Self and health: factors that encourage self-esteem and functional health.

OBJECTIVE: We are interested in whether functional health enhances self-esteem, as well as whether self-esteem, worker, parent, and friend identities are related to changes in functional health over a 2-year period of study. METHODS: Data were collected in 1992 and 1994 from 737 older workers living in a North Carolina metropolitan area. Functional health is derived from questions asking respondents about their difficulties performing seven activities. We use Rosenberg's (1965) 10-item scale to tap self-esteem, and identities are measured with 10 adjective pairs that cover being competent, confident, and sociable as a worker, parent, and friend. RESULT: Several findings are of interest. Better functional health is associated with greater self-esteem over 2 years, and self-esteem is positively related to changes in functional health. In addition, worker identity and some social background factors are associated with positive changes in self-esteem. DISCUSSION: The findings suggest that good health may contribute to positive self assessments, but also the less well-studied expectation that self processes are associated with positive changes in health. Individuals may be motivated by their desire to affirm a sense of self-worth and positive identities to maintain and improve their physical health.

Marital status, family ties, and self-rated health among elders in South India.

This article examines the impact of familial social support ties (indicated by marital status, kin availability, sources of economic support, and frequency and quality of emotional interaction) on subjective health perception among a sample of elderly men and women aged 60 and older in South India. We used 1993 survey data from three states of South India: Kerala, Tamil Nadu, and Karnataka. We hypothesized that (a) widowhood would be associated with poorer self-rated health, (b) number of kin ties would be positively associated with self-rated health, (c) economic and emotional support from kin would improve outcomes, and (d) these associations would be stronger among women than among men. Results of logistic regression techniques supported the first hypothesis and partially supported the third. With regard to the second hypothesis, the presence of specific kin rather than the number of each type of family member was important. For the fourth hypothesis, results suggest that men and women in this sample have broadly similar associations between widowhood and self-rated health. For women however, controlling for socioeconomic status did not weaken the association between widowhood and self-rated health, suggesting the symbolic/cultural importance of this status. In general, these findings suggest that theories on the importance of marital status and kin ties for older adults' self-rated health, which were developed and tested in Western societies, need to be refined for Asian societies, where the nature of marriage and widowhood are different.

Ethnic minority older adults participating in clinical research: developing trust.

OBJECTIVE: African American, Latino, and American Indian older adults are underrepresented in clinical research studies. A significant barrier to participation in research is mistrust of the scientific community and institutions. The aims of this article are to discuss the lack of representation of ethnic minorities in clinical research. METHODS: This article presents a review of the literature regarding medical research mistrust. Also described are the trust-building activities of the Resource Centers on Minority Aging Research (RCMAR), federally funded centers focused on research and aging in communities of color. DISCUSSION: The RCMAR centers are building trust with the communities they serve, resulting in the recruitment and retention of ethnic minority older adults in clinical research studies and health promotion projects. Implications are discussed for other researchers toward building trust with ethnic minority elders to increase their participation in research.

The transition to retirement: stages and factors that influence retirement adjustment.

A set of older workers from the Raleigh-Durham-Chapel Hill, North Carolina metropolitan area were followed from pre-retirement to 24 months post-retirement in order to explore stages in retirement and the impact of social psychological, social background, and gender factors on the retirement adjustment. First, we found general support for Atchley's model of retirement adjustment (1976). Second, the factors that influence retirement adjustment in the data analysis revealed that: 1) pre-retirement self-esteem and friend identity meanings, as well as pension eligibility, increased positive attitudes toward retirement at six months, 12 months, and 24 months post-retirement; 2) retirement planning and voluntary retirement increased positive attitudes toward retirement earlier, but not later, in the first two years of retirement; 3) poor health decreased positive attitudes toward retirement later rather than earlier in the first two years of retirement; and 4) there were only limited gender effects.

Grandparent identity, intergenerational family identity, and well-being.

OBJECTIVE: A new grandparent identity measure is constructed that allows us to compare grandparent identity meanings with the meanings of other adult identities and to investigate the relationships between identities and well-being. METHODS: Data were collected in 1997 from 203 older grandmothers and grandfathers living in a metropolitan area. Grandparent and parent identity meanings are measured with an introductory identifier focusing attention on being a grandparent or a parent, followed by a set of 10 adjective pairs to capture identity meanings. Intergenerational family identity combined grandparent and parent identity meanings. Self-esteem and depressive symptoms serve as two indicators of well-being. RESULTS: We find that there are no significant differences between grandparent and parent identity meanings and that men and women are more positive about their grandparent identities than they are about other adult identity meanings. Further, grandparent identity is significantly related to well-being when it is the only identity in the model but not when parent identity is included in another model. Finally, intergenerational family identity is positively related to well-being. DISCUSSION: The findings confirm the expectation that grandparent identity meanings may encourage well-being. Further, the intergenerational identity reflects the overlapping meanings and experiences of being a parent and a grandparent.

Grandparenthood: factors influencing frequency of grandparent-grandchildren contact and grandparent role satisfaction.

OBJECTIVES: Symbolic interaction theory suggests that self processes motivate individual behaviors and responses to roles. In this study, we explore the influence of self processes on grandparenthood. METHODS: Data were collected in 1997 from 203 middle-aged grandmothers and grandfathers living in the Raleigh-Durham-Chapel Hill, North Carolina, metropolitan area. We are especially interested in whether three self factors, grandparent identity meanings, grandparent centrality, and self-esteem, are related to frequency of contact with grandchildren and grandparent role satisfaction. RESULTS: Results indicate that there are gender differences in the factors that influence the frequency of contact between grandparents and grandchildren. The self variables influenced frequency of contact for grandfathers but not for grandmothers. Stronger support for our expectation emerged in the analysis of factors that influence grandparent satisfaction. All three self factors are positively related to grandparent role satisfaction for both grandmothers and grandfathers. DISCUSSION: More research is needed on the expectations and experiences of the grandparent role. In this study, we focused attention on self processes. The finding that grandparent identity meanings, grandparent centrality, and self-esteem influence grandparent role satisfaction suggests that self factors should be included in comprehensive investigations of grandparenthood. The next step is to explore the grandparent identity in more detail and investigate how it relates to other identities and to the well-being of older persons.

Recruitment of older African Americans for survey research: a process evaluation of the community and church-based strategy in The Durham Elders Project.

PURPOSE: The disproportionately high burden of morbidity and mortality among older African Americans is due, in part, to a lack of understanding of the factors contributing to these outcomes. In order to more fully understand the factors that contribute to African American morbidity and mortality, researchers must identify strategies for increasing the inclusion of older African Americans in research on social and health phenomena. DESIGN AND METHODS: This article is a process evaluation describing the successes and challenges associated with recruitment of older African Americans into research. It considers an effort to nurture collaboration between university and community institutions to both facilitate research endeavors and offer meaningful and culturally-appropriate contributions to the community. RESULTS: The primary challenges discovered in this observational process evaluation of a church-based recruitment strategy include the effective coordination of a community research advisory board, ensuring participant autonomy, and reducing concerns of exploitation among potential participants. IMPLICATIONS: A strategy of coordinating a community research advisory board to incorporate the views of community members and to drive a church-based recruitment procedure provides a starting point for tapping into an immensely important segment of society historically ignored by the research community.

Measurement adequacy of the CES-D among a sample of older African-Americans.

This manuscript examines the measurement adequacy of the CES-D when applied in older African-Americans (n=227). The response distribution was skewed towards less symptomatology on all items, and the internal consistency of the CES-D was acceptable (alpha=0.86). An exploratory factor analysis revealed four underlying factors of depressive symptomatology: (1) depressive/somatic; (2) positive; (3) interpersonal; and (4) social well-being. The primary factor was a combination of depression and somatic symptoms, a commonly reported uni-dimensional factor among ethnic groups. Additionally, a fourth factor emerged that has not previously been identified, labeled 'social well-being'. This factor consisted of three items that may tap into the social interactions of the elderly: appetite, hopeful, and talk. These findings contribute to the growing body of evidence on the unique measurement properties of the CES-D across diverse populations.

Self-gain and self-loss among African American and white caregivers.

OBJECTIVES: This study compared the effects of a traditional ideology of care and role conflict on the intrinsic rewards (self-gain) and consequences (self-loss) of caregiving among African Americans and Whites. METHODS: Using a cross-sectional telephone survey of caregivers in North Carolina (n = 481), the authors performed a structural equation groups analysis to assess the equality of an a priori caregiving model for African Americans (n = 257) and Whites (n = 224). RESULTS: Despite a stronger preference for family care among African Americans, traditional caregiving ideology was associated with more self-gain among Whites only; there was no relationship between preference for family care and self-loss for either group. Furthermore, role conflict was unrelated to self-gain but was related to more self-loss for both groups. Three additional relationships differed between African Americans and Whites: age and self-gain, gender and self-gain, and care recipient depression and role conflict. However, 12 proposed relationships were statistically significant and equivalent for African Americans and Whites. DISCUSSION: The findings suggest that contextual elements that influence preference for family care and role conflict are almost identical for African Americans and Whites. Caregiver demographics are associated with caregiving ideology, whereas care recipient frailty is related to role conflict. However, there are differences between African American and White caregivers, which primarily stem from the role of age, gender, and preference for family care with self-gain.