Designing a stakeholder-inclusive service model for an eHealth service to support older adults in an active and social life

Abstract Background Service model design is slowly being recognized among eHealth developers as a valuable method for creating durable implementation strategies. Nonetheless, practical guidelines and case-studies that inform the community on how to design a service model for an eHealth innovation are lacking. This study describes the development of a service model for an eHealth service, titled ‘SALSA’, which intends to support older adults with a physically active and socially inclusive lifestyle. Methods The service model for the SALSA service was developed in eight consecutive rounds, using a mixed-methods approach. First, a stakeholder salience analysis was conducted to identify the most relevant stakeholders. In rounds 2–4, in-depth insights about implementation barriers, facilitators and workflow processes of these stakeholders were gathered. Rounds 5 and 6 were set up to optimize the service model and receive feedback from stakeholders. In rounds 7 and 8, we focused on future implementation and integrating the service model with the technical components of the eHealth service. Results While the initial goal was to create one digital platform for the eHealth service, the results of the service modelling showed how the needs of two important stakeholders, physiotherapists and sports trainers, were too different for integrating them in one platform. Therefore, the decision was made to create two platforms, one for preventive (senior sports activities) and one for curative (physical rehabilitation) purposes. Conclusions A service model shows the interplay between service model design, technical development and business modelling. The process of service modelling helps to align the interests of the different stakeholders to create support for future implementation of an eHealth service. This study provides clear documentation on how to conduct service model design processes which can enable future learning and kickstart new research. Our results show the potential that service model design has for service development and innovation in health care.

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Sex Difference in Self-Reported Sexual Functioning Among Frail Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1002 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 313-313

Author(s):

Brianne Olivieri-Mui ◽

Sandra Shi ◽

Ellen McCarthy ◽

Dae Kim

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Sex Differences ◽

Sexual Function ◽

Older Adult ◽

Sexual Functioning ◽

Social Life ◽

Well Being ◽

Adult Males ◽

Males And Females

Abstract Frailty may differentially impact how older adult males and females perceive sexual functioning, an important part of well-being. We assessed the level of frailty (robust, pre-frail, frail) for anyone with data on 11 sexual functioning questions asked in wave 2 of the National Social Life, Health, and Aging Project, 2010-2011 (n=2060). Questions covered five domains: overall sexual function (OSF), sexual function anxiety (SFA), changes in sexual function (CSF), erectile/vaginal dysfunction (EVD), and masturbation. Logistic regression identified sex differences in frailty and reporting worse sexual functioning. Linear regression predicted the number of domains reported as worse. Among males (n=1057), pre-frailty meant higher odds of reporting SFA (OR 1.8 95%CI 1.2-6.6), CSF (OR 1.7 95%CI 1.1-2.7), and EVD (OR 1.5 95%CI 1.0-2.2). Among females (n=1003), there was no difference in reporting by frailty. Females were more likely to report worse OSF (Robust: OR 7.4, 95%CI 4.8-11.4; Pre-frail: OR 6.2, 95%CI 3.9-9.9; Frail: OR 3.4 95%CI 1.7-6.6), but less likely to report SFA (Robust OR .3, 95%CI .2-.5; Pre-frail OR .2, 95%CI .1-.3; Frail OR .2 95%CI .1-.3). Pre-frail and frail females reported fewer domains as worse (Pre-frail coefficient -0.21 SE 0.09, Frail -0.43 SE 0.14). As frailty worsened, males reported more domains as worse (Pre-frail 0.24 SE 0.07, Frail 0.29 SE 0.08). Self-reported sexual functioning differs by sex at all levels of frailty, and reporting by males, but not females, changes with frailty. Providers should be aware that sexual functioning is of importance to both sexes despite varying degrees of frailty.

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Dynamics of Multimorbidity Resilience and Health Outcomes Over Time in Community-Residing Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.3285 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 890-891

Author(s):

Yingzhi Xu ◽

Zahra Rahmaty ◽

Eleanor McConnell ◽

Tingzhong (Michelle) Xue ◽

Bada Kang ◽

...

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Physical Health ◽

Social Life ◽

Structural Equation ◽

Equation Modeling ◽

Psychological Resilience ◽

Pain Level ◽

Reciprocal Relationships ◽

Over Time

Abstract Multimorbidity resilience may mitigate the adverse effects of multiple chronic diseases on older adults’ health. Wister et al.’s (2018) multimorbidity resilience index was developed and tested in a cross-sectional sample of older adults in Canada. Building on these findings, we examined the reciprocal relationships of resilience on outcomes to test these potentially mitigating effects in a community-based, U.S. sample of older adults over time. The study sample includes 1,054 older adults from waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) study (Waite et al 2020). Wister et al.’s (2018) index was mapped to NSHAP measures, and reciprocal relationships of multimorbidity resilience and health outcomes over a 5-year period was tested using structural equation modeling (SEM). Results indicated significant effects of multimorbidity resilience on self-rated physical health and pain. Interestingly, a better functional resilience at baseline conferred better self-rated physical health at follow-up, while better psychological resilience predicted lower pain level. By contrast, the influence of health outcomes on any domain of multimorbidity resilience was not detectable at all, supporting the direction of these associations from resilience to outcomes. The study systematically investigated the dynamic hypotheses between multimorbidity resilience and health outcomes. That is, whether they are determinants or consequences, or both. Our findings suggest multimorbidity resilience predicts subsequent 5-year change in health outcomes, especially self-rated physical health and pain level, but not vice versa, strengthening the evidence of the importance of resilience in the health of older adults.

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The Sense of Smell and Aging: What We Have Learned From Population Studies

Innovation in Aging ◽

10.1093/geroni/igaa057.2947 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 810-811

Author(s):

Jayant Pinto

Keyword(s):

Mental Health ◽

Older Adults ◽

Social Life ◽

Large Scale ◽

Population Studies ◽

Vital Role ◽

Sensory Function ◽

Physical And Mental Health ◽

Sense Of Smell ◽

Health Aging

Abstract Decline of the sense of smell with age causes a marked impact on older adults, markedly reducing quality of life. Olfactory dysfunction impairs nutrition, decreases the ability to experience pleasure, and results in depression, among other burdens. Large-scale population studies have identified impaired olfaction as a key heath indicator that predicts the development of decreased physical and mental health, reduced physical activity, weight loss, mild cognitive impairment and dementia, and mortality itself. These data have been generated via analyses of data from several aging cohorts, including the National Social Life, Health, and Aging Project (NSHAP); the Beaver Dam cohort; the Atherosclerosis Risk in Communities project; the Rush Memory and Aging Project; the Health, Aging, and Body Composition project; the Washington Heights/Inwood Columbia Aging Project; among others. In this presentation, we will review the close connection between olfaction, health, aging, including discussion of insights from these studies. We will also discuss emerging data from NSHAP on the effects of sensory function on cognition, mental health, and social interaction, which demonstrate that sensory function plays a vital role in the lives of older adults. Part of a symposium sponsored by Sensory Health Interest Group.

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They Do Their Best, but Their Best Isn’t Good Enough: How Social Housing Can Support Older Tenants Aging in Place

Innovation in Aging ◽

10.1093/geroni/igaa057.075 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 23-23

Author(s):

Christine Sheppard ◽

Andrea Austen ◽

Sander Hitzig

Keyword(s):

Older Adults ◽

Social Housing ◽

Service Providers ◽

Policy Implications ◽

Service Model ◽

Building Trust ◽

Age In Place ◽

Access To Health ◽

The City

Abstract Toronto Community Housing (TCH) is the second largest social housing landlord in North America, and is home to over 27,000 older adults, half of whom live in 83 “seniors-designated” buildings. There is inadequate and inconsistent delivery of services in these buildings, negatively impacting tenants’ ability to age in place. We conducted two half-day consultations with service providers (n=74) and tenants (n=100) to identify strategies to improve unit condition, promote stable tenancies (i.e., prevent evictions) and enhance access to health and support services for older adults living in TCH. Through facilitated discussion, participants identified their top two recommendations for each priority area and reflected on the strategies that were hardest and easiest to implement, as well as the ones that would have the most and least impact on quality of life for older tenants. Participants recognized the need for more education as a way to empower older tenants and reduce stigma associated with unit condition issues (e.g., pest problems) and arrears. More frequent touch points with tenants was also recommended as a way to identify older adults at-risk of eviction and work proactively (instead of reactively) to support them. Service providers and tenants believed that system navigators working directly in the buildings would be a key facilitator to building trust and helping older tenants access needed services. Outcomes of the have several program and policy implications for TCH, as they partner with the City of Toronto to design a new integrated service model for the seniors-designated buildings.

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Driving Cessation and Social Participation in Late Life: A Systematic Review

Innovation in Aging ◽

10.1093/geroni/igaa057.1504 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 464-464

Author(s):

Weidi Qin

Keyword(s):

Older Adults ◽

Social Participation ◽

Social Engagement ◽

Social Life ◽

Late Life ◽

Cochrane Library ◽

Inclusion Criteria ◽

Driving Cessation ◽

The Us

Abstract Driving cessation is a major life transition in late life, and can affect the quality of social life in older adults. The present study aims to systematically review the literature on how driving cessation affects social participation among older adults in the US. The study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Extant literature published from 1990 to 2019 that examined driving cessation and social participation or social engagement among older adults in the US was searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Scopus, Transportation Research Board Publication Index, and Cochrane Library. Quantitative studies that met the inclusion criteria were reviewed. The assessment of methodological quality was also conducted for included studies. In total, seven studies met the inclusion criteria. Six of the included studies found significant relationships between driving cessation and at least one domain of social participation, such as volunteering, employment, leisure-time activities, and the frequency of contacts. However, the measures of social participation were inconsistent across studies, which might explain that no effects of driving cessation were found on the structure of social network, such as contacts with friends and extended family. There is a need to assist older adults in successfully transitioning to driving cessation and maintaining the social participation. The overall quality of included studies is moderate based on the assessment of risk of bias and confounding.

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Older Adults’ Utilization of Community Resources Targeting Fall Prevention and Physical Activity

The Gerontologist ◽

10.1093/geront/gnx210 ◽

2018 ◽

Vol 59 (3) ◽

pp. 436-446 ◽

Cited By ~ 3

Author(s):

Siobhan K McMahon ◽

Young Shin Park ◽

Beth Lewis ◽

Weihua Guan ◽

J Michael Oakes ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Fall Prevention ◽

Local Community ◽

Phase 1 ◽

Implementation Strategies ◽

Community Resources ◽

Phase 2 ◽

Internal Resources ◽

Diagnosis Of Dementia

Abstract Background and Objectives Despite the availability of community resources, fall and inactivity rates remain high among older adults. Thus, in this article, we describe older adults’ self-reported awareness and use of community resources targeting fall prevention and physical activity. Research Design and Methods In-depth, semistructured interviews were conducted in Phase 1 with community center leaders (n = 5) and adults (n = 16) ≥70 years old whose experience with community programs varied. In Phase 2, surveys were administered to intervention study participants (n = 102) who were ≥70 years old, did not have a diagnosis of dementia, and reported low levels of physical activity. Results Four themes emerged from Phase 1 data: (a) identifying a broad range of local community resources; (b) learning from trusted sources; (c) the dynamic gap between awareness and use of community resources; and (d) using internal resources to avoid falls. Phase 2 data confirmed these themes; enabled the categorization of similar participant-identified resources (10); and showed that participants who received encouragement to increase community resource use, compared to those who did not, had significantly greater odds of using ≥1 resource immediately postintervention, but not 6 months’ postintervention. Discussion and Implications Although participants in this study were aware of a broad range of local community resources for physical activity, they used resources that support walking most frequently. Additionally, receiving encouragement to use community resources had short-term effects only. Findings improve our understanding of resources that need bolstering or better dissemination and suggest researchers identify best promotion, dissemination, implementation strategies.

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The relationship between activities of daily living,falls and fear of falling in older adults : A crosssectional study

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v20i2.51559 ◽

2021 ◽

Vol 20 (2) ◽

pp. 420-425

Author(s):

Hamed Mortazavi ◽

Mahbubeh Tabatabaeichehr ◽

Masoumeh Taherpour ◽

Mohadece Masoumi

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Social Life ◽

Daily Living ◽

Fear Of Falling ◽

Medical Science ◽

The Elderly ◽

Cluster Sampling ◽

Elderly Persons ◽

The Relationship

Objective : Doingactivities of daily living can bring independence for the elderly. It can also maintain their health and social participation. However, experience of falls and fear of falling can affect the health and personal social life of the elderly. The aim of this study was to evaluate the relationship between falls and fear of falling with activities of daily living in older adults. Materials and methods : Four hundred and fifty elderly persons were enrolled in this cross-sectional study using cluster sampling. Demographic variables, Fall Efficacy Scale- International (FES-I) and questionnaires related to the study of activities of daily living were employed. To investigate advanced activities of daily living, open-ended questions were used. The history of falls within the last 12 months was investigated. Results : Mean score of basic activities of daily living in the elderly being studied was 15.49±1.74, and 95.4% of them were independent in doing these activities.Mean score of instrumental activities of daily living was 11.30±3.36, and 71.5% of them were independent in doing these activities. Participation of elderly persons in social activities was reported to be 77.9%. There was a significant relationship between activities of daily living (basic, instrumental, and advanced) and falls and fear of falling (p<0.05). Conclusion : Falls and fear of falling reduce the independence of elderly persons in doing activities of daily living. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.420-425

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MULTIMORBIDITY IN OLDER ADULTS: CAN DISEASE CLUSTER PREDICT DEPRESSION SEVERITY?

Innovation in Aging ◽

10.1093/geroni/igz038.1450 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S393-S394

Author(s):

Jacquelyn Minahan

Keyword(s):

Older Adults ◽

Depressive Symptom ◽

Symptom Severity ◽

Social Life ◽

Chronic Conditions ◽

Secondary Data ◽

Depression Severity ◽

Disease Clusters ◽

Disease Cluster ◽

Depressive Symptom Severity

Abstract Multimorbidity, defined as the co-occurrence of two or more chronic conditions, is positively correlated with depression severity among older adults. However, few studies have compared depression outcomes by disease cluster. To address this gap, secondary data analyses were performed using data from the National Social Life, Health, and Aging Project (NSHAP), Wave 2. For the purpose of this study, disease clusters are composed of conditions that implicate similar body systems (e.g., musculoskeletal system, cardiovascular system). Participants reported an average of 2.69 (+/- 1.97) chronic conditions. Multimorbidity and depressive symptom severity, as measured by the Center for Epidemiological Studies – Depression, Iowa Form (CES-D) were positively associated (p<0.001). Individual disease clusters, age, self-identifying as female, and lower educational attainment were predictive of depressive symptom severity (p<0.001). Findings support the necessary inclusion of social determinants (health status, gender, education, age) in the conceptualization of health and health outcomes within an aging population.

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UNIMAGINED FUTURES: THE PARADOX OF FAMILISM AND ELDERCARE AMONG AGING LATINOS IN THE CHICAGOLAND AREA

Innovation in Aging ◽

10.1093/geroni/igz038.2624 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S715-S715

Author(s):

Melissa Howe ◽

Alexis Howard ◽

Wendy Hsieh ◽

Lissette M Piedra

Keyword(s):

Older Adults ◽

Cultural Values ◽

Old Age ◽

Social Life ◽

Successful Aging ◽

Older Adulthood ◽

Nativity Status ◽

North Americans ◽

Physical Independence ◽

Latino Older Adults

Abstract Scholars of gerontology highlight the ways aging varies cross-culturally. Whereas North Americans tend to describe “successful aging” as the maintenance of social and physical independence, Latin Americans tend to view aging as a natural process of social transition. In this study, we conducted a content analysis of nine focus groups (N =101) and 20 interviews with Latino older adults in the Chicagoland area to examine how they characterize successful aging and view the health declines that accompany aging. We found that Latino older adults often used rhetoric associated with “successful aging,” which tended to emphasize the maintenance of independence and physical functioning. Even immigrant respondents employed this language, suggesting that descriptions of “good old age,” may be more culturally transferable than previously thought. At the same time, the cultural values of respeto and familismo also emerged. Regardless of the participant’s nativity status, centrality of family and the importance of respect represented constant sources of support. Still, adherence to these values came with considerable drawbacks for those intensely focused on self-sacrifice for the sake of their families. Taken together, “successful old age” was defined by the participants as one in which a person maintains physical independence in the context of an interdependent, kin-focused, social life. This paradoxical combination of valuing independence and familial interdependence produced a number of benefits and challenges for Latino adults as they transitioned into to older adulthood.

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Perception of COVID-19 Restrictions on Daily Life among Japanese Older Adults: A Qualitative Focus Group Study

Healthcare ◽

10.3390/healthcare8040450 ◽

2020 ◽

Vol 8 (4) ◽

pp. 450

Author(s):

Risa Takashima ◽

Ryuta Onishi ◽

Kazuko Saeki ◽

Michiyo Hirano

Keyword(s):

Older Adults ◽

Focus Group ◽

Rural Areas ◽

Social Life ◽

Functional Decline ◽

Purpose In Life ◽

Community Dwelling ◽

Focus Group Study ◽

Sense Of Purpose ◽

Social Risks

The coronavirus disease 2019 (COVID-19) pandemic has exposed older adults to health and social risks. This study examined the perceptions of community-dwelling older adults regarding how COVID-19 restricted their daily lives. Six focus-group interviews were conducted with 24 participants (mean age, 78.2 ± 5.5 years) living in urban and rural areas in Japan. Then, a qualitative inductive content analysis was performed. Six themes were generated: “fear of infection and public, watchful eyes,” “consistency in daily personal life,” “pain from reducing my social life,” “readiness to endure a restricted life,” “awareness of positive changes in myself,” and “concern for a languishing society.” There was no change that would make their lives untenable, and they continued their daily personal lives at a minimum level. However, their social lives were reduced, which over the long term can lead to a lost sense of purpose in life. This was reported as an adverse factor in the development of other diseases and functional decline in previous studies. While there is no doubt that infection prevention is important, supporting older adults in engaging in activities that provide a sense of purpose in life could contribute to their present and future overall health including mental health.

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