The Impact of Body Image on Women in Later Life: Effects on Quality of Life and Body Perception

Physical, mental, and emotional changes can occur throughout the aging process, making it important to treat different age groups as separate populations when researching body image. Yet, very few instruments have been validated for middle-aged and older adults. An online survey was used to perform a validation of the Body Image Quality of Life Inventory (BIQLI) and examine demographic relationships, with a sample of 947 women, ages 40-79, from across the United States. A principal component analysis (PCA) and convergent validity supported the use of the BIQLI for women ages 40 to 79. A one-factor model was validated for comparing BIQLI scores across decades. A two-factor model provided useful information about potential subscales within the BIQLI for women of certain decades. Two- and three-factor models had different patterns for each decade, making the one-factor model the only solution for comparing across age groups. The strongest demographic relationship existed between total BIQLI score and body mass index, though the relationship weakened as age increased. Income level and relationship status had small associations with BIQLI score only for the women in their 60s. Results indicate that the 60s may be a time of transition for body image and warrants continued research. Race also played a distinct role with Caucasians having lower scores than the sample with all races combined. Combining races may skew findings and lead to incorrect assumptions, especially when Caucasians are included in a sample

A novel recruiting and surveying method: Participatory research during a Pacific Islander community’s traditional cultural event

Little is known about the health status of Marshallese, a Pacific Islander subpopulation living in the United States. The Marshallese have established a growing community in Northwest Arkansas, providing a unique opportunity for increasing knowledge regarding the health of this minority group. This article describes how a community-based participatory research process was used by a community and university coalition to identify and refine questionnaires and recruit study participants. Questionnaires were self-administered on computers during a one-week traditional cultural event. A total of 874 Marshallese from Arkansas completed the questionnaire, exceeding the goal of 600 respondents. Lessons learned, including the level and timing of involvement of both the leadership and the community at large, are discussed in detail. This approach enhanced communication and collaboration between the Marshallese community, service providers and researchers, resulting in higher participation and interest among the Marshallese community.Keywords: participatory research, minority populations, community health assessment, community coalition, Marshalles

Changing behaviour 'more or less'-do theories of behaviour inform strategies for implementation and de-implementation? A critical interpretive synthesis

BACKGROUND: Implementing evidence-based care requires healthcare practitioners to do less of some things (de-implementation) and more of others (implementation). Variations in effectiveness of behaviour change interventions may result from failure to consider a distinction between approaches by which behaviour increases and decreases in frequency. The distinction is not well represented in methods for designing interventions. This review aimed to identify whether there is a theoretical rationale to support this distinction. METHODS: Using Critical Interpretative Synthesis, this conceptual review included papers from a broad range of fields (biology, psychology, education, business) likely to report approaches for increasing or decreasing behaviour. Articles were identified from databases using search terms related to theory and behaviour change. Articles reporting changes in frequency of behaviour and explicit use of theory were included. Data extracted were direction of behaviour change, how theory was operationalised, and theory-based recommendations for behaviour change. Analyses of extracted data were conducted iteratively and involved inductive coding and critical exploration of ideas and purposive sampling of additional papers to explore theoretical concepts in greater detail. RESULTS: Critical analysis of 66 papers and their theoretical sources identified three key findings: (1) 9 of the 15 behavioural theories identified do not distinguish between implementation and de-implementation (5 theories were applied to only implementation or de-implementation, not both); (2) a common strategy for decreasing frequency was substituting one behaviour with another. No theoretical basis for this strategy was articulated, nor were methods proposed for selecting appropriate substitute behaviours; (3) Operant Learning Theory makes an explicit distinction between techniques for increasing and decreasing frequency. DISCUSSION: Behavioural theories provide little insight into the distinction between implementation and de-implementation. Operant Learning Theory identified different strategies for implementation and de-implementation, but these strategies may not be acceptable in health systems. Additionally, if behaviour substitution is an approach for de-implementation, further investigation may inform methods or rationale for selecting the substitute behaviour