• Alaska Native females: understanding body image dissatisfaction in a culturally diverse country

      Naegele, Karaline M.; Cook, Christine; Renes, Susan; Harrison, Lynn (2013-05)
      The current study was conducted to expand literature on body image dissatisfaction (BID) in Alaska Native females. As BID has been a concern for European American females, and many minority groups in America, professionals should examine all cultural groups for the presence of BID. The research was comprised of qualitative interviewing methods. Interviews were conducted with Alaska Native female participants between the ages of 18 and 23 years, attending the University of Alaska Fairbanks. Research questions addressed whether or not Alaska Native females experience BID, and if so how BID develops and manifests for this population. The study found that all participants experienced BID beginning in adolescence. The development and manifestation of BID varied on an individual basis, reflecting other research findings.
    • Alaskan Physicians' Knowledge, Attitudes, And Behaviors Related To Fetal Alcohol Spectrum Disorders

      Dewane, Sarah L.; Brems, Christine; Rivkin, Inna; Johnson, Mark E.; Eldridge, Gloria (2010)
      Fetal alcohol spectrum disorders (FASDs), caused by maternal consumption of alcohol during pregnancy, constitute the leading known preventable birth defects in the US. Given high prevalence rates and lifetime costs of FASDs in Alaska, it is imperative that healthcare providers have an adequate foundation of knowledge related to FASDs, as well as a strong sense of self-efficacy vis-a-vis their personal capacity to engage in primary and secondary prevention activities. The purpose of this study was to examine Alaskan physicians' self-reported levels of knowledge, attitudes, and practice behaviors related to FASDs, and identify effective ways to educate and train physicians about primary and secondary FASD prevention. Study goals were accomplished via an explanatory mixed methods research design involving three distinct phases; namely, a quantitative, qualitative, and application phase. Through study participation, Alaskan physicians shared their perceptions and opinions about systemic and professional barriers that affect educational and training needs related to FASD prevention and clinical intervention, as well as challenges that impede access to care for individuals who are affected by FASDs. Results based on surveys from 243 physicians and interviews with 24 key informants revealed that physicians are generally knowledgeable about the risks of alcohol consumption during pregnancy. However, physicians are in need of support to provide effective services related to FASD prevention and intervention. These needs include: 1) specialized education during medical school and residency; 2) easily accessible continuing education opportunities; 3) development and dissemination of best practice protocols related to FASD care; 4) workforce development to increase referral options for patients; and 5) changes to healthcare systems to support primary and secondary prevention practices. Clearly, many challenges and obstacles identified by physicians are beyond their control and need to be addressed not only as independent practice issues but as larger medical education and healthcare systems issues. Given these realities and findings, the study concludes with suggestions and resources for physicians related to needed changes in FASD-related practice behaviors, as well as recommendations about how universities, medical schools, healthcare systems, and State and federal entities can better support physicians' efforts to reduce and treat these entirely preventable birth defects.
    • Changes in traditional gender roles for Alaska Natives: their effects on sense of purpose, direction, identity, and family and community stature

      Wirts, Eleanor Kyle (2010-08)
      "In the past century, especially since the 1960s, Alaska Natives have faced rapid cultural and socio-economic change as Western influences have increasingly infiltrated the Native life-ways; since the 1960s social problems, including alcohol abuse, violence, and suicide have plagued Native individuals, families and communities. Arguably, a source of these social problems is the striking shift from clearly defined gender roles for Native adults that guided youth to adulthood in the past to opaque and ambiguous roles for adults that draw on both traditional and Western cultures. Historically, clearly defined gender roles provided youth with the role models necessary for maturing into healthy, productive adults and thereby offered youth a sense of purpose, direction and identity. Today's youth must look for cues in both traditional and Western culture to envision their futures, and with often conflicting value systems and too few strong adult role models to follow, many youth, especially males, are floundering. Healthy adult and elder role models are essential to the well-being of Native youth as they mature into adulthood. The revitalization of mentors, role models and close relationships between adults and youth are critical to future health and well-being of Alaska Native individuals, families and communities"--Leaf iii
    • Factors Contributing To Weight Gain Among College Freshman And Beyond

      Chipp, Cody L.; Brems, Christiane; Johnson, Mark; Metzger, Jesse; Rivkin, Inna (2012)
      Background: Linked with a higher risk of life threatening illnesses, obesity in the United States has become an epidemic, with a prevalence rate of overweight and obese adults of nearly 68%. Obesity rates have accelerated over the past two decades and one crucial developmental period for weight gain is among emerging adults attending college. Using an explanatory mixed-method design, this study examined contributing factors to weight gain among college students, including eliciting university stakeholders' perceptions of supports and barriers to exercising and healthy eating among students. Method: Data collection for the quantitative phase of the study consisted of two waves, baseline and 2-year follow-up. Students completed psychosocial and anthropometric measures (height, weight, and body fat percentage). Data collected for the qualitative phase of the study consisted of key informant interviews with university administrators (n=15) and seven student focus groups (n=34 students). Qualitative analyses were conducted with NVivo software and multiple coders, using a grounded theory approach to elicit major themes. Results: Students gained 1.5lbs (p>.05), with 34% of participants gaining over 5 lbs and 17% over 10 lbs. Participants who gained weight were men, ate more calories from sweets or desserts, and consumed fewer calories from fats. Increase in calories from desserts or sweets increased odds of weight gain (OR=1.075, CI=1.01-1.14) and body fat (OR=1.106, CI=1.036-1.181). Contextualizing the quantitative findings, students and administrators identified several themes that support healthy living, including access to nutritious food and physical amenities. Both groups also identified barriers, including easy access to high-calorie foods, limited recreation facilities, and policy challenges. Administrators spoke of extant health promotion efforts; however, students did not perceive active health promotion initiatives on campus. Conclusions: Dietary habits were identified drivers of weight gain among students. Extant campus supports and barriers to exercise and healthy eating among students were equally identified by students and administrators with great reliability. Implications for future health promotion efforts, food availability, recreation, and physical amenities are discussed in the context of clears sets of recommendations for stakeholder groups. Future research should explore specific dietary foods that are increasing weight and develop targeted preventions/interventions for individuals at risk.
    • Hush, little baby: exploring the need for interpersonal affection in infancy

      Lee, Estrella D. (2010-05)
      "This study seeks to explore the links that are being made between a lack of interpersonal affection during infancy and an individual's later integration into society. Researching neglect proves difficult due to the limited ways in which data can be collected. Therefore, the base of this study employs qualitative content analysis of secondary data sources, with a supplemental piece employing standardized open-ended interviews. Interpretation of results informed the following five links, each connecting a lack of interpersonal affection to: arrested physiological development, an inability to fulfill attachment needs, erratic behavior, an inability to connect socially, and the ability to effectively receive interpersonal affection. Initial conclusions drawn from the study affirm affection to be a genuine need and a foundational component throughout the lifespan, with a final conclusion highlighting the difficulty in rectifying the detrimental effects caused by interpersonal neglect, further emphasizing the need for increased societal awareness"--Leaf iii
    • Mental health problems in the mountains: needs, assets, and recommendations for managing mental health problems in mountain-focused wilderness-based education and related fields

      Johnson, Samuel H.; Dulin, Patrick L.; Lopez, Ellen D. S.; Gifford, Valerie M.; Rivkin, Inna D. (2020-08)
      Background: Through controlled exposure to stress, wilderness-based education programs can buildcapacity for adaptive coping and produce long lasting improvements to participants' quality of life.However, stress can also overwhelm them, resulting in the emergence and exacerbation of mental health vulnerabilities in the field. However, empirically grounded best practices for training, pre-trip screening, and protocol/policy for mental health specific to the wilderness context are not well developed. Aim: The aim of this study was to assess needs and assets, and develop recommendations for training, pre-trip screening, and organizational protocol/policy to assist with successful management of mental health problems in mountain-focused, wilderness-based education and related fields such as outdoor leadership, guiding, environmental education, snow safety, search and rescue, and wilderness therapy. Methods:A pragmatic, two phase, sequential mixed methods approach was utilized to explore this topic within the context of an overarching collaborative community based participatory research (CBPR) framework with organizational partners: National Outdoor Leadership School, Outward Bound USA and Canada, the Wilderness Risk Management Conference, and the Alaska Mountaineering School. A preliminary quantitative study utilized a cloud-based survey to determine baseline characteristics for 64 wilderness-based educators, guides, outdoor leaders, snow safety professionals, and search and rescue personnel. Qualitative interviews with 16 experienced and prepared key informants addressed the study aim in more depth, consistent with partnering organization priorities, in the tradition of CBPR. Findings: Mental health topics and skills are underemphasized in current training, and training was found to be of less value than personal and professional experiences with mental health. In the future, mental health should be increased and emphasized, possibly through the utilization of existing resources such as the stress continuum or curriculum such as Psychological First Aid as well as practical training opportunities that emphasize experiential learning around mental health. Current screening can present both risks and benefits for clients, instructors, and organizations. Nondisclosure and the impacts of stigma and prejudice on the interpretation and utilization of mental health screening information were major concerns. However, screening can guide preventive and proactive efforts, and build working relationships with potential participants. Future screening should be used to inform participants about course stress, encourage disclosure, and direct curriculum development. Multi-step screening, utilizing multiple interactions with participants before the course, was identified as a utilitarian way to facilitate improvements for future screening. In protocol/policy, field management of mental health problems is underemphasized relative to evacuation, resulting in overutilization of disruptive evacuation processes. While many organizations do well at responding to instructor mental health needs after incidents such as a fatality in the line of work, inconsistencies in implementation can create unintended barriers to instructor self-care. Future protocol/policy should prioritize instructor mental health by addressing inconsistencies in implementation, removing barriers to self-care and guiding the deployment of resources such as responsive staffing or free counseling benefits. Implications: This study contributes uniquely to the literature by providing an empirically-based perspective into a little researched topic, and multiple avenues for implementation of findings such as increasing mental health content and experience-based training, utilization of multi-step screening processes, and consistent implementation of organizational protocol/policy in support of client and instructor mental health. Recommendations for implementation address weaknesses and build upon strengths already present in training, screening, and protocol/policy. Overall, practice and research in this area are in need of further investigation and development. Future dissemination, research, and practice development could help develop measures or resources to support the improvement of training, screening, and protocol/policy across wilderness-based education and related fields.
    • Not only an athlete: a curriculum for athletes at NCAA institutions

      Sawchuk, Jamie; Cook, Christine; Sheppard, Dani; Simpson, Joni (2016)
      Despite there being plenty of research regarding identity, athletic identity, and athlete transition, there is limited research on assisting athletes with blending their athletic identity with other roles in their life. Most retired athletes have difficulties letting go of their athletic identity, creating a new non-athletic identity and getting a job. Olympic committees, professional sport organizations, and collegiate athletics have created different transition programs for their athletes to aid them in transitioning to their life upon athletic retirement by helping them realize skills learned from sport are transferrable into the workforce and other areas of life. Researchers have found that athletes should not let go of their athletic identity; but rather learn to blend their athletic identity with their other identities. The following examines the extent to which student-athletes identify with their athletic identity, athletic retirement symptoms, and current athlete transition programs. The end product is a four year curriculum geared towards college level student-athletes.
    • Promoting a healthy self esteem for preadolescent girls in a rural elementary school setting

      McCune, Gianna Giusti; Cook, Christine; Renes, Susan; Gifford, Valerie (2014)
      There is a decrease in girls' self-esteem starting in the pre-teen years because self-esteem often becomes closely tied to physical attributes; many girls believe they cannot measure up to societal standards (Gurian, 2012). This drop in self-esteem affects academic achievement and should be addressed in schools. There are programs that focus on this trend designed for urban populations, yet there is a lack of opportunities for preadolescent girls who live in rural communities. This research project focused on the components needed to promote a healthy self-esteem in the rural setting for preadolescent girls. A goal-directed psychoeducational group has been developed, which is guided by empathy, unconditional regard and being genuine to oneself and others in the hope of developing resources for preadolescent girls.
    • A school-based intervention program for preadolescent girls experiencing body dissatisfaction

      Taylor, Chelsea; Renes, Susan; Dahl, Heather; McMorrow, Samantha (2018-05)
      Body dissatisfaction and poor body image are issues girls are facing in their preadolescent years. Research is demonstrating that preadolescent girls need intervention programs to help support them with the struggles of body image and self-acceptance. This project uses the literature and established research to provide school counselors with a program to help meet the needs of preadolescent girls struggling with body dissatisfaction and promote body acceptance and body positivity.
    • Self Silencing in Children and Adolescents

      Walz, Gena L. (1998-05)
      Self silencing is the theorized tendency to abnormally suppress expression of one’s own needs for the sake of a significant relationship Thought to be a predominately female behavior, self silencing has mainly been empirically studied in adults and has been associated with depression in women. To determine the extent, the approximate age of onset and the gender distribution of self silencing behavior in boys and girls, the Silencing the Self Scale (STSS) (Jack & Dill, 1992) was administered to twelfth grade students, and a modified version of this scale for children (STSS-C) was developed, tested and administered to fourth, eighth, and twelfth grade students. No significant differences in self silencing were observed between genders at any grade level. However significant age related differences in self silencing behavior were demonstrated in both boys and girls. In addition, these age related patterns differed significantly between boys and girls.
    • Shudder: Poems And Essays On Cancer, Care, And Healing

      Mohatt, Nathaniel Vincent; Burleson, Derick (2011)
      This book chronicles my journey in understanding and coming to terms with my father's illness and death. In 2005 he was diagnosed with Chronic Lymphocytic Leukemia (CLL), and in 2008 I traveled with him to the MD Anderson Cancer Center in Houston, Texas. In 2010 he died suddenly after his cancer transformed into an aggressive form of large cell lymphoma. The introductory personal essay ties together the trip to MD Anderson with writings from poetry and psychology, chronicling my experience with cancer care. The essay unveils an intimate relationship between art, the creation and experience of beauty, the provision of health care, and the meaning of healing. Like art, health care and healing are experienced in "the attempt," the process of trying to attain (health or beauty) without the ability to realize perfection. The poems weave together visions from the MD Anderson trip, other encounters with cancer, and pieces of my family's life after his death with a wide variety of images, memories, characters, and spirits. The poems begin with scenes and people from MD Anderson, then move to poems about coming into sense, discovery of the internal wild, and preparation for a time of sorrow. The later poems grapple with understanding the disease and my father's relationship with illness and conclude with in a continuation of "the attempt" even after death.
    • Stigma, self-efficacy, and adherence behaviors in people with type 2 diabetes: unexpected outcomes

      Laweryson, Annie N.; Campbell, Kendra; Dulin, Patrick; David, EJR; Rivkin, Inna (2020-08)
      Type 2 diabetes mellitus is a health condition treated with behavioral modifications including changes in diet, exercise, foot care regimens, and medication. Stigma associated with type 2 diabetes negatively effects health outcomes, whereas patient-provider relationships positively affects health outcomes. The growing literature base on type 2 diabetes stigma and health outcomes is mostly conducted outside of the United States. The present study used online crowdsourcing methods to gather cross-sectional survey data from people (n=152) who have been diagnosed with type 2 diabetes and are living in the United States. Participants completed the survey battery measuring stigma, self-efficacy, patientprovider relationships, and health behaviors. It was predicted that 1) internalized stigma would have a negative impact on self-care behaviors including diet, exercise, foot care, and medication adherence as well as glycated hemoglobin [HbA1C] levels 2) self-efficacy would mediate each of those relationships, and 3) the patient-provider relationship, characterized by trust in providers would moderate the relationship between stigma and self-efficacy thus indirectly moderating self-care behaviors and HbA1C. To test these hypotheses, a set of five moderated-mediation analysis were conducted to test each outcome variable of diet, exercise, foot care, medication adherence, and HbA1C. Main findings of this study revealed paradoxical relationships between stigma, self efficacy, and trust in providers, although consistent with psychological reactance theory. Stigma was associated with medication non-adherence and worse HbA1C, which is consistent with literature. Results of this study suggest that patients who exhibit psychological reactance may struggle to adhere to recommendations despite being more likely to report that everything is okay. This dynamic may make it difficult for providers to accurately gauge patient engagement in care, ability, or progress in health behavior change. However, one could argue responding to stigma with reactance may be protective in other ways. There was some evidence to suggest providers can attend to reactance by attuning to trust within the patient-provider relationship. In summary, this study adds to the pool of literature on stigma and type 2 diabetes, specifically within the US which is important considering variances in social climates and health care systems across nations. Future research should corroborate our suppositions about the relationships between stigma, self-efficacy, and psychological reactance.