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A MIXED METHODS STUDY OF OLDER ADULTS IN A LIFESTYLE REDESIGN® PROGRAM
by
Jeanine Martin Blanchard
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(OCCUPATIONAL SCIENCE)
December 2010
Copyright 2010 Jeanine Martin Blanchard
Object Description
| Title | A mixed methods study of older adults in a Lifestyle Redesign® program |
| Author | Blanchard, Jeanine Martin |
| Author email | jeanine@usc.edu; jeanine@usc.edu |
| Degree | Doctor of Philosophy |
| Document type | Dissertation |
| Degree program |
wellness Occupational Science |
| School | School of Dentistry |
| Date submitted | 2010 |
| Restricted until | Unrestricted |
| Date published | 2010-12-05 |
| Advisor (committee chair) | Clark, Florence |
| Advisor (committee member) |
Azen, Stanley P. Carlson, Mike Jackson, Jeanne Palinkas, Lawrence |
| Abstract | The purpose of this dissertation was to examine how a subset of 22 participants from the Well Elderly 2 Study (WE2) sample viewed the impact of the WE2 intervention and the relationships between several study constructs. A second objective was to confirm the WE2 intent-to-treat and structural equation modeling findings at the level of participants' perceptions, and reveal additional constructs and relationships not hypothesized in WE2.; Quantitative methods were used to generate a sample comprised of 22 WE2 participants, based on the principle of maximum variation. Next, qualitative data were collected, consisting of semi-structured interviews and reflexive fieldnotes. These data were condensed into thumbnail sketches of the 22 participants, organized by study constructs and other background information. The 22 thumbnail sketches show, in highly individual and nuanced ways, how the WE2 participants construed the effects of the intervention, and illustrate the participants' individual perspectives on the relationships between the different constructs studied. Brief sketches of the research settings were also generated.; In Study 1, modified analytic induction was used to analyze the qualitative data. Findings were compared to WE2 intent-to-treat findings regarding the impact of the intervention, and structural equation modeling findings regarding the mechanisms through which change occurred.; For Study 2, graphical models were generated to represent how the participants perceived the relationships among psychosocial and health-related constructs, irrespective of the intervention.; The results of Study 1 indicate that participants believed the intervention most improved their social support and healthy activity, followed by physical health, psychosocial well-being, and cognitive functioning. In addition, several themes emerged that suggested areas of intervention impact that had not been anticipated in the original study. Overall, participant perceptions were relatively uniform, with only a few individual differences in perceived impact identified.; The results of Study 2 indicate that in general, the links among mediators and outcomes that were hypothesized in WE2 were supported through the qualitative data analysis. However, certain departures from the model were detected, with nine unanticipated constructs or factors emerging (Death/Dying, Transportation, "Slipping" Routine, Disability, Taking Risks, Communication, Fear of Relocation to a Nursing Home, and Alcoholics Anonymous). Healthy activity was given centrality in most of the models.; Overall, the findings of this dissertation support the WE2 intent-to-treat findings and partially support the structural equation modeling results, with a few deviations and unexpected findings. The results of the two studies comprising this dissertation indicate that the participants perceived that the intervention impacted healthy activity, social support/social networks, perceived control, stress, perceived physical health, psychosocial well-being, and cognitive functioning. In addition, some participants indicated that positive changes in healthy activity, social support/social networks, perceived control, and stress, in turn, led to improvements in perceived physical health, psychosocial well-being, and cognitive functioning. The key differences between these qualitative findings regarding the intervention and quantitative findings from WE2 are that: (a) in WE2, the intervention was not shown to impact social support or perceived control; and (b) in WE2, cognitive functioning was not determined to be influenced by the intervention or the psychosocial constructs included in the study's conceptual model. |
| Keyword | activity-based interventions; aging; occupational science |
| Geographic subject (country) | USA |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Provenance | Electronically uploaded by the author |
| Type | texts |
| Legacy record ID | usctheses-m3583 |
| Rights | Blanchard, Jeanine Martin |
| Repository name | Libraries, University of Southern California |
| Repository address | Los Angeles, California |
| Repository email | http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/ |
| Filename | etd-Blanchard-4220 |
| Archival file | uscthesesreloadpub_Volume48/etd-Blanchard-4220.pdf |
Description
| Title | Page 1 |
| Full text | A MIXED METHODS STUDY OF OLDER ADULTS IN A LIFESTYLE REDESIGN® PROGRAM by Jeanine Martin Blanchard A Dissertation Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY (OCCUPATIONAL SCIENCE) December 2010 Copyright 2010 Jeanine Martin Blanchard |
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