Planning for Program Evaluation Improves Implementation and Assessment.

This article offers a general approach to plan and implement an educational program by illustrating the evaluation process and data from the AGE-ADAR Scholars Program. A well-designed program evaluation will also include a plan for stakeholder dissemination. We adapted a framework from the Centers for Disease Control and Prevention which includes hard and soft outcomes. Hard outcomes include improved academic metrics, including test scores and graduation rates. Soft outcomes include changes in students' attitudes, particularly those related to reduced ageism as well as readiness to pursue graduate study. While our hard and soft outcomes suggest that the ADAR program is effective in increasing interest in rural health disparities and aging research, we are hopeful that our impact will continue to enrich the lives of our students and the communities in which they live and work.

Developing, implementing, and evaluating the visiting Neighbors' program in rural Appalachia: A quality improvement protocol.

INTRODUCTION: Older adults living alone in rural areas frequently experience health declines, social isolation, and limited access to services. To address these challenges, our medical academic university supported a quality improvement project for developing and evaluating the Visiting Neighbors program in two rural Appalachian counties. Our Visiting Neighbors program trained local volunteers to visit and guide rural older adults in healthy activities. These age-appropriate activities (Mingle, Manage, and Move- 3M's) were designed to improve the functional health of older adults. The program includes four in-home visits and four follow-up telephone calls across three months. PURPOSE: The purpose of this paper was to describe the 3M's Visiting Neighbors protocol steps guiding the quality improvement procedures relating to program development, implementation, and evaluation. METHODS AND MATERIALS: This Visiting Neighbors study used a single-group exploratory quality improvement design. This program was tested using quality improvement standards, including collecting participant questionnaires and visit observations. RESULTS: Older adults (> 65 years) living alone (N = 30) participants were female (79%) with a mean age of 82.96 (SD = 7.87) years. Volunteer visitor participants (N = 10) were older adult females. Two volunteer visitors implemented each visit, guided by the 3M's activities manual. All visits were verified as being consistently delivered (fidelity). Enrollment and retention data found the program was feasible to conduct. The older adult participants' total program helpfulness ratings (1 to 5) were high (M = 51.27, SD = 3.77). All volunteer visitor's program helpfulness ratings were also high (M = 51.78, SD = 3.73). DISCUSSION: The Visiting Neighbors program consistently engaged older Appalachian adults living alone in the 3M's activities. The feasibility and fidelity of the 3M's home visits were verified. The quality improvement processes included engaging the expert advisory committee and rural county stakeholders to ensure the quality of the program development, implementation, and evaluation.

Grandchildren as Caregivers: Adding a New Layer to the Sandwich Generation.

Although 10% of family caregivers are grandchildren, only a few studies have examined the experience of grandchildren who provide care to grandparents. The current study examined the caregiving processes and outcomes of grandchild caregivers to grandparents. Participants were (N = 5,778) adults identified as a caregiver, including 311 adult grandchildren. Analyses showed that although caregivers to grandparents did not differ significantly from other family caregivers in terms of depression, grandchildren did differ on a variety of demographic and caregiving context variables. A hierarchical binary logistic regression showed that providing personal care and helping with household tasks contribute to the equation, however, grandchild status did not uniquely contribute to the equation after other elements of the caregiving and personal contexts were entered. Post-hoc analyses identified additional predictors within the group of grandchild caregivers. The current study is an important starting point in understanding the experiences of grandchildren caregivers.

Introduction to the Special Issue on Advancing Diversity in Aging Research.

The following papers represent an early contribution of the National Institute on Aging's commitment to support high-quality research and mentor a more diverse workforce in the field of aging. The International Journal of Aging and Human Development has previously issued calls for such scholarship and has provided opportunities to share some of their teaching techniques that foster and support the next generation of gerontologists. In this issue, we feature both lessons learned from those who design and supervise National Institute of Aging-supported training programs and we highlight some of the work that these diverse scholars are contributing to the field. We hope that by disseminating "lessons learned" and specific research pieces, other labs will begin similar programs. We encourage others to develop and implement innovative training models and explore some of the funding opportunities available to support increasing diversity in aging.

Religious and Spiritual Growth Goals: A Forgotten Outcome.

Religious and spiritual (R/S) growth goals have been forgotten among self-improvement goals. We used social cognitive theory, useful in other domains of self-improvement, to study R/S goals. Data from 350 adults (Mage = 40.5, SD = 14.6) were used to examine the relations among age, gender, social interactions, and commitment to R/S goals and physical activity goals. Results of the path analysis, X2 (DF = 2, N = 350) = 9.91, p < .01, showed similar contributions of positive social interactions to persistence on both goals. Differences between the two outcomes included a direct effect of age (ß = .18), dissatisfaction with negative social interactions (ß = .12), and satisfaction with positive social exchanges (ß = .15) on persistence on R/S goals. Only positive social exchanges (ß = .31) related to physical activity goals. The results are discussed in terms of the feasibility of applying goal-striving frameworks to the examination of R/S growth goals.

Emotional Well-being During the First Four Months of COVID-19 in the United States.

Relative to younger adults, older adults have demonstrated higher emotional well-being in the face of the threats of COVID-19 (e.g., Bruine de Bruin in J Gerontol 10.1093/geronb/gbaa074, 2020) and other events (Bonanno and Diminich in J Child Psychol Psychiatry 54:378-401, 2013). Thus, we predicted that levels of well-being would show minimal change in the first 4 months of COVID-19, with older adults faring better than younger adults. Adults (N = 325, M age = 39.7, SD = 12.3) were surveyed before the pandemic began and at four additional time points throughout the first 4 months of the COVID-19 outbreak in the United States. Participants provided demographic information and completed measures of positive and negative affect. Latent growth curves were used to analyze changes in well-being over time, with age as a covariate. There was a significant linear increase in positive affect. Older age was positively associated with initial levels, but age was not associated with the slope. There was a significant curvilinear pattern in negative affect, with an initial increase, which, although remaining elevated, exhibited slow decreases over time. Age was significantly and negatively associated with initial negative affect, but age did not influence the shape or rate of change over time. We detected changes in both positive affect and negative affect during the first 4 months of COVID-19. The magnitude of these changes suggests that the stress of COVID-19 does not lead to an immediate decrease in well-being. Moreover, although older adults showed higher positive affect and lower negative affect relative to other adults, age differences in the trajectory of change did not emerge. Delayed and long-term effects on well-being and whether those effects are age-invariant should be examined over longer periods of time.

The Influence of Source and Type of Support on College Students' Physical Activity Behavior.

BACKGROUND: College is a place where students develop health behaviors that persist throughout adulthood, yet a large percentage of students are not engaging in adequate physical activity. Social support is associated with physical activity; however, the effects of source (ie, family and friend) and type (ie, companionship, esteem, and informational) are not fully understood. The current study examined the effects of different sources and types of social support on college students' physical activity behaviors. METHODS: An online survey tool collected data from 733 college students enrolled at a Mid-Atlantic university. Structural equation models and a repeated-measures analysis of variance were conducted. RESULTS: Support from family and friends was associated with physical activity behaviors; however, support from friends exerted a stronger effect. Students received different types of support from their network, which differentially influenced physical activity behaviors. Students received higher levels of companionship support from their friends and higher levels of esteem support from their family, which was positively associated with physical activity behaviors. Students received higher levels of informational support from their families, which was negatively associated with physical activity behaviors. CONCLUSIONS: This study highlights the importance of examining the independent effects of source and type of support on college students' physical activity.

Personality, negative social exchanges, and physical health among bereaved adults.

While much research has investigated the association between personality and health, little research has done so using a bereaved sample. Additionally, little research has investigated how personality influences the frequency of negative social exchanges bereaved individuals receive. This study utilized a structural equation model to investigate the associations among age, gender, personality, negative social exchanges, length of bereavement, and self-reported physical health in a sample of bereaved adults. Results indicated that personality was associated with negative social exchanges and physical health. Therefore, these variables are important and should be studied further in this context.

The influence of sexual attitudes on mid- to late-life sexual well-being: age, not gender, as a salient factor.

The influence of sexual attitudes on sexual activity and expression has been relatively understudied in older populations. In the current study, we sought to understand the role sexual attitudes have on sexual well-being among middle-aged and young-old adults. Using a diverse sample of participants over the age of 45 (N = 384), a path model was analyzed to determine whether sexual attitudes contributed to sexual well-being. The model was then compared by gender. Results indicated: a) only age-relative sexual attitudes significantly contributed to sexual well-being; and b) the model was equally robust for both men and women, even though women held slightly more positive age-relative sexual attitudes than men. Therefore, among middle-aged and young-old adults, sexual well-being may be reduced by harboring negative ageist sexual attitudes. Efforts should be made to reduce stigma surrounding continued sexual activity and expression among the aged.

The influence of sexual attitudes on mid- to late-life sexual well-being: age, not gender, as a salient factor.

The influence of sexual attitudes on sexual activity and expression has been relatively understudied in older populations. In the current study, we sought to understand the role sexual attitudes have on sexual well-being among middle-aged and young-old adults. Using a diverse sample of participants over the age of 45 (N = 384), a path model was analyzed to determine whether sexual attitudes contributed to sexual well-being. The model was then compared by gender. Results indicated: a) only age-relative sexual attitudes significantly contributed to sexual well-being; and b) the model was equally robust for both men and women, even though women held slightly more positive age-relative sexual attitudes than men. Therefore, among middle-aged and young-old adults, sexual well-being may be reduced by harboring negative ageist sexual attitudes. Efforts should be made to reduce stigma surrounding continued sexual activity and expression among the aged.

Religiousness, religious doubt, and death anxiety.

Terror Management Theory (TMT) (Greenberg, Pyszczynski, & Solomon, 1986) suggests that culturally-provided worldviews (e.g., religion) may protect individuals from experiencing death anxiety, and several studies have supported this position. However, if one's worldview can offer protection, doubts concerning one's worldview could undermine this protection. The current study investigated whether age, gender, religiousness, and religious doubt were associated with death anxiety. Using data from 635 younger, middle-aged, and older adults, a structural equation model with age, gender, religiousness, and religious doubt predicting death anxiety was tested. The model had a good fit (chi2 (76) = 193.467, p < .001; GFI = .961, CFI = .976, TLI = .967, RMSEA = .049) and accounted for 12.3% of the variance in death anxiety. Results were consistent with TMT, as religiousness was inversely associated with death anxiety, while religious doubt was positively associated with death anxiety.

Dyadic analysis of self-efficacy and perceived support: the relationship of individual and spousal characteristics with physical activity among middle-aged and young-older adults.

The purpose of this study was to examine the associations among self-efficacy, perceived support, and physical activity in middle-aged and older married couples. A total of 116 middle-aged and older couples (M = 58.86 years, SD = 7.16, range 50-74) participated in the study. A dyadic approach to path modeling was taken. The final model indicated that for both husbands and wives, one's own self-efficacy was directly related to physical activity. In addition, husband self-efficacy was positively related to wive physical activity and indirectly related to wife physical activity through wife self-efficacy. Wife self-efficacy was indirectly related to husband physical activity via the level of husband perceived support. These results provide evidence for the importance of incorporating spousal characteristics in addition to individual characteristics when investigating physical activity during middle and later married life.

Adults' future time perspective predicts engagement in physical activity.

OBJECTIVE: Our aim was to examine how the relations among known predictors of physical activity, such as age, sex, and body mass index, interact with future time perspective (FTP) and perceived functional limitation to explain adults' engagement in physical activity. METHOD: Self-report data from 226 adults (range 20-88 years) were collected to examine the hypothesis that a more expansive FTP is associated with engagement in physical activity. RESULTS: Results indicated a good fit of the data to the model χ(2) (4, N = 226) = 7.457, p = .14 and accounted for a moderate amount of variance in adults' physical activity (R(2) = 15.7). Specifically, results indicated that perceived functional limitation (ß = -.140) and FTP (ß = .162) were directly associated with physical activity. Age was indirectly associated with physical activity through its association with perceived functional limitation (ß = -.264) and FTP (ß = .541). DISCUSSION: Results indicate that FTP may play an important role in explaining engagement in health promoting behaviors across the life span. Researchers should consider additional constructs and perhaps adopt socioemotional selectivity theory when explaining adults' engagement in physical activity.

Disordered eating and psychological distress among adults.

The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress. Using data from 567 adults (ages 18 to 88 years), we tested a path model in which age, gender, eating-related cognitions, and satisfaction with appearance predicted eating disorders which, in turn, predicted psychological distress. The model fit the data well (chi2 (DF = 11, N = 567) = 30.58, p < .001; GFI = .987, NFI = .963; RMSEA = .056), explaining 20.1% of the variance in psychological distress.