Mari S Wilhelm

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Journals/Publications

• Bracken, M. B., Baker, D., Cauley, J. A., Chambers, C., Culhane, J., Dabelea, D., Dearborn, D., Drews-Botsch, C. D., Dudley, D. J., Durkin, M., Entwisle, B., Flick, L., Hale, D., Holl, J., Hovell, M., Hudak, M., Paneth, N., Specker, B., Wilhelm, M., & Wyatt, S. (2013). New models for large prospective studies: Is there a risk of throwing out the baby with the bathwater?. American Journal of Epidemiology, 177(4), 285-289.
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  PMID: 23296354;Abstract: Manolio et al. (Am J Epidemiol. 2012;175:859-866) proposed that large cohort studies adopt novel models using "temporary assessment centers" to enroll up to a million participants to answer research questions about rare diseases and "harmonize" clinical endpoints collected from administrative records. Extreme selection bias, we are told, will not harm internal validity, and "process expertise to maximize efficiency of high-throughput operations is as important as scientific rigor" (p. 861). In this article, we describe serious deficiencies in this model as applied to the United States. Key points include: 1) the need for more, not less, specification of disease endpoints; 2) the limited utility of data collected from existing administrative and clinical databases; and 3) the value of university-based centers in providing scientific expertise and achieving high recruitment and retention rates through community and healthcare provider engagement. Careful definition of sampling frames and high response rates are crucial to avoid bias and ensure inclusion of important subpopulations, especially the medically underserved. Prospective hypotheses are essential to refine study design, determine sample size, develop pertinent data collection protocols, and achieve alliances with participants and communities. It is premature to reject the strengths of large national cohort studies in favor of a new model for which evidence of efficiency is insufficient. © 2013 The Author.
• Moore-Monroy, M., Wilkinson-Lee, A. M., Verdugo, L., Lopez, E., Paez, L., Rodriguez, D., Wilhelm, M., & Garcia, F. (2013). Addressing the Information Gap: Developing and Implementing a Cervical Cancer Prevention Education Campaign Grounded in Principles of Community-Based Participatory Action. Health Promotion Practice, 14(2), 274-283.
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  PMID: 22982702;Abstract: Despite significant advances in prevention, Mexican American women continue to experience disparities related to cervical cancer and access to current and relevant health information. To address this disparity a community-campus partnership initiated an outreach program to Latinas in Arizona as one part of an integrated approach. Promotoras (community health workers) provided the leadership in the development of a curriculum to (a) train promotoras on cervical cancer, (b) meet informational needs of community members, (c) address relevant social determinants of heath, and (d) promote access to health care. The purpose of this article is to describe the community-based participatory approach used in the development of the curriculum. Specifically, the article describes the leadership of promotoras, the curriculum development, and the use of continual feedback to inform the quality control. To address cervical cancer disparities for Mexican American women, the Pima County Cervical Cancer Prevention Partnership used principles of community-based participatory action. © 2012 Society for Public Health Education.
• Buka, S., Entwise, B., Flick, L., Hale, D., Holl, J., Hovell, M., Hudak, M., Paneth, N., Specker, B., Wilhelm, M., & Wyatt, S. (2012). New models for large prospective studies: Is there a risk of throwing out the baby with the bathwater?. Am J. Epidemiol.
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  (comment re Manolio et al. New models for large prospective studies: Is there a better way? Am J. Epidemiol (doi:10 1093/aje/kwr453.2012)
• Monroy, M., Wilkinson-Lee, A., Wilhelm, M., & Garcia, F. (2012). Health Promotion Practice. Addressing the information gap: Developing and implementing a cervical cancer prevention education campaign grounded in principles of community based participatory action.
• , V., Zhang, Q., Harris, R., Wilkinson-Lee, A., & Wilhelm, M. (2011). Smoking Susceptibility among Students Followed from Grade Six to Eight. Addictive Behaviors, 36(12), 1261-1266.
• Nuño, V. L., Zhang, Q., Harris, R. B., Wilkinson-Lee, A. M., & Wilhelm, M. S. (2011). Smoking susceptibility among students followed from grade six to eight. Addictive Behaviors, 36(12), 1261-1266.
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  PMID: 21868172;Abstract: Background: Smoking is a leading risk factor for heart disease and cancer. By identifying factors associated with smoking onset, more effective prevention programs can be developed. Research questions are 1) does smoking susceptibility status change from grade six to eight, 2) are indicators of risk (perceived harm, smoking susceptibility status, positive peers, and resilience) measured in sixth grade associated with smoking susceptibility status in eighth grade and, 3) are there differences by gender in either research question? Methods: The current study is a secondary analysis of data collected during the evaluation of a Safe Schools Healthy Students Project. Students were followed from grade six to grade eight, with survey data collected in each grade from August 2006 to December 2008. Participants (n = 577) were in grade six at baseline, 52% were girls and 57% identified as White, non-Hispanic. Results: From grade six to grade eight the number of students in the high smoking susceptibility status doubled (5% to 17%). More boys than girls moved into the high susceptibility group over time. By eighth grade, boys were twice as likely to belong to the high smoking susceptibility group compared to girls (p = 0.01). Multiple logistic regression models showed that the positive peers' variable in grade six was protective for girls in their reported smoking susceptibility in grade eight. In contrast, higher resilience scores in grade six were protective for boys' reported smoking susceptibility in grade eight. Conclusions: Smoking susceptibility rose over time for all adolescents, but boys had notably sharper increases. Positive peers and having resources important to resilience may be beneficial in preventing the attitudes that support smoking initiation. Based on these results, we recommend gender-tailored, school-based smoking prevention programs that begin in grade six. © 2011 Elsevier Ltd.
• Page, M., & Wilhelm, M. (2011). Preparing graduate students for teaching: Expected and unexpected outcomes from participation in a GK-12 classroom fellowship. Journal of College Science Teaching.
• Sotomayor, M., Wilhelm, M., & Card, N. (2011). Actor and partner effects in couple s parenting: Comparing European-American and Hispanic parents. Early Child Development and Care, 181(1), 103-122.
• Sotomayor-Peterson, M., Wilhelm, M. S., & Card, N. A. (2011). Marital relationship quality and couples' cognitive stimulation practices toward their infants: Actor and partner effects of White and Hispanic parents. Early Child Development and Care, 181(1), 103-122.
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  Abstract: The present study explores actor and partner effects on mothers' and fathers' cognitive stimulation within an Actor-Partner Interdependence Model (APIM). This model allows us to evaluate whether mothers' and fathers' practices are impacted not only by their own experiences but also by their partners' experiences. The APIM treats the couple as the level of analyses, thus explicitly modelling such interdependence. The model assessed associations among marital conflict and happiness, closeness with own parents and depressive symptoms of both fathers and mothers among White, high acculturated Hispanic, and low acculturated Hispanic couples. The data used comes from the Early Childhood Longitudinal Study-Birth Cohort, a nationally representative dataset. Results show that marital conflict is associated with less cognitive stimulation for White mothers, White fathers and low acculturated Hispanic fathers. For high acculturated Hispanic couples, results show that fathers' perception of conflict is associated with more cognitive stimulation by the mother. Marital happiness is associated with increased cognitive stimulation by White and high acculturated Hispanic fathers. Closeness with their own parents is associated with higher levels of cognitive stimulation, especially for low acculturated Hispanic fathers as well as for White fathers and mothers. Depression was not found to have a direct impact on behaviours, but within low acculturated Hispanic couples, mother's depressive symptoms were associated with less cognitive stimulation by the father. © Taylor & Francis Group.
• Wilhelm, M., Nuño, V. L., Zhang, Q., Harris, R. B., Wilkinson-Lee, A. M., & Wilhelm, M. S. (2011). Smoking susceptibility among students followed from grade six to eight. Addictive behaviors, 36(12).
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  Smoking is a leading risk factor for heart disease and cancer. By identifying factors associated with smoking onset, more effective prevention programs can be developed. Research questions are (1) does smoking susceptibility status change from grade six to eight, (2) are indicators of risk (perceived harm, smoking susceptibility status, positive peers, and resilience) measured in sixth grade associated with smoking susceptibility status in eighth grade and, (3) are there differences by gender in either research question?
• Wilhelm, M., Wilkinson-Lee, A. M., Zhang, Q., Nuno, V. L., & Wilhelm, M. S. (2011). Adolescent emotional distress: the role of family obligations and school connectedness. Journal of youth and adolescence, 40(2).
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  The current study draws upon ecodevelopmental theory to identify protective and risk factors that may influence emotional distress during adolescence. Hierarchical regression analyses were used to examine the relationship among family obligations, school connectedness and emotional distress of 4,198 (51% female) middle and high school students who were primarily (59%) European American. The overall model explained 21.1% of the variance in student emotional distress. A significant interaction effect was found indicating that school connectedness moderated the relationship between family obligations and emotional distress. Specifically, for students with low to moderate levels of family obligations, a stronger sense of school connectedness was associated with lower emotional distress. The buffering effect of school connectedness was weakened as the level of family obligations increased and completely disappeared for students who experienced high levels of family obligations. The creation of a program that takes a holistic approach, in order to curtail the levels of highly emotionally distressed adolescents, must continue to address the ever changing demands that adolescents encounter and prepare youth to deal with functioning within multiple contexts and do so while maintaining emotional well-being.
• Wilkinson-Lee, A. M., Zhang, Q., Nuno, V. L., & Wilhelm, M. S. (2011). Adolescent Emotional Distress: The Role of Family Obligations and School Connectedness. Journal of Youth and Adolescence, 40(2), 221-230.
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  PMID: 20013149;Abstract: The current study draws upon ecodevelopmental theory to identify protective and risk factors that may influence emotional distress during adolescence. Hierarchical regression analyses were used to examine the relationship among family obligations, school connectedness and emotional distress of 4,198 (51% female) middle and high school students who were primarily (59%) European American. The overall model explained 21.1% of the variance in student emotional distress. A significant interaction effect was found indicating that school connectedness moderated the relationship between family obligations and emotional distress. Specifically, for students with low to moderate levels of family obligations, a stronger sense of school connectedness was associated with lower emotional distress. The buffering effect of school connectedness was weakened as the level of family obligations increased and completely disappeared for students who experienced high levels of family obligations. The creation of a program that takes a holistic approach, in order to curtail the levels of highly emotionally distressed adolescents, must continue to address the ever changing demands that adolescents encounter and prepare youth to deal with functioning within multiple contexts and do so while maintaining emotional well-being. © 2009 Springer Science+Business Media, LLC.
• Wilkinson-Lee, A., Zhang, Q., Leybas-Nuno, V., & Wilhelm, M. (2011). Adolescent emotional distress: The role of family obligations and school connectednes. Journal of Youth and Adolescence, 40, 221-230.
• Kasle, S., Wilhelm, M. S., McKnight, P. E., Sheikh, S. Z., & Zautra, A. J. (2010). Mutuality's prospective beneficial effects on inflammation in female patients with rheumatoid arthritis. Arthritis Care and Research, 62(1), 92-100.
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  PMID: 20191496;Abstract: Objective. Supportive close relationships are important for health. Mutuality, the reciprocal sharing of thoughts and feelings in close relationships, is linked with better outcomes for patients with rheumatoid arthritis (RA) in crosssectional data. Hypothesizing that mutuality has a beneficial impact on inflammation, we tested potentially causal relations of couple mutuality with erythrocyte sedimentation rate (ESR) in prospective data. Methods. Female patients with RA (n = 70; mean age 57 years, mean RA disease duration 5 years) completed questionnaires at baseline, 6 months, and 12 months, including measures of mutuality, RA flares, and negative affect. ESR laboratory values available near questionnaire dates were collected from medical charts. Using regression, we examined cross-lagged effects of mutuality and ESR over the two 6-month time spans (baseline to 6 months, 6 months to 12 months). We anticipated that mutuality would exert lagged inverse effects on subsequent ESR levels, and that ESR would have no effect on subsequent mutuality levels. Results. After controlling for lagged effects of earlier inflammation, disease-modifying antirheumatic drugs, antiinflammatory drugs, RA flares, and negative affect, mutuality's lagged inverse effects over both time spans accounted for unique variance in subsequent levels of ESR, explaining 9% at 6 months and 12.5% at 12 months. Concomitantly, earlier ESR had no effect on subsequent mutuality. Conclusion. Patients with RA reporting more mutuality had less inflammation at subsequent time points, but inflammation had no effect on subsequent reports of mutuality. This suggests that mutuality exerts a beneficial effect on inflammation. Clinical implications and potential applications are discussed. © 2010, American College of Rheumatology.
• Melissa, M. P., Wilhelm, M. S., Gamble, W. C., & Card, N. A. (2010). A comparison of maternal sensitivity and verbal stimulation as unique predictors of infant social-emotional and cognitive development. Infant Behavior and Development, 33(1), 101-110.
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  PMID: 20089309;Abstract: Although maternal sensitivity has been shown to influence social-emotional development, the role of verbal stimulation on infant developmental outcomes has received less exploration. Recent research has focused on intentional behaviors within the context of a mother-infant interaction as a critical influence and as distinct from sensitivity. In this investigation 6377 mother-infant dyads participated in a teaching task as part of the sample from the Early Childhood Longitudinal Study Birth Cohort (ECLS-B). Analyses focused in deciphering the role of maternal sensitivity and verbal stimulation as contributors to the infant's social-emotional (S-E) and cognitive (Cog) development. We further hypothesized that inclusion of infant age as a moderator of maternal behaviors would illuminate any differences between younger and older infants. Results: For the infant's S-E development, our hypothesis that maternal sensitivity would be a stronger predictor than verbal stimulation was not supported; nor did we find support for our hypothesis that the association would be moderated by age. For Cog development, only verbal stimulation had a direct positive effect on the infant's cognitive ability; our findings for moderation showed that mothers spoke more to older infants than younger infants. Conclusion: Identification of specific maternal behaviors associated with infant outcomes informs the child development field, and also provides strategies for early intervention to assist mothers with developing or maintaining a consistent relationship that includes sensitivity and verbal stimulation. © 2010.
• Kasle, S., Wilhelm, M. S., & Zautra, A. J. (2008). Rheumatoid arthritis patients' perceptions of mutuality in conversations with spouses/partners and their links with psychological and physical health. Arthritis Care and Research, 59(7), 921-928.
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  PMID: 18576302;Abstract: Objective. Mutuality, measured as subjects' perceptions of responsiveness in conversations with their spouse/partners, is linked with women's psychological health. Our objectives were to examine physical and psychological health outcomes of married/partnered patients with rheumatoid arthritis (RA) in relation to their perceptions of their own responsiveness (self-mutuality), their partner's responsiveness (partner-mutuality), and combined responsiveness (overall mutuality), and to examine potential sex differences in the links between mutuality and depressive symptoms. Methods. Symptoms of depression and anxiety, physical disability, and arthritis impact reported by RA patients were examined in correlation matrices with their perceptions of overall mutuality, partner-mutuality, and self-mutuality in conversations with spouses/partners in the whole sample (n = 148) and separately for men (n = 34) and women (n = 114). Sex moderation of the links between mutuality and depression was tested in hierarchical regressions. Results. In the whole sample and among women, all mutuality measures had significant inverse correlations with all health outcomes. In men, physical disability was unrelated to mutuality measures, but otherwise correlations approximated those in the whole sample and for women. Sex (being female) interacted with self-mutuality, but not overall or partner-mutuality, in predicting fewer depressive symptoms. Conclusion. RA patients' perceptions of mutuality in conversations with spouses/partners predicted better health across a spectrum of outcomes. Overall mutuality and partner-mutuality predicted fewer depressive symptoms for both men and women, but self-mutuality appeared more important for women than for men. The clinical relevance of findings and their implications for behavioral interventions with RA patients are discussed. © 2008, American College of Rheumatology.
• Page, M., & Wilhelm, M. S. (2008). Postpartum daily stress, relationship quality, and depressive symptoms (Contemporary Family Therapy (2007) 29, 4, (237-251) DOI: 10.1007/s10591-007- 9043-1. Contemporary Family Therapy, 30(3), 179-180.
• Page, M., & Wilhelm, M. S. (2007). Postpartum daily stress, relationship quality, and depressive symptoms. Contemporary Family Therapy, 29(4), 237-251.
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  Abstract: This study explored the relationships among daily stresses, specifically interpersonal conflict, the quality of supportive spousal relationships, and the experience of postpartum depressive symptoms. In our sample of 51 women nearly 30% reported symptoms consistent with postpartum depression. Using regression analysis and controlling for depression during pregnancy, results suggested that arguments with family members and the depth of the spousal relationship acted as significant predictors of the severity of reported postpartum depressive symptoms. Results of the regression were in the expected direction, but due to the small sample size, the findings should be interpreted with caution. Post-hoc analyses were conducted separating the women into three groups based on their depression scores. Therapeutic interventions to reduce postpartum depressive symptoms are considered. © 2007 Springer Science+Business Media, LLC.
• Kasle, S., Wilhelm, M. S., & Reed, K. L. (2002). Optimal health and well-being for women: Definitions and strategies derived from focus groups of women. Women's Health Issues, 12(4), 178-190.
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  PMID: 12093582;Abstract: Women participating in focus groups were asked how they define health and well-being, and what strategies they would suggest for health optimization. Women defined health and well-being largely in terms of relationships. Their strategies for improving health involved enhancement of the quality of relationships with families, partners, and community. These proposed strategies included: creating a context for resilience; valuing and nurturing children, parents, and families; promoting interpersonal connections and community; realizing equality for women; and cultivating relational values. These perspectives can inform clinicians and health policy.
• Ridley, C. A., Wilhelm, M. S., & Surra, C. A. (2001). Married couples' conflict responses and marital quality. Journal of Social and Personal Relationships, 18(4), 517-534.
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  Abstract: In order to further our understanding of conflict within a marital relationship, this study had two purposes: (i) to identify married couples' conflict response profiles, and (ii) to relate these conflict profiles to appraisals of marital quality. Spouses in 173 intact married couples completed a questionnaire that included measures of a sample of aggressive, withdrawing, and problem-solving responses occurring during conflict episodes, and indices of marital quality. Cluster analyses of married dyads' conflict responses generated four conceptually interesting profiles - two symmetrical ('distancing couples' and 'engaging couples') and two asymmetrical ('distancing husbands' and 'distancing wives'). Results indicated that couples who endorse different conflict profiles could be distinguished according to their level of marital adjustment. The advantages to understanding conflict responses within a marriage by studying the couple as the unit of analysis were highlighted.
• Hayhoe, C. R., & Wilhelm, M. S. (1998). Modeling perceived economic well-being in a family setting: A gender perspective. Journal of Financial Counseling and Planning, 9(1), 21-34.
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  Abstract: Perceived economic well-being refers to judgments of one's economic situation in light of what is required and desired. Two hypotheses were tested and confirmed with a sample of couples: 1) that before reaching judgment, people pass objective and perceptual information through two mediators, comparison of economic outcomes and level of strain and 2) that men and women differ. Comparison of economic outcomes accounted for over half the explained variance in two models. Level of strain was significant in both models, but accounted for only a small portion of the explained variance. © 1998, Association for Financial Counseling and Planning Education.
• Hayhoe, C. R., & Wilhelm, M. S. (1995). Discriminating between primary family financial managers and other adults in the family. Journal of Financial Counseling and Planning, 6, 75-83.
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  Abstract: This study examined the intergender differences between men and women primary family financial managers (PFFM). The results supported the need for research to examine differences between men and women besides examining the differences between men and women PFFMs. Of the 20 variables employed in this study, only the money attitude of power/spending differentiated between men and women PFFMs but not between men and women in general. However, the money attitude of power/spending did differentiate between men and women in general when tested individually. The sample consisted of 395 heterosexual couples from two rural counties in Arizona and in California. Further research is needed to determine the differences between men and women PFFMs. © 1995, Association for Financial Counseling and Planning Education.
• Bauer, J. W., Hira, T. K., Wilhelm, M. S., Varcoe, K. P., & Thomas, S. (1993). The determinants of worry over chronic health condition for rural couples. Journal of Family and Economic Issues, 14(3), 275-291.
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  Abstract: This study investigates the determinants of chronic health conditions that worry the member of rural couples who serves as the household financial manager. A sample of 1,115 rural couples from the NC-182 regional research project "Family Resource Utilization as a Factor in Determining Economic Well-Being of Rural Families" is used. The logit analysis finds that the probability of having a condition that worries the financial manager increases if she or he is middle aged or older, is not employed, and has external Locus of Control. This probability also increases when the dissatisfaction with the resources available to handle a financial emergency increases and the more often the financial manager does not have money to pay for the doctor. © 1993 Human Sciences Press, Inc.
• Wilhelm, M. S., Varcoe, K., & Fridrich, A. H. (1993). Financial satisfaction and assessment of financial progress: Importance of money attitudes. Journal of Financial Counseling and Planning, 4, 181-199.
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  Abstract: A survey of 280 males and 279 females living in rural Arizona and California was used to explore the importance of money beliefs (obsession, retention, power/spending, and effort/ability), after controlling for objective indicators of financial well-being (income, value of assets, and amount of debt), in predicting appraisals of financial satisfaction and perception of financial progress. Results of a hierarchical model of stepwise regression suggest that money beliefs contribute more to predicting an individual's financial satisfaction than to perception of financial progress. Results also indicate gender differences in the role of money beliefs in predicting financial satisfaction and perception of financial progress.
• Hanley, A., & Wilhelm, M. S. (1992). Compulsive buying: An exploration into self-esteem and money attitudes. Journal of Economic Psychology, 13(1), 5-18.
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  Abstract: The purpose of the current study was to explore differences between a group of self-reported compulsive spenders (n = 43) and a group of 'normal' consumers (n = 100) on their self-esteem and on their money attitudes. Rosenberg's Self-Esteem Scale and Furnham's Money Beliefs and Behavior Scale were used to measure the variables of interest. Hotelling's T2 and discriminant function analysis were performed on these variables to determine differences between the two groups of consumers. Findings support the theoretical model that compulsive spenders have relatively lower self-esteem than 'normal' consumers and that compulsive spenders have beliefs about money which reflect its symbolic ability to enhance self-esteem. © 1992.
• Price, D. Z., & Wilhelm, M. (1988). From the co-guest editors. Lifestyles Family and Economic Issues, 9(2), 93-96.
• Price, D. Z., & Wilhelm, M. S. (1988). Socioeconomic stress in rural families: Part II from the co-guest editors. Lifestyles Family and Economic Issues, 9(4), 279-280.
• Ridley, C. A., & Wilhelm, M. S. (1988). Adaptation to unemployment: Effects of a mine closure on husbands and wives. Lifestyles Family and Economic Issues, 9(2), 145-160.
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  Abstract: The purpose of this study was to increase understanding of how individuals/couples respond to the unemployment of the primary breadwinner. Data were collected from 66 individuals (33 couples) shortly after becoming unemployed and again one year later. Results determined that the significant predictor variables of economic satisfaction, marital adjustment, and depression were primarily economic, marital, and emotional variables, respectively. Findings also showed that interaction existed among economic, marital, and emotional variables in predicting the three well-being outcomes. Additionally, differences were found in the pattern of results for husbands and for wives. Based on these findings, areas and hypotheses for future study are proposed. © 1988 Human Sciences Press.
• Wilhelm, M. S., & Ridley, C. A. (1988). Unemployment induced adaptations: Relationships among economic responses and individual and marital well-being. Lifestyles Family and Economic Issues, 9(1), 5-20.
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  Abstract: This study explores the impact of consumption changes, implemented during unemployment, on perceived economic, marital, and emotional functioning of 34 husbands and 34 wives. Questionnaires completed at the onset of unemployment assessed initial level of perceived functioning. Questionnaires completed one year later assessed the level of functioning in three areas and the extent to which seven categories of consumption changes were implemented. Multivariate analyses determined that credit use and income raising are significant predictors of economic satisfaction. Changes in income raising, credit use, planning, and store choice are significant predictors of marital adjustment. None of the changes predict depression. © 1988 Human Sciences Press.

Others

• Wilhelm, M. S., & Roebuck, J. (2014, Fall). Evaluation of the Arizona Young Breast Cancer Survivor Support Initiative.. Report for the John C. Lincoln Health Center..
• Wilhelm, M. S., Roebuck, J., & Christine, K. (2014, Summer). Youth Empowered for Success (YES): FY 2013-14 End of Year Report (55 pages).. Consumer Partnerships of Southern Arizona.