scholarly journals Reinventing Housing Care: Environmental Negotiations Made in Congregate Settings During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 377-377
Author(s):  
Ian Johnson ◽  
Terri Lewinson

Abstract The COVID-19 pandemic prompted an urgent reconsideration of space and place within congregate housing. Research has only underscored the need for health-promoting physical alterations to residential environments (Peters & Halleran, 2020), but also generated lasting questions about the relationships between congregate environments and their residents, visitors, and workforce —among them, what ways can environments be negotiated to reduce risk (Dosa et al., 2020)? How can environments enact care for formal caregivers (Chen & Chavalier, 2021)? Who might be challenged by this care which may question the dangers associated with proximity (Lynn, 2020)? This symposium focuses on the ways stakeholders within congregate housing observed, related to, and negotiated changes to space and place during the pandemic. Paper 1 presents an organizational case study investigating provider perspectives of how housing and healthcare responses to COVID have shaped palliative care with unhoused patients during the pandemic. Paper 2 highlights the collaborative work of a multi-sector coalition working to address timely needs of residents in low-income senior buildings. Paper 3 reflects on the formation of a cross-national senior housing network and the interdisciplinary exchange of best practices and policy recommendations that emerged. The collective findings of these papers challenge previous notions of care in congregate environments, illuminate how provider networks respond to crises and share emergent knowledge, and consider how institutional decisions about the pandemic have re-placed and re-spaced provider and patient experiences. This symposium offers observations and strategies that may assist in envisioning successful congregate care during COVID-19 and beyond.

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 201-208
Author(s):  
Noah J. Webster ◽  
Toni C. Antonucci ◽  
Neil B. Alexander

Objective: Only 16% of people aged >65 years engage in recommended levels of physical activity, putting a vast major­ity at risk for multiple chronic conditions including heart disease. Physical activity is even lower among older adults with fewer economic resources. Research is needed to develop context-specific approaches to pair with physical activity interventions to increase effectiveness. In this pilot study, we examine social ties and physical activity levels of older adults living in a US Depart­ment of Housing and Urban Development subsidized senior housing community to test feasibility of a social network-based approach to physical activity interventions. This study is grounded in Social Contagion Theory and the Convoy Model of Social Relations, which argue health and health-related behaviors are facilitated through network ties.Methods: Data were collected through face-to-face interviews conducted over the course of three months (September- November 2018) with 46 residents living in a low-income senior housing community in southeast Michigan. Residents were asked about physical activity, people they know in the community, and their close social network composition.Results: Residents reported knowing, on average, six other residents and approxi­mately 28% of those in their close networks were also residents. Sociocentric network analysis identified two socially engaged (known by seven or more other residents) physically active residents, whereas ego-centric analysis identified four (60% or more of their network comprised residents).Conclusions: This study demonstrates potential feasibility of a strategic partnership that involves pairing social resources with physical activity interventions in afford­able senior housing. Multiple approaches, which need to be evaluated, exist to identify socially engaged residents.Ethn Dis. 2019;29(Suppl 1): 201-208; doi:10.18865/ ed.29.S1.201.


Author(s):  
Christina M Patch ◽  
Terry L Conway ◽  
Jacqueline Kerr ◽  
Elva M Arredondo ◽  
Susan Levy ◽  
...  

Abstract As the U.S. population ages, communities must adapt to help older adults thrive. Built environment features, like safe sidewalks and crosswalks, provide the foundation for age- and physical activity-friendly communities. Controlled studies are needed to evaluate advocacy training programs that instruct and support seniors to advocate for more walkable neighborhoods. The Senior Change Makers Pilot Study evaluated an advocacy program that taught seniors to evaluate pedestrian environments using the validated MAPS-Mini audit tool, identify barriers, and advocate for improvements. Participants (n = 50) were recruited from four low-income senior housing sites in San Diego, CA, which were randomly assigned to an 8-week advocacy program or physical activity (PA) comparison intervention. Evaluation included surveys, accelerometers to assess PA, and direct observation. Primary outcomes were seniors’ advocacy confidence and skills. Main analyses used repeated measures ANOVAs. Seniors in the advocacy condition (n = 17) increased their advocacy outcome efficacy (p = .03) and knowledge of resources (p = .04) more than seniors in the PA condition (n = 33). Most seniors in the advocacy condition completed a street audit (84%), submitted an advocacy request (79%), or made an advocacy presentation to city staff (58%). Environmental changes included repairs to sidewalks and crosswalks. City staff approved requests for lighting, curb cuts, and crosswalk markings. Seniors’ accelerometer-measured PA did not significantly increase, but self-reported transportation activity increased in the PA condition (p = .04). This study showed the potential of advocacy training to empower seniors to make communities more age- and activity-friendly.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S583-S583
Author(s):  
Philip A Rozario ◽  
Emily Greenfield ◽  
Nancy Kusmaul

Abstract Social networks provide opportunities for engagement with others and structure the receipt and provision of emotional, instrumental, informational and appraisal support. Indeed scholars in this field have documented the importance of having strong social networks in influencing older adults’ well-being and quality of life. The three papers in this symposium draw on the convoy model of social relations and ecological model to examine and better understand the micro, mezzo, macro contexts that shape and influence how older people engage with and benefit from their networks in three areas: low-income senior housing communities, urban areas specifically targeting older Latinos with dementia, and disaster preparedness in micropolitan counties in eastern Iowa. The first paper, a cross-sectional study focusing on social connections in senior housing communities, examines levels of social networks, engagement, support and loneliness and their relationship with well-being outcomes. The second paper, a community-based participatory research project, reports an intervention that seeks to train natural helpers in a predominantly Latino urban neighborhood to identify and refer older Latinos with dementia to bilingual assessment services. The third paper, synthesizing findings from interventions targeting network building at the individual and state levels as well as a community-based network analysis, presents ways to strengthen networks at the mezzo and macro levels as well as environmental contexts that enable better disaster preparedness for community-based older adults. These papers will consider practice, policy and research implications in strengthening social networks and engagement to optimize older adults’ well-being in various settings.


2017 ◽  
Vol 31 (6) ◽  
pp. 610-616 ◽  
Author(s):  
Antoinette B. Coe ◽  
Leticia R. Moczygemba ◽  
Kelechi C. Ogbonna ◽  
Pamela L. Parsons ◽  
Patricia W. Slattum ◽  
...  

Older adults may be at risk of adverse outcomes after emergency department (ED) visits due to ineffective transitions of care. Semi-structured interviews were employed to identify and categorize reasons for ED use and problems that occur during transition from the ED back to home among 14 residents of low-income senior housing. Qualitative thematic and descriptive analyses were used. Ambulance use, timely ED use or a wait-and-see approach, and lack of health-care provider contact before ED visit were emergent themes. Delayed medication receipt, no current medication list, and medication knowledge gaps were identified. Lack of a personal health record, follow-up care instruction, and worsening symptoms education emerged as transition problems from ED to home. After an ED visit, education opportunities exist around seeing primary care providers for nonurgent conditions, follow-up care, medications, and worsening condition symptoms. Timely receipt of discharge medications and medication education may improve medication-related transition problems.


2016 ◽  
Vol 44 (3) ◽  
pp. 463-475 ◽  
Author(s):  
Rebecca Langford ◽  
Christopher Bonell ◽  
Kelli Komro ◽  
Simon Murphy ◽  
Daniel Magnus ◽  
...  

The World Health Organization’s Health Promoting Schools (HPS) framework is a whole-school approach to promoting health that recognizes the intrinsic relationship between health and education. Our recent Cochrane systematic review found HPS interventions produced improvements in a number of student health outcomes. Here we reflect on what this review was not able to tell us: in other words, what evidence is missing with regard to the HPS approach. Few HPS interventions engage with schools’ “core business” by examining impacts on educational outcomes. Current evidence is dominated by obesity interventions, with most studies conducted with children rather than adolescents. Evidence is lacking for outcomes such as mental or sexual health, substance use, and violence. Activities to engage families and communities are currently weak and unlikely to prompt behavioral change. The HPS approach is largely absent in low-income settings, despite its potential in meeting children’s basic health needs. Intervention theories are insufficiently complex, often ignoring upstream determinants of health. Few studies provide evidence on intervention sustainability or cost-effectiveness, nor in-depth contextual or process data. We set out an agenda for future school health promotion research, considering implications for key stakeholders, namely, national governments, research funders, academics, and schools.


2016 ◽  
Vol 32 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Stephen J. Hile ◽  
Matthew B. Feldman ◽  
Amanda R. Raker ◽  
Mary K. Irvine

Purpose: To collect information that will inform the development of an intervention to support the maintenance of HIV-related health-promoting behaviors. Design: Focused, in-depth individual and group interviews. Setting: The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) and DOHMH-funded community-based organizations that primarily serve low-income people living with HIV within the five boroughs of NYC. Participants: A total of 42 individuals who had participated in The Positive Life Workshop—an HIV self-management intervention adapted and implemented by the NYC DOHMH. Method: Purposive sampling was used to recruit study participants. Five 60- to 90-minute focus groups (n = 38) and 4 individual interviews were conducted to assess motivations for and barriers to maintaining HIV-related health-promoting behaviors and to elicit feedback on the content and format for the proposed maintenance intervention. Thematic analysis was used to summarize the data. Results: Participants reported that relationships with family, a responsibility to protect others from HIV, and faith/spirituality supported the maintenance of health-promoting behaviors. Barriers to behavior maintenance included substance use and mental health issues. Meeting in small groups was also highlighted as a motivator to sustaining health behaviors, particularly in decreasing isolation and receiving affirmation from others. Conclusion: Participants identified several factors that could be incorporated into an intervention to support HIV-related health-promoting behavior maintenance that could supplement existing HIV self-management interventions.


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