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1.  Enhancing computer self-efficacy and attitudes in multi-ethnic older adults: a randomised controlled study 
Ageing and society  2011;31(6):911-933.
Several studies have documented the health-related benefits of older adults' use of computer technology, but before they can be realised, older individuals must be positively inclined and confident in their ability to engage in computer-based environments. To facilitate the assessment of computer technology attitudes, one aim of the longitudinal study reported in this paper was to test and refine a new 22-item measure of computer technology attitudes designed specifically for older adults, as none such were available.1 Another aim was to replicate, on a much larger scale, the successful findings of a preliminary study that tested a computer technology training programme for older adults (Laganà 2008). Ninety-six older men and women, mainly from non-European-American backgrounds, were randomly assigned to the waitlist/control or the experimental group. The same six-week one-on-one training was administered to the control subjects at the completion of their post-test. The revised (17-item) version of the Older Adults' Computer Technology Attitudes Scale (OACTAS) showed strong reliability: the results of a factor analysis were robust, and two analyses of covariance demonstrated that the training programme induced significant changes in attitudes and self-efficacy. Such results encourage the recruitment of older persons into training programmes aimed at increasing computer technology attitudes and self-efficacy.
PMCID: PMC4265211  PMID: 25512679
computer training; computer attitudes; computer self-efficacy; older ethnic minorities
2.  Bodily pain and coping styles among four geriatric age groups of women 
Journal of health psychology  2011;17(4):545-555.
No research is available regarding the association between coping styles and bodily pain by age-specific sub-groups in non-clinical older populations. To address this research gap, we recruited 317 older women (age 55–105, mainly from minority ethnic backgrounds) and divided our sample into sub-groups by decade. Regression analyses on the total sample and the age group of 65–74 demonstrated that denial and venting were inversely related to pain. Findings for the age groups 55–64 and 75–84 were non-significant. Among women age 85 or older, seeking emotional support was inversely associated with pain, while active coping was related to higher pain reports.
PMCID: PMC4265213  PMID: 21948111
coping styles; developmental processes; elderly population; ethnic minorities; pain
3.  Abbreviated Posttraumatic Stress Screen for Ethnically Diverse Older Women 
Educational gerontology  2009;35(8):732-751.
It is difficult for busy health care providers to perform routine screening for older women’s posttraumatic stress symptomatology, due, at least partially, to a paucity of instruments specifically tested on such a population. To address this issue, in this preliminarily study we tested an abbreviated screen from the set of 20 items comprising the Distressing Event Questionnaire (DEQ; Kubany, Leisen, Kaplan, & Kelly, 2000) on a convenience sample of 94 ethnically diverse older women (ages 52–105). This new 5-item derivation, named “Brief Posttraumatic Stress Screening Scale (BPSSS)”, assesses posttraumatic stress based on the Diagnostic and Statistical Manual of Mental Disorders - IV (DSM-IV; American Psychiatric Association, 1994). Its conciseness reduces the likelihood that older women would become fatigued during assessment, making it ideal for use in busy health care settings. Because the BPSSS has only five items, a single factor was hypothesized to account for a large proportion of the variance in its items, in view of the hypothesized cohesiveness of the tool’s five items. We also expected that scores on the screen would correlate (to a certain extent) with those on measures of depression and perceived stress of a non-traumatic and non-medical nature. A standardized alpha of .86 demonstrated high internal consistency of the BPSSS and the exploratory factor analysis showed that one factor accounted for 58% of the five items’ variance. Moreover, the correlations of BPSSS scores with scores on non-traumatic stress and depression were moderate yet significant (r = .37, p < .01 and r = .50, p < .01, respectively).
PMCID: PMC4231786  PMID: 25400322
instrument development; psychometrics; PTSD; stress; ethnic minorities
4.  Older Women's Sexual Desire Problems: Biopsychosocial Factors Impacting Them and Barriers to Their Clinical Assessment 
BioMed Research International  2014;2014:107217.
Sexual desire is a major component of sexuality at any age, and inhibited desire is one of the main sexual dysfunctions reported by older women. Nonetheless, in medical settings, for a variety of reasons discussed herein, its assessment—as well as the assessment of older women's sexual health in general—is typically avoided or conducted by asking a single sex question. In this paper, we have reviewed the literature (most of which is preliminary in nature) regarding the main psychosocial and health factors that could impact older women's sexual desire, as well as potential obstacles to the assessment and treatment of this geriatric sexual issue. It is certainly advisable that medical care providers who are uncomfortable discussing older women's sexual concerns be prepared to make appropriate referrals to clinicians who possess the proper training to accurately assess and treat sexual challenges (and female sexual interest problems in particular) in this neglected patient population.
PMCID: PMC4066710  PMID: 24995267
5.  Urinary Incontinence: Its Assessment and Relationship to Depression among Community-Dwelling Multiethnic Older Women 
The Scientific World Journal  2014;2014:708564.
Urinary Incontinence (UI) affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Of the various mental health problems identified in the literature as being comorbid with UI, the most notable one continues to be depression. Despite a wealth of research contributions on this topic, the available literature is underrepresentative of ethnic minority older women. Culture has been shown to have a significant impact on a woman's perception of her own UI symptoms; this demonstrates the necessity for the recruitment of ethnically and culturally diverse samples when studying UI. In the present study, we determined the prevalence of UI among 140 community-dwelling, ethnically diverse older women (28.2%), discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant. The clinical and research implications of our findings are discussed.
PMCID: PMC3984862  PMID: 24982981
6.  The validation of a new measure quantifying the social quality of life of ethnically diverse older women: two cross-sectional studies 
BMC Geriatrics  2011;11:60.
To our knowledge, the available psychometric literature does not include an instrument for the quantification of social quality of life among older women from diverse ethnic backgrounds. To address the need for a tool of this kind, we conducted two studies to assess the initial reliability and validity of a new instrument. The latter was created specifically to quantify the contribution of a) social networks and resources (e.g., family, friends, and community) as well as b) one's perceived power and respect within family and community to subjective well-being in non-clinical, ethnically diverse populations of older women.
In Study 1, we recruited a cross-sectional sample of primarily non-European-American older women (N = 220) at a variety of community locations. Participants were administered the following: a short screener for dementia; a demographic list; an initial pool of 50 items from which the final items of the new Older Women's Social Quality of Life Inventory (OWSQLI) were to be chosen (based on a statistical criterion to apply to the factor analysis findings); the Single Item Measure of Social Support (SIMSS); and the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36). Study 2 was conducted on a second independent sample of ethnically diverse older women. The same recruitment strategies, procedures, and instruments as those of Study 1 were utilized in Study 2, whose sample was comprised of 241 older women with mostly non-European-American ethnic status.
In Study 1, exploratory factor analysis of the OWSQLI obtained robust findings: the total variance explained by one single factor with the final selection of 22 items was over 44%. The OWSQLI demonstrated strong internal consistency (α = .92, p < .001), adequate criterion validity with the SIMSS (r = .33; p < .01), and (as expected) moderate concurrent validity with the MOS SF-36 for both physical (r = .21; p < .01) and mental (r = .26; p < .01) quality of life. In order to confirm the validity of the 22-item OWSQLI scale that emerged from Study 1 analyses, we replicated those analyses in Study 2, although using confirmatory factor analysis. The total variance accounted for by one factor was about 42%, again quite high and indicative of a strong single-factor solution. Study 2 data analyses yielded the same strong reliability findings (i.e., α = .92, p < .001). The 22-item OWSQLI was correlated with the SIMSS (r = .27, p < .001) in the expected direction. Finally, correlations with the MOS SF- 36 demonstrated moderate concurrent validity for physical (r = .14; p < .01) and mental (r = .18; p < .01) quality of life, as expected.
The findings of these two studies highlight the potential for our new tool to provide a valid measure of older women's social quality of life, yet they require duplication in longitudinal research. Interested clinicians should consider using the OWSQLI in their assessment battery to identify older women's areas of lower versus higher social quality of life, and should establish the maximization of patients' social quality of life as an important therapeutic goal, as this variable is significantly related to both physical and mental health.
PMCID: PMC3221620  PMID: 21982161
7.  Sexual desire among Mexican-American older women: a qualitative study 
Culture, health & sexuality  2010;12(6):705-719.
Although researchers have related sexual desire in older women to quality-of-life variables such as overall physical health, well-being, and life satisfaction, little is known about the socio-cultural mechanisms that shape sexual desire in minority ethnic older women. We investigated this sexual variable among Mexican-American older women in a qualitative fashion. Date were collected from 25 community-dwelling women of Mexican descent (aged 59–89 years) using a semi-structured interview protocol and a grounded theory approach. We inquired about dimensions of sexual desire including sexual fantasies and the desire to engage in sexual activity within the context of several socio-cultural and health-related factors. Using content analysis, we were able to identify key themes differentiating among respondents’ levels of sexual desire and fantasies. These included the availability of a suitable partner, cultural and religious norms pertinent to women’s sexuality, stigma related to sexuality in older age, and health status. Traditional socio-cultural restrictions coupled with unmarried status and physical health problems emerged as critical issues associated with limited or no sexual fantasies and desire in our sample. Many respondents indicated that their sexual needs were unmet.
PMCID: PMC2997623  PMID: 20526982
sexual health; sexual desire; older women; minority ethnic groups; USA
8.  A cross-sectional study on health and physical functioning in relation to coping strategies among community-dwelling, ethnically diverse older women 
BMC Women's Health  2010;10:10.
Although empirical evidence is available on the coping-health link in older age, research on this topic is needed with non-clinical samples of ethnically diverse older women. To contribute to filling such a research gap, we tested whether these women's general health and functional limitations were associated with specific coping strategies (selected for their particular relevance to health issues) and with known health-related demographics, i.e., age, ethnicity, income, and married status.
In this cross-sectional study, respondents were recruited at community facilities including stores and senior centers. The sample consisted of 180 community-dwelling women (age 52-98) screened for dementia; 64% of them reported having an ethnic minority status. The assessment battery contained the Mini-Cog, a demographics list, the Brief COPE, and the Medical Outcome Study 36-Item Short-Form Health Survey.
Hierarchical multiple regression analyses showed that older women who used behavioral disengagement and, to a smaller degree, self-distraction as a form of coping reported lower levels of general health. The opposite was the case for positive reframing and, to a lesser degree, substance use. Moreover, lower income was related to worse general health and (together with more advanced age) physical functioning. None of the coping strategies achieved significance in the physical functioning model.
These cross-sectional findings need corroboration by longitudinal research prior to developing related clinical interventions. Based on the initial evidence provided herein, clinicians working with this population should consider establishing the therapeutic goal of increasing the use of positive reframing while diminishing behavioral disengagement.
PMCID: PMC2876066  PMID: 20350331

Results 1-8 (8)