scholarly journals Increased Self-Efficacy among Older Adults Aging-in-Place during COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 619-620
Author(s):  
Lee Lindquist ◽  
Amber Miller ◽  
Ruqayyah Muhammed ◽  
Lauren Opsasnick ◽  
Alaine Murawski ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Self Efficacy ◽  
Aging In Place ◽  
Community Dwelling ◽  
Measurement Information ◽  
Age In Place ◽  
Home Based ◽  
Low Health Literacy ◽  
Patient Reported

Abstract Self-efficacy is defined as a person's belief in their capacity to execute behaviors necessary to produce specific performance attainments. It also reflects confidence in the ability to exert control over motivation, behavior, and environment. During the COVID-19 pandemic, older adults were stressed with forced isolation, concerns over mortality, and finding alternate means of fulfilling their home-based needs. We sought to assess how COVID-19 pandemic affected the self-efficacy of a cohort of older adults aging-in-place. The LITCOG cohort is a group of community-dwelling older adults (65 years and older) who have had longitudinally assessment of cognition, health literacy, and functional skills over the past 15 years. As part of a larger study of the LITCOG cohort assessing decision making for aging-in-place, we assessed self-efficacy using validated PROMIS (Patient-Reported Outcomes Measurement Information System) measures with older adults prior to COVID-19 and during the COVID-19 pandemic. Survey results were obtained from 214 subjects (n=66 pre-COVID and n=148 during COVID). Nearly half of the sample (48.2%) had either marginal (25.5%) or low health literacy (22.7%). PROMIS General Self Efficacy was higher among those assessed during the COVID-19 pandemic (45.8 (7.7) pre-COVID vs 43.7 (8.0), p=0.07). PROMIS Self Efficacy for managing social interactions was higher during the COVID pandemic (45.0 (6.1) pre-COVID-19 vs. 48.7 (8.3) during COVID-19, p=0.02). During the stress and social isolation of the COVID-19 pandemic, older adults exhibited increased levels of self-efficacy. Ongoing longitudinal follow-up will determine how this self-efficacy evolves after the COVID-19 pandemic and impacts the ability to age-in-place.

2 Feet 4 Life : feasibility of a foot care self-management intervention for older adults without diabetes

2019 ◽  
Author(s):  
◽  
Jennifer J. O'Connor
Keyword(s):  
Older Adults ◽  
Self Efficacy ◽  
Community Dwelling ◽  
Self Management ◽  
Control Group ◽  
Foot Pain ◽  
Foot Care ◽  
Foot Health ◽  
Management Intervention ◽  
Patient Reported

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Foot problems are prevalent, impact over 30% of older adults, and can lead to loss of function, falls, and hospitalization. This pilot intervention study, based on Social Cognitive Theory, evaluated the feasibility, acceptability and preliminary efficacy of the 2 Feet 4 Life foot care self-management intervention on foot care knowledge, self-efficacy, self-management behaviors, foot pain and foot health. Thirty-two non-diabetic, community-dwelling older adults were recruited from two senior centers. One community center was randomized to receive the Intervention; the other served as Control. Within the Control group, participants were randomized into two subgroups: True Control and Bias Control. The 2 Feet 4 Life intervention consisted of one hour sessions for four consecutive weeks. Assessments occurred at baseline, one month, four months and seven months. Study recruitment and retention goals were met (90.6% retention rate). The intervention was safely and accurately implemented within the anticipated timelines. Although some participants reported difficulties with select vocabulary used on one or more the patient-reported outcome tools, participants found the intervention content valuable and session length and frequency acceptable. Modest improvements in foot care knowledge, foot care behaviors, and foot health were observed in the Intervention group. Based on our analysis, the estimated between group effect size of 2 Feet 4 Life intervention appears to be large for foot care knowledge, self-efficacy, and behaviors. Our findings suggest that the patient-reported and provider-reported outcome tools used in this study require further refinement and psychometric testing. Future fully powered studies need to include diverse samples of older adults with greater variability in foot health and foot pain.

Aging Gracefully in Place: An Evaluation of the Capability of the CAPABLE© Approach

2021 ◽  
pp. 073346482110426
Author(s):  
Jill Breysse ◽  
Sherry Dixon ◽  
Jonathan Wilson ◽  
Sarah Szanton
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Aging In Place ◽  
Intervention Group ◽  
Health Improvement ◽  
Control Group ◽  
Adult Health ◽  
Age In Place ◽  
Home Based

As American adults live longer, society must prioritize effective strategies promoting safe aging-in-place and decreasing institutional health care costs. Social determinants of health, especially housing, critically influence older adult health, particularly for disadvantaged, low-income older adults. Johns Hopkins University developed Community Aging in Place—Advancing Better Living for Elders (CAPABLE©), a client-centered, home-based program to improve older adults’ function and capacity to age in place. This evaluation studied CAPABLE’s long-term effectiveness in four distinct locations in California, North Carolina, Pennsylvania, and Vermont. Seven months after CAPABLE, intervention group participants experienced greater improvements than the control group in activities of daily living limitations (2-point vs. 0.7-point improvement, p = .012), falls efficacy (8.9-point improvement vs. 0.1-point worsening, p = .012), depression (1.3-point improvement vs. 0.4-point worsening, p = .021), and pain (1.5-point improvement vs. 0.3-point worsening, p = .002). These results add to existing research on short-term effectiveness in urban locales, showing CAPABLE yields long-term health improvement for older adults in micropolitan and small urban locations, with different implementation organizations, housing stocks, and clients.

scholarly journals Supporting Older Adults and Caregivers Through Integrative Service Learning During COVID

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 958-958
Author(s):  
Keith Chan ◽  
Sarah LaFave ◽  
Maggie Ratnayake ◽  
Christina Marsack-Topolewski ◽  
Jillian Graves ◽  
...  
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Community Resources ◽  
Learning Models ◽  
Process Data ◽  
Community Based ◽  
Age In Place ◽  
Home Based ◽  
Hands On ◽  
Hands On Learning

Abstract There is a growing population of older adults who are living longer and acquiring chronic illness and disabilities, making it difficult for them to complete everyday activities and age in place. More than 2 million of these older adults are homebound and 5 million need help leaving their homes. They experience social isolation, food insecurity, and lack of connection to community resources which has intensified since the pandemic. Integrative service learning models can provide home-based support to older adults while offering valuable, hands-on learning experiences for students. This study examined findings for a community-based program which trained university students to provide practical home-based support for older adults and their caregivers. Data was collected for 109 older adults who were connected with student trainees. Students provided services with groceries, companionship, and help accessing needed services. Findings from t-test results using the UCLA Loneliness Scale indicated that older adults reported less loneliness after engagement with students (mean difference = 6.15, t = 3.14, df = 82, p < 0.01). Qualitative process data suggested that older adults benefited from services and a connection to their assigned students prior to and during the pandemic. Student trainees reported that the experience enriched their learning and reaffirmed their commitment to working with older adults. Community-based service learning can address home-based needs of older adults and their caregivers and enhance learning opportunities for students. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers and students.

scholarly journals Promoting Problem Solving About Health Management: A Mixed-Methods Pilot Evaluation of a Digital Health Intervention for Older Adults With Pre-Frailty and Frailty

2021 ◽  
Vol 7 ◽  
pp. 233372142098568
Author(s):  
Annie T. Chen ◽  
Frances Chu ◽  
Andrew K. Teng ◽  
Soojeong Han ◽  
Shih-Yin Lin ◽  
...  
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
Health Literacy ◽  
Problem Solving ◽  
Self Efficacy ◽  
Health Management ◽  
Digital Health ◽  
Post Intervention ◽  
Problem Solving Skills ◽  
Health Related

Background: There is a need for interventions to promote health management of older adults with pre-frailty and frailty. Technology poses promising solutions, but questions exist about effective delivery. Objectives: We present the results of a mixed-methods pilot evaluation of Virtual Online Communities for Older Adults (VOCALE), an 8-week intervention conducted in the northwestern United States, in which participants shared health-related experiences and applied problem solving skills in a Facebook group. Methods: We performed a mixed-methods process evaluation, integrating quantitative and qualitative data, to characterize the intervention and its effects. We focus on four areas: health-related measures (health literacy and self-efficacy), participation, problem solving skills enacted, and subjective feedback. Results: Eight older adults with pre-frailty and frailty (age = 82.7 ± 6.6 years) completed the study. There was an upward trend in health literacy and health self-efficacy post-intervention. Participants posted at least two times per week. Content analysis of 210 posts showed participants were able to apply the problem solving skills taught, and exit interviews showed participants’ increased awareness of the need to manage health, and enjoyment in learning about others. Conclusion: This mixed-methods evaluation provides insight into feasibility and design considerations for online interventions to promote health management among vulnerable older adults.

scholarly journals Cost Effectiveness of a Home-Based Intervention That Helps Functionally Vulnerable Older Adults Age in Place at Home

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Eric Jutkowitz ◽  
Laura N. Gitlin ◽  
Laura T. Pizzi ◽  
Edward Lee ◽  
Marie P. Dennis
Keyword(s):  
Cost Effectiveness ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Model Parameters ◽  
Potential Cost ◽  
Functional Difficulties ◽  
Age In Place ◽  
Home Based ◽  
Occupational And Physical Therapy ◽  
Home Based Intervention

Evaluating cost effectiveness of interventions for aging in place is essential for adoption in service settings. We present the cost effectiveness of Advancing Better Living for Elders (ABLE), previously shown in a randomized trial to reduce functional difficulties and mortality in 319 community-dwelling elders. ABLE involved occupational and physical therapy sessions and home modifications to address client-identified functional difficulties, performance goals, and home safety. Incremental cost-effectiveness ratio (ICER), expressed as additional cost to bring about one additional year of life, was calculated. Two models were then developed to account for potential cost differences in implementing ABLE. Probabilistic sensitivity analyses were conducted to account for variations in model parameters. By two years, there were 30 deaths (9: ABLE; 21: control). Additional costs for 1 additional year of life was $13,179 for Model 1 and $14,800 for Model 2. Investment in ABLE may be worthwhile depending on society's willingness to pay.

scholarly journals Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-294
Author(s):  
Moriah Splonskowski ◽  
Holly Cooke ◽  
Claudia Jacova
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Old Age ◽  
Cognitive Assessment ◽  
Community Dwelling ◽  
Subjective Cognitive Decline ◽  
Cognitive State ◽  
Home Based ◽  
Increased Risk

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

EFFECTS OF COMPUTERIZED COGNITIVE TRAINING ON GAIT SPEED IN COMMUNITY DWELLING OLDER ADULTS, A PILOT STUDY

2016 ◽  
pp. 1-6
Author(s):  
J. Blackwood ◽  
T. Houston
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Gait Speed ◽  
Independent Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Home Based ◽  
Improved Function ◽  
Community Dwelling Older Adults

Background: In older adults declines in gait speed have been identified as predictors of functional decline and have been found in those with cognitive dysfunction. Cognitive training interventions that emphasize addressing executive function (EF) have resulted in a transfer effect from training cognitive processes into improved function. However research examining the effects of an EF specific computerized cognitive training (CCT) program on gait speed (GS) is limited. Objectives: To compare the effects of a six week EF specific CCT program on GS in community dwelling older adults using a pretest/posttest experimental design with subgroup comparisons based on a cutoff GS of 1.0m/s. Setting: Home based Participants: Forty independent living older adults (>65 years) without diagnosed cognitive impairment participated in either the intervention or control groups. Intervention: A six week long progressively challenging EF focused CCT program was performed at home. Measurements: Demographic variables, cognitive function (Trail-Making Test Part B) and GS were measured at baseline at week 7. Between group comparisons were completed for the whole sample initially with subgroup comparisons performed based on participants’ initial GS (Slow walkers: GS<1.0m/s; Fast Walkers: GS>1.0m/s). Results: No differences in GS were found for the whole population, but subgroup analyses restricted to slow walkers demonstrated a statistically significant improvement in GS after 6 weeks of CCT (µ =0.33 m/s, p = 0.03). Other outcomes measures were not statistically different at posttest. Conclusions: Older adults who walk at speeds <1.0m/s may benefit from a progressively challenging CCT program when self-administered in the home.

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