Pivoting an MCI Empowerment Program to Online Engagement

In the Spring of 2020, closures and safe distancing orders swept much of the United States due to the COVID-19 pandemic. This paper presents a case study of pivoting an in-person empowerment program focused on lifestyle interventions for people newly diagnosed with Mild Cognitive Impairment (MCI) to an online program. Working as rapidly as possible to sustain participant engagement, our design decisions and subsequent iterations point to initial constraints in telehealth capabilities, as well as learning on the fly as new capabilities and requirements emerged. We present the discovery of emergent practices by family members and healthcare providers to meet the new requirements for successful online engagement. For some participants, the online program led to greater opportunities for empowerment while others were hampered by the lack of in-person program support. Providers experienced a sharp learning curve and likewise missed the benefits of in-person interaction, but also discovered new benefits of online collaboration. This work lends insights and potential new avenues for understanding how lifestyle interventions can empower people with MCI and the role of technology in that process.

Methods and efficacy of social support interventions in preventing suicide: a systematic review and meta-analysis

QuestionSuicide is a global public and mental health problem. The effectiveness of social support interventions has not been widely demonstrated in the prevention of suicide. We aimed to describe the methods of social support interventions in preventing suicide and examine the efficacy of them.Study selection and analysisWe searched literature databases and conducted clinical trials. The inclusion criteria for the summary of intervention methods were as follows: (1) studies aimed at preventing suicide through method(s) that directly provide social support; (2) use of one or more method(s) to directly provide social support. The additional inclusion criteria for meta-analysis on the efficacy of these interventions included: (1) suicide, suicide attempt or social support-related outcome was measured; (2) randomised controlled trial design and (3) using social support intervention as the main/only method.FindingsIn total, 22 656 records and 185 clinical trials were identified. We reviewed 77 studies in terms of intervention methods, settings, support providers and support recipients. There was a total of 18 799 person-years among the ten studies measuring suicide. The number of suicides was significantly reduced in the intervention group (risk ratio (RR)=0.48, 95% CI 0.27 to 0.85). In 14 studies with a total of 14 469 person-years, there was no significant reduction of suicide attempts in the overall pooled RR of 0.88 (95% CI 0.73 to 1.07).ConclusionsSocial support interventions were recommended as a suicide prevention strategy for those with elevated suicide risk.

Health Behaviors in Times of COVID: Different Sources of Support for Older Adults

Eating a nutritious diet reduces vulnerability to common chronic diseases. Yet, older adults struggle to meet nutritional guidelines; many have found it particularly challenging to access fresh foods such as fruits and vegetables during the pandemic. Thus, it is vital to better understand how older adults may recruit the help of close others to support healthy dietary intake. This COVID-19 study examines the role of support for promoting fruit and vegetable consumption in daily life. Ninety-seven older adults participated with a close other of their choice (62 % spouse; 38% non-spouse Mage partner1 = 72, SD = 5.26, Mage partner2 = 62, SD = 16.38). Both partners completed two daily questionnaires for 10 days. In the morning they reported their intentions for eating fruit and vegetables. In the evening, they noted their consumed fruit and vegetable servings, the extent to which this matched their intentions, and their partners support in doing so. Consistent with previous research, the older participants were, the more they consumed fruits and vegetables. On days when participants received more support from their partner, they were more successful at reaching their dietary goals. Interestingly, initial findings suggest that associations were stronger when support was provided from a non-spouse than if the support came from spouse. Follow-up analyses, with a larger sample, will further examine some of the underlying mechanisms so as to better understand the role of different kinds of support providers during the pandemic and shed light on who may be best suited to provide support.

Bereavement Support Services in a National Sample of Hospices: A Content Analysis

Although the Medicare Hospice Benefit mandates that hospices provide bereavement services to families for 1 year following death, it does not stipulate what services should be offered or how. Thus, this study aimed to explore the range of hospice bereavement services. This study stems from Cagle et al.’s (2020) prior study surveying 600 randomly selected agencies, stratified by state and profit status. Most participants (N = 76) worked as clinical supervisors or directors of patient services (41.6%) for medium-sized (53.2%), for-profit hospices (50.6%). Responses to “What types of bereavement support does your hospice provide to families?” were content analyzed. Analyst triangulation and peer debriefing enhanced trustworthiness. Four domains emerged: timing of support, providers of support, targets of support, and formats of support. Each domain reflected substantial variability. All hospices offered postdeath bereavement support. A minority described offering predeath support, often through bereavement risk assessment and supportive services targeting those at risk. Providers frequently included trained bereavement counselors, social workers, and chaplains. Less often, hospices leveraged familiar members of the decedents’ care team to encourage family participation. Although bereavement services predominantly targeted surviving adult family members of deceased hospice patients, services tailored to children and hospice-unaffiliated community members also emerged. The format of bereavement services demonstrated the widest variability. Commonly reported formats included written materials, support groups, and phone calls. Most hospices employed multiple formats. Although findings are consistent with prior research, the variability in each domain complicates rigorous investigation of which aspects offer the greatest benefit to bereaved family members.

The Association Between Spousal Support And Attitude For Gerontechnology Via Facilitating Conditions

This study examined the mediating effects of facilitating conditions (FC) on the association between types of social support providers and attitude toward using gerontechnology (AUG) or between types of social support and AUG. The sample was 256 older Koreans having a partner and children (N=256; 66-88 years old; M=69.91; SD=4.19). The dependent variable was AUG in terms of an exoskeleton robot for exercise. There were two kinds of independent variables: 1) four types of social support provider (spouse, children, siblings/relatives, and friends/neighbors), and 2) four types of social support (emotional, instrumental, physical, and financial support). Mediating variable was calculated as the mean of FC from five questions. There were two analytic steps: 1) structural equation modeling with four latent variables about types of social support provider, and 2) path analysis with four types of social support if only for significant providers at the first analysis. The results from the first step of analysis showed that only social support from spouses had a significant effect on AUG via FC to use gerontechnology. In the second step of analysis, emotional support from spouses was associated with the higher level of AUG via FC to use gerontechnology. The findings could shed light on the salience of emotional support from spouses in terms of the positive attitude on technology usage in later life through enhancing FC for technology acceptance.

Who Matters For The Subjective Perceptions Toward Gerontechnology?

The present study aims to investigate how personal relationship satisfaction moderate the associations between types of social support providers and the subjective perceptions toward gerontechnology among Korean older adults. Data were collected by an online survey in February 2021. The sample was 256 older Koreans who have a partner and children (N=109 older adults with low personal relationship satisfaction, N=147 older adults with high personal relationship satisfaction, Age: 66-88, M=69.91, SD=4.19). The dependent variables for the subjective perceptions toward gerontechnology were attitude toward using gerontechnology and anxiety for gerontechnology. Independent variables were four types of social support providers (spouse, children, siblings/relatives, and friends/neighbor). Personal relationship satisfaction was a binary moderator, dividing the sample into low and high personal relationship satisfaction groups. We applied multigroup structural equation modeling. The results showed associations between social support providers and subjective perceptions toward gerontechnology differed by the quality of personal relationships. In detail, receiving support from spouses was associated with the lower level of anxiety of using gerontechnology among older adults in the low personal relationship satisfaction group. Moreover, receiving support from spouses was associated with a higher level of attitude toward using gerontechnology in the high personal relationship group. Receiving social support from other providers were not significant in both groups. The findings imply that the partner living with was salience for positive perception toward gerontechnology. Furthermore, support from spouses may differently work on the subjective perception toward gerontechnology by the quality of personal relationships.

Hindrance to Online Education during Lockdowns

This study aims to identify the hindrances to online education students in schools and colleges during the lockdown. The online survey through Google Forms with a structured questionnaire with both restricted and unrestricted responses was designed to identify the hindrance to online education during the third lockdown. Total of 425 responses of students who attend online classes during lockdown from Phuentsholing Higher Secondary, Phuentsholing Middle Secondary, Sonamgang Middle Secondary Schools, and College of Science and Technology in Phuentsholing, Bhutan. The result indicates that socio-economic, technological, and psychological situations hinder effective online teaching and learning. Household chores, large family members, data packages, and poor internet connectivity are other difficulties students face making online education ineffective. Some of the measures to support economically disadvantaged students and provide personal computers/laptops to teachers for preparing and developing teaching-learning materials are suggested. Other recommendations and viable measures based on surveys are suggested to overcome such challenges for students and support providers to make online education effective and focused

Sophisticated Mediators: New Zealand-Born Samoan First-Time Mothers and Strategies for Their Health and Wellbeing

<p>This thesis explores the experiences of four New Zealand-born Samoan first time mothers during pregnancy, childbirth and early motherhood living in Wellington. The impetus for this research arose from findings that showed a considerable variation in the prevalence of postnatal depression between Samoan women (7.6%), Tongan women (30.9%) and others (20% for all New Zealand mothers). Qualitative, face-to-face individual interviews were conducted within a qualitative feminist framework. The two interviews with each woman were conducted during the last trimester of their pregnancy (28+weeks gestation); and 12 months post-birth. The thesis drew upon the four-element model – Epistemology, Theoretical Perspective, Methodology and Methods to provide a framework to conceptualise and clarify the foundation for this research project. Thus the thesis is best described as a feminist phenomenological social constructionist approach. The findings revealed the women of this study were „Sophisticated Mediators‟ who, although faced with many challenges throughout their pregnancy, childbirth and early motherhood experiences, mediated successfully between, and within, existing cultural and belief systems i.e. Samoan traditional values and New Zealand cultural system; to acquire or maintain resilience toward depressive symptoms during early motherhood. Support structures such as family, in particular mothers, proved to be a vital source of support for the women. Recommendations arising from the research are targeted at support providers and family members and this is discussed in detail. Antenatal care was important although antenatal classes not so; conversely, the women were high adopters of technology in the form of the internet to access information. It is vital for support providers to recognise the high regard the women had for the internet as a source of valuable and easily accessible information, and utilise those avenues more to provide information that will complement or improve the existing support structures. During the antenatal period, women should be encouraged to develop or strengthen relationships with a significant female who will be with them throughout the childbirth and early motherhood process.</p>

Sophisticated Mediators: New Zealand-Born Samoan First-Time Mothers and Strategies for Their Health and Wellbeing

<p>This thesis explores the experiences of four New Zealand-born Samoan first time mothers during pregnancy, childbirth and early motherhood living in Wellington. The impetus for this research arose from findings that showed a considerable variation in the prevalence of postnatal depression between Samoan women (7.6%), Tongan women (30.9%) and others (20% for all New Zealand mothers). Qualitative, face-to-face individual interviews were conducted within a qualitative feminist framework. The two interviews with each woman were conducted during the last trimester of their pregnancy (28+weeks gestation); and 12 months post-birth. The thesis drew upon the four-element model – Epistemology, Theoretical Perspective, Methodology and Methods to provide a framework to conceptualise and clarify the foundation for this research project. Thus the thesis is best described as a feminist phenomenological social constructionist approach. The findings revealed the women of this study were „Sophisticated Mediators‟ who, although faced with many challenges throughout their pregnancy, childbirth and early motherhood experiences, mediated successfully between, and within, existing cultural and belief systems i.e. Samoan traditional values and New Zealand cultural system; to acquire or maintain resilience toward depressive symptoms during early motherhood. Support structures such as family, in particular mothers, proved to be a vital source of support for the women. Recommendations arising from the research are targeted at support providers and family members and this is discussed in detail. Antenatal care was important although antenatal classes not so; conversely, the women were high adopters of technology in the form of the internet to access information. It is vital for support providers to recognise the high regard the women had for the internet as a source of valuable and easily accessible information, and utilise those avenues more to provide information that will complement or improve the existing support structures. During the antenatal period, women should be encouraged to develop or strengthen relationships with a significant female who will be with them throughout the childbirth and early motherhood process.</p>