Likert-type, questionnaire was distributed on-line to 222 health care providers (HCPs). It was completed by 33 health care professionals, employees of one or more of the approximately 41 federally-funded tribal healthcare organizations located within the California Area Indian Health Service. Results: Fewer than half of the health care providers (33 %) indicated “very knowledgeable” about older adult fall prevention. Most (97 %) acknowledged that preventing falls in older adults is “urgent' or “somewhat urgent”. A majority of health care providers perceived older adult fall prevention as “very important”, responses at 85 % and above. However, practice-wise, as to the six older adult fall prevention services, most indicated their organizations provided them only “sometimes or for some patients” or by “referral to other person or organization”. No statistically significant relationships were found between agg (open full item for complete abstract)

Committee: Deborah Lindell (Committee Chair); Carol Musil (Committee Member); Bruce Finke (Committee Member) Subjects: Health Care; Native Americans; Nursing; Public Health

Master of Fine Arts, The Ohio State University, 2018, Design

The population of those aged 65+ years old (“older adults”) is increasing. With this change, attention is being placed on their health, wellness, and roles in society. Specifically, studies on healthy aging are addressing ways to update our thinking about older adulthood. This increase in the aging population has also triggered a focus on evidence-based research to understand both aging and the currently aging cohort of Baby Boomers (those born between 1946–1964). Primary concerns for older adults focus on targeted healthcare and age-friendly residences. While these efforts are critical to older adults, they focus primarily on the biological aspect of aging. As a companion to these efforts, this research seeks to address the experiences of older adults in public places (i.e., libraries, parks, retail stores) in the interest of supporting their social and emotional wellness. These places can be areas of rich interaction, exchange, and discourse. Participation in this “public life” is the hallmark of integration and independence. To foster this engagement, public places must be designed to address the social, mental, and physical needs of older adults. Supporting older adults in public places is a new reality as their percent of the total population continues to grow. Current inclusive design efforts at public places are primarily driven by Americans with Disabilities Act (“ADA”) code that requires ramps, handrails, and other features to provide accessibility. In practice, the application of these requirements varies wildly, and the requirements are seldom planned together. (An example of this is a park that provides both accessible parking and restrooms yet locates them at opposite ends of a parking lot.) These efforts may provide access, but they do not support a desired situation. Instead, solutions need to address both the needs of the aging condition (i.e., larger print sizes for vision loss, intuitive layouts to reduce cognitive load) and support the needs (open full item for complete abstract)

Committee: Paul Nini (Advisor); Elizabeth B.-N. Sanders Ph.D. (Committee Member); Douglas Crews Ph.D. (Committee Member) Subjects: Aging; Design

Psy. D., Antioch University, 2017, Antioch Santa Barbara: Clinical Psychology

HIV among older African Americans represents one of the fastest and largest growing populations of infected groups in America (CDC, 2008). With the availability of anti-retrovirals (ARV), or AIDS cocktail drugs, HIV has become a chronic illness. As African Americans are living longer with HIV, they are encountering the diseases that are consonant with aging. The effect of aging with HIV and an age-related comorbid condition can be physically and emotionally debilitating. Many of these older adults are also dealing with poverty, stigma, poor healthcare access, and limited social support. The purpose of this study was to explore how these older African Americans make sense of their experience of living with HIV and an age-related comorbidity, through semi-structured interviews. Using a form of qualitative analysis called interpretative phenomenological analysis (IPA), this researcher located three superordinate themes or principal areas of concern to older HIV-positive African American adults' understanding of their lived experiences with HIV and age-related co-morbid conditions: “HIV as the new normal,” “HIV spurs self-advocacy,” and “health as a fragile construct.” The results suggest that while older African Americans' current experiences of HIV may be less daunting, their experiences of co-morbid conditions are more acute and severe, and combined with HIV, have left them more vulnerable and in need of support. The electronic version of the dissertation is accessible at the Ohiolink ETD center http://www.ohiolink.edu/etd

Committee: Dan Schwartz PhD (Committee Chair); Steven Kadin PhD (Committee Member); Charles Hilliard PhD (Other) Subjects: African Americans; Black Studies; Clinical Psychology; Mental Health

Doctor of Philosophy, Case Western Reserve University, 2017, Nursing

The purpose of the study is to evaluate the temporal development of symptom onset and severity and to determine relationships between delayed wound healing (wound total surface area), symptoms (depressive symptoms [DS], pain, sleep disturbance [SD]), and health related quality of life (HRQoL) in older adults undergoing Mohs micrographic surgery [MMS] of lower extremity non melanoma skin cancer (NMSC) healing by secondary intention. This is a prospective exploratory study of patients undergoing MMS for NMSC in a single academic dermatological surgery clinic. Subjects were enrolled on the day of surgery and followed weekly for 4 weeks, except 4 subjects were followed weekly until healed. Descriptive statistics and T-tests were used to explore differences between those with and without wound expansion at week 1 among these variables: demographics, co-morbidities, laboratory values, and NIH PROMIS DS, pain, SD, and HRQoL surveys. Logistic regression was performed between the variables and the wound expansion group to determine predictors of wound healing. An analysis revealed that subjects undergoing MMS for NMSC generally have good HRQoL, and symptom measures and HRQoL consistently improve by week 4 postoperatively. There was no significant relationships noted between demographics, co-morbidities, laboratory values, symptom measures, HRQoL, and wound total surface area. A trend was noted with the 14 subjects with 5 experiencing wound expansion greater than -15% expansion and 9 were without expansion at week 1. No significant differences were noted between demographics, co-morbidities, laboratory values, symptom measures, or health related quality of life with those with and without wound expansion, except for age. Age was significantly different with the wound expansion group averaging 12 years older (p = 0.02). Of the 4 subjects followed until healed, 2 subject's wounds expanded and required 10-12 weeks to heal compared to 6-8 weeks in 2 subjects without wound expansi (open full item for complete abstract)

Committee: Elizabeth Madigan PhD, RN (Committee Chair); Kevin Cooper MD (Committee Co-Chair); Andrew Reimer PhD, RN (Committee Member); Diana Morris PhD, RN (Committee Member) Subjects: Medicine; Nursing

Master of Arts, Miami University, 2016, Gerontology

The main purpose of this study was to understand the experiences and everyday life of family caregivers who are taking care of older adults in rural Thai villages. This study applied a phenomenological approach consisting of interviews with ten participants who willingly shared their personal experiences on caregiving to the elderly. Based on the findings, family caregivers experienced various feelings during their care duties. Those were 1) changing in their life path; 2) suffering alone; 3) double trouble; 4) disheartenment; and 5) the need for freedom. The justifications, which persuaded family caregivers continuing to undertake caring duties for disabled older adults were 1) compassion; 2) moral responsibility; 3) commitment; and 4) belief in the law of karma. The findings also revealed that the older adults who had an unhealthy relationship with his/her caregivers would not be provided with the best care. Many case studies shown people's bias against caregiving for the elderly. This study highlighted some key recommendations, such as health resources, rewards, encouragement, and material assistance should be provided to family caregivers. The need for family-oriented mental health services should be developed and the more certain interventions should be made in support of the well-being of family caregivers in rural areas, especially among the aged spousal caregivers. The experience of family caregivers in urban areas and other regions should be conducted in future research.

Committee: Pramote Prasartkul Ph.D (Committee Member); Chai Podhisita Ph.D (Committee Member); Jennifer Kinney Ph.D (Committee Member) Subjects: Gerontology

Master of Gerontological Studies, Miami University, 2014, Gerontology

As the older population of the United States rises to unprecedented numbers, practitioners, researchers, and policymakers are searching for innovative approaches that promote age-integrated communities. Non-familial intergenerational (IG) programs, which establish intentional connections between people who are under 22 years of age and people who are 60 years and older, can be effective and efficient in enhancing communities. The contributions of IG programs to society and to individual development are well supported in practice, theory, and research. Unfortunately, three barriers hinder the expansion of IG programs: evidence spans many disciplines; no systematic categorization and quantification of program outcomes; and limited dissemination of program outcomes. This meta-analysis evaluated IG scholarly literature from several disciplines to categorize and quantify IG program outcomes. Outcome data were organized into a conceptual framework, stratified by central dimensions of human development and age groups. A majority of articles found positive outcomes only among all target participant age groups and dimensions of human development. This evidence further supports the magnitude and potential impact of IG programs on society, community, and the individual.

Committee: Suzanne Kunkel PhD (Committee Chair); Jane Straker PhD (Committee Member); Matthew Kaplan PhD (Committee Member) Subjects: Aging; Developmental Psychology; Early Childhood Education; Gerontology; Individual and Family Studies; Psychology; Sociology

MS, University of Cincinnati, 2009, Allied Health Sciences : Nutrition

Purpose. To determine if an older adult can meet their Dietary Reference Intakes (DRI's) for selected vitamins and minerals and achieve an adequate macronutrient distribution range after being counseled on a high carbohydrate diet compared to those counseled on a low carbohydrate diet. Methods. Twenty six older adults were randomly selected into a high carbohydrate or low carbohydrate diet group. Both groups completed food records 5 days prior to intervention as well as during the 6 week time period they were following a high or low carbohydrate diet. Nutrition information was entered from written food records and analyzed using Minnesota Nutrition Data Systems for Research software. To determine the dietary adequacy of the high carbohydrate versus low carbohydrate diet groups, mean differences for weight, body mass index (BMI), fiber, calories, macronutrients and micronutrients were compared using Students' t-tests for each nutrient at baseline, 3-weeks, and 6-weeks. An analysis of the group prevalence of inadequacy using the Estimated Average Requirement (EAR) cutoff point method was also completed. Results. There were no significant differences between groups for nutrient intake at baseline. The low carbohydrate group consumed greater amounts of fat and protein, while the high carbohydrate group consumed more calories and fiber during the 6-week study. At week 6 significant differences in intake of vitamin C, thiamin, niacin, vitamin B-6, folate, magnesium, iron, and potassium were observed between groups. Using the EAR cutoff, the prevalence of inadequacy of vitamin C, B-6, thiamin, niacin, folate, and magnesium was significantly higher in the low carbohydrate group compared to the high carbohydrate group. Conclusion. The results of this study suggest that a low carbohydrate diet (≤ 20 g) should not be recommended for the older adult for an extended period of time without proper supplementation.

Committee: Sarah Couch PhD (Committee Chair); Seung-Yeon Lee PhD (Committee Member) Subjects: Nutrition

Doctor of Philosophy, The Ohio State University, 2011, Allied Medical Professions

The objective of this research was to investigate characteristics, perceptions, and outcomes related to the use of adult day health services (ADS) among primary, informal caregivers of older adults. To accomplish this, a review of the literature about caregivers, adult day health services, and older adults was completed; this information was used to inform further investigation using one group of caregivers newly enrolling a loved one into ADS (ADS caregivers) and a second group of caregivers who were aware of, but not utilizing, this service option (non-ADS caregivers). Comparative baseline analyses, quasi-experimental investigation over time, and review of qualitative data from these caregivers aided with addressing research objectives. The most significant differences noted were: ADS caregivers had poorer self-rated health, felt more anger towards their care recipients, felt as if care recipients were dependent solely upon them (caregivers), and were more frustrated with memory/behavioral issues exhibited by care recipients. The findings may assist care professionals with an enhanced understanding of caregiver characteristics that may align with use of ADS for respite and support. As the population of older adults in the United States grows, the concomitant increase in family caregivers will require additional community-based services such as ADS.

Committee: Jane Case-Smith EdD (Committee Co-Chair); Margaret Teaford PhD (Committee Co-Chair); Holly Dabelko-Schoeny PhD (Committee Member); Jill Clutter PhD (Committee Member); Sally Rudmann PhD (Committee Member) Subjects: Gerontology

Doctor of Philosophy, The Ohio State University, 2007, Nursing

Coronary heart disease (CHD) is the number one cause of mortality and disability in the United States (U.S.). The burden of CHD disproportionately impacts the older adult population of the U.S. in relation to mortality, disability, and economic cost. The secondary prevention of CHD may be effectively promoted through cardiac rehabilitation utilization. Unfortunately, only 6.6% to 53.5% of eligible adults 65 years or older in the U.S. participate in cardiac rehabilitation. Research efforts have identified a variety of factors that influence older adult participation in cardiac rehabilitation. The purpose of this dissertation was to develop, pilot test, and evaluate the effectiveness of a tailored illness representation intervention to increase cardiac rehabilitation utilization among older adults. The first manuscript reviews the literature related to representations of cardiac rehabilitation and CHD among older adults. From this review of literature, a preliminary self-regulatory model of cardiac rehabilitation utilization is proposed to guide the development of tailored interventions to increase cardiac rehabilitation utilization among older adults. The second manuscript reports a complete, detailed description of the research design, tailored illness representation intervention, study procedures, and results of the present pilot study with implications for future research. The tailored illness representation was delivered during a single post hospital discharge home telephone session using a scripted protocol. The intervention was based upon the individual patient assessment of CHD illness representation during hospitalization for an AMI, angioplasty, stent, or coronary artery bypass graft surgery. Cardiac rehabilitation utilization rates in this pilot study were considerably higher than the national level. Sixty-seven percent of intervention group participants and 74% of control group participants attended at least one cardiac rehabilitation session. The majority (open full item for complete abstract)

Committee: Karen Ahijevych (Advisor) Subjects:

Master of Arts (MA), Ohio University, 2009, Art Education (Fine Arts)

The purpose of this study was to investigate the affects that art programs in community centers can have on older adults. This is a case study that examined the activities and participants of an art program in a community senior center. Another aim was to consider how the program could influence the artwork of the students in the class. Finally, how these programs affected the participants cognitively, socially, and emotionally were examined. Qualitative research methods were utilized to gain insights and understandings of the research topic. The data consisted of observations, field notes, and interviews with the students and the instructor. It was found that this particular art program provides participants with many cognitive, social, and emotional benefits. It was also discovered that the program does have a positive influence on the artwork produced. The research suggests that other programs like this one could provide its participants with a beneficial and meaningful experience.

Committee: Rosemarie Basile (Advisor); Melissa Haviland (Committee Member); David LaPalombara (Committee Member) Subjects: Art Education