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Kilmer G, Omura JD, Bouldin ED, Walker J, Spears K, Gore J, Ali AR, McGuire LC. Changes in Health Indicators Among Caregivers - United States, 2015-2016 to 2021-2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:740-746. [PMID: 39207933 PMCID: PMC11361412 DOI: 10.15585/mmwr.mm7334a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Caregivers provide support to persons who might otherwise require placement in long-term care facilities. Approximately one in five U.S. adults provides care to family members or friends who have a chronic health condition or disability. Promoting the well-being of this large segment of the population is a public health priority as recognized by the 2022 National Strategy to Support Family Caregivers. Although negative associations between caregiving and caregiver health are known, changes in the health status of caregivers over time are not. Data from the 2015-2016 and 2021-2022 Behavioral Risk Factor Surveillance System were analyzed to compare changes in the prevalence of 19 health indicators among cross-sectional samples of caregivers and noncaregivers at different time points. Caregivers experienced improvements in prevalence of four health indicators, whereas six worsened. Some health indicators, such as cigarette smoking, improved for both caregivers and noncaregivers, although smoking prevalence remained higher for caregivers (16.6% versus 11.7%). Prevalence of lifetime depression increased for both groups and remained higher among caregivers (25.6%) than among noncaregivers (18.6%). During 2021-2022, age-adjusted estimates for caregivers were unfavorable for 13 of the 19 health indicators when compared with noncaregivers. Strategies for supporting caregivers are available, and integrating these with existing programs to address mental health and chronic diseases among this population might improve caregiver well-being. For example, many community organizations support caregivers by offering interventions designed to relieve caregiver strain, including skills training, support groups, and care coordination.
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Kuharic M, Mulhern B, Sharp LK, Turpin RS, Pickard AS. Comparison of the EQ-HWB and EQ-HWB-S With Other Preference-Based Measures Among United States Informal Caregivers. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:967-977. [PMID: 38492925 DOI: 10.1016/j.jval.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/14/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Several measures have been used or developed to capture the health and well-being of caregivers, including the EQ Health and Well-being (EQ-HWB) and its short form, EQ-HWB-S. This study aimed to evaluate the psychometric properties and construct validity of the EQ-HWB/EQ-HWB-S in a US caregiver population. METHODS A cross-sectional survey was conducted involving 504 caregivers. Eligible participants were 18+ years old, provided unpaid care to a relative/friend aged 18+ in the past 6 months, and spent on average of at least 1 hour per week caregiving. Survey included the following measures: EQ-HWB, Adult Social Care Outcomes Toolkit for Carers-Carer, CarerQol, and EQ-5D-5L. Psychometric properties were assessed using response distributions, floor/ceiling effects, Spearman's correlation for convergent validity, and effect sizes (ES) for known-group validity based on caregiving situations and intensity. RESULTS The average age of caregivers was 49.2 (SD = 15.4), with 57.5% being female. More than half (54.4%) reported high caregiving intensity, and 68.3% lived with the care recipient. The EQ-HWB-S index showed a strong positive correlation with the EQ-5D-5L (rs = 0.72), Adult Social Care Outcomes Toolkit for Carers (rs = 0.54), and CarerQol (rs = 0.54) indices. Notably, the EQ-HWB-S index showed the largest ES among measures in differentiating caregiving scenarios with a large ES for caregiver's general health (d = 1.00) and small ES for caregiving intensity (d = 0.39). CONCLUSIONS Results support construct validity of EQ-HWB and EQ-HWB-S as measures for assessing health and well-being of adult informal caregivers in comparison with other validated instruments. Differing levels of known-group validity across anchors emphasize the importance of selecting appropriate measures for caregivers, depending on research question and/or intervention aims.
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Affiliation(s)
- Maja Kuharic
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Lisa K Sharp
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - A Simon Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, USA
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Lee S, Ory MG, Vollmer Dahlke D, Smith ML. Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study. JMIR Aging 2024; 7:e50759. [PMID: 38717339 PMCID: PMC11084119 DOI: 10.2196/50759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 02/18/2024] [Accepted: 02/18/2024] [Indexed: 05/12/2024] Open
Abstract
Background Informal caregivers are called upon to provide substantial care, but more needs to be known about technology use among older adult and caregiver dyads. Objective This study described technology use among older adults and their caregivers, explored potential correlates of technology use, and highlighted implications for practice. Methods A cross-sectional survey was conducted among unpaid caregivers of older adults (n=486). Primary outcomes were self-reported technology (devices and functions) use among caregivers and their oldest care recipient. The concordance of technology use among caregivers and care recipients was also examined. Multivariable regression models were conducted separately for caregivers and care recipients. Results Greater proportions of caregivers used all examined technologies, except for the medication alerts or tracking function, than care recipients. Caregivers used an average of 3.4 devices and 4.2 functions, compared to 1.8 devices and 1.6 functions used by their care recipients. Among caregivers, younger age, higher income, and higher education were associated with more technology use (P<.05). Among care recipients, younger age, not having cognitive dysfunction, and caregiver's technology use were associated with more technology use (P<.05). Conclusions Understanding technology use patterns and device adoption across diverse caregiver and care recipient populations is increasingly important for enhancing geriatric care. Findings can guide recommendations about appropriate technology interventions and help providers communicate and share information more effectively with patients and their caregivers.
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Affiliation(s)
- Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Marcia G Ory
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX, United States
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
| | - Deborah Vollmer Dahlke
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
- DVD Associates, LLC, Austin, TX, United States
| | - Matthew Lee Smith
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
- Department of Health Behavior, Texas A&M University, College Station, TX, United States
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Hwang W, Cheng KJ, Brown MT, Silverstein M. Stability and change of religiosity among baby boomers in adulthood: Associations with familism over time. ADVANCES IN LIFE COURSE RESEARCH 2023; 56:100542. [PMID: 38054882 PMCID: PMC10906812 DOI: 10.1016/j.alcr.2023.100542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 12/07/2023]
Abstract
While it is commonly understood that familism is influenced by religiosity, less is known about how religiosity between young adulthood and midlife is related to the trajectory of familism from midlife over the later life course. In this study, we identified a multidimensional typology of religiosity among baby boomers in young adulthood and midlife, explored how membership in this religious typology changed from young adulthood to midlife, and examined how transition patterns of religiosity were associated with familism over time. We used data from a sample of 471 baby boomers (mean age 19 years in 1971) from the Longitudinal Study of Generations (LSOG), Wave-1 (1971) through Wave-8 (2005). Using latent class and latent transition analysis, we identified three latent religiosity classes in Wave-1 (1971) and Wave-3 (1988): strongly religious, weakly religious, and privately religious, and identified nine transition patterns of religiosity from you between these waves from young adulthood to midlife. Using latent growth curve analysis (Wave-3 to Wave-8), we found that respondents who remained strongly or privately religious or whose religiosity increased had higher initial levels of familism (Wave-3) compared to those who stayed in the weakly religious class. However, the gap in familism across religiosity transition patterns decreased over time up to late middle age. Our findings indicate that while religiosity was positively associated with familism, its impact weakened over time possibly due to change in the centrality of family life and societal factors.
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Affiliation(s)
- Woosang Hwang
- Department of Human Development and Family Sciences, Texas Tech University, United States.
| | - Kent Jason Cheng
- Social Science Ph.D. Program, Syracuse University, United States
| | - Maria T Brown
- School of Social Work, Syracuse University, United States; Aging Studies Institute, Syracuse University, United States
| | - Merril Silverstein
- Department of Sociology, Syracuse University, United States; Department of Human Development and Family Science, Syracuse University, United States; Aging Studies Institute, Syracuse University, United States
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Luo T, Kostandini G. Omnibus or Ominous immigration laws? Immigration policy and mental health of the Hispanic population. HEALTH ECONOMICS 2023; 32:90-106. [PMID: 36127812 DOI: 10.1002/hec.4611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 07/22/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
This study examines the impact of Omnibus Immigration Laws on the mental health of the Hispanic populations in the U.S. We use a Difference-in-Differences framework and data from the Behavioral Risk Factor Surveillance System Survey of Centers for Disease Control and Prevention for the 2000-2016 period that contains information on more than 400 thousand Hispanics residing in the U.S. We find that the most stringent provision, namely, "show me your papers" laws, adversely affects the mental health of Hispanics and contributes to an increase of 12%-16% in the number of unhealthy mental days and an increase of 13%-18% in the probability of having frequent mental distress in the states with "show me your papers" laws. OIL provisions that enforced the use of E-Verify or limited the use of public benefits to unauthorized immigrants did not have any effect on mental health. The study also examines (1) police stops, (2) physical health, insurance, and employment status, (3) co-ethnic density, and (4) immigration enforcement awareness as potential mechanisms that could lead to a deterioration in the mental health of Hispanics. The evidence indicates their vulnerability to strict immigration enforcement. The social and public health cost should be carefully evaluated when formulating and implementing immigration policies.
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Jackson EM, Omura JD, Boring MA, Odom EL, Foster AL, Olivari BS, McGuire LC, Croft JB. Prevalence and Characteristics of Arthritis Among Caregivers — 17 States, 2017 and 2019. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1389-1395. [PMID: 36327155 PMCID: PMC9639441 DOI: 10.15585/mmwr.mm7144a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Greaney ML, Kunicki ZJ, Drohan MM, Nash CC, Cohen SA. Sleep Quality Among Informal Caregivers During the COVID-19 Pandemic: A Cross-Sectional Study. Gerontol Geriatr Med 2022; 8:23337214211057387. [PMID: 35024381 PMCID: PMC8744195 DOI: 10.1177/23337214211057387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/12/2021] [Indexed: 12/25/2022] Open
Abstract
Sleep is an integral component of health. The impact of the COVID-19 pandemic on sleep quality among informal caregivers, individuals who provide unpaid care or assistance to family members or friends, assisting older adults is not well understood. Therefore, informal caregivers in the United States providing care for individuals aged 50+ were recruited via Amazon's Mechanical Turk, an online platform for enrolling study participants into social and behavioral science research, to complete an online survey. The sample of informal caregivers (n = 835) was 69% male and 55% non-Hispanic. Multivariable linear regression models were constructed to assess the associations between sleep disturbance scores (SDS) and sleep-related impairment scores (SIS) and caregiving-related measures (hours caregiving/week, length of time spent caregiving, and caregiver burden), demographics, and region of the United States. The analysis determined that Black (β = 2.6, 95% CI [-4.3, -0.9]) and Asian informal caregivers (β = -1.8, 95% CI [-3.4, -0.3]) had lower mean SIS than White caregivers, the referent group. In addition, increasing caregiver burden was associated with increased SDS (β = 0.8, 95% CI [0.6, 1.0]) and SIS (β = 1.3, 95% CI [0.7, 1.6]). In conclusion, higher caregiver burden was associated with higher SIS and SDS, suggesting that informal caregivers' sleep should be assessed, and when needed interventions should be offered.
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Affiliation(s)
- Mary L. Greaney
- Department of Health Studies, University of Rhode Island, Kingston, RI, USA
| | - Zachary J. Kunicki
- Department of Psychiatry and Human
Behavior, Warren Alpert Medical School of Brown
University, Providence, RI, USA
| | - Meghan M. Drohan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Caitlin C. Nash
- Department of Health Studies, University of Rhode Island, Kingston, RI, USA
| | - Steven A. Cohen
- Department of Health Studies, University of Rhode Island, Kingston, RI, USA
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Jeffers EM, Bouldin ED, McGuire LC, Knapp KA, Patel R, Guglielmo D, Taylor CA, Croft JB. Prevalence and Characteristics of Subjective Cognitive Decline Among Unpaid Caregivers Aged ≥45 Years - 22 States, 2015-2019. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1591-1596. [PMID: 34793418 PMCID: PMC8601410 DOI: 10.15585/mmwr.mm7046a1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Miyawaki CE, Bouldin ED, Taylor CA, McGuire LC. Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9694. [PMID: 34574619 PMCID: PMC8467135 DOI: 10.3390/ijerph18189694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 11/29/2022]
Abstract
One in four Baby Boomers fills the informal caregiver role in the United States. The objectives of this study were to estimate the prevalence of Baby Boomers who are informal caregivers for people living with dementia and compare their physical and mental health status to caregivers for persons with conditions other than dementia using 2015-2018 Behavioral Risk Factor Surveillance System data (N = 10,602). We identified caregiving status (assisting a family member/friend with a long-term illness or disability in the past month, managing personal care, and not caring for a child/grandchild) and whether the care recipient's major health condition was dementia. We calculated weighted estimates and used chi-square tests and log-binomial regression for comparisons of selected characteristics. Among Baby Boomer caregivers, 15.4% were caring for someone with dementia. Dementia caregivers were more likely to be female, caring for a parent/parent-in-law, and providing care longer than caregivers for persons without dementia. After adjusting for sociodemographic and caregiving characteristics, the prevalence of fair/poor health, frequent mental distress, and chronic conditions were similar across types of caregivers. Although no differences in caregiver's physical and mental health by care recipient's dementia status were found, we should underscore the importance of maintaining Baby Boomer caregivers' health and well-being.
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Affiliation(s)
- Christina E. Miyawaki
- Graduate College of Social Work, University of Houston, 3511 Cullen Boulevard, Room 110HA, Houston, TX 77204-4013, USA
| | - Erin D. Bouldin
- Department of Health & Exercise Science, Appalachian State University, 1179 State Farm Rd, Suite 432, P.O. Box 32071, Boone, NC 28608, USA;
- Alzheimer’s Disease & Healthy Aging Program, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, USA; (C.A.T.); (L.C.M.)
| | - Christopher A. Taylor
- Alzheimer’s Disease & Healthy Aging Program, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, USA; (C.A.T.); (L.C.M.)
| | - Lisa C. McGuire
- Alzheimer’s Disease & Healthy Aging Program, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, USA; (C.A.T.); (L.C.M.)
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Muruthi JR, Green A, Ehlinger PP, Osa ML, Yang D. Sociodemographic, Health, and Caregiving Patterns of Aging Caregivers in Oregon: Gender Comparisons and the Role of Leisure Activities. Int J Aging Hum Dev 2021; 94:362-382. [PMID: 34514858 DOI: 10.1177/00914150211040458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent studies have projected an increase in aging informal caregivers who are often dealing with their frailty. However, little is known about their health, caregiving factors, or coping resources that promote health. Informed by lifespan perspective and health behavior models, this study examined the gender differences in health and caregiving profiles of aging informal caregivers and investigated the association between leisure activity and unhealthy days. A sample of 565 informal caregivers (>50 years) was drawn from the Oregon version of the 2017 Behavioral Risk Factor Surveillance System. Descriptive analyses revealed that the caregivers were mainly women between 60 and 69, White non-Hispanic, married, college graduates, retired and healthinsured. Negative binomial regression showed that leisure activities were related to fewer odds of reporting unhealthy days for most comparison scenarios. Findings emphasize the importance of accounting for group differences and similarities in understanding health and caregiving factors among informal caregivers.
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Affiliation(s)
- James R Muruthi
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Aubrey Green
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Peter P Ehlinger
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Maggie L Osa
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Di Yang
- Department of Education Studies, University of Oregon, Eugene, USA
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Greaney ML, Kunicki ZJ, Drohan MM, Ward-Ritacco CL, Riebe D, Cohen SA. Self-reported changes in physical activity, sedentary behavior, and screen time among informal caregivers during the COVID-19 pandemic. BMC Public Health 2021; 21:1292. [PMID: 34215246 PMCID: PMC8252978 DOI: 10.1186/s12889-021-11294-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/14/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Informal caregivers providing unpaid assistance may be vulnerable to changes in health behaviors due to modifications in caregiving during the COVID-19 pandemic. Therefore, this cross-sectional study explored self-reported changes in physical activity (PA), sedentary behavior, and screen time among informal caregivers providing care for older adults aged 50+ during the pandemic. METHODS Study participants were recruited via Amazon's Mechanical Turk and reported their perceived changes (increased a lot, increased a little, remained the same, decreased a little, decreased a lot) in moderate-intensity PA (MPA), vigorous-intensity PA (VPA), sedentary behavior, and screen time (weekday and weekend) during the pandemic. For analytic purposes, response categories were categorized into three-level ordinal variables-increased (increased a lot, increased a little), no change (remained the same), decreased (decreased a little, decreased a lot). Multinomial logistic regression models assessed the likelihood of changes (vs. no change) in MPA, VPA, sedentary behavior, and screen time (weekday, weekend) based on caregiving and demographic characteristics. RESULTS In total, 2574 individuals accessed the study link, 464 of whom did not meet eligibility requirements. In addition, people who completed 80% or less of the survey (n = 1171) and/or duplicate IP addresse (n = 104) were excluded, resulting in an analytic sample of n = 835. The sample was 69% male, had a mean age of 34 (SD = 9.7), and 48% reported increased VPA, while 55% reported increased MPA. The majority also reported increased sedentary behavior, as well as increased screen time. Respondents living with their care recipient were more likely to report increased weekday screen time (Odds Ratio [OR] = 1.55, 95% CI 1.11-2.16) and sedentary behavior (OR = 1.80, 95% CI 1.28-2.53) than respondents not living with the care recipient. Those living with their care recipient were also more likely to reported increased MPA (OR = 1.64, 95% CI 1.16-2.32), and VPA (OR = 1.53, 95% CI 1.09-2.15), but also more likely to report a decrease in VPA (OR = 1.75, 95% CI 1.14-2.70). CONCLUSION The majority of respondents reported that their MPA, VPA PA, sedentary behavior, and screen time had changed during the pandemic. Living with the care recipient was associated with both positive and negative changes in behavior. Future research can explore factors associated with these reported changes in behavior.
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Affiliation(s)
- Mary L Greaney
- Department of Health Studies, University of Rhode Island, 25 West Independent Way, Kingston, Rhode Island, 02881, USA.
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Megan M Drohan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | | | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Steven A Cohen
- Department of Health Studies, University of Rhode Island, 25 West Independent Way, Kingston, Rhode Island, 02881, USA
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