IU Indianapolis ScholarWorks :: Browsing by Author "Hanna, Kathleen M."

Browsing by Author "Hanna, Kathleen M."

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Alcohol Use Trajectories after High School Graduation among Emerging Adults with Type 1 Diabetes
(Elsevier, 2014-08) Hanna, Kathleen M.; Stupiansky, Nathan W.; Weaver, Michael T.; Slaven, James E.; Stump, Timothy E.; IU School of Nursing
Objective Explore alcohol involvement trajectories and associated factors during the year post-high school (HS) graduation among emerging adults with type 1 diabetes. Methods Youth (N=181) self-reported alcohol use at baseline and every 3 months for 1 year post-HS graduation. Data were also collected on parent-youth conflict, diabetes self-efficacy, major life events, living and educational situations, diabetes management, marijuana use, cigarette smoking, and glycemic control. Trajectories of alcohol use were modeled using latent class growth analysis. Associations between trajectory class and specific salient variables were examined using analysis of variance, chi square, or generalized linear mixed model, as appropriate. Results Identified alcohol involvement trajectory classes were labeled as: 1) Consistent Involvement Group (n=25, 13.8%) with stable, high use relative to other groups over the 12 months; 2) Growing Involvement Group (n=55, 30.4%) with increasing use throughout the 12 months; and 3) Minimal Involvement Group (n=101, 55.8%) with essentially no involvement until month nine. Those with minimal involvement had the best diabetes management and better diabetes self-efficacy than those with consistent involvement. In comparison to those minimally involved, those with growing involvement were more likely to live independently of parents; those consistently involved had more major life events; and both the growing and consistent involvement groups were more likely to have tried marijuana and cigarettes. Conclusions This sample of emerging adults with type 1 diabetes has 3 unique patterns of alcohol use during the first year after high school. Implication and Contribution Among youth with type 1 diabetes in the year post-HS graduation, alcohol involvement knowledge was extended by identifying patterns of such use. Further research of alcohol use patterns is needed to guide health care professionals in their assessments and researchers in testing interventions that target unique patterns.
Association of Self-Efficacy and Self-Regulation with Nutrition and Exercise Behaviors in a Community Sample of Adults
(Taylor and Francis, 2015-11) Shieh, Carol; Weaver, Michael T.; Hanna, Kathleen M.; Newsome, Kathleen; Mogos, Mulubrhan; IU School of Nursing
This study examined the association of self-efficacy and self-regulation with nutrition and exercise behaviors. The study used a cross-sectional design and included 108 participants (54 men, 54 women). Nutrition behaviors (fruit/vegetable consumption, dinner cooking, and restaurant eating) and exercise were measured using total days in last week a behavior was reported. Instruments measuring self-efficacy and self-regulation demonstrated excellent Cronbach’s alphas (.93–.95). Path analysis indicated only fruit/vegetable consumption and exercise were associated with self-efficacy and self-regulation. Self-regulation showed direct association with fruit/vegetable consumption and exercise, but self-efficacy had direct association only with exercise. Self-efficacy and self-regulation should be strategically used to promote health behaviors.
COMPARISON OF DIABETES-RELATED QUALITY OF LIFE FOR LATE ADOLESCENTS WITH TYPE 1 DIABETES USING INSULIN PUMP THERAPY VS. MULTIPLE DAILY INJECTIONS
(Office of the Vice Chancellor for Research, 2012-04-13) Woods, Jasmine; Hanna, Kathleen M.
Traditionally, multiple daily injections (MDI) have been used to manage insulin levels, while insulin pump therapy is rising as an option for treat-ment. When determining which form of insulin to use, an important outcome to consider is the adolescent’s quality of life (QOL). Studies have showed mixed results as which form of insulin therapy shows a positive effect on the adolescent’s QOL. The purpose of this study will be to examine the differ-ences in diabetes-related quality of life for late adolescents with type 1 dia-betes in relation to insulin administration (multiple daily injections versus pump therapy). Late adolescents have just been enrolled in a larger longitu-dinal study and have completed questionnaires on Diabetes Related Quality of Life (DQOL) and a question on the type of administration. T-tests will be conducted to determine mean differences in (DQOL) for late adolescents who use pump therapy and who use MDI. This study will provide information on the differences between MDI and insulin pump therapy in relation to QOL.
The Described Experience of Primary Caregivers of Children with Mental Health Needs
(2012-10) Oruche, Ukamaka M.; Gerkensmeyer, Janis; Stephen, Linda; Wheeler, Corrine A; Hanna, Kathleen M.
About 10% of our nation's children have serious mental health needs that result in significant functional impairments. Although research has found that primary caregivers of children with mental health needs have high levels of depressive symptoms and distress, little is known about the challenges these caregivers face. Focus groups with 20 caregivers of children with mental health needs between 2 and 17 years of age revealed these themes: struggling with care systems, living in fear, being burdened and exhausted, worrying about the rest of the family, and having good things happen. Caregivers described extreme challenges and many unmet needs that are important to consider in efforts to improve both children's and caregivers' well-being.
Diabetes-related quality of life and the demands and burdens of diabetes care among emerging adults with type 1 diabetes in the year after high school graduation
(Wiley Online Library, 2014-10) Hanna, Kathleen M.; Weaver, Michael T.; Fortenberry, J. Dennis; DiMeglio, Linda A.; Department of Biostatistics, School of Public Health
The roles of glycemic control, diabetes management, diabetes care responsibility, living independently of parents, and time since high school graduation in predicting diabetes-related quality of life (DQOL) were examined in 184 emerging adults with type 1 diabetes. Data were collected at graduation and 1 year later. Analyses controlling for selected covariates were completed using generalized linear mixed models. Better diabetes management was associated with more positive responses on all four dimensions of DQOL. Impact and worry of DQOL were greater in the presence of depressive symptoms, and life satisfaction was lower. DQOL life satisfaction was lower in those living independently of parents. Young women reported poorer diabetes-related health status than did young men. Time since graduation was not linked to DQOL. Further research is needed on ways to improve DQOL in conjunction with diabetes management and on ways that families can support DQOL when youth live independently.
Emerging Adults with Type 1 Diabetes during the First Year Post-High School: Perceptions of Parental Behaviors
(2014-06) Hanna, Kathleen M.; Weaver, Michael T.; Stump, Timothy E.; Guthrie, Diana; Oruche, Ukamaka M.
Among 182 emerging adults with type 1 diabetes (93% White and 57% female), changes during the year post-high school were examined in perceptions of diabetes-specific conflict with parents, parent–youth shared responsibility, parental tangible aid, and parental autonomy support, as well as the moderating effects of living situation, gender, years with diabetes, and glycemic control. A linear mixed effects model, controlling for baseline values, tested the changes in and relationships among these variables over time. Changes over time in parent–youth conflict were moderated by living independently of parents; autonomy support and shared responsibility were moderated by years with diabetes; and tangible aid was moderated by glycemic control. Future longitudinal research needs to examine whether changes in parental behaviors lead to positive or negative diabetes outcomes among these emerging adults with diabetes.
Factors Associated with Asthma Self-Management in African American Adolescents
(Elsevier, 2015-11) Crowder, Sharron J.; Hanna, Kathleen M.; Carpenter, Janet S.; Broome, Marion E.; IU School of Nursing
Few studies have focused on asthma self-management in African American adolescents, a group with high rates of the disease. This study examined factors associated with asthma self-management in 133 African Americans aged 14-16 years including gender, asthma impairment, prior asthma education, cognitive and emotional illness representations. Twenty-five percent of the variance in asthma self-management was explained by having attended an asthma education program, perceiving more asthma consequences (illness consequences), and reporting greater understanding of asthma as an illness (illness coherence). Findings suggest that these variables may be important targets of interventions to improve asthma self-management in African American middle adolescents.
Illness representations and self-management behaviors of African American adolescents with asthma
(2013-10-07) Crowder, Sharron Johnson; Hanna, Kathleen M.; Broome, Marion; Mays, Rose M.; Pike, Lynn M.; Swigonski, Nancy L.
African American adolescents have inadequate self-management behaviors, particularly during middle adolescence (14-16 years of age). Inaccurate beliefs, degree of asthma impairment (well controlled or not well controlled), and gender could influence asthma self-management (symptom management, medication management, and environmental control). The researcher used the illness representations concept from the common sense self-regulation model as the framework for this study. The descriptive correlational study explored (1) differences in illness representations (cognitive and emotional) and self-management behaviors by gender, asthma impairment, and gender by asthma impairment of African American adolescents with asthma; and (2) relationships between illness representations and asthma self-management behaviors, gender, and asthma impairment in 133 African American adolescents with asthma. Data were collected using the Asthma Control Test, the Illness Perceptions Questionnaire-Revised, and the Asthma Self-Care Practice Instrument. Data were analyzed using ANOVA, MANOVA, Pearson correlations, and multiple regressions. Findings indicated that females whose asthma was not well controlled had more beliefs about the chronicity of their asthma than those who were well controlled. However, there were no differences in such beliefs among males whose asthma was not well controlled from those who were well controlled. Well controlled adolescents differed from not well controlled adolescents for cognitive representations of cyclic timeline, treatment control, psychological attributes, and consequences as well as for emotional representations. There were no significant differences in the means of the self-management behaviors by gender, by asthma impairment, or by gender by asthma impairment. A significant bivariate relationship was found between representations of identity, consequences, treatment control, and symptom management. In the multiple regression model, representations of treatment control and consequences contributed to variances in symptom management; however, no other representations, gender, or asthma impairment variables were statistically significant. The representations, gender, and asthma impairment variables did not contribute to variances in medication management or environmental control. Limited studies have been conducted with African American adolescents with asthma; therefore, the findings will contribute information to the literature on their illness representations and self-management behaviors. The findings also contribute to the literature information based on adolescents' genders and levels of asthma impairment.
The Relationship of Worry About Hypoglycemia With Diabetes-specific and Typical Youth Behavior Among Emerging Adults With Type 1 Diabetes
(Sage Publications, 2014-03-27) Hanna, Kathleen M.; Weaver, Michael T.; Stump, Timothy E.; Fortenberry, J. Dennis; DiMeglio, Linda A.; IU School of Nursing
PURPOSE: Little is known about the relationship of worry about hypoglycemia with diabetes-specific and typical youth behaviors among emerging adults with type 1 diabetes. This study's purpose was to examine the relationship among worry about hypoglycemia, diabetes management, and glycemic control within the context of alcohol use, hypoglycemia-related weight control behaviors, depressive symptoms, and impulse control among emerging adults with type 1 diabetes. RESEARCH DESIGN AND METHODS: The sample was 181 emerging adults with type 1 diabetes who were part of a larger study. Path analysis was used to test associations among worry about hypoglycemia, diabetes management, hypoglycemia-related weight control behaviors (WCB), alcohol use, impulse control, depressive symptoms, and glycemic control. RESULTS: Path model fit and modification indices suggested that a feedback loop between worry about hypoglycemia and diabetes management should be incorporated into the original model. Youth with fewer depressive symptoms reported fewer hypoglycemia-related WCB and less worry about hypoglycemia; those with higher impulse control had less alcohol use and better diabetes management; those with lower alcohol use had more worry about hypoglycemia; and better glycemic control was associated with better diabetes management. CONCLUSIONS: Health care professionals need to understand how multiple factors related to worry about hypoglycemia and diabetes management interact in emerging adults. In the context of depressive symptoms, impulse control, alcohol use, and hypoglycemia-related WCB, the path model results suggest several potential avenues for intervening to improve glycemic control in emerging adults.
Retention strategies in longitudinal studies with emerging adults
(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2014-01) Hanna, Kathleen M.; Scott, Linda L.; Schmidt, Karen K.; IU School of Nursing
PURPOSE/OBJECTIVES: The purpose of this report was to describe retention strategies that were useful and those that were not in a longitudinal study of emerging adults. BACKGROUND: A longitudinal study examining the transition to young adulthood among emerging adults with type 1 diabetes, which had success in retention, provided the context for describing retention strategies. RATIONALE: A challenge in longitudinally designed studies is retention of participants because the loss decreases power for statistical analysis. Given that emerging adulthood is a period of instability, retention is particularly challenging among this population. However, longitudinal studies are the best way to understand developmental changes, and it is also important to increase our knowledge of health outcomes during emerging adulthood. DESCRIPTION: Retention strategies used in the study are described, including promoting a positive relationship with participants, maintaining contact with participants, having a study staff with good interpersonal skills, using incentives, conveying respect for participants, and using user-friendly data collection. OUTCOMES: Useful strategies to promote a positive relationship included sending cards and newsletters to participants, maintaining consistency of contact person, and expressing appreciation for participant's time and effort. Useful strategies for maintaining contact with participants included obtaining contact information at every data collection point, maintaining birth dates and chart numbers in tracking databases, monitoring returned mail, and using Web search engines. Other useful strategies were providing incentives to participants, employing staff with good interpersonal skills, providing participants with choices when appropriate, and using user-friendly data collection. One strategy, using contests, was not found useful. CONCLUSIONS: Despite the challenges of conducting longitudinally designed studies with emerging adults, multiple retention strategies can be used that are useful to retention. IMPLICATIONS: It is feasible to conduct longitudinal studies with emerging adults despite the challenges.

Browsing by Author "Hanna, Kathleen M."

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