RESEARCH INNOVATION
Research in Georgia State University’s College of Education & Human Development • Spring 2025
Cen red on R e ch and Prof sional Development
Georgia State University’s College of Education & Human Development has several centers that contribute research to their respective fields and provide professional development opportunities and other services to the community. In this issue of Research & Innovation, we highlight research and outreach from the Center for Movement and Rehabilitation Research, the Ken Matheny Center for the Study of Stress, Trauma and Resilience and the Principals Center.
Treadmill Training for Older Adults with Hip Osteoarthritis
For older adults, walking speed can be an indicator of their overall health – including how their musculoskeletal and cognitive systems are functioning.
Older adults diagnosed with hip osteoarthritis, a degenerative disease that affects hip joints, have been shown to walk slower than their peers, which can impact their physical activity levels.
Assistant Professor Chun-Hao (Philip) Huang, Ph.D., a faculty member in the Center for Movement and
Rehabilitation Research, co-authored a study in the Journal of Orthopaedic Research that explores how hip osteoarthritis impacts walking in older adults and what interventions might help them maintain their walking speed and function.
“Identifying biomechanical mechanisms underlying reduced walking speed in people with hip osteoarthritis would thus lead to novel strategies to reduce disability and
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promote healthy aging in this population,” he and his colleagues wrote.
Eleven women over 60 years old with a hip osteoarthritis diagnosis participated in the study, which used an instrumented split-belt treadmill – a special kind of treadmill that has two belts at the bottom instead of one for users to walk on and a safety harness to keep individuals safe when using it.
Participants were buckled into the safety harness and completed four treadmill walking periods: A three-minute warm-up; a one-minute pre-adaptation period; a 10minute asymmetrical period; and a one-minute postadaptation period.
Participants selected the treadmill speed they wanted to simulate their normal walking speed, and both treadmill belts moved at the participant's set speed except during the asymmetrical period.
“The belt under the limb affected by osteoarthritis moved
at half the self-selected speed, while the other belt moved at the self-selected speed,” Huang explained. “This asymmetry challenged participants' gait and aimed to encourage adaptation in step length and propulsion mechanics. Participants likely felt uneven ground movement during the asymmetry period, requiring them to adjust their walking pattern to maintain balance and coordination.”
Huang and his colleagues compared the data from their study to participant data collected during a previous, unpublished study, and they found that individuals whose gait is more varied responded positively to the treadmill intervention and could benefit from using it moving forward.
The treadmill training used in this study had a significant impact on participants’ walking – specifically, “increasing propulsive force on the involved limb with significant effects,” according to the researchers.
These results indicate that the instrumented split-belt treadmill intervention program could be beneficial for adults with hip osteoarthritis.
“Split-belt treadmill training increased propulsive force on the involved limb with significant effects,” Huang said. “Enhanced propulsive mechanics could improve walking speed, reduce fall risk and maintain independence for older adults with hip osteoarthritis.”
Study Finds Faster Walking Speed, Ankle Weights Help Children with Down Syndrome Improve Walking Stability
Down syndrome (DS) is the most common genetic condition that causes physical, cognitive and language developmental delays, including how children learn to walk.
Children with DS often take shorter, wider steps and may prefer a slower walking speed than typically developing children, due to underdeveloped balance control and increased stability challenges they face.
But are there ways to improve their walking stability?
Jerry Wu, chair of the College of Education & Human Development’s (CEHD) Department of Kinesiology and Health and faculty member in the Center for Movement and Rehabilitation Research, alum Matthew Beerse (M.S. '14, Ph.D. '18) and doctoral student Tasnuva Alam conducted a study on walking stability in children with and without DS.
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Chun-Hao (Philip) Huang
Twenty-four children, ages 7-12 years, participated in this study – 12 children with DS paired with 12 typically developing peers who were the same age and gender.
Each child was instructed to walk barefoot on a walkway at two speeds: Their normal walking speed and their fastest walking speed (as fast as possible without running). The research team also tested these two speeds while the children walk with additional weights that were attached above their ankles and weighed two percent of their body mass.
To collect data on their walking stability, the researchers attached 18 retroreflective markers in multiple places on each child's body, from their heels, toes and ankles up to their elbows, shoulders and head. The researchers captured the children's movement on the walkway using an eight-camera Vicon motion capture system, which created digital models of each participant’s walking.
These models were instrumental in identifying each child’s margin of stability (MOS) – the distance between someone’s base of support, or their feet, and their center of mass, where a person’s body weight is balanced.
The study’s results, published in the journal Clinical Biomechanics, indicate that children with DS benefitted from increased walking speeds and the use of ankle weights when walking.
“In response to increasing walking speed and addition of ankle weights, children with DS have the capacity to modify MOS in a similar pattern as their typically developing peers,” they wrote. “These task manipulations might be considered for physical interventions, as they could challenge the balance control of children with DS during gait.”
Study Shows Higher Fall Risk for Older Adults with Alzheimer’s Compared to Mild Cognitive Impairment
Older adults face various physical and mental challenges as they age, including an increased risk of falling.
This is especially true for individuals with mild cognitive impairments (MCI) – the early stages of cognitive disorders that can lead to dementia – and those diagnosed with Alzheimer’s disease (AD), a type of dementia that affects memory, thinking and behavior, according to the Alzheimer’s Association.
Post-doctoral fellow Caroline Simpkins (Ph.D. ’24), Dean’s Doctoral Research Fellow Sara Mahmoudzadeh Khalili and Associate Professor Feng Yang, a faculty member in the Center for Movement and Rehabilitation Research, conducted a meta-analysis of 35 studies on the annual fall
risk for older adults with MCI or AD, to determine if the risks differ between these two populations.
After the literature search, they narrowed the studies to include only those that fit the following criteria: 1) They were conducted among adults ages 65 and older with MCI or AD, 2) They tracked the number of falls that study participants had over a 12-month period and 3) They were published in a peer-reviewed journal.
Simpkins, Mahmoudzadeh Khalili and Yang took the results from each study and calculated the annual fall prevalence for older adults with MCI and AD based on the number of
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Jerry Wu
people who fell once or more over 12 months and the study’s sample size. The annual number of falls was also compared between the two dementia subgroups.
Their meta-analysis, published in Advances in Geriatric Medicine and Research, found that older adults with AD had a higher risk of falling (43.55 percent) and a higher number of falls per year (1.3) compared to those with MCI (35.26 percent risk of falling and 0.77 falls per year).
Dementia affects walking, balance and mobility, and the studies in this meta-analysis indicate that the “more severe the cognitive impairments, the stronger the correlation between falls and cognitive deficits.”
“This relationship not only explains why people with dementia exhibit a higher fall risk than their cognitively
intact peers, but also the greater fall risk among people with AD than those with MCI since AD is a more advanced dementia stage than MCI,” the authors wrote. “Another possible contributor to the positive correlation could be the side effects of taking medications used to treat dementia. The potential side effects include dizziness, postural instability, confusion, difficulty in coordinating body movements and decreased blood pressure, which can all increase the fall risk.”
The results from their meta-analysis could help public officials, researchers and healthcare providers decide how best to support older adults with MCI and AD.
“This information could guide different stakeholders, such as policymakers, to better distribute fall prevention resources among people with AD or MCI,” the authors wrote. “It can also assist researchers and clinicians with developing modalities to assess fall risk, identifying individuals with an elevated fall risk and establishing treatment strategies to lower the fall risk for these populations.”
Higher Stress, PTSD Risk Among Adults with Low Literacy
Adults with low literacy levels can face difficulties applying for jobs, reading and understanding health information and making other crucial decisions in their daily lives.
These stressors can have a profound impact on this population, but there are few research studies that have focused specifically on adult learners’ stress levels and how they deal with these struggles.
To address this gap, a team of Georgia State University researchers – including Ken Matheny Center for the Study of Stress, Trauma and Resilience faculty members Ken Rice, Daphne Greenberg, Sarah Carlson and Claire Spears and alumni Michelle Aiello and Barbara S. Durán – conducted a study to better understand the stress, traumatic experiences, resilience and psychological distress that adults with low literacy levels experience.
Psychologists have developed written assessments to measure the four focus areas of this study. However, these assessments can be more difficult to administer to adults who struggle with reading.
The Georgia State research team adapted four such assessments, including the Perceived Stress Scale, the
Post-Traumatic Stress Disorder Checklist, the Connor-Davidson Resilience Scale and K6 Psychological Distress Scale, to make them more accessible to this population of adults.
The 23 study participants were split up into small groups. Each group was assigned a researcher who administered
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Feng Yang
the questions verbally and in written form, providing examples to help participants understand how to respond to each question. Also, there were a few research assistants assigned to each group to help answer participants' questions.
“Based on their attentiveness, task involvement and questions, they seemed to benefit from the session leader reading the directions and items,” the researchers wrote. “They also seemed to benefit from having other research assistants in the room because they frequently raised their hands when they needed individual assistance with any questions or issues. They also acknowledged clearer understanding when the research assistants provided assistance.”
The study’s results, published in the Adult Literacy Education Journal, indicate that this population experiences higher levels of perceived stress on
average compared to other adults, and they expressed lower levels of resilience in the face of stress. Participants were at a much higher risk for post-traumatic stress disorder (77 percent) compared to the general population (7 percent).
The findings – and the methods they used to administer this study to adult learners – can be instructive for future research and policy decisions that affect adults with low literacy levels.
“Results provide preliminary empirical evidence that supports adult literacy practitioner reports that many of their learners appear to experience high levels of stress, anxiety and depression,” the research team wrote.
“As policymakers and researchers attempt to create and implement curricular modifications to facilitate an increase in adult foundational academic skills, more attention is warranted on the psychosocial needs of the adult literacy learner population.”
“Based on their attentiveness, task involvement and questions, they seemed to benefit from the session leader reading the directions and items.”
Spiritual First Aid Training Supports Disaster Response Skills
According to the Center for Research on the Epidemiology of Disasters, more than 100 million people experienced natural disasters across the world in 2021, resulting in more than 10,000 deaths and $252.1 billion in economic losses.
While mental health professionals play a crucial role in providing care for people affected by natural disasters, that role is often through training community members to make a difference in their own community. Counseling psychologists are committed to equipping community members, not just waiting for people to come to psychotherapy.
College of Education & Human Development scholars published a pilot study in Spirituality in Clinical Practice on the effectiveness of training people to care for natural disaster survivors using Spiritual First Aid. The project was led by CEHD alumni Aaron McLaughlin (a former Dean’s Doctoral Research Fellow) and included Professor Don Davis and doctoral students Hannah Cowart and Sarah Gazaway working in the Ken Matheny Center for the Study of Stress, Trauma and Resilience.
Spiritual First Aid was developed by counseling and psychology researchers with expertise in providing care
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Ken Rice
Daphne Greenberg
Sarah Carlson
during natural disasters. When people are dealing with extreme stress, trauma or grief, it is easy for volunteers with good intentions to try to help in ways that make things worse. Nonprofit organizations of all kinds –churches, faith-based organizations and other nonprofit organizations – need help training volunteers to help in ways that translate good intentions into effective and coordinated care. Spiritual First aid includes a manual, training videos, role-playing scenarios and other resources designed to help disaster spiritual and emotional care providers offer support to communities in the aftermath of disasters.
“Equipping religious leaders and lay helpers with mental health resources for responding to spiritual and emotional needs in the wake of disasters could be a strong strategy for addressing nuances of religiousness and spirituality that psychologists may not be able to address due to disciplinary and professional roles,” the research team wrote. “Effective aid could help survivors connect back with their faith community, receive support and move toward coherence, security and/or personal growth.”
The training is very practical and skill focused. In the pilot study, participants completed an eight-hour online course in Spiritual First Aid. Before and after the training, they practiced responses to a series of vignettes. Participants had to read each vignette, which centered on a hypothetical scenario related to the COVID-19 pandemic, and then select the correct multiple-choice answer for how someone should respond based on the spiritual first aid training.
"The multiple-choice responses included a correct answer that represented a practical or humble helping response and also 'pitfalls,' which were incorrect answers including unhelpful (or potentially harmful) responses," the researchers explained. "Correct responses were based on
examples provided in the curriculum. For 20 of these items, pitfalls were related to trying to fix a problem too quickly, being impractical in supporting the need or missing the need altogether."
The research group found a “small but significant increase” in the percentage of participants who chose the correct answers from the pre-test to the post-test. They also saw a small decrease in the number who selected a “too quick to fix” pitfall after completing the training.
The largest difference between the pre- and post-tests came from the answers on the vignettes about safety risks, where “incorrect choices were categorized as indirectly assessing safety or choosing not to assess or respond to the risk at all.”
After finishing the spiritual first aid training, participants decreased their number of indirect responses (from 21.68 percent to 10.5 percent) and chose more direct ways of responding to safety risks (from 55.58 percent to 72.43 percent).
As a result of the training, volunteers were “more adept at choosing responses that were practical, humble and risk reducing in times of disaster and trauma,” the authors wrote. “They were less likely to be ‘quick-to-fix’ a need and more likely to be direct in assessing safety risks.”
“Equipping religious leaders and lay helpers with mental health resources for responding to spiritual and emotional needs in the wake of disasters could be a strong strategy for addressing nuances of religiousness and spirituality that psychologists may not be able to address due to disciplinary and professional roles.”
Don Davis
The satellite site began its work in November 2024 with the Beginning Principals Academy – Year 1, one of the center’s Cohort Series programs. It’s designed to build new principals’ capacity to enhance student learning and create success for their schools and for themselves.
Twenty-three principals enrolled in the academy, and they meet multiple times during the academic year to discuss approaches to solving leadership challenges, supporting teaching and learning in the classroom, and leading and managing their schools more effectively.
The satellite site’s opening aligns with the goals set forth in the Principals Center’s five-year strategic plan, according to Dionne Cowan, the center’s executive director.
It also allows the center, which celebrated its 40th anniversary in 2024, to expand the number of educational leaders who have access to its professional development series.
“Our new satellite site represents more than just progress in supporting school leaders in Middle Georgia – it embodies our unwavering belief in the power of community,” Cowan said. “We’re honored to partner with the Bibb County School District to build the capacity of both practicing and aspiring school leaders in the region.”
Principals Center, Fulton County Schools Partnership Improves Retention Rates for New Principals
The Principals Center has partnered with Fulton County Schools’ Department of Professional Learning and Leadership Development for 12 years on its New Principal Induction Program, which has significantly improved retention rates for new principals in the county.
The school district reached out to the Principals Center to support its new principals during their first three years in their positions. In response, the center created a customized induction program that included monthly on-site coaching sessions during the academic year –a system that shifted online during the COVID-19 pandemic.
“Performance-based professional learning opportunities, combined with effective coaching, allows leaders to reduce their time to reach competency while also developing a relationship with a skilled leader who asks thought-provoking questions, provides specific feedback and creates powerful conversations,” said Dionne Cowan, executive director of the Principals Center.
The center selects local principals and central office professionals to serve as coaches for Fulton’s new principals. These educational leaders “must demonstrate skill in leading school improvement, have a proven history of improving student performance and be proficient in analyzing systems and determining the most critical areas of need,” Cowan said.
Thanks to this partnership, Fulton County Schools currently maintains a 97 percent retention rate for its new principals.
For Corneil Jones, coordinator of the K-5 Learning, Engagement and Assistance Program (LEAP) at College Park Elementary School, the mentoring she received through the partnership offered practical advice that she could implement right away.
“My coach’s extensive experience with schools similar to mine made her uniquely aware of the challenges I face, enabling us to collaborate and problem-solve with precision,” Jones said. “As a new program leader, I deeply appreciate the time she dedicated to understanding my vision and offering unwavering support. Every interaction resulted in clear, actionable next steps, making her an indispensable partner in driving my program forward.”
Parklane Elementary School Principal Brandi Nichols found the mentoring program a meaningful one that gave her support when she needed it most.
“She was always available, especially during tough times, and her guidance made a significant impact,” Nichols said of her mentor. “Her unwavering encouragement – along with her ability to push me to think deeper – truly built my capacity as a leader. ”
Dionne Cowan