bluuebunny/crossref_metadata_2025_split huggingface dataset:
RESULTS FROM RESEARCH ON A HEALTH-COACHED WALKING PROGRAM IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Flanagan Jane , Post Kathryn , Hill Rebecca 
Published: November 2019

Abstract
Caregivers of persons with dementia demonstrate increased levels of stress, anxiety and depression, placing them at increased risk for poor health-related outcomes. Walking is widely supported as a cost-effective, accessible exercise and way to maintain physical fitness and mitigate stress levels. There is a critical gap in addressing health promotion strategies in caregivers. The specific aims of this health-coaching (HC) walking study using wireless pedometers in family caregivers of persons with dementia were to: 1) establish the feasibility of HC and wireless pedometer use, 2) examine outcomes of well-being, stress and activity level and 3) understand the experience of participation. This 2-group comparative study used a repeated measure design and mixed methods approach. We enrolled 27 females and 5 male caregivers (n=32), μ age 57 years: with both 16 in the control in the intervention arm. Pre-post measures of general health (body mass index [BMI], blood pressure, heart rate, cognition, well-being, stress and perceived activity level) were obtained from caregivers at baseline and again at 12 weeks. Results indicate that those who received HC had a statistically significant improvement in BMI (p = .01). There were no other statistically significant improvements in outcomes in either group. Qualitative findings suggest that participants reported many stresses that made self-care challenging. In summary, this was a feasible intervention that resulted in improved BMI in the HC group. Work is needed to understand the long-term impact of this outcome. Further exploration of other health-promoting interventions that may be beneficial for this population is essential.
QUALITY OF LIFE OF GRANDPARENTS RAISING GRANDCHILDREN IN NIGERIA
Authors: Aransiola Joshua O , Togonu-Bickersteth Funmi , Aliyu Kolawole , Afolabi Mojirayo , Akinyemi Akanni 
Published: November 2019

Abstract
This article examined the personal and household characteristics influencing the quality of life (QoL) of grandparents caring for grandchildren in Skipped Generation Households in Nigeria with a sample of 2, 144 grandparents in Imo, Lagos and Kano. Chi square and multinomial logistic regression were employed to understand the relationship between the dependent variable (QoL) and independent variables (personal and household characteristics). The level of the QoL of the grandparents almost spread evenly among low (34.3%), average (34.3%) and high (31.4%). Five domains of QoL were examined including level of independence (LI), psychological well-being (PW), social relation (SR), physical health (PH), environment (ENV) and engagement in income generating activities (IGA). Personal characteristics including; state of residence was significantly associated with all the domains except LI and PW, age was associated with IGA, LI and ENV, sex was associated with SR and ENV and level of education was associated with all the domains except IGA and ENV while religious affiliation was associated with IGA. Household characteristics including; sex of household head was significantly associated with PH, SR and ENV, age of household head was associated with IGA and LI and wealth index was associated with all the domains while the number of household members was significantly associated with ENV. The regression analysis shows that only state of residence and wealth index significantly influence the QoL of the grandparents (P≤0.05). The state of residence and wealth index are therefore important in any policy intervention for this category of elderly persons in Nigeria.
FEASIBILITY OF A LOW-DOSE FRAILTY PREVENTION INTERVENTION AMONG OLDER AFRICAN AMERICANS
Authors: Fritz Heather A , Tarraf Wassim , Patel Pragnesh 
Published: November 2019

Abstract
Older African Americans (OAA) are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet OAA have largely been excluded from frailty intervention research. Many interventions are also time and resource intensive, making them inaccessible to socially disadvantaged OAA. We present results of a feasibility trial of a low dose frailty prevention intervention among 60 community-dwelling, pre-frail OAA aged 55+ recruited from a primary care clinic between June 1st and October 31st 2018. Using a 2-arm RCT, participants were assigned to the intervention, which was delivered by an occupational therapist (OT) and comprised of four sessions over four months (an OT evaluation, and sessions on healthy dietary practices, increasing physical activity, and maintaining a healthy lifestyle), or enhanced usual care (publicly available information about healthy lifestyle, home safety, and local elder services). Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Participants were 65% female with an average age of 76.58 years, 51.67% of which lived alone and 51.67% lived off of less than 15K per year. Feasibility metrics were met. The study recruited 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. Mean satisfaction scores were 93%. The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.
CULTURALLY ADAPTING A TIMED ACTIVITY INTERVENTION FOR OLDER LATINOS WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Perez Adriana G 
Published: November 2019

Abstract
The number of Latinos living with Alzheimer’s Disease (AD) is expected to grow from 379,000 in 2012 to 3.5 million in 2060. The purpose of this study was to generate recommendations for meaningful approaches to culturally adapt a timed-activity intervention, Healthy Patterns, to promote quality of life in this population. Consistent with a descriptive qualitative approach, community-based focus groups were conducted among a purposive sample of older Latinos with AD and their caregivers. Seventeen dyads participated. Surface structure issues included: need for linguistically appropriate intervention sessions; partnerships with local, trusted community organizations. Deep structure themes, included: 1) embedding social support through group sessions; 2) culturally relevant activities; and 3) building individual and caregiver motivation for participation. This study gives “voice” to older Latinos and caregivers in adapting a timed-activity intervention. Results may inform the design and implementation of AD interventions, including recruitment and retention of older Latinos in clinical trials.
AM I FRAIL, LOVE? YES, I SUPPOSE I AM: WHAT 10 OLDER PEOPLE CAN TELL US ABOUT LIVING WITH FRAILTY
Authors: Todd Oliver M , Clegg Andrew , Godfrey Mary 
Published: November 2019

Abstract
We sought to explore what matters in later life with frailty from an older persons perspective. Between March and May 2018, we recruited ten people, purposively sampled from the CARE75+ ageing cohort study. Interviews took place at the participant’s own home in two sittings, each 45 minutes long. Interviews were semi-structured, used narrative techniques based on a topic guide developed with a patient representative. We used systematic analysis of the narrative experience to identify meaning in the context of an individual’s time, space and history. Participants had a mean age of 84 years (range 77 to 93), half were women, and three were interviewed with their care-givers. All had moderate or severe frailty: mean frailty index 0.36 (range 0.25 to 0.47); mean Fried score 4 (range 3 -5). Half knew hunger as children; most grew up in large families and left school early; two survived TB in early life; all lived through or were affected by war. The term frailty was: never voluntarily used; described negatively and in value laden terms; seen better in others than themselves. Decision making was best delegated to doctors who knew you and your family over time. Narratives focused on health events of a spouse; symptoms featured more than diagnoses. Survivorship, reciprocity and community were sustaining values. To engage elders in shared decision making we learnt to consider influences of cohort, of people closest to them; and to describe rather than declare someone to be frail, in terms that are real to them.
INTERPROFESSIONAL SOCIALIZATION AND VALUING SCALE FOR HEALTH PROFESSIONAL STUDENTS WORKING WITH OLDER ADULTS
Authors: Cicala David , Ang Nicholas , Mendez Jennifer , Brown Shanique , Schiller Martha 
Published: November 2019

Abstract
Interprofessional education allows students from two or more professions the opportunity to collaboratively practice patient centered care. Given the importance of interprofessional education in helping individuals become effective team members and understanding their value to a healthcare team, there is a need to evaluate the experiences. The Interprofessional Socialization and Valuing Scale (ISVS), aims to measure self-perceived experiences with interprofessional collaborative teamwork, including the ability, value, and comfort in working with others. The Wayne State University Interprofessional Team Visit (IPTV) program is an older adult home visit program that places pharmacy, social work, occupational therapy, nursing, and medical students in teams. Students form teams of 3 different disciplines and interview the older adult to assess various aspects of health and wellbeing. In order to evaluate the interprofessional educational experiences of the students, they are given a pre- and post- survey utilizing the ISVS tool. 18 questions pertaining to perceptions of what students have learned about working with professionals from other disciplines. Students respond to each statement using a 7-point scale with 1 = “Not at All” and 7 = “To a Very Great Extent.” Statistical analysis is conducted in order to compare pre- to post-surveys and also assess differences between groups. It is found that ISVS scores increase from pre- to post-survey, second year medical students and third year pharmacy students feel more comfortable working in teams, and teams consisting of these two have higher average scores.
INTERDISCIPLINARY CURRICULUM FOR THE CARE OF OLDER ADULTS: CREATING NETWORKS OF COLLABORATIVE LEARNERS
Authors: Yankeelov Pamela , Faul Anna , D'Ambrosio Joe , Cotton and Samantha G 
Published: November 2019

Abstract
Serving older adults with multiple chronic conditions and variable social, emotional, or physical support effectively within the primary care setting requires an interdisciplinary approach to care. Our GWEP program has developed an interprofessional education center that educates and prepares students and professionals from social work, medicine, nursing, dentistry, pharmacy, and community health partners, to function within a transformed integrated patient-centered geriatric primary care and community-based service delivery system. Learners from multiple disciplines attend a face-to-face Interdisciplinary Case Management Experience (ICME) session lasting 2.5 hours. Sessions include learners from each discipline and, if possible, at least one community practitioner in small groups of 6–8 learners at each table facilitated by 1 faculty member. Approximately 1,200 learners have received the curriculum. To evaluate the program, Kirkpatrick’s Training Evaluation Model was used to determine if learners were satisfied with the content, skilled, and confident in their abilities to utilize the curriculum. Learners completed a satisfaction survey after taking each module, along with an interdisciplinary geriatric care knowledge test and self-efficacy test before and after taking each module to measure learning outcomes. Analysis showed that learners, irrespective of discipline, were satisfied with the program. All disciplines showed a significant increase from pre- to posttest for all 5 online modules achieving a mean post-knowledge score of 85% across all 5 online training modules. All disciplines experienced significant differences in their self-efficacy with working on interdisciplinary teams from pre to post ICME. Implications for future interprofessional curriculum will be discussed.
FOSTERING INTERPROFESSIONAL COLLABORATION IN HISPANIC GERIATRIC PATIENT CARE: NEW GME PROGRAM AND PALLIATIVE TEAM
Authors: Martin Jessica G , Rivera-Burciaga Andrya , Gutierrez Cesar , Dentino Andrew , Bravo Vianis 
Published: November 2019

Abstract
Hispanic minorities have a higher incidence of chronic disease which may result in increased hospitalizations and life-threatening illness. Our growing geriatric population led our community hospital to create a dedicated Palliative Care department, an interprofessional team of physicians, nursing, pharmacy, social work, counselors, and chaplains whose collaborative practice has improved outcomes thus strengthening healthcare delivery. When our new medical school established graduate programs, including Internal Medicine residency and Hospice/Palliative Medicine fellowship, our team embraced the opportunity to optimize our palliative service through enhanced interprofessional care. We created a geriatric rotation on July 1, 2018 in which 60% of residents worked with palliative care professionals as a consult team bringing together the inpatient resident service and palliative interdisciplinary team. This collaborative model allowed the palliative team to interface with our trainees and teach them to identify the range of needs of older adults early on in their care. Residents reported 100% satisfaction on evaluations, specifically on clinical training, goal fulfillment, and team support. Our learners valued the opportunity to learn with and from other healthcare professionals. Supervising providers also felt that working with residents was beneficial to their practice habits (i.e., providing evidence-based practices, application of guidelines), which offered them a more holistic approach in caring for patients and families. The interprofessional collaboration between a community hospital and medical school to educate and train clinicians who care for individuals with advanced illness has fostered confidence, trust, mutual respect, open communication and effective sharing of critical information for both clinicians and patients.
MOBILITY EDUCATION FOR THE DIVERSE AGING COMMUNITY, CAREGIVERS, AND THEIR HEALTH CARE PROVIDERS
Authors: Karnick Chrysanne , Manna Ruth , Gangai Natalie , Muniz Rosario Costas , Korc-Grodzicki Beatriz 
Published: November 2019

Abstract
Older adults can reduce fall risk in their homes and the community. Health care professionals (HCP) have a role in preventing falls. An interprofessional team of HCPs at a comprehensive cancer center created and delivered educational workshops to increase knowledge about falls prevention. Educational workshops were provided in community centers, libraries, places of worship and at local hospitals to medically underserved, diverse community members, caregivers and HCP. An Occupational (OT) and Physical Therapist (PT) taught three workshops together and the OT taught nine workshops. Workshops included fall prevention, home modifications, safe patient handling (SPH), and the role of OT/ PT in geriatric oncology care. Practical and culturally competent steps were emphasized, with translation of written materials and live interpretation provided as appropriate. Knowledge increase was assessed, and post-session qualitative data was collected. The mean age of community members was 68 years, of nurses was 42, and of caregivers 63. A majority of participants were female. 220 older adults completed surveys, 40 caregivers, and 11 registered nurses. The Falls Prevention workshops with unmatched (n=79) and matched data (n=140) showed significant improvements in knowledge [t(135)=-3.33, p&lt;0.001; t(139)=-4.03, p&lt;.001; respectively). Caregivers who participated in the SPH workshop improved their learning for the unmatched (n=12) and matched data (n=28) after participating in the workshops [t(22)=-3.50, p=.002; t(27)=-3.95, p&lt;.001] respectively. For nurses, the change in scores from pre (M=.56) to post scores (M=.73) were significant (t=-2.76, df=10, p=.02). Caregivers and HCPs benefit from continued education to promote safer, holistic care for family members and patients.
EFFECTS OF A SHARED DECISION MAKING INTERVENTION FOR OLDER ADULTS WITH CHRONIC CONDITIONS: AN OBSERVATIONAL STUDY
Authors: Pel-Littel Ruth E , Buurman Bianca , Pol Marjolein van de , Tulner Linda , Minkman Mirella , Reimer Wilma Scholte op , Weert Julia van 
Published: November 2019

Abstract
Shared decision making (SDM) in older patients is more complex when multiple chronic conditions (MCC) have to be taken into account. The aim of this research is to explore the effect of the evidence based implementation intervention SDMMCC on (1) the preferred and perceived participation (2) decisional conflict and (3) actual SDM during consultations. 216 outpatients participated in a video observational study. The intervention existed of a SDM training for geriatricians and a preparatory tool for patients. Consultations were videotaped and coded with the OPTIONMCC. Pre- and post-consultation questionnaires were completed. Participation was measured by the Patients’ perceived Involvement in Care Scale (PICS). Decisional conflict was measured by the Decisional Conflict Scale (DCS). The patients mean age was 77 years, 56% was female. The preparatory tool was completed by 56 older adults (52%), of which 64% rated the tool as positive. The preparatory tool was used in 12% of the consultations. The mean overall OPTIONMCC score showed no significant changes on the level of SDM(39.3 vs 39.3 P0.98), however there were significant improvements on discussing goals and options on sub-items of the scale. There were no significant differences found in the match on preferred and perceived participation (86.5% vs 85.0% P 0.595) or in decisional conflict (22.7 vs 22.9 P0.630). The limited use of the preparatory tool could have biased the effect of the intervention. In future research more attention must be paid towards the implementation of preparatory tools, not only among patients but also among geriatricians.
THE DEVELOPMENT OF AN INTERVENTION TO IMPROVE SHARED DECISION MAKING IN GERIATRIC OUTPATIENTS
Authors: Pel-Littel Ruth E , Weert Julia van , Minkman Mirella , Reimer Wilma Scholte op , Pol Marjolein van de , Buurman Bianca 
Published: November 2019

Abstract
Shared decision making (SDM) contributes to personalised decisions that fit the personal preferences of patients. However, older adults frequently face multiple chronic conditions (MCC). Therefore, implementing SDM requires special features. The aim of this paper is to describe the development of an intervention to improve SDM in older adults with MCC. Following the Medical Research Council framework for developing complex interventions, the SDMMCC intervention was developed step-wise. Based on a literature review and empirical research we developed in a co-creation process with the end-users a training for geriatricians and a preparatory tool for older patients with MCC and informal caregivers. After assessing feasibility the intervention was implemented at two outpatient geriatric clinics in a pilot study (N=108). Key elements of the training for geriatricians include: developing skills how to involve older adults with MCC and informal caregivers in SDM and learning how to explore personal goals related to quality of life. Key elements of the preparatory tool for patients include: an explicit invitation to participate in SDM, nomination that the patient’s own knowledge is valuable, invitation to form a partnership with the geriatrician, encouragement to share information about daily and social functioning and exploration of possible goals. Furthermore, invitation of informal caregivers to share their concerns. Through a process of co-creation both a training for geriatricians and a preparatory tool for older adults and their informal caregivers were developed, tailored to the needs of the end-users and based on the ‘Dynamic model of SDM with frail older adults’.
BELIEFS REGARDING GERIATRICS PRIMARY CARE TOPICS AMONG MEDICAL STUDENTS AND INTERNAL MEDICINE RESIDENTS
Authors: Jester Dylan J , Hyer Kathryn , Andel Ross 
Published: November 2019

Abstract
Our study evaluated and contrasted responses to 25 content areas essential to the primary care of older adults by medical students and residents, and identified attitudes toward aging amongst students and residents. One hundred and thirty-six medical students and 61 Internal Medicine residents completed a survey including the 25-item Geriatrics Clinician-Educator Survey and 18-item Images of Aging Scale. Students and residents rated importance and knowledge for content areas from 1 (low) to 10 (high). Gap scores reflecting the difference in ratings between importance and knowledge were calculated. The Images of Aging scale ranges between 0 (furthest from what you think) and 6 (closest to what you think). Results indicated that students and residents reflected similar beliefs about the importance of content areas, but students provided lower ratings in knowledge. Students revealed larger gap scores in areas that reflected general primary care (e.g., assess chronic conditions, medications), whereas residents revealed larger gap scores in areas that reflected specialists’ expertise (e.g., driving risk, cognition, psychiatric symptoms). Attitudes toward older adults did not differ appreciably between students and residents. In sum, primary care topics applicable for any age demographic were rated as most important by first-year medical students and Internal Medicine residents. Topics relevant to older populations – particularly those requiring specialists’ knowledge of or requiring sensitive discussion with older adults – were rated as less important and were less well mastered.
COST-BENEFIT ANALYSIS OF COMMUNITY-BASED SERVICES AS A MEANS OF PROMOTING ACTIVE AGING IN GALILEE
Authors: Hantman Shira 
Published: November 2019

Abstract
Increase in life expectancy has benefits, but also costs from increased expenses related to morbidity and prevention. These costs may be reduced by adopting a healthier lifestyle. The goal of the study was to quantify the economic value of a variety of activities in which older adults partake: e.g. cultural, intellectual, physical and nutritional activities. Research questions: Are the monetary benefits of improved health different when measured on a subjective willingness-to-pay (WTP) approach or on an objective Cost-of-Illness (COI) approach? Is the monetary benefit of active aging larger than the cost associated in doing that? 300 older adults participating in various activities of the local senior center and a control group not participating filled out a life style survey. A choice modelling (CM) approach estimated a subjective monetary welfare and compared it to an objective measure of benefit associated with the occurrence of different health symptoms associated with more active aging. An association was found between the various activities explored and the objective and subjective perspective of health. Moreover, all older adult activities passed the cost benefit test albite the order was different between objective and subjective estimations. Nutrition related activities were found to be the most beneficial. Cultural activity ranked second objectively and subjectively. Intellectual activity ranked last objectively and physical activity ranked last subjectively. Participants will understand the need to provide optimal policy and efficient resource distribution between the various activities offered to older adults. This will result in better health lowering public health expenditures.