scholarly journals Not out-of-reach: Engaging the older old isolated African Americans with and without MCI

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 630-631
Author(s):  
Laura Struble ◽  
Kathleen Potempa ◽  
Benjamin Hampstead ◽  
Alexis Ellis ◽  
Jesica Pedroza ◽  
...  
Keyword(s):  
Older Adults ◽  
African Americans ◽  
Retention Rate ◽  
Recruitment Methods ◽  
Successful Recruitment ◽  
Technology Intervention ◽  
Internet Connections ◽  
Home Training ◽  
Black Elders ◽  
User Friendly

Abstract The Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTrials.gov: NCT02871921) is a multi-center randomized, 12-month efficacy study. There is converging evidence that social isolation is a risk factor of cognitive decline and dementia. We hypothesized that increasing social interaction in older adults with normal cognition or mild cognitive impairment (MCI) could improve or sustain cognitive function through internet-based conversational engagement. African Americans (AA) are at higher risk for developing dementia but their participation in clinical trials is low. Objectives: (1) discuss the effective outreach process to recruit urban AA older old adults (mean targeted age of 80+); (2) describe how we retained participants in a yearlong study using technology-based interventions. The most successful outreach and recruitment sources were the voter registration mass mailings and the Healthier Black Elders Research Center. Successful recruitment methods included: hiring diverse staff, compensating participants’ time, and adjusting research protocols for opting out of MRIs and genetic saliva samples. Technology intervention strategies included: providing user-friendly Chromebooks and free internet connections, simple instructions with pictures, vision and hearing correction, and in-home training with technology support backup. During the pandemic, we could assists participants in learning to use the laptop remotely. Over 12,000 subjects were contacted, which led to 39 randomized participants. Our retention rate thus far is over 75%. This demonstrates that AA older adults are reachable, willing to participate in research and able to use communication technology with appropriate supports for long-term sustainable interaction that may improve cognition and health equity.

scholarly journals The Health and Well-Being of African-American Older Adults With a History of Incarceration

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 506-506
Author(s):  
Rodlescia Sneed
Keyword(s):  
Older Adults ◽  
African American ◽  
African Americans ◽  
Well Being ◽  
Formerly Incarcerated ◽  
Older Prisoners ◽  
Health Related ◽  
History Of ◽  
Health And Well Being ◽  
African American Older Adults

Abstract African-Americans are overrepresented in the criminal justice system. Longer prison stays and release programs for older prisoners may result in an increased number of community-dwelling older adults with a history of incarceration. In recent years, there has been a substantial increase in research on health-related outcomes for currently incarcerated older adults; however, there has been little inquiry into outcomes for formerly incarcerated African-American older adults following community re-entry. In this study, we used secondary data from the Health and Retirement Study to describe employment, economic, and health-related outcomes in this population. Twelve percent of the 2238 African-Americans in our sample had been previously incarcerated. Those who had been previously incarcerated had higher rates of lung disease, arthritis, back problems, mobility problems, and mental health issues than their counterparts. They also had higher rates of hospitalization and lower use of dental health services. Further, while they did not experience lower employment rates than those with no criminal history, those who had been incarcerated had more physically demanding jobs and reported greater economic strain. Given the disproportionate incarceration rates among African-Americans, the aging of the prison population, and the increase in community re-entry for older prisoners, research that explores factors that impact the health and well-being of formerly incarcerated individuals has broad impact. Future work should focus on addressing the needs of this vulnerable population of African-American older adults.

scholarly journals Near-falls in Singapore community-dwelling older adults: a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shawn Leng-Hsien Soh ◽  
Chee-Wee Tan ◽  
Judith Lane ◽  
Ting-Ting Yeh ◽  
Benjamin Soon
Keyword(s):  
Older Adults ◽  
Retention Rate ◽  
Community Dwelling ◽  
Retention Rates ◽  
Reach To Grasp ◽  
Balance Recovery ◽  
Recruitment And Retention ◽  
Body Regions ◽  
Near Falls ◽  
Community Dwelling Older Adults

Abstract Background A near-fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near-falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near-fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near-fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near-falls and associated balance recovery manoeuvres. Texting and calling methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near-fall or fall incidence over 21 days using either daily texting or calling. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near-falls or falls. Secondary outcomes included the self-reported incidence of falls and near-falls. Results Thirty older adults were recruited in 5 weeks. All participants completed the study. They understood near-fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected calling as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near-falls were recorded. Sixteen participants (53.3%) experienced near-falls and half of this group experienced two or more near-falls. The use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near-falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near-falls and balance recovery manoeuvres. Both texting and calling were feasible reporting methods, but texting was preferred. Trial registration ClinicalTrials identifier: NCT04087551. Registered on September 12, 2019

Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

2021 ◽  
pp. 1-14
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Lun-Ching Chang
Keyword(s):  
Older Adults ◽  
Health Disparities ◽  
African Americans ◽  
Health Outcomes ◽  
Sex Education ◽  
Screening Program ◽  
Healthcare Services ◽  
Social Dimension ◽  
Medical Comorbidities ◽  
Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

scholarly journals Evaluation of the design and implementation of municipal ice cleat distribution programs for the prevention of ice-related fall injuries among older adults in Sweden

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253054
Author(s):  
Robin Holmberg ◽  
Johanna Gustavsson ◽  
Carl Bonander
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Injury Rates ◽  
Fall Injuries ◽  
Behavior Change Theory ◽  
Barriers To Implementation ◽  
Group Interviews ◽  
Main Barrier ◽  
And Behavior ◽  
User Friendly

Introduction The risk for outdoor falls tends to increase during winter due to icy road conditions. Several Swedish municipalities have introduced programs that provide their senior citizens with a pair of ice cleats in an attempt to tackle this problem. In this paper, we perform a process evaluation to identify potential barriers to the success of these programs and analyze the logic of their design. Methods We sent a survey to all 290 Swedish municipalities to collect data on the characteristics of ice cleat distribution programs. We also performed focus-group interviews with older adults to gain insight into their thoughts about ice cleat programs. We synthesized our data with existing literature on ice cleats and behavior change theory to populate a logic model to identify and analyze hidden assumptions and potential flaws using program theory analysis. Results On average, about 40% of the eligible population living in the intervention municipalities collected a pair of ice cleats. While we identified some other, but mostly minor, barriers to implementation, the main barrier appears to be a lack of scale (i.e., insufficient procurement and distribution of ice cleats), as 90% of all purchased ice cleats were eventually distributed. While previous research suggests that ice cleats can decrease injury risks if worn, we find that there is limited evidence on the effects of distribution on ice cleat use. Our interviewees emphasized the potential utility of ice cleats for staying safe and active during winter but stressed that ice cleats need to be user-friendly and of high-quality to increase the likelihood that a distribution program encourages behavior change. Conclusion Existing ice cleat distribution programs appear to have reached a meaningful share of the targeted population. Additional research is required to assess their effects on ice cleat use and injury rates.

scholarly journals Temporal aspects of wellbeing in later life: gardening among older African Americans in Detroit

2019 ◽  
Vol 40 (12) ◽  
pp. 2614-2634
Author(s):  
Jessica C. Robbins ◽  
Kimberly A. Seibel
Keyword(s):  
Older Adults ◽  
African Americans ◽  
Social Relations ◽  
Multiple Scales ◽  
Later Life ◽  
Structural Inequality ◽  
City Life ◽  
Social And Emotional ◽  
Older African Americans ◽  
Nuanced Understanding

AbstractGardening has well-established physical, social and emotional benefits for older adults in varied circumstances. In Detroit, Michigan (United States of America), as in many cities, policy makers, funders, researchers, community organisations and residents regard gardening as a means of transforming bodies, persons, communities, cities and broader polities. We draw on ethnographic research conducted during one gardening season with 27 older African Americans in Detroit to foreground the social dimensions of wellbeing in later life and thus develop a more robust and nuanced understanding of gardening's benefits for older adults. Based on anthropological understandings of personhood and kinship, this article expands concepts of wellbeing to include social relations across multiple scales (individual, interpersonal, community, state) and temporalities (of the activity itself, experiences of ageing, city life). Even when performed alone, gardening fosters connections with the past, as gardeners are reminded of deceased loved ones through practices and the plants themselves, and with the future, through engagement with youth and community. Elucidating intimate connections and everyday activities of older African American long-term city residents counters anti-black discourses of ‘revitalisation’. An expansive concept of wellbeing has implications for understanding the generative potential of meaningful social relations in later life and the vitality contributed by older adults living in contexts of structural inequality.

Recruitment lessons learned from a tailored web-based health intervention Project Y.E.A.H. (Young Adults Eating and Active for Health)

2015 ◽  
Vol 115 (5) ◽  
pp. 470-479 ◽  
Author(s):  
Onikia Brown ◽  
Virginia Quick ◽  
Sarah Colby ◽  
Geoffrey Greene ◽  
Tanya M. Horacek ◽  
...  
Keyword(s):  
College Students ◽  
Community Based Participatory Research ◽  
Health Intervention ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Recruitment Strategies ◽  
Web Based ◽  
Content Type ◽  
Recruitment Methods ◽  
Successful Recruitment

Purpose – Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach – The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings – Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications – This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value – This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

scholarly journals Feasibility of Conducting Nonpharmacological Interventions to Manage Dementia Symptoms in Community-Dwelling Older Adults: A Cluster Randomized Controlled Trial

2019 ◽  
Vol 35 ◽  
pp. 153331751987263 ◽  
Author(s):  
Juyoung Park ◽  
Magdalena I. Tolea ◽  
Diane Sherman ◽  
Amie Rosenfeld ◽  
Victoria Arcay ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Retention Rate ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Cluster Randomized Controlled Trial ◽  
Group Differences ◽  
Significant Group ◽  
Randomized Controlled ◽  
Cluster Randomized

This study assessed the feasibility of conducting 3 nonpharmacological interventions with older adults in dementia, exploring the effects of chair yoga (CY), compared to music intervention (MI) and chair-based exercise (CBE) in this population. Using a cluster randomized controlled trial (RCT), 3 community sites were randomly assigned 1:1:1 to CY, MI, or CBE. Participants attended twice-weekly 45-minute sessions for 12 weeks. Thirty-one participants were enrolled; 27 safely completed the interventions and final data collection (retention rate of 87%). Linear mixed modeling was performed to examine baseline and longitudinal group differences. The CY group improved significantly in quality of life compared to the MI group (CY mean = 35.6, standard deviation [SD] = 3.8; MI mean = 29.9, SD = 5.3, P = .010). However, no significant group differences were observed in physical function, behavioral, or psychological symptoms (eg, for mini-PPT: slopetime = 0.01, standard error [SE] = 0.3, P = .984 in the CBE group; slopetime = −0.1, SE = 0.3, P = .869 in the MI group; slopetime = −0.3, SE = 0.3, P = .361 in the CY group) over the 12-week intervention period. Overall, this pilot study is notable as the first cluster RCT of a range of nonpharmacological interventions to examine the feasibility of such interventions in older adults, most with moderate-to-severe dementia. Future clinical trials should be conducted to examine the effects of nonpharmacological interventions for older adults with dementia on health outcomes.

scholarly journals 86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Sasiporn Ounjaichon ◽  
Chris Todd ◽  
Emma Stanmore ◽  
Elisabeth Boulton
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Retention Rate ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Programme ◽  
Community Dwelling ◽  
Control Group ◽  
Functional Exercise ◽  
Randomised Controlled

Abstract Introduction Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults. Methods Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention. Results We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported. Conclusion The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.

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