Anticipated support from children and later-life health in the United States and China.
ABSTRACT: Past research has shown that anticipated support, the belief that someone will provide support if needed, benefits health. Few studies considered whether the relationship between anticipated support and health depends on the source of such support. This project addresses this gap and examines how anticipated support from children is related to older parents' health and whether such support can be replaced by anticipated support from other relatives and friends. Ordered logit and negative binomial regression models with lagged health outcomes were estimated using nationally representative data from the 2010 and 2012 Health and Retirement Study and the 2011 and 2013 China Health and Retirement Longitudinal Study. Results suggest that anticipated support from children is related to older parents' better self-rated health and fewer depressive symptoms in both countries. In the U.S. where filial norms are relatively weak, anticipated support from others is no less important for health than anticipated support from children. However, in China where filial norms are relatively strong, parents anticipating support only from others are no different in health from those anticipating support from no one.
Project description:Preparing for future scenarios in pediatric palliative care is perceived as complex and challenging by both families and healthcare professionals. This interpretative qualitative study using thematic analysis aims to explore how parents and healthcare professionals anticipate the future of the child and family in pediatric palliative care. Single and repeated interviews were undertaken with 42 parents and 35 healthcare professionals of 24 children, receiving palliative care. Anticipating the future was seen in three forms: goal-directed conversations, anticipated care, and guidance on the job. Goal-directed conversations were initiated by either parents or healthcare professionals to ensure others could align with their perspective regarding the future. Anticipated care meant healthcare professionals or parents organized practical care arrangements for future scenarios with or without informing each other. Guidance on the job was a form of short-term anticipation, whereby healthcare professionals guide parents ad hoc through difficult situations.Conclusion: Anticipating the future of the child and family is mainly focused on achievement of individual care goals of both families and healthcare professionals, practical arrangements in advance, and short-term anticipation when a child deteriorates. A more open approach early in disease trajectories exploring perspectives on the future could allow parents to anticipate more gradually and to integrate their preferences into the care of their child. What is Known: • Anticipating the future in pediatric palliative care occurs infrequently and too late. What is New: • Healthcare professionals and parents use different strategies to anticipate the future of children receiving palliative care, both intentionally and unwittingly. Strategies to anticipate the future are goal-directed conversations, anticipated care, and guidance on the job. • Parents and healthcare professionals are engaged to a limited extent in ongoing explorative conversations that support shared decision-making regarding future care and treatment.
Project description:The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one's positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one's negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt.
Project description:Filial piety is a Confucian concept derived from Chinese culture, which advocates a set of moral norms, values, and practices of respect and caring for one's parents. According to the dual-factor model of filial piety, reciprocal and authoritarian filial piety are two dimensions of filial piety. Reciprocal filial piety is concerned with sincere affection toward one's parent and a longstanding positive parent-child relationship, while authoritarian filial piety is about obedience to social obligations to one's parent, often by suppressing one's own wishes to conform the demands of the parent. The primary aim of this study is to investigate the moderating effect of culture on the relationships between filial piety and palliative care knowledge. The secondary aim is to investigate whether filial piety is a universal construct across Singaporean and Australian cultures. A total of 508 participants living in Singapore and Australia were surveyed between May and October 2020. The final sample comprised of 406 participants, with 224 Singaporeans and 182 Australians. There were 289 females (71.1%), 115 males (28.3%), and two unspecified gender (0.6%) in the sample, with an average age of 27.27 years (SD = 9.79, range = 18-73). Results indicated a significant effect of culture on authoritarian filial piety and palliative care knowledge. Singaporeans showed higher authoritarian filial piety and higher palliative care knowledge than Australians. However, no effect of culture was found on reciprocal filial piety. Overall, no significant correlation existed between palliative care knowledge and reciprocal filial piety and authoritarian filial piety. For Singaporeans, a weak negative correlation was found between palliative care knowledge and authoritarian filial piety. In contrast, Australians and Singaporeans indicated a positive, moderate correlation between reciprocal and authoritarian filial piety. Further, culture moderated the relationship between authoritarian filial piety and palliative care knowledge. High authoritarian filial piety was associated with increased palliative care knowledge among Australians, while high authoritarian filial piety was associated with decreased palliative care knowledge among Singaporeans. The results support the conceptualization of filial piety as a possible psychological universal construct. In addition, the results point out an important implication that public health programs should target the appropriate filial piety types to enhance palliative care knowledge among Singaporeans and Australians.
Project description:BACKGROUND:Large portion sizes encourage overconsumption. Prior studies suggest that this may be due to errors in anticipating the effects of portion size, although the studies were limited to adults and energy-dense foods. OBJECTIVE:Our aim was to investigate potential anticipation errors related to the effects of portion size on hunger, eating enjoyment, and healthiness ratings among 8-to-11-year-old children, for snacks differing in energy density and healthiness perception, and as a function of initial hunger. METHODS:In a within-subject design, 83 children aged 8 to 11?years old were first asked to anticipate how much they would enjoy, how hungry they would feel after eating, and how healthy it would be to eat a recommended serving size, a 50% larger portion, and a 125% larger portion of brownie or applesauce. Over six subsequent sessions, the children were asked to eat all of each of these portions and then rate their post-intake enjoyment, residual hunger, and healthiness perceptions. We also measured hunger at the beginning of each session. RESULTS:For both snacks, larger portions reduced anticipated and experienced residual hunger similarly. In contrast, larger portions increased anticipated but not experienced eating enjoyment for both snacks; although larger portions increased anticipated and experienced enjoyment ratings among extremely hungry children. All children under-anticipated how much they would enjoy the smaller portion sizes. Healthiness ratings were unaffected by portion size for both snacks but differed across foods (applesauce vs. brownie). CONCLUSIONS:Children anticipate the effects of portion size on hunger change accurately, overestimate the effects of portion size on eating enjoyment, and rate food healthiness on food type and not portion size. Helping children better anticipate the enjoyment from smaller (recommended) portion sizes and understand that food quantity, not just quality, matters for healthy eating may be a solution to improve portion control.
Project description:<h4>Introduction</h4>Employment is particularly beneficial for persons living with HIV (PLWH). However, PLWH experiencing internalized stigma or anticipating that they may experience stigma may be less likely to seek employment due to additional barriers associated with HIV. The purpose of this study was to understand the associations between internalized and anticipated stigma and employment barriers for PLWH.<h4>Methods</h4>Participants (N = 712) from 12 sites across the United States were recruited and interviewed about barriers to employment, HIV stigma, and several other factors related to health. A series of unadjusted and adjusted linear regression models were conducted using cross-sectional data.<h4>Results</h4>Adjusted models suggest that greater anticipated stigma was related to increased employment barriers (β = 0.12, p = 0.04). Mental and physical health functioning also positively predicted employment barriers (β = -0.18, p <0.001; β = -0.40, p <0.001, respectively).<h4>Discussion</h4>Employment among PLWH has beneficial impacts on HIV-related health outcomes. This study suggests that anticipated stigma may limit and individual's willingness to seek out employment, or may cause them to leave employment. Internalized stigma may not play as large of a role in employment as anticipated stigma for PLWH. HIV-related stigma reduction interventions focused on community-level and employers are essential to improve employment opportunities for PLWH.
Project description:BACKGROUND: Consumer directed health care proposes that patients will engage as informed consumers of health care services by sharing in more of their medical costs, often through deductibles. We examined knowledge of deductible plan details among new enrollees, as well as anticipated care-seeking changes in response to the deductible. METHODS: In a large integrated delivery system with a range of deductible-based health plans which varied in services included or exempted from deductible, we conducted a mixed-method, cross-sectional telephone interview study. RESULTS: Among 458 adults newly enrolled in a deductible plan (71% response rate), 51% knew they had a deductible, 26% knew the deductible amount, and 6% knew which medical services were included or exempted from their deductible. After adjusting for respondent characteristics, those with more deductible-applicable services and those with lower self-reported health status were significantly more likely to know they had a deductible. Among those who knew of their deductible, half anticipated that it would cause them to delay or avoid medical care, including avoiding doctor's office visits and medical tests, even services that they believed were medically necessary. Many expressed concern about their costs, anticipating the inability to afford care and expressing the desire to change plans. CONCLUSION: Early in their experience with a deductible, patients had limited awareness of the deductible and little knowledge of the details. Many who knew of the deductible reported that it would cause them to delay or avoid seeking care and were concerned about their healthcare costs.
Project description:Developed countries throughout the world are challenged with the ageing of their labour force. In these societal contexts, low employment rates and early labour market exits of older employees are at stake, as well as arrangements for retirement, financial household considerations and mutual obligations between generations. Although proactive behaviour has been extensively studied, no research has addressed the proactive behaviour of older employees themselves when facing (re)hiring and retention versus early retirement. For the first time, this study tests the relationships of proactive behaviour with job-related affective well-being and anticipated retirement age in a sample of employees aged 50+ (N = 89) in Belgium. The findings are obtained by using a self-report questionnaire. Statistical analysis includes correlation and regression analysis. Major findings are that (i) proactive older employees feel energetic, enthusiastic, inspired, at ease, relaxed and satisfied; and (ii) later retirement is anticipated when experiencing positive affective well-being at study.
Project description:OBJECTIVES:The objective of this analysis was to examine older adults' preferences for economic support in the context of competition between grandparents and grandchildren for the middle generation's financial resources in rural China. Specifically, it examined how relative need, lineage, and gender of grandchildren depicted in a vignette were evaluated and how personal characteristics of the evaluators influenced beliefs for which generation should receive more support. METHOD:The sample consisted of 989 older adults participating in three waves of a longitudinal study in Anhui Province, China. Multinomial logistic regression was applied to examine how older respondents evaluated the relative priority of grandparents versus grandchildren in their claim for monetary assistance using a hypothetical vignette with randomized conditions. RESULTS:Relatively greater need of either the vignette grandparent or grandchild increased their priority to receive economic support. The vignette granddaughter was most disadvantaged in the competition with her paternal grandparent. Respondents who were single, in worse functional health, and whose children all migrated gave the vignette grandparent greater priority; those who coresided with children gave the vignette grandparent lower priority. DISCUSSION:Findings support the altruistic perspective on filial support and the corporate group/mutual aid model of family functioning, within the family system that differentiates patrilineal from matrilineal lines of descent. Under budget constraints, selective children are considered to have legitimate claims on the resources of the middle generation, tempering filial piety toward aging parents. Lack of personal resources plays a role in whether self-interest shapes beliefs that favor older over younger generations.
Project description:OBJECTIVES:Research on the socioeconomic gradient in mental health links disadvantaged family background with subsequent symptoms of depression, demonstrating the "downstream" effect of parental resources on children's mental health. This study takes a different approach by evaluating the "upstream" influence of adult children's educational attainment on parents' depressive symptoms. METHODS:Using longitudinal data from the U.S. Health and Retirement Study (N = 106,517 person-years), we examine whether children's college attainment influences their parents' mental health in later life and whether this association increases with parental age. We also assess whether the link between children's college completion and parents' depression differs by parents' own education. RESULTS:Parents with children who completed college have significantly lower levels of depressive symptoms than parents without college-educated children, although the gap between parents narrows with age. In addition, at baseline, parents with less than a high school education were more positively affected by their children's college completion than parents who themselves had a college education, a finding which lends support to theories of resource substitution. DISCUSSION:Offspring education is an overlooked resource that can contribute to mental health disparities among older adults in a country with unequal access to college educations.
Project description:The relation between social support and mental health has been thoroughly researched and structural characteristics of the social network have been widely recognised as being an important component of social support. The aim of this paper is to clarify the association between children and depressive mood states of their older parents. Based on international comparative data from the Survey of Health, Ageing and Retirement in Europe we analysed how the number of children, their proximity and the frequency of contact between older parents and their children are associated with the mental health of older people, using the EURO-D index. Our results indicate a positive association of children and depressive mood since childless men and women report more depressive symptoms. Moreover, few contacts with children were associated with an increased number of depressive symptoms. The family status was related to mental health as well: older men and women living with a spouse or partner had the lowest levels of depression. Interestingly, the presence of a spouse or partner was more relevant for the mental health of older people than the presence of, or contact with, their children.