A Qualitative Study of the Aging Experience among Korean Older Adults Residing in Urban, Rural, and the US Immigrant Context

2019 ◽  
Vol 39 (3) ◽  
pp. 589-612
Author(s):  
Jun-woo Lee ◽  
Jenny H Pak ◽  
Hyuna Lee
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
The Us ◽  
Urban Rural

scholarly journals A Qualitative Study on the US Forest Service’s Risk Management Assistance Efforts to Improve Wildfire Decision-Making

Forests ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 344
Author(s):  
Courtney A. Schultz ◽  
Lauren F. Miller ◽  
Sarah Michelle Greiner ◽  
Chad Kooistra
Keyword(s):  
Decision Making ◽  
Risk Management ◽  
Decision Support ◽  
Qualitative Study ◽  
Fire Management ◽  
Perceived Value ◽  
Forest Service ◽  
The Us ◽  
Decision Biases ◽  
Line Officers

To support improved wildfire incident decision-making, in 2017 the US Forest Service (Forest Service) implemented risk-informed tools and processes, together known as Risk Management Assistance (RMA). The Forest Service is developing tools such as RMA to improve wildfire decision-making and implements these tools in complex organizational environments. We assessed the perceived value of RMA and factors that affected its use to inform the literature on decision support for fire management. We sought to answer two questions: (1) What was the perceived value of RMA for line officers who received it?; and (2) What factors affected how RMA was received and used during wildland fire events? We conducted a qualitative study involving semi-structured interviews with decision-makers to understand the contextualized and interrelated factors that affect wildfire decision-making and the uptake of a decision-support intervention such as RMA. We used a thematic coding process to analyze our data according to our questions. RMA increased line officers’ ability to communicate the rationale underlying their decisions more clearly and transparently to their colleagues and partners. Our interviewees generally said that RMA data analytics were valuable but did not lead to changes in their decisions. Line officer personality, pre-season exposure to RMA, local political dynamics and conditions, and decision biases affected the use of RMA. Our findings reveal the complexities of embracing risk management, not only in the context of US federal fire management, but also in other similar emergency management contexts. Attention will need to be paid to existing decision biases, integration of risk management approaches in the interagency context, and the importance of knowledge brokers to connect across internal organizational groups. Our findings contribute to the literature on managing change in public organizations, specifically in emergency decision-making contexts such as fire management.

scholarly journals The Value of Vaccination in Older Adults: The Why

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 806-807
Author(s):  
Philip Buck
Keyword(s):  
Older Adults ◽  
Time Horizon ◽  
Pneumococcal Disease ◽  
Population Aging ◽  
Indirect Costs ◽  
Health Behavior Change ◽  
Vaccine Preventable Diseases ◽  
Time Period ◽  
The Us ◽  
The Impact

Abstract The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

scholarly journals Voices of Experience: What Do Low-Income Older Adults Tell Us About Mobility, Technology, and Social Participation?

2021 ◽  
pp. 073346482110125
Author(s):  
Haley B. Gallo ◽  
Lia W. Marshall ◽  
Lené Levy-Storms ◽  
Kathleen H. Wilber ◽  
Anastasia Loukaitou-Sideris
Keyword(s):  
Older Adults ◽  
Los Angeles ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Social Participation ◽  
Low Income ◽  
Technology Use ◽  
Diverse Group ◽  
Senior Center ◽  
Perceived Safety

Mobility and technology can facilitate in-person and virtual social participation to help reduce social isolation, but issues exist regarding older adults’ access, feasibility, and motivation to use various forms of mobility and technology. This qualitative study explores how a diverse group of low-income, urban-living older adults use mobility and technology for social participation. We conducted six focus groups ( N = 48), two each in English, Spanish, and Korean at a Los Angeles senior center. Three major themes emerged from thematic analysis: using technology for mobility; links between mobility and social participation; and technology-mediated social participation. Cost, perceived safety, (dis)ability, and support from family and friends were related to mobility and technology use. This study demonstrates the range of mobility and technology uses among older adults and associated barriers. The findings can help establish a pre-COVID-19 baseline on how to make mobility and technology more accessible for older adults at risk of isolation.

scholarly journals Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder
Keyword(s):  
Older Adults ◽  
New York ◽  
Health System ◽  
Medical Center ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
New York University ◽  
The Us ◽  
Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

scholarly journals Sex in Late Life: Assessing Adults’ Expectations and the Role of Healthcare Professionals

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 313-313
Author(s):  
Jill Naar ◽  
Raven Weaver ◽  
Shelbie Turner
Keyword(s):  
Older Adults ◽  
Sexual Health ◽  
Health Behaviors ◽  
Healthcare Professionals ◽  
Late Life ◽  
Sexual History ◽  
Growth Curve Models ◽  
The Us ◽  
Sexual Health Behaviors ◽  
The Life Course

Abstract Sexual activity contributes to quality of life throughout the lifespan. However, stigma about sex in late life influences older adults’ perceptions and healthcare professionals’ perceptions of older adults’ sexual health/behaviors. Using a multi-methods approach, we examined attitudes and knowledge about sexual health/behaviors in late life. Using longitudinal data from the Midlife in the US Study (Wave 1-3; N=7049), we ran age-based growth curve models to analyze changes in levels of optimism about sex in their future. We also piloted a survey with healthcare professionals assessing attitudes, knowledge, and awareness of policy about sexual health/behaviors among older adults. Adults’ expectations became less optimistic with increased age (β = -0.1, SE = 0.003, p < .0001). Men were more optimistic than women at age 20 (p = 0.016), but men’s optimism decreased over the life course at a faster rate than did women’s (p < .0001), so that from ages 40-93, men were less optimistic than women. Among healthcare professionals (N=21), the majority indicated never or rarely asking their clients about sexual history or health/behaviors; however, they indicated some knowledge about issues relevant to older adults (e.g., safe-sex practices, sexual dysfunction). Few indicated awareness about policies related to sexual behavior among residents (i.e., issues of consent, STIs). Among adults, there is a need to address declining optimism for expectations about sex in late life. Health professionals are well-situated to raise awareness and normalize discussions about sexual health, thus countering negative stigma and contributing to increasing optimism for expectations to remain sexually active.

scholarly journals A qualitative study of the needs of older adults with intellectual disabilities

2021 ◽  
Author(s):  
Darragh McCausland ◽  
Suzanne Guerin ◽  
Janette Tyrrell ◽  
Clare Donohoe ◽  
Isabelle O'Donoghue ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Intellectual Disabilities ◽  
Adults With Intellectual Disabilities

scholarly journals Perceptions of Treatment Burden Among Elders With Diabetes and Comorbid Alzheimer’s Disease and Related Dementias

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 276-276
Author(s):  
Victoria Vaughan Dickson ◽  
Halia Melnyk ◽  
Rosie Ferris ◽  
Joshua Chodosh ◽  
Caroline Blaum
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Qualitative Study ◽  
Financial Burden ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Patient Treatment ◽  
Treatment Burden ◽  
Treatment Plans

Abstract Background: An estimated 25% of older adults with diabetes (DM) may have co-occurring Alzheimer’s Disease and Related Dementias (ADRD), complicated by multiple treatment plans and providers. Assessing treatment burden has been limited to patients’ perspectives; little is known about caregiver perceptions of treatment burden despite their important role in personal care and treatment adherence. The purpose of this qualitative study was to describe caregiver perceptions of treatment burden for older adults with DM-ADRD. Methods: This qualitative study was conducted in the formative phase of “Enhanced Quality in Primary care for Elders with DM-ADRD (EQUIPED-ADRD) a pragmatic randomized controlled trial in a large, diverse healthcare system. A diverse sample of caregivers (n=15) of patients enrolled in the RCT participated in interviews about their caregiver role and perceptions of treatment burden of DM-ADRD clinical management. Qualitative data were analyzed using content analysis and themes about treatment burden were compared to domains on the Treatment Burden Questionnaire (TBQ). Results: Caregivers reported high levels of burden related to treatment plans for patients with DM-ADRD. Themes related to complexity and burden of medication management, monitoring (e.g., blood pressure, glucose monitoring), dietary and physical activity regimens, navigating healthcare providers and financial burden were reported. Caregivers also described high levels of emotional burden that was associated with patient’s cognitive decline and family functioning stress. Conclusions: Interventions to reduce treatment burden for patients and caregiver should include activating social/nursing services, respite care and care coordination that may support caregivers especially as patient treatment increases in complexity over time.

scholarly journals Older Adults’ Experiences of a Physical Activity and Sedentary Behaviour Intervention: A Nested Qualitative Study in the SITLESS Multi-Country Randomised Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4730
Author(s):  
Nicole Blackburn ◽  
Mathias Skjodt ◽  
Mark Tully ◽  
Ilona Mc Mullan ◽  
Maria Giné-Garriga ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Qualitative Study ◽  
Management Strategies ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Individual Interviews ◽  
Perceived Effects ◽  
Qualitative Methodologies ◽  
Exercise Referral

Background: The SITLESS programme comprises exercise referral schemes and self-management strategies and has been evaluated in a trial in Denmark, Spain, Germany and Northern Ireland. The aim of this qualitative study was to understand the implementation and contextual aspects of the intervention in relation to the mechanisms of impact and to explore the perceived effects. Methods: Qualitative methodologies were nested in the SITLESS trial including 71 individual interviews and 12 focus groups targeting intervention and control group participants from postintervention to 18-month follow-up in all intervention sites based on a semi-structured topic guide. Results: Overarching themes were identified under the framework categories of context, implementation, mechanisms of impact and perceived effects. The findings highlight the perceived barriers and facilitators to older adults’ engagement in exercise referral schemes. Social interaction and enjoyment through the group-based programmes are key components to promote adherence and encourage the maintenance of targeted behaviours through peer support and connectedness. Exit strategies and signposting to relevant classes and facilities enabled the maintenance of positive lifestyle behaviours. Conclusions: When designing and implementing interventions, key components enhancing social interaction, enjoyment and continuity should be in place in order to successfully promote sustained behaviour change.

scholarly journals 1381. Rotavirus Gastroenteritis among older adults: discussion based on a systematic literature review

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S700-S701
Author(s):  
Cristina Carias ◽  
Susanne Hartwig ◽  
M Nabi Kanibir ◽  
Ya-Ting Chen
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Acute Gastroenteritis ◽  
Rate Ratio ◽  
Rotavirus Gastroenteritis ◽  
Incident Rate Ratio ◽  
The Us ◽  
Incident Rate ◽  
The Uk ◽  
Retrospective Database

Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)

scholarly journals Understanding the Occupational Adaptation Process and Well-Being of Older Adults in Magallanes (Chile): A Qualitative Study

2019 ◽  
Vol 16 (19) ◽  
pp. 3640 ◽  
Author(s):  
Palma ­Candia ◽  
Hueso­Montoro ◽  
Martí-García ◽  
Fernández-Alcántara ◽  
Campos-Calderón ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Well Being ◽  
Self Esteem ◽  
Adaptation Process ◽  
Occupational Adaptation ◽  
Use Of Time ◽  
Low Levels ◽  
Interpretative Approach ◽  
Depth Interviews

Background: Aging and longevity are important topics nowadays. Purpose: To describe how older adults perform the occupational adaptation process in the extreme region of Magallanes (Chile), and to identify the factors that might contribute to successful occupational adaptation and well-being. Method: Qualitative study, with a phenomenological interpretative approach. In-depth interviews were carried out with 16 older adults, with high or low levels of well-being, assessed with the Ryff Scale. An inductive content analysis according to Elo and Kyngäs was performed. Findings: Resilience, self-esteem and interdependence with significant others are key elements that promote well-being. Participants develop strategies to minimize the effects of environmental factors. The occupation’s function in terms of socialization, use of time, and social participation is revealed as a conditioning factor of occupational adaptation. Implications: Interventions with older people to achieve a successful occupational adaptation process must take into consideration the commitment to meaningful activities.

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