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Wellness and Health Promotion for the Older Adults

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 73134

Special Issue Editor

Health Resources and Services Administration, Rockville, MD 20857, USA
Interests: health management; aging; health policy; dementia

Special Issue Information

Dear Colleagues,

Promotion of health and wellness interventions for older adults is important in controlling the onset and progression of disabilities and disease. An initial step in determining how to promote health and wellness is to consult with older adults directly. This core principle of what matters most to the individual, added to the other three principles of the 4Ms of age-friendly healthcare—medications, mentation and mobility—defines the core topics that must be addressed in order to effectively promote health and wellness in older adults. Health promotion topics under the 4Ms rubric that are particularly important to older adults include sleep, nutrition, isolation, oral health, exercise and elder justice (freedom from abuse, neglect, exploitation or discrimination due to intentional or negligent acts). Overarching approaches needed to achieve effective health and wellness promotion include interprofessional team care; communication; social determinants of health; fostering health equity; and acknowledging and addressing health disparities. Many of these topics will be presented in this Special Issue with the intent of showing healthcare providers, students, faculty, patients and their families how to identify evidence-based practices that support wellness and good health in the older adults for whom they provide care.

Dr. Nina Tumosa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • older adult
  • wellness
  • health promotion
  • 4Ms
  • what matters
  • medication
  • mentation
  • mobility
  • health disparities
  • health equity

Published Papers (28 papers)

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Editorial

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5 pages, 280 KiB  
Editorial
Using the Age-Friendly Health Systems Framework to Track Wellness and Health Promotion Priorities of Older Adults in the Global Community
by Nina Tumosa
Int. J. Environ. Res. Public Health 2023, 20(5), 4617; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20054617 - 06 Mar 2023
Viewed by 1373
Abstract
The promotion of health and wellness interventions for older adults is important in controlling the onset and progression of disabilities as well as disease in these individuals [...] Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)

Research

Jump to: Editorial, Other

19 pages, 411 KiB  
Article
Socioeconomic Background and Self-Reported Sleep Quality in Older Adults during the COVID-19 Pandemic: An Analysis of the English Longitudinal Study of Ageing (ELSA)
by Adam N. Collinge and Peter A. Bath
Int. J. Environ. Res. Public Health 2023, 20(5), 4534; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20054534 - 03 Mar 2023
Cited by 2 | Viewed by 1377
Abstract
The COVID-19 pandemic negatively impacted sleep quality. However, research regarding older adults’ sleep quality during the pandemic has been limited. This study examined the association between socioeconomic background (SEB) and older adults’ sleep quality during the COVID-19 pandemic. Data on 7040 adults aged [...] Read more.
The COVID-19 pandemic negatively impacted sleep quality. However, research regarding older adults’ sleep quality during the pandemic has been limited. This study examined the association between socioeconomic background (SEB) and older adults’ sleep quality during the COVID-19 pandemic. Data on 7040 adults aged ≥50 were acquired from a COVID-19 sub-study of the English Longitudinal Study of Ageing (ELSA). SEB was operationalized using educational attainment, previous financial situation, and concern about the future financial situation. Sociodemographic, mental health, physical health, and health behavior variables were included as covariates. Chi-squared tests and binary logistic regression were used to examine associations between SEB and sleep quality. Lower educational attainment and greater financial hardship and concerns were associated with poor sleep quality. The relationship between educational attainment and sleep quality was explained by the financial variables, while the relationship between previous financial difficulties and sleep quality was explained by physical health and health behavior variables. Greater financial concerns about the future, poor mental health, and poor physical health were independent risk factors for poor sleep quality in older adults during the pandemic. Healthcare professionals and service providers should consider these issues when supporting older patients with sleep problems and in promoting health and wellness. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
17 pages, 1534 KiB  
Article
The Impact of the Medical Insurance System on the Health of Older Adults in Urban China: Analysis Based on Three-Period Panel Data
by Hongfeng Zhang, Peng Cheng and Lu Huang
Int. J. Environ. Res. Public Health 2023, 20(5), 3817; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20053817 - 21 Feb 2023
Cited by 2 | Viewed by 1399
Abstract
The impact of the medical insurance system (MIS) on the health of older adults is a key element of research in the field of social security. Because China’s MIS consists of different types of insurance, and the benefits and levels of coverage received [...] Read more.
The impact of the medical insurance system (MIS) on the health of older adults is a key element of research in the field of social security. Because China’s MIS consists of different types of insurance, and the benefits and levels of coverage received by participating in different medical insurance vary, different medical insurance may have a differential impact on the health of older adults. This has rarely been studied before. In this paper, the panel data of the third phase of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015 and 2018 were used to investigate the impact of participation in social medical insurance (SMI) and commercial medical insurance (CMI) on the health of urban older adults and its mechanism relationship. The study found that SMI had a positive impact on the mental health of older adults, but only in the eastern region. Participation in CMI was positively correlated with the health of older adults, but this association was relatively small and was only observed in the sample of older adults aged 75 years and above. In addition, future life security plays an important role in the process of improving the health of older adults through medical insurance. Both research hypothesis 1 and research hypothesis 2 were verified. The results of this paper show that the evidence of the positive effect of medical insurance on the health of older adults in urban areas proposed by scholars is not convincing enough. Therefore, the medical insurance scheme should be reformed, focusing not only on coverage, but on enhancing the benefits and level of insurance, so as to enhance its positive impact on the health of older adults. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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12 pages, 913 KiB  
Article
The Role of Community Health Workers in the Health and Well-Being of Vulnerable Older Adults during the COVID Pandemic
by Matthew Hodges, Dawn Butler, Ariel Spaulding and Debra K. Litzelman
Int. J. Environ. Res. Public Health 2023, 20(4), 2766; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20042766 - 04 Feb 2023
Cited by 1 | Viewed by 2283
Abstract
The COVID-19 pandemic disrupted social support networks as well as resource access for participants. The purpose of this study was to: analyze the experiences of older adults enrolled in a geriatric-focused community health worker (CHW) support program, to gain a better understanding of [...] Read more.
The COVID-19 pandemic disrupted social support networks as well as resource access for participants. The purpose of this study was to: analyze the experiences of older adults enrolled in a geriatric-focused community health worker (CHW) support program, to gain a better understanding of how CHWs might enhance care delivery, and to further understand how COVID-19 affected the social and emotional needs and well-being of older adults during the first 18 months of the pandemic. Qualitative analysis was performed on notes entered by CHWs based on 793 telephone encounters with 358 participants between March 2020 and August 2021. Analysis was performed by two reviewers independently coding the data. Weighing the benefits of seeing family against the risks of COVID exposure was a source of emotional distress for participants. Our qualitative analysis suggests that CHWs were effective in providing emotional support and connecting participants to resources. CHWs are capable of bolstering the support networks of older adults and carrying out some of the responsibilities conventionally fulfilled by family supports. CHWs addressed participant needs that are frequently unmet by healthcare team members and provided emotional support to participants contributing to health and well-being. CHW assistance can fill gaps in support left by the healthcare system and family support structures. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 603 KiB  
Article
Preventive Care and Outcomes of Interprofessional Medicare Annual Wellness Visits for Older Adults
by Camlyn Masuda, Lovedhi Aggarwal, Michele Lani Bray, Christabel K. Cheung, Bum Jung Kim, Aida Wen, Lauren Okamoto, Matthew Uechi, Yeonjung Jane Lee and Kamal Masaki
Int. J. Environ. Res. Public Health 2022, 19(24), 16752; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416752 - 13 Dec 2022
Cited by 3 | Viewed by 1816
Abstract
As we anticipate a growing population of older adults, we will see an increase in chronic conditions such as dementia and falls. To meet these public health needs, we must systematically provide screening, education, preventive care, and supportive care for older patients and [...] Read more.
As we anticipate a growing population of older adults, we will see an increase in chronic conditions such as dementia and falls. To meet these public health needs, we must systematically provide screening, education, preventive care, and supportive care for older patients and their caregivers in a primary care setting. This will require a workforce trained in providing for the complex medical and psychosocial needs of an older adult population in an interprofessional and collaborative fashion. By integrating geriatric screening tools into an interdisciplinary Annual Wellness Visit teaching clinic, we were able to successfully improve rates of geriatric screening for dementia, depression, falls, medication reconciliation and advance care planning. We also saw improvements in patient care and satisfaction and provided the opportunity for interprofessional collaboration and education for students in medicine, nursing, pharmacy and social work. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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13 pages, 1503 KiB  
Article
An Approach for Fall Prediction Based on Kinematics of Body Key Points Using LSTM
by Bahareh Mobasheri, Seyed Reza Kamel Tabbakh and Yahya Forghani
Int. J. Environ. Res. Public Health 2022, 19(21), 13762; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192113762 - 22 Oct 2022
Cited by 2 | Viewed by 1805
Abstract
Many studies have used sensors attached to adults in order to collect signals by which one can carry out analyses to predict falls. In addition, there are research studies in which videos and photographs were used to extract and analyze body posture and [...] Read more.
Many studies have used sensors attached to adults in order to collect signals by which one can carry out analyses to predict falls. In addition, there are research studies in which videos and photographs were used to extract and analyze body posture and body kinematics. The present study proposes an integrated approach consisting of body kinematics and machine learning. The model data consist of video recordings collected in the UP-Fall Detection dataset experiment. Three models based on long-short-term memory (LSTM) network—4p-SAFE, 5p-SAFE, and 6p-SAFE for four, five, and six parameters—were developed in this work. The parameters needed for these models consist of some coordinates and angles extracted from videos. These models are easy to apply to the sequential images collected by ordinary cameras, which are installed everywhere, especially on aged-care premises. The accuracy of predictions was as good as 98%. Finally, the authors discuss that, by applying these models, the health and wellness of adults and elderlies will be considerably promoted. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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9 pages, 665 KiB  
Article
Targeted Telehealth Education Increases Interest in Using Telehealth among a Diverse Group of Low-Income Older Adults
by Emily Jezewski, Abigale Miller, MaryAnn Eusebio and Jane Potter
Int. J. Environ. Res. Public Health 2022, 19(20), 13349; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192013349 - 16 Oct 2022
Cited by 4 | Viewed by 1757
Abstract
Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of [...] Read more.
Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of Annual Wellness Visits, which are known to improve use of preventive services. To increase telehealth use, we targeted vulnerable, low-income, minority older adults and provided education to improve knowledge of and identify barriers to telehealth use. Ultimately, this could serve as a means of improving health and preventive care services. Participants resided at independent living facilities, low-income housing, and elders of the Native American coalition; N = 257. Participants received written education materials; a subset attended a 20-min presentation. In this quasi-experimental study, participants completed a pre-post survey. Results were analyzed using Chi-Squared and Fisher’s Exact tests. Participants included 54 ‘in-person’ and 203 ‘at-home’ learners. Most were female (79%), single/widowed (51%), and white (65%). At baseline, 39% were familiar with telehealth; following education 73% stated understanding on accessing telehealth. Nearly 40% of participants said they would use telehealth in the future; a larger proportion of “in-person” (73%) learners were willing to use telehealth than “at-home” learners (41%) (p = 0.001). Divorced older adults and Blacks voiced greater likelihoods of using telehealth than their married/widowed and White counterparts, respectively (Χ2(3, N = 195) = 9.693, p = 0.02), (p = 0.01). This education program demonstrates an increase likelihood in health promotion among older adults by increasing confidence in accessing and future use of telehealth; therefore, we achieved our aim of promoting telehealth use and improving health promotion. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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14 pages, 716 KiB  
Article
Exploring Perceptions of a Fresh Food Prescription Program during COVID-19
by Rachel Zimmer, Ashley Strahley, Jane Weiss, Sheena McNeill, Allison S. McBride, Scott Best, David Harrison and Kimberly Montez
Int. J. Environ. Res. Public Health 2022, 19(17), 10725; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710725 - 28 Aug 2022
Cited by 5 | Viewed by 2155
Abstract
This qualitative study aimed to elicit the perspectives of individuals with food insecurity (FI) who were enrolled in a Fresh Food Prescription (FFRx) delivery program through a collaboration between an academic medical center and multiple community partners in the southeastern United States. Semi-structured [...] Read more.
This qualitative study aimed to elicit the perspectives of individuals with food insecurity (FI) who were enrolled in a Fresh Food Prescription (FFRx) delivery program through a collaboration between an academic medical center and multiple community partners in the southeastern United States. Semi-structured interviews and open-ended survey responses explored the experiences of participants enrolled in a FFRx delivery program during the COVID-19 pandemic. The interviews probed the shopping habits, food security, experience, and impact of the program on nutrition, health, and well-being; the surveys explored the perceptions of and satisfaction with the program. A coding scheme was developed inductively, and a thematic analysis was conducted on raw narrative data using Atlas.ti 8.4 to sort and manage the data. The themes included that the program promoted healthy dietary habits, improved access to high-quality foods, improved well-being, enhanced financial well-being, and alleviated logistical barriers to accessing food and cooking. Participants provided suggestions for FFRx improvement. Future studies may facilitate improved clinical–community partnerships to address FI. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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12 pages, 3345 KiB  
Article
Electroencephalography-Based Neuroemotional Responses in Cognitively Normal and Cognitively Impaired Elderly by Watching the Ardisia mamillata Hance with Fruits and without Fruits
by Juan Du, Xiaomei Chen, Li Xi, Beibei Jiang, Jun Ma, Guangsheng Yuan, Ahmad Hassan, Erkang Fu and Yumei Huang
Int. J. Environ. Res. Public Health 2022, 19(16), 10020; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191610020 - 14 Aug 2022
Cited by 2 | Viewed by 1304
Abstract
Background: The purpose of this study is to explore the difference between the indexes of neuro-emotion between the cognitively normal elderly (CNE) and cognitively impaired elderly (CIE) while viewing the Ardisia mamillata Hance with red fruit (F) and without red fruit (NF) to [...] Read more.
Background: The purpose of this study is to explore the difference between the indexes of neuro-emotion between the cognitively normal elderly (CNE) and cognitively impaired elderly (CIE) while viewing the Ardisia mamillata Hance with red fruit (F) and without red fruit (NF) to determine which kind of the Ardisia mamillata Hance would be more beneficial to the participants’ neuro-emotions. Methods: Nine CNE individuals and nine CIE individuals, ranging in age from 80–90 years old, participated in this study and signed the informed consent form before beginning the experiment. Six mood indicators (engagement, excitement, focus, interest, relaxation, and stress) were measured by an EEG headset during the participants’ viewing of the NF, F, and NF + F. Results: For the CNE group, their engagement, excitement, and focus values were the lowest, while their interest value was the highest when they view the NF + F; therefore, we obtain the results that the combination of NF + F was the most beneficial to their EEG emotions. For the CIE group, the combination of NF + F increased their interest score, but decreased their focus score, which indicated that the NF + F was the most beneficial to their neuro-emotions. Conclusions: This study concluded that the combination of plants with and without fruits was most beneficial to the neural emotions of both groups of elderly people. Especially for the CIE, plants with larger and warmer colors, such as yellow, red, and orange fruits, should be considered for installation indoors or outdoors, as this would be better for their emotional well-being. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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10 pages, 668 KiB  
Article
Promoting Older Adult Health with Interprofessional Education through Community Based Health Screening
by Susan Ostertag, Jade Bosic-Reiniger, Chris Migliaccio and Rachael Zins
Int. J. Environ. Res. Public Health 2022, 19(11), 6513; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19116513 - 27 May 2022
Cited by 2 | Viewed by 1513
Abstract
IPHARM (ImProving Health Among Rural Montanans) is a university-based community health screening program that provides valuable interprofessional teamwork and clinical skills training for health care students while addressing the health of older adults. Students perform a variety of health care screenings dependent on [...] Read more.
IPHARM (ImProving Health Among Rural Montanans) is a university-based community health screening program that provides valuable interprofessional teamwork and clinical skills training for health care students while addressing the health of older adults. Students perform a variety of health care screenings dependent on the health care professions present and the requests of the community group served. Education, counseling, and recommendations for participants are provided by the interprofessional student teams under supervision and guidance from faculty and clinicians. Supported in part by federal grants such as the Health Service and Resource Administration Geriatric Workforce Enhancement Program (HRSA GWEP), IPHARM has provided interprofessional training for over 2100 students and conducted over 30,000 health screenings at 814 different community events. Surveys from students indicate that the experience promotes effective interprofessional team skills related to communication, an increased understanding of the roles and responsibilities of the health care team, and how to positively impact the health of older adults. These interprofessional screening events for older adults, conducted in the community by health professions students and faculty, help prepare the future workforce for collaborative and effective health care delivery. The purpose of this article is to describe the IPHARM objectives, methods, and impact this program has had on the health of older adults and the training of our future health care workforce. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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8 pages, 323 KiB  
Article
Communication Disparities between Nursing Home Team Members
by Timothy W. Farrell, Jorie M. Butler, Gail L. Towsley, Jacqueline S. Telonidis, Katherine P. Supiano, Caroline E. Stephens, Nancy M. Nelson, Alisyn L. May and Linda S. Edelman
Int. J. Environ. Res. Public Health 2022, 19(10), 5975; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19105975 - 14 May 2022
Cited by 2 | Viewed by 2345
Abstract
Optimal care in nursing home (NH) settings requires effective team communication. Certified nursing assistants (CNAs) interact with nursing home residents frequently, but the extent to which CNAs feel their input is valued by other team members is not known. We conducted a cross-sectional [...] Read more.
Optimal care in nursing home (NH) settings requires effective team communication. Certified nursing assistants (CNAs) interact with nursing home residents frequently, but the extent to which CNAs feel their input is valued by other team members is not known. We conducted a cross-sectional study in which we administered a communication survey within 20 Utah nursing home facilities to 650 team members, including 124 nurses and 264 CNAs. Respondents used a 4-point scale to indicate the extent to which their input is valued by other team members when reporting their concerns about nursing home residents. We used a one-way ANOVA with a Bonferroni correction. When compared to nurses, CNAs felt less valued (CNA mean = 2.14, nurse mean = 3.24; p < 0.001) when reporting to physicians, and less valued (CNA mean = 1.66, nurse mean = 2.71; p < 0.001) when reporting to pharmacists. CNAs did not feel less valued than nurses (CNA mean = 3.43, nurse mean = 3.37; p = 0.25) when reporting to other nurses. Our findings demonstrate that CNAs feel their input is not valued outside of nursing, which could impact resident care. Additional research is needed to understand the reasons for this perception and to design educational interventions to improve the culture of communication in nursing home settings. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
11 pages, 673 KiB  
Article
A Collaborative Implementation Strategy to Increase Falls Prevention Training Using the Age-Friendly Health Systems Approach
by Jennifer Jurado Severance, Solymar Rivera, Jinmyoung Cho, Jessica Hartos, Amal Khan and Janice Knebl
Int. J. Environ. Res. Public Health 2022, 19(10), 5903; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19105903 - 12 May 2022
Cited by 3 | Viewed by 2169
Abstract
Falls in the home and in community environments are the leading cause of injuries and long-term disabilities for the aging population. The purpose of this study was to examine outcomes of a partnership among an academic institution, government agency, community organizations, and emergency [...] Read more.
Falls in the home and in community environments are the leading cause of injuries and long-term disabilities for the aging population. The purpose of this study was to examine outcomes of a partnership among an academic institution, government agency, community organizations, and emergency management services to implement a falls prevention training program using an Age-Friendly Health Systems approach. In this prospective study, partners identified gaps in services and targeted and non-targeted delivery areas for implementation of an evidence-based falls prevention intervention addressing the 4Ms of Age-Friendly Health Systems—Mobility, Medications, Mentation, and What Matters. Descriptive statistics were calculated for program implementation and participant demographic variables, and paired t-test analysis compared scores for self-assessed general health and falls efficacy prior to and after program participation. Twenty-seven falls prevention classes were implemented, with over half (52%) in targeted areas. A total of 354 adults aged 50 and older participated, with N = 188 participants (53%) completing the program by attending at least five of eight sessions. Of completers, 35% resided in targeted areas. The results showed a statistically significant improvement in falls efficacy by program completers in targeted and non-targeted areas. However, there was no statistically significant difference in self-rated health. Overall, the findings of this study indicate that collaboration to deliver falls prevention training can be effective in reaching at-risk older adults. By mobilizing collaborative partnerships, limited resources can be allocated towards identifying at-risk older adults and improving community-based falls prevention education. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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8 pages, 311 KiB  
Article
Women’s Expressed Motivational Factors for Participation in Aquarobics Classes
by Janet L. Currie
Int. J. Environ. Res. Public Health 2022, 19(9), 5274; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095274 - 26 Apr 2022
Cited by 1 | Viewed by 1772
Abstract
Leisure provides a vehicle for women to develop friendships in later life, yet few studies have explored older women’s experiences of social and emotional connections with leisure. This article provides insights into the perceived benefits a group of older women state they gain [...] Read more.
Leisure provides a vehicle for women to develop friendships in later life, yet few studies have explored older women’s experiences of social and emotional connections with leisure. This article provides insights into the perceived benefits a group of older women state they gain from participation in aquarobics for leisure. The main themes to emerge from the focus group interview data (n = 19 women, x¯ age = 75 years), illustrating the key motivational factor for participation in the classes, included an individual desire to improve one’s overall fitness. Participants also expressed a strong sense of belonging from being able to socialize after the activity, and highly valued the welcoming atmosphere and feeling of comradery involved. The aquarobics instructor was noted as performing a very important role in ensuring delivery of an enjoyable class experience where participants experienced variety, had fun, and felt happy taking part. For this group of women, aquarobics forms a health promoting leisure context offering an important space for gaining subjective wellbeing, building social connectedness and resisting the dominant ideology of aging. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
17 pages, 327 KiB  
Article
Creating Interprofessional Readiness to Advance Age-Friendly U.S. Healthcare
by Leland Waters, Sarah A. Marrs, Catherine J. Tompkins, Robert Fix, Sheryl Finucane, Constance L. Coogle, Kevin Grunden, Emily S. Ihara, Madeline McIntyre, Pamela Parsons and Patricia Slattum
Int. J. Environ. Res. Public Health 2022, 19(9), 5258; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095258 - 26 Apr 2022
Cited by 6 | Viewed by 2260
Abstract
A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, [...] Read more.
A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH). An interprofessional team employed a multidimensional approach to create age-friendly, person-centered practitioners. In this mixed methods study, questionnaires were disseminated and focus groups were conducted with two cohorts of CIRCAA scholars to determine their ability to incorporate learned evidence-based strategies into their own practice environments. Themes and patterns were identified among transcribed interview recordings. Multiple coders were used to identify themes and patterns and inter-coder reliability was assessed. The findings indicate that participants successfully incorporated age-friendly principles and best practices into their own work environments and escaped the silos of their disciplines through the implementation of their capstone projects. Quantitative data supported qualitative themes and revealed gains in knowledge of critical components of age-friendly healthcare and perceptions of interprofessional collaborative care. These results are discussed within a new conceptual framework for studying the multidimensional complexity of what it means to be age-friendly. Our findings suggest that programs such as CIRCAA have the potential to improve older adults’ health by addressing SDOH, advancing age-friendly and patient-centered care, and promoting an interprofessional model of evidence-based practice. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
18 pages, 1273 KiB  
Article
A Mixed-Methods Formative Evaluation of a Dementia-Friendly Congregation Program for Black Churches
by Janelle Gore, Jamilla Toliver, Miranda A. Moore, Dawn Aycock and Fayron Epps
Int. J. Environ. Res. Public Health 2022, 19(8), 4498; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084498 - 08 Apr 2022
Cited by 5 | Viewed by 2100
Abstract
Black churches have traditionally been a haven for Black American families; however, many churches do not currently have programs to support families living with dementia. Alter™ was established to assist faith communities in meeting the needs of these families and becoming a viable [...] Read more.
Black churches have traditionally been a haven for Black American families; however, many churches do not currently have programs to support families living with dementia. Alter™ was established to assist faith communities in meeting the needs of these families and becoming a viable resource to promote their health and wellness. Alter™ achieves this aim through a three-pronged approach: (1) conducting educational sessions, (2) modifying Black churches to be dementia-inclusive spaces, and (3) providing ongoing support. The principal goal of Alter™ is to offer guidance to churches in adapting their community to reflect a supportive environment for families affected by dementia. Alter™ uses a partnership checklist to encourage activities that incorporate dementia education opportunities, environmental modifications, and dementia resources and support. This paper reports on a formative mixed-methods evaluation of church partners enrolled in Alter™. Church partner ambassadors within the faith communities participated in the evaluation survey (n = 8) and two focus groups (n = 11). Ambassadors are appointed by church leadership to lead the implementation of program activities. Data were collected concerning the levels of helpfulness, difficulty, usefulness, or utility of checklist activities and modifications and the ease of program implementation. The evaluation also assessed the COVID-19 pandemic’s impact on each church’s ability to implement activities and modifications. The survey results revealed that most required partnership activities and modifications were found to be at least moderately helpful. Some of the items (themes) that differed across church partners included barriers to implementing activities, the support provided and needed, and the use of program funding. This evaluation provides key insights to consider in developing and refining community-based, dementia-friendly communities (including faith communities). As implementation science expands and improves, the need to evaluate the implementation of programs continues to be highlighted. Our formative evaluation shed light on key areas in which modifications to our original programming would lead to program improvement and sustainability. Additionally, implementing the modifications identified in our evaluation will facilitate the achievement of the mission of Alter™ to improve the well-being of older adults affected by dementia and their families. Other programs would reap substantial benefits from engaging in similar formative evaluation efforts. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 1792 KiB  
Article
Three-Month vs. One-Year Detraining Effects after Multicomponent Exercise Program in Hypertensive Older Women
by Luis Leitão, Moacir Marocolo, Hiago L. R. de Souza, Rhai André Arriel, Yuri Campos, Mauro Mazini, Ricardo Pace Junior, Teresa Figueiredo, Hugo Louro and Ana Pereira
Int. J. Environ. Res. Public Health 2022, 19(5), 2871; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052871 - 01 Mar 2022
Cited by 9 | Viewed by 1994
Abstract
Background: Chronic diseases are the leading causes of death and disability in older women. Physical exercise training programs promote beneficial effects for health and quality of life. However, exercise interruption periods may be detrimental for the hemodynamic and lipidic profiles of hypertensive older [...] Read more.
Background: Chronic diseases are the leading causes of death and disability in older women. Physical exercise training programs promote beneficial effects for health and quality of life. However, exercise interruption periods may be detrimental for the hemodynamic and lipidic profiles of hypertensive older women with dyslipidemia. Methods: Nineteen hypertensive older women with dyslipidemia (exercise group: 67.5 ± 5.4 years, 1.53 ± 3.42 m, 71.84 ± 7.45 kg) performed a supervised multicomponent exercise training program (METP) during nine months, followed by a one-year detraining period (DT), while fourteen hypertensive older women (control group: 66.4 ± 5.2 years, 1.56 ± 3.10 m, 69.38 ± 5.24 kg) with dyslipidemia kept their continued daily routine without exercise. For both groups, hemodynamic and lipidic profiles and functional capacities (FCs) were assessed four times: before and after the METP and after 3 and 12 months of DT (no exercise was carried out). Results: The METP improved hemodynamic and lipidic profiles (p < 0.05), while three months of DT decreased all (p < 0.05) parameters, with the exception of diastolic blood pressure (DBP). One year of DT significantly (p < 0.01) decreased systolic blood pressure (7.85%), DBP (2.29%), resting heart rate (7.95%), blood glucose (19.14%), total cholesterol (10.27%), triglycerides (6.92%) and FC—agility (4.24%), lower- (−12.75%) and upper-body strength (−12.17%), cardiorespiratory capacity (−4.81%) and lower- (−16.16%) and upper-body flexibility (−11.11%). Conclusion: Nine months of the exercise program significantly improved the hemodynamic and lipid profiles as well as the functional capacities of hypertensive older women with dyslipidemia. Although a detraining period is detrimental to these benefits, it seems that the first three months are more prominent in these alterations. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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18 pages, 1458 KiB  
Article
Toxic Psychosocial Stress, Resiliency Resources and Time to Dementia Diagnosis in a Nationally Representative Sample of Older Americans in the Health and Retirement Study from 2006–2016
by Allan K. Nkwata, Ming Zhang, Xiao Song, Bruno Giordani and Amara E. Ezeamama
Int. J. Environ. Res. Public Health 2022, 19(4), 2419; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042419 - 19 Feb 2022
Cited by 5 | Viewed by 1778
Abstract
Background: Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia in a nationally representative sample (n = 6516) of American adults ≥50 years enrolled in the Health and Retirement Study between 2006 and 2016. Methods: [...] Read more.
Background: Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia in a nationally representative sample (n = 6516) of American adults ≥50 years enrolled in the Health and Retirement Study between 2006 and 2016. Methods: TS included experiences of everyday discrimination and RPF included personal mastery. Race/ethnicity was self-reported as African American, Caucasian, or Other. Multivariable Cox proportional hazards regression models estimated TS-, RPF- and race-associated hazard ratios (HR) for dementia diagnosis and 95% confidence intervals (CIs) with adjustment for comorbidity, lifestyle, and socio-demographic confounders. Results: Discrimination-associated risk of dementia diagnosis on average increased with education level [discrimination x education, p = 0.032; HR = 1.75 (95% CI: 1.01–3.03) if < high school, HR = 5.67 (95% CI: 2.94–10.94) if high school completed and HR = 2.48 (95% CI: 1.53–4.00) if ≥some college education]. Likewise, African American vs. Caucasian race disparity in new-onset dementia was evident (HR = 2.12, 95% CI: 1.42–3.17) among adults with high-mastery while absent (HR = 1.35, 95% CI: 0.75–2.41) among adults with low mastery (Mastery x Race, p = 0.01). Conclusions: TS is a contextual driver of incident dementia that seemingly operates in a race and RPF-dependent fashion among American adults. Association pattern suggests that TS may overwhelm the cognitive reserve benefit of RPF particularly in status-inconsistent contexts including persons subjected to discrimination despite high education and persons of African American descent despite high mastery. Policies that reduce discrimination and promote equitable treatment by race/ethnicity may support cognitive resiliency and reduce the risk of dementia diagnosis in adult Americans. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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17 pages, 493 KiB  
Article
Lived Experiences of Newly Admitted to Long-Term Care Facilities among Older Adults with Disabilities in Taiwan
by Nai-Hui Chien, Chin-Hsing Tsai and Hung-Ru Lin
Int. J. Environ. Res. Public Health 2022, 19(3), 1816; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031816 - 05 Feb 2022
Cited by 3 | Viewed by 1968
Abstract
This study aimed to explore the lived experiences of Taiwanese older adults with disabilities newly admitted to long-term care facilities (LTCFs). A descriptive phenomenological method was used. Colaizzi’s method analysis of 15 participant interviews revealed six themes: “living here is a last resort”, [...] Read more.
This study aimed to explore the lived experiences of Taiwanese older adults with disabilities newly admitted to long-term care facilities (LTCFs). A descriptive phenomenological method was used. Colaizzi’s method analysis of 15 participant interviews revealed six themes: “living here is a last resort”, “I don’t like it but still have to live here”, “my needs are not understood”, “looking forward to emotional support”, “practicing the way of survival”, and “trying to make myself better”. The older adults were admitted to the LTCF as they or their family members could not take care of themselves due to their disability. Participants explained their new life in the LTCF was like a prison, it was not easy for their needs to be understood. They used self-adjustment and established relationships with staff in the LTCF in order to live a stable life. They lived their lives with silence and alertness to practice the way of survival. They strived to make themselves better through rehabilitation, taking good care of their bodies, and finding their focus and value of life. It is important to pay attention to the care needs as well as life adjustment problems for newly older adults with disabilities in order to assist them in opening up new life experiences in LTCFs. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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18 pages, 2059 KiB  
Article
Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis
by Ae-Ri Jung, Dasom Kim and Eun-A Park
Int. J. Environ. Res. Public Health 2021, 18(21), 11535; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111535 - 02 Nov 2021
Cited by 11 | Viewed by 3570
Abstract
Background: Outside activities have decreased due to the spread of the COVID-19 since 2019; therefore, the need for education using information and communication technology (ICT) for older adults with mild cognitive impairment (MCI) has increased. This study systematically evaluated the effects of cognitive [...] Read more.
Background: Outside activities have decreased due to the spread of the COVID-19 since 2019; therefore, the need for education using information and communication technology (ICT) for older adults with mild cognitive impairment (MCI) has increased. This study systematically evaluated the effects of cognitive enhancement interventions using ICT on older adults with MCI. Methods: Six electronic databases (CINAHL, Cochrane CENTRAL, EMBASE, PubMed, RISS, and KISS) were searched for relevant articles published from 25 January to 10 February, 2021. Results: As a result of the systematic literature review, 12 research papers were finally selected as the literature for quality evaluation, and 11 final papers were selected, excluding one in the quality evaluation. From the synthesis in this study, it was found that cognitive intervention using ICT showed a statistically significant positive effect on cognitive function when compared with various control groups (SMD = 0.4547; p < 0.001; 95% CI: 0.1980–0.7113). Conclusions: Through this study, cognitive intervention using ICT showed a small effect size for older adults with mild cognitive impairment, and statistically significant results were found. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 516 KiB  
Article
System Redesign: The Value of a Primary Care Liaison Model to Address Unmet Social Needs among Older Primary Care Patients
by Jungyoon Kim, Valerie Pacino, Hongmei Wang, April Recher, Isha Jain, Vaibhavi Mone, Jihyun Ma, Mary Jo Spurgin, Daniel Jeffrey, Stephen Mohring and Jane Potter
Int. J. Environ. Res. Public Health 2021, 18(21), 11135; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111135 - 23 Oct 2021
Cited by 5 | Viewed by 2398
Abstract
Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling [...] Read more.
Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling to identify unmet needs, and mapping referral services through cross-sectoral partnerships. A PCL worked with three patient-centered medical homes (PCMHs) that are part of a large integrative health system. A mixed-methods approach using a post-training survey and a patient tracking tool, was used to understand the reach, adoption, and implementation of the PCL model. From June 2020 to May 2021, the PCL trained 61 primary care staff to assess and address unmet social needs of older patients. A total of 327 patients, aged 65 years and older and within 3–5 days of acute-care hospital discharges, were counseled by the PCL. For patients with unmet needs, support services were arranged through community agencies: transportation (37%), in-home care (33%), food (16%), caregiver support (2%), legal (16%), and other (16%). Our preliminary results suggest that the PCL model is feasible and implementable within PCMH settings to address unmet social needs of older patients to improve their health outcomes. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 352 KiB  
Article
What Makes Chinese Adult Children Behave Differently during Parents’ End of Life: A Discriminant Analysis of Macao Chinese
by Wai I. Ng, Sok Leng Che, Xiang Li and Ming Xia Zhu
Int. J. Environ. Res. Public Health 2021, 18(20), 10737; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010737 - 13 Oct 2021
Cited by 4 | Viewed by 1849
Abstract
The daily practice of filial piety (FP) is well prescribed under the traditional filial norms in the Chinese community. However, exploration of FP practices at the end of parents’ lives is limited. The current study explored the FP representation and good death preferences [...] Read more.
The daily practice of filial piety (FP) is well prescribed under the traditional filial norms in the Chinese community. However, exploration of FP practices at the end of parents’ lives is limited. The current study explored the FP representation and good death preferences of Macao Chinese. A cross-sectional web-based survey was conducted and discriminant analysis was used to identify possible predictors of FP representation in the context of parents’ end of life. Results showed that Macao Chinese were inclined to perform most of the filial duties in the last journey of their parents. Among 705 participants, 150 (21.3%) tended to practice authoritarian FP, and 555 (78.7%) tended to practice reciprocal FP. Age, education, religion, and good death preferences were identified as predictors of different FP representation groups. The findings could help clinicians to obtain a preliminary perception of FP representation of Chinese patients and to determine the appropriate approach for end-of-life care from a family perspective. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
17 pages, 323 KiB  
Article
Applying the Pender’s Health Promotion Model to Identify the Factors Related to Older Adults’ Participation in Community-Based Health Promotion Activities
by Hsuan-Hui Chen and Pei-Lin Hsieh
Int. J. Environ. Res. Public Health 2021, 18(19), 9985; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18199985 - 23 Sep 2021
Cited by 10 | Viewed by 11461
Abstract
Aging societies have garnered global attention regarding issues related to older adults’ health promotion. This cross-sectional study aimed to identify factors associated with older adults’ participation in community-based health promotion activities. The Older Adults’ Health Promotion Activity Questionnaire was developed to collect data, [...] Read more.
Aging societies have garnered global attention regarding issues related to older adults’ health promotion. This cross-sectional study aimed to identify factors associated with older adults’ participation in community-based health promotion activities. The Older Adults’ Health Promotion Activity Questionnaire was developed to collect data, and a total of 139 older adults were recruited from a community care center in Taoyuan City. Participants’ mean age was 72.7 years (SD = 6.0 years), 74.8% were females, 64.7% were married, 59% had a lower level of education, 51.8% had lower income, 59% reported their health status not good, and 76.3% had chronic disease. Our findings indicated that age, perceived benefits, and self-efficacy were identified as significant predictors of participation in health promotion activities. Among them, perceived benefits were found to have the strongest association with participation in health promotion activities (β = 0.305; p < 0.05). The findings showed that the Pender’s Health Promotion Model is useful to provide information for predicting and detecting significant factors related to older adults’ participation in community-based health promotion activities. By using this model as a framework, researchers can design more specific studies that are directed towards improving healthy lifestyles and detecting the key components of health-related behaviors among different age groups. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
17 pages, 4910 KiB  
Article
Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China
by Huanhuan Zhu, Lin Pan, Yiji Li, Huiming Jin, Qian Wang, Xin Liu, Cong Wang, Peng Liao, Xinyang Jiang and Luo Li
Int. J. Environ. Res. Public Health 2021, 18(19), 9964; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18199964 - 22 Sep 2021
Cited by 4 | Viewed by 1871
Abstract
The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address [...] Read more.
The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address this issue involves using geographic information systems (GIS)-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. This study employed gravity model and empirical Bayesian Kriging (EBK) interpolation analysis to evaluate the elderly’s spatial access to prehospital EMS in Ningbo, China. In our study, we aimed to solve the following specific research questions: In the study area, “what are the characteristics of the prehospital EMS demand of the elderly?” “Do the elderly have equal and convenient spatial access to prehospital EMS?” and “How can we satisfy the prehospital EMS demand of an aging population, improve their spatial access to prehospital EMS, and then ensure their quality of life?” The results showed that 37.44% of patients admitted to prehospital EMS in 2020 were 65 years and older. The rate of utilization of ambulance services by the elderly was 27.39 per 1000 elderly residents. Ambulance use by the elderly was the highest in the winter months and the lowest in the spring months (25.90% vs. 22.38%). As for the disease spectrum, the main disease was found to be trauma and intoxication (23.70%). The mean accessibility score was only 1.43 and nearly 70% of demand points had scored lower than 1. The elderly’s spatial accessibility to prehospital EMS had a central-outward gradient decreasing trend from the central region to the southeast and southwest of the study area. Our proposed methodology and its spatial equilibrium results could be taken as a benchmark of prehospital care capacity and help inform authorities’ efforts to develop efficient, aging-focused spatial accessibility plans. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 1126 KiB  
Article
Death Anxiety and Loneliness among Older Adults: Role of Parental Self-Efficacy
by Lee Greenblatt-Kimron, Miri Kestler-Peleg, Ahuva Even-Zohar and Osnat Lavenda
Int. J. Environ. Res. Public Health 2021, 18(18), 9857; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189857 - 18 Sep 2021
Cited by 11 | Viewed by 4625
Abstract
Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an [...] Read more.
Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an unexplored variable among older adults, namely, parental self-efficacy. A convenience sample of 362 Israeli parents over the age of 65 was recruited through means of social media. Participants completed self-reported questionnaires, which included background characteristics, death anxiety, parental self-efficacy, and loneliness measures. The findings showed that death anxiety was positively associated with loneliness among older adults. The findings also confirmed that parental self-efficacy moderated this association in this population. We concluded that the combination of death anxiety and low parental self-efficacy identified a group of older adults that are at higher risk of developing increased loneliness levels. Mental health professionals should consider intergenerational relationships as a fundamental component of older adults’ daily lives, focusing on parental self-efficacy in old age, as this appears to be a resilience resource. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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9 pages, 541 KiB  
Article
Social Support and Cognitive Impairment: Results from a Portuguese 4-Year Prospective Study
by Ricardo Pais, Luís Ruano, Carla Moreira, Sílvia Fraga, Ofélia P. Carvalho and Henrique Barros
Int. J. Environ. Res. Public Health 2021, 18(16), 8841; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168841 - 22 Aug 2021
Cited by 10 | Viewed by 2026
Abstract
(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of [...] Read more.
(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of older Portuguese people. (2) Methods: From the Portuguese EpiPorto cohort study, we followed a sample of participants with 60 to 85 years (N = 656) between 2009 and 2015 (4.63 mean years of follow-up). The participants’ perception of social support from family, friends and significant others was evaluated. Cox’s regression models were used to investigate the association between this and sociodemographic variables. (3) Results: It was found that social support from friends reduces the risk of cognitive impairment. Men, participants aged 60 to 64 and those not married have a lower risk of cognitive impairment after adjusting for other variables. Participants between 80 and 85 years old (p = 0.021), those with less than four years of education (p < 0.001), and those with cognitive impairment (p = 0.007) have perception of less social support from friends. (4) Conclusions: A social support network from friends reduces the risk of cognitive impairment for older people. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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11 pages, 340 KiB  
Article
Prevalence and Predictors of Willingness to Make Advance Directives among Macao Chinese
by Sok Man Leong, Kuai In Tam, Sok Leng Che and Ming Xia Zhu
Int. J. Environ. Res. Public Health 2021, 18(15), 7942; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157942 - 27 Jul 2021
Cited by 9 | Viewed by 2166
Abstract
While advance directives (ADs) are considered to be part of government’s healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public’s views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese [...] Read more.
While advance directives (ADs) are considered to be part of government’s healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public’s views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese people’s willingness to make ADs. Data were collected from 724 residents aged 18 years and above. Results showed that 533 respondents (73.6%) claimed that they were willing to complete an AD if the document was recognized legally. The experience of caring for relatives or friends with terminal illnesses, palliative care as the preferred end-of-life treatment option, and scoring higher in the Hospice Care Attitude Scale were the predictors of willingness to make ADs. Results of the study suggested that there was a relatively high number of people who would consider setting up ADs. Our study recommends that healthcare professionals should equip themselves to raise ADs-related discussions with patients. Moreover, the Macao Government is responsible for facilitating the introduction and implementation of ADs in order to improve overall end-of-life care quality in Macao. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
12 pages, 330 KiB  
Article
The Association between Health and Culture: The Perspective of Older Adult Hospital In-Patients in Israel
by Ahuva Even-Zohar, Varda Shtanger, Anat Israeli, Emma Averbuch, Gad Segal, Haim Mayan, Shmuel Steinlauf, Alex Galper and Eyal Zimlichman
Int. J. Environ. Res. Public Health 2021, 18(12), 6496; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126496 - 16 Jun 2021
Cited by 2 | Viewed by 2369
Abstract
People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective [...] Read more.
People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective of Israeli older adult hospital in-patients regarding the association between health and culture and to understand the meaning of the participants’ experiences with regards to the medical staff’s attitude towards them. This study was carried out using qualitative methodology that followed the interpretive interactionism approach. The research participants were 493 (mean age 70.81, S.D.: 15.88) in-patients at internal care departments at a hospital in Israel who answered an open-ended question included in the questionnaire as part of a wide study held during 2017 to 2018. Two main themes were found: (1) a humane attitude of respect and the right to privacy and (2) beliefs, values, and traditional medicine that are passed down through generations. The findings highlighted the issue of the patients’ cultural heritage and ageist attitudes they ascribed to the professional staff. This study provided recommendations for training the in-patient hospital workforce on the topic of cultural competence, beginning from the stage of diagnosis through treatment and to discharge from the hospital, in order to improve the service. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)

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10 pages, 866 KiB  
Concept Paper
A New Interprofessional Community-Service Learning Program, HATS (Health Ambassador Teams for Seniors) to Improve Older Adults Attitudes about Telehealth and Functionality
by Donald Jurivich, Carter Schimke, Dakota Snustad, Mitchell Floura, Casey Morton, Marsha Waind, Jeremy Holloway, Sclinda Janssen, Meridee Danks, Karen Semmens and Gunjan Dhawan Manocha
Int. J. Environ. Res. Public Health 2021, 18(19), 10082; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910082 - 25 Sep 2021
Cited by 3 | Viewed by 3064
Abstract
Senior population health often is underrepresented in curricula for medical and allied health students. Furthermore, entrenched and dense curricular schedules preclude interprofessional teams from clinical experiences related to senior population health. Community service learning potentially offers the opportunity to engage interprofessional students with [...] Read more.
Senior population health often is underrepresented in curricula for medical and allied health students. Furthermore, entrenched and dense curricular schedules preclude interprofessional teams from clinical experiences related to senior population health. Community service learning potentially offers the opportunity to engage interprofessional students with a panel of older adults to assess health promotion metrics over time. To test this educational concept, we created Health Ambassador Teams for Seniors, also known as HATS. Utilizing a telehealth platform, interprofessional student teams were tasked with older adult wellness promotion. The annual Medicare wellness exam served as a template for patient encounters which was enhanced with key elements of geriatric assessment such as gait and balance, cognition, and functional evaluations. The objective was to have dyads of interprofessional students conduct telehealth visits and gather healthcare data to be used for serial patient encounters and track functional trajectories over time. As a proof of concept, pilot telehealth encounters with medical, physical therapy, nursing and occupational therapy students revealed that data on older adult functional performances such as gait speed, Timed Up and Go test (TUG), and Mini-Cog test could be acquired through telehealth. Equally importantly, trainees received diverse feedback from faculty, peers and volunteer patients. A Research Electronic Data Capture (REDCap) data repository allows trainees to track patient trends relative to their health promotion recommendations as well as handoff their patient panel to the next set of trainees. The HATS program promises to strengthen the Geriatric Workforce, especially with senior population health. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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