DSpace Repository :: Browsing by Author "Kim, Minjung"

Browsing by Author "Kim, Minjung"

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The association between the number of chronic health conditions and advance care planning varies by race/ethnicity
(Routledge, 2020) Choi, Shinae; McDonough, Ian M.; Kim, Minjung; Kim, Giyeon; University of Alabama Tuscaloosa; Ohio State University; Chung Ang University
Objectives: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States. Method: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates. Results: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased. Conclusion: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.
Do older adults with Alzheimer's disease engage in estate planning and advance care planning preparation?
(Routledge, 2019) Choi, Shinae; Kim, Minjung; McDonough, Ian M.; University of Alabama Tuscaloosa; Ohio State University
Objectives: This study investigated the estate planning and advance care planning (ACP) of older adults diagnosed with Alzheimer's disease (AD) for the presence of (1) a valid will, (2) a durable power of attorney for health care, and (3) a living will. Method: We analyzed 10,273 adults aged 65 and older from the 2012 Health and Retirement Study (HRS) using multilevel logistic regression. Results: We found that a diagnosis of AD was significantly associated with the ACP variables. Older adults with AD were more likely to assign a durable power of attorney for health care and have a written living will than older adults without an AD diagnosis. However, we found no significant association between a diagnosis of AD and having a valid will. These findings were robust when adjusting for demographic and socioeconomic variables. Other factors decreased engagement in estate planning and ACP, including lower socioeconomic status, being male, and being a minority. Conclusion: Our findings suggest that a diagnosis of AD is associated with more engagement in ACP for individuals and their families, but important barriers exist for people with fewer resources.
How MAOA, decision-making, and negative parenting impact aggression and conduct problems in children: a gene by environment interaction study
(University of Alabama Libraries, 2019) Powe, Cameron E.; Lochman, John E.; University of Alabama Tuscaloosa
Objective: Test if decision-making moderates the relationship between MAOA gene variant and aggression/conduct problems and if low/high MAOA and negative parenting will moderate decision-making and aggression/conduct problems. Method: Study used archival baseline data from a population of at-risk children. Measures include the buccal swab, the Iowa Gambling Task, the Teacher Report of Proactive and Reactive Aggression, the Behavior Assessment System for Children, and the Alabama Parenting Questionnaire. Analyses: Base models will test if MAOA variants, decision-making, and negative parenting impacts reactive aggression/conduct problems, and if the interactions between MAOA gene variants x decision-making and negative parenting x decision-making impacts reactive aggression/conduct problems. Moderation models will test if MAOA gene variants and negative parenting impacts decision-making, and if the interaction between MAOA gene variants x negative parenting behaviors impacts decision-making. Results: There was a significant moderation between MAOA gene variants and ADM when predicting to reactive aggression as well as a significant moderation between MAOA gene variants and ADM when predicting to conduct problems. Discussion: The moderation effect between affective decision-making and MAOA gene variants predicting to reactive aggression and the moderation effect between low affective decision-making and MAOA gene variants predicting to conduct problems, demonstrates that the higher MAOA allele can act as a protective factor. However, a different relationship exists between high affective decision-making and MAOA gene variants when predicting to conduct problems. In this moderation, higher affective decision-making can act as a protective factor against the risks associated with having the lower MAOA variant, but children with the higher MAOA variant engage in more conduct problem behavior. The study utilized a sample of aggressive and conduct problem youth, and these children may be more effective at using conduct problem behaviors to achieve their goals, even though they have the affective decision-making abilities to understand the differences between reward and punishment.
Impact of an equality constraint on the class-specific residual variances in regression mixtures: A Monte Carlo simulation study
(Springer, 2016) Kim, Minjung; Lamont, Andrea E.; Jaki, Thomas; Feaster, Daniel; Howe, George; Van Horn, M. Lee; University of Alabama Tuscaloosa; University of South Carolina Columbia; Lancaster University; University of Miami; George Washington University; University of New Mexico
Regression mixture models are a novel approach to modeling the heterogeneous effects of predictors on an outcome. In the model-building process, often residual variances are disregarded and simplifying assumptions are made without thorough examination of the consequences. In this simulation study, we investigated the impact of an equality constraint on the residual variances across latent classes. We examined the consequences of constraining the residual variances on class enumeration (finding the true number of latent classes) and on the parameter estimates, under a number of different simulation conditions meant to reflect the types of heterogeneity likely to exist in applied analyses. The results showed that bias in class enumeration increased as the difference in residual variances between the classes increased. Also, an inappropriate equality constraint on the residual variances greatly impacted on the estimated class sizes and showed the potential to greatly affect the parameter estimates in each class. These results suggest that it is important to make assumptions about residual variances with care and to carefully report what assumptions are made.
Investigating the relationship between alcohol cue reactivity and approach motivation
(University of Alabama Libraries, 2017) Ryerson, Nicole Claudette; Gable, Philip A.; University of Alabama Tuscaloosa
Alcohol cue reactivity (ACR) is a critical component within many models of alcohol use and abuse. ACR can be conceptually defined as the physiological and subjective reactions that occur in response to alcohol related stimuli. Using a two-study design, the current research sought to investigate approach motivation and alcohol consumption as underlying mechanisms of subjective and neurophysiological ACR. Study 1 (n = 53) investigated the hypothesis that approach motivation and alcohol consumption would relate to ACR. Approach motivation did not relate to enhanced ACR. Additionally, analyses produced conflicting results concerning the impact of alcohol consumption on ACR. Heavy drinkers rated alcohol pictures higher in subjective ACR compared with light drinkers. However, light drinkers demonstrated enhanced neurophysiological ACR during alcohol consistent dot probe trials. The unpredicted results of Study 1 may have occurred due to the appetitive nature of the water pictures, which were intended to serve as a neutral comparison picture set. Study 2 (n = 132) investigated the hypothesis that inducing an approach motivation state would enhance ACR in comparison to a neutral or positive state and that this effect would be paramount for heavy drinkers. Results from Study 2 found that inducing an approach motivated state enhanced neurophysiological cue reactivity for water pictures, but not alcohol pictures. However, inducing a positive state enhanced neurophysiological cue reactivity for alcohol pictures. These results were specific to heavy drinkers. The unpredicted results of Study 2 were likely due to the writing prompt instructions used to induce an approach state. Many of the participants in this condition wrote about health focused goals that may have resulted in an aversive response to alcohol pictures instead of the intended appetitive response. Finally, research has yet to address the relationship between subjective and neurophysiological ACR. Therefore, analyses were conducted to investigate the hypothesis that approach motivation and alcohol consumption moderate the relationship between subjective and neurophysiological ACR. Approach motivation and alcohol consumption were not identified as moderator variables of the relationship between these broad categories of measurement. However, results suggest that a positive mood state may enhance the relationship between subjective and neurophysiological ACR.
Limited English Proficiency and Trajectories of Depressive Symptoms Among Mexican American Older Adults
(Oxford University Press, 2019) Kim, Giyeon; Kim, Minjung; Park, Soohyun; Jimenez, Daniel E.; Chiriboga, David A.; Chung Ang University; Ohio State University; University of Alabama Tuscaloosa; University of Miami; University of South Florida
Background and Objectives: This study examined the effect of limited English proficiency (LEP) on trajectories of depressive symptoms among Mexican American older adults in the United States. Research Design and Methods: The sample was drawn from Waves 1 to 6 (1993-2007) of the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE). A total of 2,945 Mexican American older adults were included in the analyses. A latent growth curve modeling was conducted. Results: After adjusting for covariates, results show that Mexican American older adults with LEP had higher levels of depressive symptoms than those with English proficiency (EP) at baseline as well as over a 14-year period. Differential trajectories were observed between those with LEP and EP over time, indicating that those with LEP had a significantly steeper curve of depressive symptom trajectories over time than those with EP. Discussion and Implications: These results suggest that LEP is a risk factor not merely for greater depressive symptomatology at each time point, but for an accelerated trajectory of depressive symptoms over time among Mexican American older adults. Overall, the findings emphasize the need to assist not only the informal support system of Mexican American older adults with LEP, but also the formal system.
Longitudinal social support and quality of life among participants of psychosocial chronic pain management groups
(University of Alabama Libraries, 2018) Van Dyke, Benjamin Prime; Thorn, Beverly E.; University of Alabama Tuscaloosa
Objective: The primary goal of the current study was to characterize perceived social support (PSS) and isolation longitudinally among people with chronic pain (CP) who were and were not receiving group psychosocial interventions for CP. The second goal of the study was to describe how PSS and isolation variables are associated with quality-of-life (QOL) variables over time for those same participants. Background: Previous research has demonstrated that positive social support can predict better outcomes for people with CP and negative social support can predict poorer outcomes. Furthermore, CP is associated with decreased social support and greater isolation. Despite the knowledge that PSS can be an important coping resource for people with CP, research on the longitudinal patterns of PSS and isolation and their relationships to QOL variables over time is lacking, especially among people with CP. Method: Social health and QOL data from 290 participants from the Learning About My Pain study (Eyer & Thorn, 2015) were used to examine longitudinal PSS and isolation with piecewise linear growth models using multilevel modeling. Participants were randomly assigned to participate in group cognitive-behavioral therapy (CBT), group pain psychoeducation (EDU), or medical treatment-as-usual (TAU) for 10 weeks followed by a 6-month post-treatment follow-up period. Participants were assessed pre-, mid-, and post-treatment, as well as at follow-up. Results: PSS was relatively stable over the treatment and follow-up periods except for small decreases in emotional and informational support among TAU and social isolation among EDU during the follow-up period. Companionship was associated with decreasing pain interference, disability, and depression, and emotional support was associated with decreasing pain interference and depression, whereas instrumental support and isolation were associated with worsening QOL. The Buffering Hypothesis of PSS was not supported in the current sample. Conclusions: A potential benefit of participating in psychosocial group treatments for CP appears to be the lack of deterioration of emotional and informational support for CBT and EDU and decreasing isolation for EDU participants. Social health was predictive of QOL. Future research and treatment of CP should account for PSS and isolation and the ways in which they interact with pain and QOL.
Nutritional Status of Rural Older Adults Is Linked to Physical and Emotional Health
(Elsevier, 2017) Jung, Seung Eun; Bishop, Alex J.; Kim, Minjung; Hermann, Janice; Kim, Giyeon; Lawrence, Jeannine; University of Alabama Tuscaloosa; Oklahoma State University - Stillwater
Background Although nutritional status is influenced by multidimensional aspects encompassing physical and emotional well-being, there is limited research on this complex relationship. Objective The purpose of this study was to examine the interplay between indicators of physical health (perceived health status and self-care capacity) and emotional wellbeing (depressive affect and loneliness) on rural older adults' nutritional status. Design The cross-sectional study was conducted from June 1, 2007, to June 1, 2008. Participants/setting A total of 171 community-dwelling older adults, aged 65 years and older, residing within nonmetro rural communities in the United States participated in this study. Main outcome measures Participants completed validated instruments measuring self-care capacity, perceived health status, loneliness, depressive affect, and nutritional status. Statistical analyses performed Structural equation modeling was employed to investigate the complex interplay of physical and emotional health status with nutritional status among rural older adults. The chi(2) test, comparative fit index, root mean square error of approximation, and standardized root mean square residual were used to assess model fit. Results The chi(2) test and the other model fit indexes showed the hypothesized structural equation model provided a good fit to the data (chi(2) (2)=2.15; P=0.34; comparative fit index=1.00; root mean square error of approximation=0.02; and standardized root mean square residual=0.03). Self-care capacity was significantly related with depressive affect (gamma=-0.11; P=0.03), whereas self-care capacity was not significantly related with loneliness. Perceived health status had a significant negative relationship with both loneliness (gamma=-0.16; P=0.03) and depressive affect (gamma=-0.22: P=0.03). Although loneliness showed no significant direct relationship with nutritional status, it showed a significant direct relationship with depressive affect (beta=.4; P<0.01). Finally, the results demonstrated that depressive affect had a significant negative relationship with nutritional status (beta=-.30; P<0.01). The results indicated physical health and emotional indicators have significant multidimensional associations with nutritional status among rural older adults. Conclusions The present study provides insights into the importance of addressing both physical and emotional well-being together to reduce potential effects of poor emotional well-being on nutritional status, particularly among rural older adults with impaired physical health and self-care capacity.
The Optimal Starting Model to Search for the Accurate Growth Trajectory in Latent Growth Models
(Frontiers, 2018) Kim, Minjung; Hsu, Hsien-Yuan; Kwok, Oi-Man; Seo, Sunmi; Ohio State University; University of Texas Health Science Center Houston; Texas A&M University College Station; University of Alabama Tuscaloosa
This simulation study aims to propose an optimal starting model to search for the accurate growth trajectory in Latent Growth Models (LGM). We examine the performance of four different starting models in terms of the complexity of the mean and within-subject variance-covariance(V-CV) structures when there are time-invariant covariates embedded in the population models. Results showed that the model search starting with the fully saturated model (i.e., the most complex mean and within-subject V-CV model) recovers best for the true growth trajectory in simulations. Specifically, the fully saturated starting model with using Delta BIC and Delta AIC performed best (over 95%) and recommended for researchers. An illustration of the proposed method is given using the empirical secondary dataset. Implications of the findings and limitations are discussed.
Rationalizing undeserved outcomes: effects of random positive events on reactions to victims
(University of Alabama Libraries, 2017) Elmore, Joseph Dean; Hamilton, James C.; University of Alabama Tuscaloosa
Previous research has identified several coping strategies that people may use to restore psychological equanimity after being exposed to the suffering of an innocent person, including victim blaming, victim derogation, and helping / prosocial behavior. In this investigation, I proposed an alternative strategy for coping with just-world threats, the offsetting rationalization, in which people reinforce their belief that the world is just by selectively viewing undeserved good and bad events as balancing each other out in the lives of others. In three experiments, I sought to assess (1) whether people would consciously engage in offsetting rationalizations, and (2) whether engaging in offsetting rationalizations would reduce people’s need to use other strategies for coping with just-world threats. I found that participants were indeed willing to explicitly construe positive events experienced by victims as offsetting their misfortunes, with undeserved positive events possessing the greatest offsetting capacity (Experiment 1). However, contrary to predictions, participants’ use of other threat reduction strategies was not influenced by their ability to engage in an offsetting rationalization, with participants showing victims the same level of kindness (Experiment 2) and blaming victims to the same extent (Experiment 3) regardless of the type of event that preceded their misfortune. Although the current investigation provides insight into people’s reactions to co-occurring good and bad events in the lives of other people, the results of the three experiments reported here must be considered in the context of several important methodological limitations.

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