scholarly journals Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart

2019 ◽  
Vol 75 (5) ◽  
pp. 922-928 ◽  
Author(s):  
Jessica E Ramsay ◽  
Cainnear K Hogan ◽  
Mary R Janevic ◽  
Rebecca R Courser ◽  
Kristi L Allgood ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Interventions ◽  
Controlled Trial ◽  
Management Program ◽  
Lessons Learned ◽  
Low Ses ◽  
Community Members ◽  
Face To Face ◽  
Urban Minority ◽  
Trial Testing

Abstract Background Few published studies report lessons learned for recruiting older adults from racial/ethnic minority, low SES communities for behavioral interventions. In this article, we describe recruitment processes and results for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, urban, low SES adults 50 years or older living in Detroit. Methods Older adults were recruited via community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) methods. Recruitment processes, demographic characteristics of enrolled participants, yield and cost, lessons learned, and best practices for each method are described. Results Within 22 months, 1,478 potential participants were identified, 1,223 were contacted and 453 enrolled, resulting in an overall recruitment yield of 37%. The CB method had the highest yield at 49%, followed by HC at 36% and EMR at 16%. Of six CB approaches, information sessions and flyers had the highest yields at 60% and 59%, respectively. The average cost of recruiting and enrolling one participant was $142. Conclusions CB, EMR, and HC methods each made important contributions to reaching our recruitment goal. The CB method resulted in the highest recruitment yield, while EMR had the lowest. Face-to-face interaction with community members and hiring a community health worker were particularly useful in engaging this population. Further research is needed to confirm these findings in urban, minority, low SES populations of older adults.

scholarly journals Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 344-344
Author(s):  
Cainnear Hogan ◽  
Mary Janevic ◽  
Rebecca Courser ◽  
Kristi Allgood ◽  
Cathleen Connell ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Controlled Trial ◽  
Management Program ◽  
Lessons Learned ◽  
Low Ses ◽  
Community Based ◽  
Recruitment Methods ◽  
Face To Face ◽  
Recruitment Challenges ◽  
Trial Testing

Abstract Few studies report best practices for recruiting older adults from minority, low SES communities for behavioral interventions. In this presentation, we describe recruitment processes and numbers for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, low SES adults 50 years or older in Detroit. Community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) recruitment methods were implemented. Within 22 months, 453 participants were enrolled, with an overall recruitment yield of 37%. The CB method had the highest yield (49%), followed by HC (36%) and EMR (16%). The average cost of recruiting and enrolling one participant was $142. Face-to-face interactions and employing a community health worker were particularly useful in engaging this population. Further research is needed to confirm these findings in other minority and low SES populations and share lessons learned about recruitment challenges and successes.

scholarly journals The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Jennifer Deal ◽  
Nicholas Reed ◽  
David Couper ◽  
Kathleen Hayden ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Observational Study ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Study Staff ◽  
Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

scholarly journals Feasibility and Acceptability of an mHealth Delivered Mindfulness Therapy for Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 316-316
Author(s):  
Elissa Kozlov ◽  
XinQi Dong
Keyword(s):  
Older Adults ◽  
Behavioral Interventions ◽  
Pilot Trial ◽  
Evidence Base ◽  
Negative Effects ◽  
Face To Face ◽  
Proven Efficacy ◽  
Managing Stress ◽  
With Memory ◽  
Mindfulness Therapy

Abstract Decades of research have documented the profound, negative effects of caregiving on unpaid caregivers. Mindfulness Therapy (MT) is a promising, non-pharmacological technique with proven efficacy and effectiveness in managing stress, depression and anxiety in diverse populations. While the evidence-base for MT in caregiving is growing, traditional MT (8+ hours of face-to-face treatment with trained providers) is likely not a realistic treatment model for most caregivers due to lack of trained personnel, time constraints of the caregiver, and reimbursement issues. Therefore, in order to meet the unique needs of caregivers of older adults with cognitive impairment, an innovative delivery model is required. MHealth can be a useful tool to deliver behavioral interventions, as it overcomes barriers of traditional psychotherapy such as provider availability, scheduling conflicts, and cost. The objective of this paper is to report the feasibility, acceptability and preliminary efficacy of a pilot trial of mHealth delivered MT for stress and caregiver burden in caregivers of persons with dementia. The average age of participant was 63.2 years old. After two weeks, 93% of participants reported using the mindfulness app for an average of 48.38 minutes per week. At eight weeks, 88% of users reported using the mindfulness app for an average of 35 minutes per week. At 8 weeks, 100% of users reported practicing mindfulness without using the app for an average of 45.6 minutes per week. MHealth mindfulness therapy appears to be a feasible method of delivering mindfulness to caregivers of older adults with memory impairment.

scholarly journals Reflections on Hip Fracture Recovery From Older Adults Enrolled in a Clinical Trial

2017 ◽  
Vol 3 ◽  
pp. 233372141769766 ◽  
Author(s):  
Sarah Stott-Eveneshen ◽  
Joanie Sims-Gould ◽  
Megan M. McAllister ◽  
Lena Fleig ◽  
Heather M. Hanson ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Hip Fracture ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Management Program ◽  
Knowledge Resources ◽  
Study Staff ◽  
Fracture Management ◽  
Positive Perspective

This study describes patients’ perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic), compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups) twice over 12 months. A total of 32 women (64%) and 18 men (36%) participated in the study with a mean age at baseline of 82 (range = 65-98) years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants’ knowledge, resources, and monthly contact with study staff (perceived as a form of social support). The most frequently reported barriers to participants’ recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.

scholarly journals The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 17 (14) ◽  
pp. 4966
Author(s):  
Ziyan Li ◽  
Mimi Tse ◽  
Angel Tang
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Controlled Trial ◽  
The Elderly ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Pain Management Program ◽  
Community Dwelling Older Adults ◽  
Experimental Group

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

scholarly journals Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Dori E Rosenberg ◽  
Amy K Lee ◽  
Melissa Anderson ◽  
Anne Renz ◽  
Theresa E Matson ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Interventions ◽  
Sedentary Time ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Self Report ◽  
Sitting Time ◽  
Future Research ◽  
Innovative Strategy ◽  
Novel Approaches

BACKGROUND Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. OBJECTIVE The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. METHODS Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. RESULTS Study enrollment has ended and data processing is underway. CONCLUSIONS Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches CLINICALTRIAL ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

scholarly journals The First Intervention Study for LGBTQ+ Older Adults With Dementia and Caregivers: COVID-19 Lessons Learned

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Karen Fredriksen Goldsen ◽  
Linda Teri ◽  
Hyun-Jun Kim ◽  
Charles Emlet ◽  
Ryan Petros ◽  
...  
Keyword(s):  
Older Adults ◽  
Culturally Responsive ◽  
Intervention Study ◽  
Retention Rate ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Technology Support ◽  
Disadvantaged Communities ◽  
Aging Services ◽  
Home Technology

Abstract LGBTQ+ older adults face significant health disparities with higher rates of cognitive impairment and social isolation. Yet, the cognitive health needs of LGBTQ+ adults and caregivers have not been adequately addressed in clinical trials and services. In this presentation, we will share findings from Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), the first randomly controlled trial (RCT) intervention study designed to improve quality of life of LGBTQ+ adults living with dementia and caregivers, and to reduce institutionalization. In this presentation, we will share preliminary efficacy findings, the effectiveness of culturally responsive approaches, and Covid-19 adaptations, including delivery by virtual chat rather than in-home, technology training, ensuring safety of virtual intervention components, and providing on-going technology support. Preliminary findings suggest a higher intervention retention rate in the virtual delivery as compared to in-home. This study illustrates innovative ways to serve disadvantaged communities in dementia care and aging services.

scholarly journals Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial

2021 ◽  
pp. 1-10
Author(s):  
Natalie L. Marchant ◽  
Thorsten Barnhofer ◽  
Roxane Coueron ◽  
Miranka Wirth ◽  
Antoine Lutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
State Anxiety ◽  
Controlled Trial ◽  
Management Program ◽  
Anxiety Symptoms ◽  
Self Management ◽  
Subjective Cognitive Decline ◽  
Depression Symptoms

<b><i>Introduction:</i></b> Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. <b><i>Objective:</i></b> To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. <b><i>Methods:</i></b> SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). <b><i>Results:</i></b> One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, <i>n</i> = 73; HSMP, <i>n</i> = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. <b><i>Conclusions:</i></b> A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. <b><i>ClinicalTrials.gov identifier:</i></b> NCT03005652.

LGBT OLDER ADULTS, CHOSEN FAMILY, AND CAREGIVING

2016 ◽  
Vol 31 (2) ◽  
pp. 150-168 ◽  
Author(s):  
Nancy J. Knauer
Keyword(s):  
United States ◽  
Older Adults ◽  
Elder Care ◽  
The United States ◽  
Lessons Learned ◽  
Community Members ◽  
Policy Makers ◽  
Lgbt Community ◽  
Bisexual And Transgender ◽  
High Level

AbstractIn the United States, informal elder care is principally the responsibility of younger relatives. Adult children perform the majority of elder care and non-relatives perform only 14 percent of care. Caregiving in the lesbian, gay, bisexual, and transgender, or LGBT, community follows a very different pattern that reflects the importance of “chosen family” in the lives of LGBT older adults. Instead of relying on relatives, LGBT older adults largely care for each other. Relatives provide only 11 percent of all elder care. This article explores the high level of caregiving by non-relatives in the LGBT community. It asks what motivates friends, neighbors, and community members to provide care for someone whom the law considers a legal stranger. It also asks what steps policy makers can take to facilitate and encourage this type of caregiving. Finally, it asks what lessons can be learned from LGBT older adults about the nature of both caregiving and community. As the aging population becomes more diverse, aging policies will have to become more inclusive to address the differing needs of various communities, including LGBT older adults. The potential lessons learned from the pattern of elder care in the LGBT community, however, extend far beyond a simple commitment to diversity.

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