Digital Commons Network^™

Staff Education Project To Reduce Falls In Assisted Living Through Improved Caregiver Knowledge, Attitude, And Skill, Crystal Morrow

Walden Dissertations and Doctoral Studies

Wisconsin has the highest death rates from falls in the nation. In a brief, the Wisconsin Aging Advocacy Network indicated that most falls among individuals over 65 occur in residential settings. Further, a significant number of elderly people will fall each year, resulting in hospitalizations or fatalities. The purpose of this project was to provide staff education in one Wisconsin assisted living facility to effectively improve knowledge, attitude, and skill among frontline staff for fall prevention management. A formal Fall Education Day was provided to improve knowledge and shape positive attitudes among staff. A pretest-posttest design was used to measure …

Emergency Department-Initiated Palliative Care Screening Among Older Adults: A Systematic Review And Meta-Analysis Protocol, Dimitri E Lin, Satheesh Gunaga, Fabrice I Mowbray, Eric D Isaacs, Daniel Markwalter, Naomi George, Alison E Hay, Rita Manfredi, Erica Westlake, Murtaza Akhter, Jason K Bowman, Naomi Rebollo-Lee, Brian Gacioch, Alexander D Ginsburg, Justin Kenneth Brooten, Sarah Pajka, Katie Selman, Paul Bain, Joshua J Davis, Shan Liu, Kei Ouchi

Faculty, Staff and Students Publications

Introduction: The rapidly growing population of older adults (individuals aged 65 years and older) presents a new set of challenges for healthcare providers in the emergency department (ED), given the prevalence of severe and life-threatening conditions among this group, such as chronic cancer, Alzheimer's disease/dementia and congestive heart failure. ED encounters often represent a critical point in an older patient's trajectory of care and can thus be an important opportunity for various interventions such as palliative care consultation. Therefore, identifying those who will benefit most from palliative care is of high importance, especially in determining the course of future treatment. …

Evaluating Correlates Of Healthy Eating And Dietary Quality Among Older Adults: A Mixed Methods Approach To Development And Application Of A New Survey Instrument, Sara K. Rosenkranz, Donya Shamati, Anna Biggins, Alissa Mick, Christopher Acosta, Richard R. Rosenkranz

Kinesiology and Nutrition Sciences Faculty Research

Objectives: Community-dwelling older adults face unique challenges related to nutrition and health, but little is known about their barriers and facilitators for healthy eating behaviors. This study sought to develop and evaluate a new instrument to measure the capability, opportunity, and motivation for healthy eating behaviors (COM-HE) among community-dwelling older adults.

Design: A mixed methods approach was used to obtain qualitative and quantitative data. Participants were aged 65 years or older, community-dwelling, and English-speaking. Participants engaged in focus groups (n = 12) and pilot-testing (n = 81) to evaluate the COM-HE instrument. The Rapid Eating Assessment for Participants – Shortened …

Neuro Rehab In Rural America: Interprofessional Strategies For Implementing Evidence Based Practice, Stacie Mae Larreau Christensen, Rebecca L. Kinnison, Amy J. Goldman, Colleen Spellman

Posters and Presentations: Physical Therapy

No abstract provided.

An Interdisciplinary Functional Exercise Program For Individuals With Parkinson’S Disease: A Case Series, Lauren Turbeville, Caroline Adams, Amy Wedge, Kailey Smitherman, Kathrin Rothermich

The Open Journal of Occupational Therapy

Background: Traditional exercise programs are beneficial in managing Parkinson’s disease (PD). Little research exists on interdisciplinary, functional exercise programs designed and implemented by licensed therapists.

Method: Our case series presents the development, implementation, and results of an interdisciplinary functional exercise program for individuals with PD and the effects this program had on daily functioning and quality of life. Participants were recruited via flyers, email, and phone communication, and consented to data collection for our objectives. Participants attended two sessions per week for 8 weeks. Sessions addressed fine and gross motor skills, dexterity, cognition, functional strength, gait, balance, and …

Cv: Jeannine Haberman (Nursing), Jeannine Haberman

Nursing Department Faculty Curricula Vitae

No abstract provided.

Anthropometric And Metabolic Assessment In Adults With Down Syndrome: The Need For Novel Indices And Tailored Criteria ​, Seli̇n Teki̇n, Nergi̇s Basmaci, İnci̇lay Lay, Alper Gürlek

Turkish Journal of Medical Sciences

Background/aim: This study aimed to evaluate the metabolic profile of adults with Down syndrome (DS) using novel anthropometric and metabolic indices, while also highlighting the limitations of traditional obesity assessment methods compared with the non-DS population.

Materials and methods: This cross-sectional study included 22 adults with DS and 28 age- and sex-matched non-DS controls. Anthropometric measurements, including BMI, waist circumference (WC), and hip circumference (HC), were recorded alongside novel indices such as waist-to-height ratio (WHtR), body adiposity index (BAI), A body shape index (ABSI), and visceral adiposity index (VAI). Metabolic parameters (fasting plasma glucose, HbA1c, lipid profiles, HOMA-IR) and CBC-derived …

Identifying Older Adult Orthopedic Patients’ Learning Styles For Tailored Communication And Health Literacy, Alexis Flippen Von Zimmer

Pacific Journal of Health

Effective patient communication supports health literacy, treatment compliance, and health outcomes. This study examined whether older adult orthopedic patients’ learning style modality preferences differ from general population norms and characterized their multimodal communication preference profiles to inform tailored provider–patient interactions. Using the Barsch Learning Style Inventory (BLSI), 57 English-speaking male orthopedic patients (50+ years) in a semi-rural Northern California practice were assessed. Primary learning modality distributions (n = 50 with single primary preferences) differed significantly from the BLSI theoretical norms using an exact multinomial goodness-of-fit test (p = 0.048), with fewer auditory learners and more kinesthetic learners than expected. …

Stay Independent: Enhancing Healthy Aging In Iowa And Louisiana, Sarah L. Francis, Elizabeth Gollub, Savannah Schultz

Journal of Human Sciences and Extension

This evaluation study assessed the impact of Stay Independent participation on topic familiarity and the likelihood of making a recommended behavior change among community-residing older adults. Stay Independent focuses on the nutritional needs of older adults, emphasizing Whole Person Wellness and the Health Belief Model. It was initially created in Iowa for community-residing adults aged 60 and older and has been adapted for cultural appropriateness in Louisiana. Stay Independent is a healthy aging program consisting of six standalone food and health modules. It is offered both virtually and face-to-face (F2F) in Iowa and Louisiana. Participants who attended Stay Independent between …

Planning Ahead: A Holistic Approach To End-Of-Life Planning, Kristin Litzelman, Ashley Berghoff, Jennifer Abel, Carol Bralich, Jackie Carattini, Selena Freimark, Jenna Kink, Sara Richie

Journal of Human Sciences and Extension

End-of-life planning can be an intimidating, confusing, and emotional process, which may explain why only 37% of Americans have completed advance care directives. To address this need, we developed the Planning AHEAD (Advance directives, Handling financial changes, Estate planning, and Arriving at Decisions for the end of this life) curriculum. Planning AHEAD is a seven-session course designed to help participants make important decisions that reflect their end-of-life wishes and document this information to relieve stress for their loved ones. In the first two years of the program, Extension educators facilitated 45 Planning AHEAD series across Wisconsin, reaching over 600 participants. …

What Do Rural Caregivers Need? Implications Of Formal Service Usage And The Role Of Cooperative Extension Systems, Naomi R. Meinertz, Jeong Eun Lee, Erin L. Martinez, Leacey Brown, Chelsey Byers, Sara Richie, Kathy Tutt

Journal of Human Sciences and Extension

The well-being of caregivers in the U.S. is a public health crisis. Caregivers experience greater rates of depression, chronic disease, and social isolation; however, the context of rural and urban living experiences creates different caregiving realities. Using two representative datasets of caregivers in the North Central and Northeast regions of the U.S., this paper examined the experiences of rural and urban caregivers in using formal support services. Rurality was negatively related to formal support service usage. Results from a multiple regression revealed a positive association between formal service utilization and caregiver well-being. These findings suggested that formal services can play …

The Impact Of Cooperative Extension Programs On Late Life Mental Health Outcomes: A Systematic Review, Naomi R. Meinertz, Kate Perepezko, Jeong Eun Lee, Mary E. Dozier Phd

Journal of Human Sciences and Extension

Rural-dwelling older adults have greater mental health disparities with higher rates of depression and anxiety compared to their urban counterparts; however, reaching these communities to understand and address the specific psychological needs of rural-dwelling older adults remains a barrier for gerontologists. Due to the extensive reach of the Cooperative Extension System, university Extension systems are primed to facilitate connections between researchers and rural communities to improve mental health outcomes for older adults. Despite the potential benefits of such partnerships, Extension is largely unknown and underutilized by gerontological researchers, leaving many older adults disconnected from resources available through land-grant universities that …

A Comprehensive Nutrition Education Program Promotes Behavior Change And Perception Of Food Access Across The Older Adult Age Span, Sarah Misyak, Camille Mcguire, Victor Olayemi, Maria Denunzio, Paige Harrigan, Elena Serrano

Journal of Human Sciences and Extension

Strategies to promote healthy behaviors among older adults are needed to mitigate vulnerabilities to negative health outcomes, especially for those with low income. Healthy Eating and Staying Active as We Age (HESA), a nine-lesson educational series for Supplemental Nutrition Assistance Program-eligible older adults, was created to promote health among aging audiences. The purpose of this study was to evaluate the behavior change of older adults following participation in HESA, which covers food resource management, nutrition, food safety, and physical activity behaviors, as well as perceived food affordability and accessibility, and to determine if HESA is appropriate across the age span …

Intergenerational Creative Movement Program: A Social Connection Intervention To Foster Health And Well-Being, Claire M. Reardon, Mohammad Khalilian, Amy F. Kostelic, Susan Thiel, Anthony R. Bardo

Journal of Human Sciences and Extension

A sense of connection and belonging is widely recognized to be essential for mental health. Yet, since the COVID-19 pandemic, loneliness, social isolation, and mental health problems have remained elevated across America. Transitions into young adulthood and older age, while distinct, similarly challenge social connectedness, especially among women. Our multi-lesson education program connected first-generation female college students with college-educated forty-plus women to foster belonging and improve mental health. The program integrated dance as a creative physical activity, promoted intergenerational engagement through a humanistic focus on generativity, and used a social network approach to gauge the development of connections among participants …

Empowering Public Employees For Retirement Security: Evidence From A Pre-Retirement Financial Education Program, Suzanne Bartholomae, Mengya Wang

Journal of Human Sciences and Extension

The United States is facing a retirement crisis, with eight in ten older adult households experiencing or at risk of financial insecurity (Tavares et al., 2024). National data shows 60% of Americans regularly contribute to retirement accounts, and just 40% have estimated their retirement savings needs (Lin et al., 2022). With approximately 5,900 Baby Boomers retiring daily (Fry, 2019), there is considerable interest in identifying effective strategies and policies to address retirement preparedness. This paper presents evaluation findings from a retirement planning financial education program delivered to 750 public employees by Iowa’s public employee retirement system and Cooperative Extension educators. …

Identifying Key Influencing Factors Of Elderly Health Information Search Based On Meta-Ethnography, Zhumei Sun, Zhibing Wang

Journal of Scientific Information Research

[Purpose/significance] Health information search is an important way for elderly people to actively cope with aging. Identifying the key factors affecting of their health information searching and exploring the correlation among these factors are of positive significance for promoting the elderly proactive health ability.

[Method/process] This paper firstly integrated the original research through a meta-ethnographic approach to form a set of factors influencing the elderly health information search. The DEMATEL method was then used to analyze the interrelationships among the influencing factors and identify the key influencing factors.

[Result/conclusion] The study finds that, the influencing factors of elderly health information …

Full Issue, Volume 13, Number 2, James S. Bates, Donna J. Peterson Dr., Scott Cummings, Erin L. Martinez

Journal of Human Sciences and Extension

No abstract provided.

Community Partnerships To Address Social Determinants Of Health Among Older Adults, Cory Bolkan, Raven Weaver, Cheryl Eschbach, Erik Geissal, Breanne Wise-Swanson

Journal of Human Sciences and Extension

Focusing on social determinants of health (SDOH) among older adults is key to addressing health disparities, maintaining independence in their homes/communities, improving health outcomes, and avoiding high-cost institutional care. While primary care settings are equipped to meet older adults’ physical health needs, the network of Area Agencies on Aging (AAA) is designed to meet social needs (e.g., transportation, nutrition, caregiver support). Yet, cross-sector community partnerships between AAAs and primary care are rare. This article shares an evaluation of one such partnership, where SDOH screenings were routinely implemented in primary care, yielding social prescribing and direct referral to AAA’s support services. …

Loma Linda Nurse - Vol. 34, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Jordan Robison Profile

6 | LLUSN Mission Service— A Living Legacy

10 | Steps to a New School

12 | Entry Level Master’s at Murietta

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-27 | ACADEMICS

28-33 | HOMECOMING

34-37 | FACULTY UPDATES

Fall Reduction Utilizing Fall Tailored Intervention For Patient Safety In Acute Care, Lauren Poindexter

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospitalized patient falls cause physical, psychological, and financial harm and persist despite prevention bundles. A Midwest Ohio acute medical unit experienced higher-than-benchmark fall rates (1.53–7.58 falls/1,000 patient days; unit rate 113% of the national median), with a rising trend in FY25. Reliance on the Schmid tool and existing interventions lacked structured patient/family engagement, as well as comprehensive medication assessment, leading to under-recognition of risk and limited nurse-driven prevention.

Aim of the Project: The aim of the project was to reduce inpatient fall rates and fall-related injuries on a medical unit by implementing the Agency for Healthcare Research and Quality …

Fall Prevention In Home Care: The Introduction Of The Steadi Initiative As Evidence-Based Tool, Margarida Barbosa - Barreiro

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls continue to be one of the leading causes of injury and mortality among older adults and remain a significant driver of healthcare utilization and cost. Within the home health setting, inconsistent practices in fall risk assessment and intervention have contributed to care gaps and increased patient vulnerability. The absence of a standardized, evidence-based process created the need for a structured quality improvement initiative to strengthen patient safety.

Aim of the Project: The purpose of this quality improvement project was to integrate the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit into home health visits to enhance the …

Genetic Architecture Of Cerebral White Matter Hyperintensities In Diverse Hispanic/Latino Adults, Myriam Fornage, Rui Xia, Adriana Ordonez, Tamar Sofer, Carmen R Isasi, Richard B Lipton, Ariana M Stickel, Wassim Tarraf, Hector M Gonzalez, Charles S Decarli

Faculty, Staff and Student Publications

Background and objectives: Cerebral white matter hyperintensities (WMHs) on MRI are part of the spectrum of age-related brain vascular injury and are associated with increased risk of stroke and dementia. Genome-wide association studies (GWASs) conducted mostly in populations of European ancestry have identified several genetic loci. Although Hispanic/Latino adults have a greater burden of WMHs than their non-Hispanic White counterparts, they are vastly underrepresented in genetic studies. We sought to characterize the genetic architecture of WMHs in a Hispanic/Latino cohort by investigating the transferability of known WMH genetic loci and by leveraging Hispanic/Latino genetic diversity to map novel loci.

Methods: …

Mechanisms For The Age-Related Increase In Fatigability Of The Elbow Flexor Muscles In Healthy Adults, Blaine E. Arney, Andrew Kuplic, Mitchell D. Adam, Christopher W. Sundberg, Sandra Hunter

Exercise Science Faculty Research and Publications

The mechanisms for the age-related increase in fatigability of the elbow flexor muscles during dynamic contractions are unknown. The purpose of this study was to determine the contribution of supraspinal and contractile mechanisms for the age-related increase in fatigability of the elbow flexor muscles. Twenty-eight young (23.2 ± 2.6 years; 14 females) and 32 older adults (72.6 ± 5.6 years; 15 females) performed 80 maximal velocity contractions at 20% of maximal isometric strength. Voluntary activation and muscle contractile properties were assessed before and immediately following the fatiguing exercise using transcranial magnetic stimulation (TMS) and electrical stimulation. Fatigability (% reduction in …

Recommended Best Practices For Construct-Centered Adaptation Of The Harmonized Cognitive Assessment Protocol, Emily Briceño, Darina Bassil, Pranali Khobragade, Anthony Ngugi, Martine Bejjani, Eric Ochieng, Silvia Mejia-Arango, Salima Douhou, Kazione Kulisewa, Miguel Rentería

Population Health, East Africa

Objectives The Harmonized Cognitive Assessment Protocol (HCAP) neuropsychological assessment approach aims to support the collection of harmonizable data on cognitive function for cross-national cognitive aging and dementia research. As the measurement of cognition is sensitive to differences in contextual, cultural, educational, linguistic, social, and other factors that may influence cognitive test performance, HCAP requires adaptation to be appropriate for the contexts in which it is administered. We aim to provide methodological recommendations for the adaptation and implementation of the HCAP and other cognitive data collection tools in novel settings.

Methods We drew from existing guidelines on cross-cultural psychological test adaptation …

Feasibility And Usage Of A Virtual Assistant Device In Cognitively Impaired Homebound Older Adults, Matthew Nunez, Prisha Patel, Lindsey Ulin, Leslie Kian, Martin Cominsky, Jason Burnett, Jessica L Lee

Faculty, Staff and Student Publications

Social technology in older adults can improve self-rated health; however, there can also be difficulties using it. Our study aimed to evaluate the feasibility and acceptance of virtual assistant device (VAD) use in cognitively impaired homebound older adults. 52 newly referred Meals on Wheels clients aged 60 and older were recruited for a three-phase study: 6 weeks of meals alone (control), followed by 6 weeks of meals+Alexa Echo Show 8 (AES8) basic usage, and lastly 6 weeks of meals+AES8 advanced usage. Technology acceptance with the AES8 was significantly higher by the end of the study and participants anecdotally enjoyed playing …

I’M Here Whether I Like It Or Not: A Focused Ethnographic Description Of Transition Into Residential Aged Care, Stacey Scott, Annette Raynor, Julie Dare, Jennifer Grieve, Leesa Costello

Research outputs 2022 to 2026

Transition into residential aged care (RAC) is a challenging process, often characterised by vulnerability, fear, and isolation. This study aimed to provide a contextualised description of transition within a care-facility in Australia to deepen our understanding of this major life event. A focused ethnography was conducted, which included formal interviews with residents during their first 6 months of living in RAC. The findings provide an account of the participants’ views on acceptance, highlight the challenges of loss, and showcase the coping practices new residents used. This paper provides a type of report card for the sector, which reveals that there …

Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming To Enhance Quality Of Life For Aboriginal Australian Survivors Of Stroke And Traumatic Brain Injury, Elizabeth Armstrong, Tapan Rai, Judith M. Katzenellenbogen, Sandra J. Thompson, Meaghan Mcallister, Natalie Ciccone, Deborah Hersh, Leon Flicker, Dominique A. Cadilhac, Erin Godecke, Graeme J. Hankey, Neil Drew, Colleen Hayward, Deborah Woods, Mel Robinson, Ivan Lin, Sanita Kratina, Jane White, Juli Coffin

Research outputs 2022 to 2026

Objective: To determine the effect of cultural security training (CST) for health professionals and access to an Aboriginal Brain Injury Coordinator (ABIC) for Aboriginal Australians with stroke or traumatic brain injury (TBI). Design: A stepped wedge cluster randomised controlled trial; the intervention package consisted of CST for hospital professionals and 6-month access to ABICs providing education, support, liaison and advocacy; the commencement order of the intervention phase was randomised. Setting: Four urban and four rural hospitals in Western Australia, 2018–2022. Participants: Aboriginal adults ≥ 18 years hospitalised with stroke or TBI. Main Outcome Measures: Primary outcome was quality of life …

Exploring Patients' Perceptions Of An Advance Care Planning Intervention In The Emergency Department: A Qualitative Study, Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi

Faculty, Staff and Students Publications

Objectives: Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

Methods: We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients …

Dermatological Primary Health Care Services For Older Adults In Thailand, Chinmanat Lekhavat, Jiruth Sriratanaban

Journal of Health Research

Background: The increasing population aging worldwide poses challenges to accessibility to dermatological care, especially in rural areas with limited dermatologist availability. Establishing dermatological primary health care (PHC) services for older adults is crucial for improving access, efficiency, and equity. However, no study has systematically explored such a system.

Method: This mixed-methods study employed a participatory action research (PAR) model to identify structural and procedural requirements, patient journeys, health needs, and expectations. Data were collected through focus groups, in-depth interviews, and surveys. Design thinking workshops, guided by PAR principles, were used to develop dermatological PHC services. A survey was conducted across …

Social Disparities, Delirium Occurrence, And Related Outcomes Among Hospitalized Older Adults, Alan P Pan, Kathryn Agarwal, Thomas Potter, Karim Borei, Sara Nowakowski, Courtenay R Bruce, George E Taffet, Farhaan S Vahidy

Faculty, Staff and Students Publications

Background: Underlying socio-economic and health burden may variably impact delirium presentation among older adults. We characterized differences in patient factors related to social marginalization and studied their effects on delirium occurrence and hospital outcomes.

Methods: We conducted a 7-year retrospective analysis of older adults (aged ≥ 70 years) who systematically underwent screening for delirium at an 8-hospital healthcare system. Our primary exposure included patient characteristics related to demographics and social marginalization. Multivariable logistic regression models were built to identify factors associated with increased odds of delirium occurrence, either (1) present-on-admission (D-POA) or (2) hospital-acquired (HAD). Secondary outcomes included hospital length …