scholarly journals Exploring Household Food Security and Malnutrition Risk with Psychosocial Indicators of Healthy Ageing in Place: The Food Train - Eat Well Age Well Partnership Project

2020 ◽  
Author(s):  
Kate Reid ◽  
catherine lido ◽  
Hannah Ross ◽  
Michelle Carruthers ◽  
Laura Cairns ◽  
...  
Keyword(s):  
Older Adults ◽  
Food Insecurity ◽  
Food Access ◽  
Third Sector ◽  
Psychosocial Health ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Policy Implications ◽  
Risk Indicators ◽  
Household Food Security

In Scotland, and United Kingdom, there are stark inequalities in the experience of older age, particularly for those with limited social contact, poorer health, located in deprived neighbourhoods (Centre for Ageing Better 2015). This mixed-methodology research, reports survey findings with n=169 community dwelling older adults in Scotland (average age 79.5), supported with qualitative interviews to evidence the underexplored connection between food insecurity and physiological risk indicators of undernutrition (malnutrition), with psychosocial indicators of healthy ageing. Findings are grounded in collaboration with a third sector social enterprise – Food Train, who provide food shopping and volunteer meal making for those aged 65+. Findings revealed correlations between food insecurity and early indicators of malnutrition risk with poorer wellbeing, and social connectedness. Supported food access mitigates the negative cycle of food insecurity on mental health, via empowerment (locus of control) over one’s life. Qualitative findings suggest that risks of food insecurity may not be financial (food poverty), or attributable to health realities associated with ageing. Rather, psychosocial health and wellbeing diverge as older adults attempt to draw upon available resources, reflective of their own social capital. Mitigators of malnutrition risk includes empowerment through social care located in the third sector, as well as social aspects of food access e.g. social eating, warranting future investigation. These findings are considered post Covid-19, with key policy implications.

scholarly journals Broadening the Conception of Food Insecurity Among Older Adults: Development of a Summary Indicator in the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 773-773
Author(s):  
Emma Tucher ◽  
Tamra Keeney ◽  
Alicia Cohen ◽  
Kali Thomas
Keyword(s):  
Older Adults ◽  
Food Insecurity ◽  
Food Access ◽  
Community Dwelling ◽  
Financial Barriers ◽  
Adequate Food ◽  
Multivariable Regression ◽  
Using Data ◽  
Multivariable Regression Models ◽  
Community Dwelling Older Adults

Abstract Comprehensive measurement of food insecurity among older adults has focused on financial barriers to food access. Using data from the community-dwelling older adults in Round 5 of the U.S. National Health and Aging Trends Study (n=7,070), we constructed a summary indicator of food insecurity and inadequate food access incorporating items related to food scarcity within three domains: functional, social support, and financial limitations. We analyzed the construct validity of the summary indicator for known biopsychosocial factors associated with food insecurity among older adults. In 2015, 4.3% of community-dwelling older adults, approximately 1,673,775 million people, were characterized as food insecure or lacking adequate food access. Multivariable regression models identified that being homebound, frail, and experiencing community disability were associated with food insecurity and inadequate food access. These findings indicate food insecurity and inadequate food access among older adults is associated with functional and mobility characteristics and not isolated to financial barriers.

scholarly journals The Effect of Neighborhood Experiences on Positive Mental Health Among Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 436-436
Author(s):  
Daniel R Y Gan ◽  
Grand H-L Cheng ◽  
Tze Pin Ng ◽  
John Chye Fung ◽  
Im Sik Cho
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Path Analysis ◽  
Linear Regression Analysis ◽  
Psychosocial Health ◽  
Positive Mental Health ◽  
Community Dwelling ◽  
Neighborhood Environment ◽  
Community Based Interventions ◽  
Psychosocial Wellbeing

Abstract Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

scholarly journals Assessing the relevance of neighbourhood characteristics to the household food security of low-income Toronto families

2010 ◽  
Vol 13 (7) ◽  
pp. 1139-1148 ◽  
Author(s):  
Sharon I Kirkpatrick ◽  
Valerie Tarasuk
Keyword(s):  
Social Capital ◽  
Food Security ◽  
Food Insecurity ◽  
Low Income ◽  
Food Access ◽  
Household Food Security ◽  
Cross Sectional Survey ◽  
Household Food ◽  
Neighbourhood Social Capital ◽  
Neighbourhood Characteristics

AbstractObjectiveAlthough the sociodemographic characteristics of food-insecure households have been well documented, there has been little examination of neighbourhood characteristics in relation to this problem. In the present study we examined the association between household food security and neighbourhood features including geographic food access and perceived neighbourhood social capital.DesignCross-sectional survey and mapping of discount supermarkets and community food programmes.SettingTwelve high-poverty neighbourhoods in Toronto, Ontario, Canada.SubjectsRespondents from 484 low-income families who had children and who lived in rental accommodations.ResultsFood insecurity was pervasive, affecting two-thirds of families with about a quarter categorized as severely food insecure, indicative of food deprivation. Food insecurity was associated with household factors including income and income source. However, food security did not appear to be mitigated by proximity to food retail or community food programmes, and high rates of food insecurity were observed in neighbourhoods with good geographic food access. While low perceived neighbourhood social capital was associated with higher odds of food insecurity, this effect did not persist once we accounted for household sociodemographic factors.ConclusionsOur findings raise questions about the extent to which neighbourhood-level interventions to improve factors such as food access or social cohesion can mitigate problems of food insecurity that are rooted in resource constraints. In contrast, the results reinforce the importance of household-level characteristics and highlight the need for interventions to address the financial constraints that underlie problems of food insecurity.

scholarly journals The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Gordana Dermody ◽  
Lisa Whitehead ◽  
Graham Wilson ◽  
Courtney Glass
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Virtual Reality ◽  
Pain Management ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Psychosocial Health ◽  
Community Dwelling ◽  
Residential Aged Care ◽  
Community Dwelling Older Adults

BACKGROUND Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults. OBJECTIVE The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults. METHODS Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews. RESULTS In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment. CONCLUSIONS Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made. CLINICALTRIAL PROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504

scholarly journals NUTRITIONAL ADEQUACY AND ORAL NUTRITIONAL SUPPLEMENTATION IN OLDER COMMUNITY-DWELLING ADULTS

2019 ◽  
pp. 1-8
Author(s):  
L. McKeever ◽  
I.C. Farrar ◽  
S. Sulo ◽  
J. Partridge ◽  
P. Sheean ◽  
...  
Keyword(s):  
Older Adults ◽  
Dietary Intake ◽  
Food Insecurity ◽  
Social Isolation ◽  
Diet Quality ◽  
Contextual Factors ◽  
Community Dwelling ◽  
Poor Diet ◽  
Inadequate Dietary Intake ◽  
Hispanic White

Background: Older adults (65 years and older) comprise a high-risk group that are susceptible to the development of malnutrition. Dietary intake and diet quality represent key modifiable risk factors to help prevent and to treat declines in nutrition status, with oral nutritional supplements (ONS) often being a cost-effective therapy for many to increase protein and caloric intake. The DETERMINE Checklist offers a series of questions capable of mapping the initial landscape of contextual factors that influence the dietary patterns of the at-risk populations. Objectives: To examine independent predictors of inadequate dietary intake and poor diet quality amongst a multi-ethnic sample of urban community-dwelling older adults in an effort to identify target groups of participants that could benefit most from an ONS intervention. Design: Cross-sectional. Participants: Chicago, Illinois, United States urban residents greater than 55 years of age who self-reported to be non-Hispanic White, non-Hispanic Black, or Hispanic. Methods: Telephone surveys were conducted to obtain basic demographic information. The DETERMINE Checklist was administered to (1) characterize participants’ nutritional risk, and (2) identify participants with inadequate intake and/or poor diet quality. Predictors of inadequate intake, defined as any participant who reported either to eat less than two meals per day and/or poor diet quality, defined as any participant who reported to eat few fruits, vegetables or dairy were used to identify groups of participants who could benefit most from ONS consumption. Mantel-Hanzel chi square, Breslow-day tests, and logistic regressions were conducted. Results: 1001 ethnically diverse participants were interviewed (37% non-Hispanic White, 37% non-Hispanic Black, and 26% Hispanic). Respondents were predominantly female (69%) with a mean age of 66.9 (± 6.4) years. The majority were found to be at either moderate or high nutrition risk (78.7%). Domains of the DETERMINE Checklist that predicted either inadequate dietary intake or poor diet quality included social isolation, lower levels of educational attainment, food insecurity, limitations in activities of daily living (ADL), polypharmacy, or three or more alcoholic drinks per day. Of the participants who met the criteria as those who would benefit from ONS, less than 50% had reported consuming ONS in the past six months. Conclusion: Older community-dwelling adults living in an urban setting, especially those with social isolation, lower levels of education, food insecurity, limitations with ADLs, polypharmacy, and those reporting heavy alcohol intake represent a population who could benefit from consuming ONS. Efforts should be made towards further understanding these contextual factors and providing nutrition education along with an ONS intervention that could be beneficial to supplement dietary inadequacies in this population.

scholarly journals The Tribulations of Trials: Lessons Learnt Recruiting 777 Older Adults Into REtirement in ACTion (REACT), a Trial of a Community, Group-Based Active Aging Intervention Targeting Mobility Disability

2020 ◽  
Vol 75 (12) ◽  
pp. 2387-2395
Author(s):  
Janet Withall ◽  
Colin J Greaves ◽  
Janice L Thompson ◽  
Jolanthe L de Koning ◽  
Jessica C Bollen ◽  
...  
Keyword(s):  
Older Adults ◽  
Public Relations ◽  
Healthy Aging ◽  
Third Sector ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Community Group ◽  
Third Sector Organizations ◽  
Recruitment Methods ◽  
Multicenter Rct

Abstract Background Challenges of recruitment to randomized controlled trials (RCTs) and successful strategies to overcome them should be clearly reported to improve recruitment into future trials. REtirement in ACTion (REACT) is a United Kingdom-based multicenter RCT recruiting older adults at high risk of mobility disability to a 12-month group-based exercise and behavior maintenance program or to a minimal Healthy Aging control intervention. Methods The recruitment target was 768 adults, aged 65 years and older scoring 4–9 on the Short Physical Performance Battery (SPPB). Recruitment methods include the following: (a) invitations mailed by general practitioners (GPs); (b) invitations distributed via third-sector organizations; and (c) public relations (PR) campaign. Yields, efficiency, and costs were calculated. Results The study recruited 777 (33.9% men) community-dwelling, older adults (mean age 77.55 years (SD 6.79), mean SPPB score 7.37 (SD 1.56)), 95.11% white (n = 739) and broadly representative of UK quintiles of deprivation. Over a 20-month recruitment period, 25,559 invitations were issued. Eighty-eight percent of the participants were recruited via GP invitations, 5.4% via the PR campaign, 3% via word-of-mouth, and 2.5% via third-sector organizations. Mean recruitment cost per participant was £78.47, with an extra £26.54 per recruit paid to GPs to cover research costs. Conclusions REACT successfully recruited to target. Response rates were lower than initially predicted and recruitment timescales required adjustment. Written invitations from GPs were the most efficient method for recruiting older adults at risk of mobility disability. Targeted efforts could achieve more ethnically diverse cohorts. All trials should be required to provide recruitment data to enable evidence-based planning of future trials.

scholarly journals Assessing food insecurity among hospitalized patients at an NCI-designated comprehensive cancer center

2021 ◽  
Author(s):  
Marium Husain ◽  
Electra Paskett ◽  
Alice Hinton ◽  
Emmanuel Boateng ◽  
Nicole Leonard ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Food Access ◽  
Hospitalized Patients ◽  
Comprehensive Cancer Center ◽  
Household Food Security ◽  
Cancer Center ◽  
Insurance Status ◽  
Patients With Cancer ◽  
Zip Code

Abstract PURPOSE: To evaluate the prevalence of food insecurity among patients with cancer and to validate the Hunger Vital Sign (HVS) instrument compared to the standard-of-care USDA 18-item Household Food Security Scale (HFSS). The secondary objective was to assess disparities in food access based on race, zip code and insurance status.PATIENTS AND METHODS: Patients with cancer who were hospitalized at The Ohio State University James Comprehensive Cancer Center (OSU-CCC) were identified to participate by the Department of Social Work. Each patient completed the HVS and the 18-item HFSS. The prevalence of food insecurity was estimated and 95% Wilson score confidence intervals were calculated. The agreement between the prevalence of food insecurity as measured by the two different instruments were compared through the use of McNemar’s test. Disparities in food access based on race, zip code and insurance status were further assessed with Fisher exact tests. RESULTS: One hundred and twelve patients participated. We found that the HVS identified food insecurity in 14.3% (95% Confidence Interval (CI): 9.1, 21.7) of participants, whereas the 18-item HFSS identified 8.6% (95% CI: 4.8, 15.1) of participants. However, there was no significant difference between food insecurity as measured by the HVS and the 18-item HFSS (p = 0.289). There were also no significant differences in food insecurity based on race, insurance status or geographical location of patients.CONCLUSION: The HVS is an alternative to the 18-item HFSS as a valid tool to assess food security amongst hospitalized patients with cancer.

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