BACKGROUND:Missingness in randomized controlled trials (RCTs) might mask or inflate effects with consequences for translating results confidently. The current study presents three steps to establishing confidence in results in light of missing data using an RCT examining the preventive potential of computerized cognitive training for the onset of dementia. METHODS:Participants (n = 2832) consented to complete a computerized cognitive training study and ranged in age from 65 to 94 years (M = 73.33; SD = 5.74). Variables related to baseline demographic, physical, cognitive, and psychological functioning were examined as predictors of missingness to identify auxiliary variables. Secondary data analysis was conducted using data from the Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE). Confidence in the sustained impact of the intervention group was examined using two types of MNAR models (i.e., selection and pattern mixture modeling frameworks). RESULTS:Using auxiliary variables, there were slight changes in the pattern of results of the cognitive training intervention, suggesting that missing data was contributing to slight increases and decreases in model estimates, but not creating major changes in the interpretation of the trial. The analysis under MNAR models did not suggest any systemic bias in the study outcomes due to missing data but highlighted potential differences in those with complete data compared to those with incomplete data. CONCLUSIONS:The current study demonstrates how to expand examination of missingness and triangulate multiple methods for investigating bias under MAR and MNAR. It is recommended that the checklist for reporting for randomized controlled trials (i.e., CONSORT-ROUTINE) be amended to reflect specificity for requirements necessary for missingness.

IntroductionThough Black Americans are twice as likely as White Americans to be diagnosed with Alzheimer's Disease, they may be excluded from the mental representation of a person with dementia.MethodsParticipants (N = 143, median age = 19) created visualized mental representations of a person, a man, a woman, a Black man, or a Black woman diagnosed with dementia by repeatedly selecting which among 12 faces looked most like each target category.ResultsThe visualized representation of a person with dementia was more similar to the representation of a man and a Black woman than to a Black man and a woman, respectively.DiscussionThese findings highlight how intersectionality shapes mental representations of dementia, revealing that certain combinations of marginalized identities are perceived differently rather than excluded entirely.

Background and Objectives Participants' motivations may explain why they participate in Alzheimer's disease and related dementias (ADRD) research. Drawing on the Activator, Motivator, Outside mediator, Re-enforcer (AMOR) model of research engagement, this article utilized a mixed methods design to (a) explore participants' reasons for participating and, in some cases, withdrawing from computerized cognitive training studies and (b) connect these reasons to study retention.Research Design and Methods Our convenience sample included community-dwelling adults (N = 423) between 55 and 88 years (M = 67.45, SD = 7.22) from two randomized controlled trials involving computerized cognitive training (Everyday Function Intervention Trial, NCT04651582; Elucidating the Necessary Active Components of Training, NCT05366023). The authors analyzed participants' reasons for participating (shared via written responses) and, when relevant, stated reasons for withdrawing (ascertained via study personnel's notes in participant files) using inductive coding then theoretically informed pattern coding. Associations between reasons for participation and study retention were examined using chi-square tests and logistic regression.Results Primary reasons for participating in research included activating and motivating factors; reasons for withdrawing included outside contextual factors and re-enforcers. Re-enforcers were particularly relevant for withdrawals during the cognitive training phase. Participation reasons were not associated with reasons for, nor likelihood of, withdrawal.Discussion and Implications Findings support an adapted version of the AMOR model for explaining research engagement. Reasons for participating in and withdrawing from trials for computerized cognitive training are nuanced with participants considering multiple factors in their decisions. Applying models of research engagement is critical for identifying and refining recruitment and retention efforts.

Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children (Mage = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Family mealtimes are associated with benefits for children, including healthy eating, fewer behavior problems, and healthy psychological well-being. However, the interactions during family mealtimes, and the parent and child characteristics, which may affect both the family mealtime environment and the associated benefits in children are not fully understood. The goal of this study was to examine the role of child and parent characteristics on the family mealtime environment. We tested several mediation models to explain how child temperament (negative affectivity), parent stress, and the dimensions of parent feeding style (responsiveness and demandingness) interact and influence each other to impact the structure and quality of the mealtime environment. Parents (68 mothers; 82 fathers) of children between 2 and 6 years completed an online survey. Measures included the Children's Behavior Questionnaire, Perceived Stress Scale, Caregiver's Feeding Styles Questionnaire, and The Meals in Our Household Questionnaire. Child negative affectivity was associated with poorer mealtime quality and structure. These associations were mediated through parent responsiveness, but not demandingness. The role of demandingness in family mealtimes may depend on parent responsiveness. When examined together in a serial mediation model, child negative affectivity increased parent stress, which reduced responsiveness, and led to poorer mealtime quality and structure. These results emphasize the complex relationships between child temperament, parent stress, and the dimensions of parenting styles that occur within the mealtime context. This line of research is essential for understanding family mealtime dynamics and informing future studies aimed at creating positive interactions between parents and children during mealtimes.

Abstract 6.5 million Americans aged 65 and older are currently living with Alzheimer’s disease or related dementias (ADRD; Alzheimer’s Association, 2022). By 2060, it is estimated that this number will increase to 13.9 million (Matthews et al., 2018). Therefore, it is imperative to gain insight into participants’ personal motivations and expectations of research to advance community participation. The Preventing Alzheimer’s with Cognitive Training (PACT) study is a National Institute of Health, National Institute on Aging-funded, multi-site clinical trial examining the prevention of mild cognitive impairment and ADRD through computer-based cognitive training. Across 5 locations, data were collected from 2,360 cognitively normal participants (M=73.03 years, range=65–97, SD=5.04). The current project explores individuals’ motivations and expectations of cognitive training (CT) utilizing a mixed-method approach by coding qualitative open-ended questions about motivation to participate and comparing how motivational themes aligned with expectations about CT from the Expectations Assessment Scale (EAS; Rabipour et al., 2018). Six themes for participant motivation emerged: direct experience with the disease (26.9%), concern about brain health and aging (23.9%), general personal interest (17.9%), general interest in research (20.1%), referral to the study (5.8%), and altruism (5.4%). After completing the initial training session, motivation themes did not differentiate satisfaction with (p=.06) or perceived success of (p=.11) the CT program. Understanding participants’ motivations can further expand and optimize recruitment and retention strategies in AD prevention research. Future research will focus on how these themes influence adherence and retention and relate to participant demographic characteristics (i.e., education, gender, race, and ethnicity).

The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these lowincome samples, on average, were heavier than their same-aged peers across all parent feeding styles.

Background: To address the rising prevalence of Alzheimer's disease and related dementias, effective interventions that can be widely disseminated are warranted. The Preventing Alzheimer's with Cognitive Training study (PACT) investigates a commercially available computerized cognitive training program targeting improved Useful Field of View Training (UFOVT) performance. The primary goal is to test the effectiveness of UFOVT to reduce incidence of clinically defined mild cognitive impairment (MCI) or dementia with a secondary objective to examine if effects are moderated by plasma beta-amyloid level or apolipoprotein E e4 (APOE e4) allele status. Methods/design: This multisite study utilizes a randomized, controlled experimental design with blinded assessors and investigators. Individuals who are 65 years of age and older are recruited from the community. Eligible participants who demonstrate intact cognitive status (Montreal Cognitive Assessment score > 25) are randomized and asked to complete 45 sessions of either a commercially available computerized-cognitive training program (UFOVT) or computerized games across 2.5 years. After three years, participants are screened for cognitive decline. For those demonstrating decline or who are part of a random subsample, a comprehensive neuropsychological assessment is completed. Those who perform below a pre-specified level are asked to complete a clinical evaluation, including an MRI, to ascertain clinical diagnosis of normal cognition, MCI, or dementia. Participants are asked to provide blood samples for analyses of Alzheimer's disease related biomarkers. Discussion: The PACT study addresses the rapidly increasing prevalence of dementia. Computerized cognitive training may provide a non-pharmaceutical option for reducing incidence of MCI or dementia to improve public health.

Objectives: The current study investigates the differential coping strategies and mental health consequences of food insecurity in relation to period of the lifespan (middle vs. late adulthood) and household composition (living with vs. without children).Method: Using a cross-sectional design, food-related coping strategies, anxiety (GAD-7), and depression (WHO-5) were compared among the following groups: middle adults with vs. without children, and middle adults without children vs. late adults without children. Predictive models using hierarchical linear regression examined the main effects of age and household composition with food insecurity predicting mental health; additionally, the interaction of food insecurity with age and household composition was tested in a separate model.Results: Middle-adults with and without children share similar frequencies in levels of food insecurity and coping strategies, which were significantly higher than late adults.Conclusion: The link between food insecurity and depression was stronger for middle-adults without children than late adults. Food insecurity was a stronger predictor of anxiety for middle-adults with children than those without.

For decades, researchers across disciplines in the social and health sciences have sought to create theories of health behavior change that can be used to promote healthful change and inform intervention design and implementation. And although theory and research have made great progress in elucidating the predictors and processes affecting positive changes in health behavior, many challenges remain. This entry begins with a discussion of prominent and influential theories of health behavior change, analyzing continuum models (i.e., models that specify predictors of behavior that do not vary by person and situation) and stage models (i.e., models that specify that people move sequentially through stages and that predictors of change vary depending on stage). It concludes with a discussion of challenges to health behavior change and promising new directions.

Despite the demonstrated benefits of computerized cognitive training for older adults, little is known about the determinants of training behavior. We developed and tested scales to quantify expectations about such training, examine whether expectations predicted training adherence, and explore if training expectations changed from pre- to post-training. Participants (N=219) were healthy older adults aged 55-96 years (M=75.36, SD=9.39), enrolled in four studies investigating Dakim, Insight, or Posit Science Brain Fitness computerized cognitive training programs. Instruments were adapted from existing health behavior scales: Self Efficacy for Cognitive Training, Outcome Expectations for Cognitive Training, Perceived Susceptibility to Cognitive Decline, Dementia or Alzheimer's Disease, and Perceived Severity of Cognitive Decline, Dementia or Alzheimer's Disease. Participants completed scales at baseline (N=219) and post-training (n=173). Eight composites were derived from factor analyses. Adherence rates were high (M=81%), but none of the composites predicted training adherence. There was an overall significant effect of time, Wilks' λ=.843, F(8, 114)=2.65, p=.010, partial η 2 =.157, a significant overall effect of training group, Wilks' λ=.770, F(16, 228)=1.99, p=.015, partial η 2 =.123, and an overall significant group x time interaction, Wilks' λ=.728, F(16, 226)=2.44, p=.002, partial η 2 =.147. Significant effects of time were found for expected psychological outcomes and self-efficacy. Post-training, participants more strongly agreed that training was enjoyable and increased their sense of accomplishment. Changes in self-efficacy for cognitive training varied by program, improvingfor Dakim- and declining for the more challenging Brain Fitness- and InSight participants. These newly devised scales may be useful for examining cognitive training behaviors. However, more work is needed to understand factors that influence older adults' enrollment in and adherence to cognitive training.

Community-based learning (CBL) is a pedagogical practice that encompasses a number of educational practices including student volunteerism, experiential learning, service-learning and community-engaged coursework for academic credit. Community-based learning models also have incorporated problem-based service learning, direct service learning, and community-based research. In this chapter, we posit that for students to have meaningful experiences at university, the CBL experiences should have transformational components integrated into the community-based activities. Three different student experiences are examined, and we pose the question of how much of an impact CBL has on the transformational experiences of student learning.

Introduction: In 2012, the Center for Disease Control announced children's blood lead levels (BLLs) above 5 g/dL should be provided assistance, as no level of lead exposure is safe.Method: A community-based randomized controlled trial targeting children from low-income families (BLLs: 3-9.9 g/dL) was implemented utilizing educational and environmental tactics.Results: All groups evidenced a significant decrease in children's BLLs and a significant increase in lead knowledge, but no main effects based on group assignment. When compared to a post-hoc passive control group, all intervention groups evidenced significant BLL reduction.Discussion: Findings are discussed in terms of low-cost primary prevention initiatives and mechanisms explaining intervention efficacy.

Background: Indoor environmental contaminants (ECs) are prevalent and have dire consequences to children’s development, especially for children under six. To optimize the efficacy of programs aiming to prevent exposure to ECs, it is necessary to investigate parental factors that influence behavioral change. The current study presents a measure developed to assess parental self-efficacy for preventing children from being exposed to ECs, the Parental Self-efficacy for Contaminant Exposure Prevention (PS-CEP). Method: The PS-CEP was administered to parents of children under six drawn from a low-income preschool (n=206) and an on-line polling website (n=377). An exploratory factor analysis was conducted, convergent and discriminant validity was assessed, and the relation of the measure to demographic and parenting characteristics were examined. Results: Based on model fit indices, a four-factor model was the best fit. Factors represented confidence in prevention using cleaning, medical care, children’s physical environment, and meal time. All factors of the PS-CEP demonstrated good reliability and construct validity and were related to more optimal parenting characteristics. Conclusion: A measure of this type will allow interventions to be tailored based on parents’ self-efficacy to more appropriately support them in taking steps to create healthier environments for their children.

OBJECTIVE:To investigate whether preschoolers are able to identify and categorize foods, and whether their ability to classify food as healthy predicts their hypothetical food choice.DESIGN:Structured interviews and body measurements with preschoolers, and teacher reports of classroom performance.SETTING:Six Head Start centers in a large southeastern region.PARTICIPANTS:A total of 235 preschoolers (mean age [SD], 4.73 [0.63] years; 45.4% girls).INTERVENTION(S):Teachers implemented a nutrition education intervention across the 2014-2015 school year in which children were taught to identify and categorize food as sometimes (ie, unhealthy) and anytime (ie, healthy).MAIN OUTCOME MEASURES:Preschooler responses to a hypothetical snack naming, classifying, and selection scenario.ANALYSIS:Hierarchical regression analyses to examine predictors of child hypothetical food selection.RESULTS:While controlling for child characteristics and cognitive functioning, preschoolers who were better at categorizing food as healthy or unhealthy were more likely to say they would choose the healthy food. Low-contrast food pairs in which food had to be classified based on multiple dimensions were outside the cognitive abilities of the preschoolers.CONCLUSIONS AND IMPLICATIONS:Nutrition interventions may be more effective in helping children make healthy food choices if developmental limitations in preschoolers' abilities to categorize food is addressed in their curriculum. Classification of food into evaluative categories is challenging for this age group. Categorizing on multiple dimensions is difficult, and dichotomous labeling of food as good or bad is not always accurate in directing children toward making food choices. Future research could evaluate further preschoolers' developmental potential for food categorization and nutrition decision making and consider factors that influence healthy food choices at both snack and mealtime.

Inherent in applied developmental sciences is the threat to validity and generalizability due to missing data as a result of participant drop-out. The current paper provides an overview of how attrition should be reported, which tests can examine the potential of bias due to attrition (e.g., t-tests, logistic regression, Little's MCAR test, sensitivity analysis), and how it is best corrected through modern missing data analyses. To amend this discussion of best practices in managing and reporting attrition, an assessment of how developmental sciences currently handle attrition was conducted. Longitudinal studies ( n = 541) published from 2009–2012 in major developmental journals were reviewed for attrition reporting practices and how authors handled missing data based on recommendations in the Publication Manual of the American Psychological Association (APA, 2010). Results suggest attrition reporting is not following APA recommendations, quality of reporting did not improve since the APA publication, and a low proportion of authors provided sufficient information to convey that data properly met the MAR assumption. An example based on simulated data demonstrates bias that may result from various missing data mechanisms in longitudinal data, the utility of auxiliary variables for the MAR assumption, and the need for viewing missingness along a continuum from MAR to MNAR.

The current study presents a brief-version of an existing Community-Service Attitudes Scale (CSAS; Shiarella, McCarthy, & Tucker, 2000) that is theoretically-grounded, psychometrically-sound, and empirically validated. Students ( n = 544) participating in courses which required a service-learning component were administered the original CSAS and validation measures. An exploratory factor analysis suggested an 8-factor, 24 item solution with simple structure and good fit-indices; a confirmatory factor analysis suggested good model fit, good internal consistency, and construct validity.