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The Effect Of A Stage Of Change Tailored Intervention On Physical Activity And Psychological States Of Older Adults, Emilee Blosser

Senior Honors Projects, 2010-2019

Abstract

The Effect of a Stage of Change Tailored Intervention on Physical Activity and Psychological States of Older Adults

Introduction: As life expectancy increases in the United States, activity promotion programs aim to help older adults continue to remain happy, healthy, and productive. Programs that facilitate exercise and lifestyle changes can offset regular age-related declines and improve participation in regular fitness programs. Developing more active lifestyles can help the elderly maintain independence in their everyday activities.

Purpose: The goal of this study was to determine the effectiveness of a physical activity intervention tailored to participants’ stage of change on attitudes …

Patients Are Our Teachers, Robert E. Becker, Mary V. Seeman

Journal of Patient-Centered Research and Reviews

In the patient-physician encounter, physicians hone their skills while alleviating the patient’s suffering. Both benefit. Leaning on the work of Hippocrates, Darwin, and William Osler, the authors sketch out the case for honoring patients as indispensable teachers of the art and science of medicine. They argue that this tradition of Hippocratic medicine both anticipates modern precision medicine and reawakens a focus on public health medicine, each a benefit to the patients and communities served by physicians. A community that compromises the learning relationship of physician to patient and population undermines quality of care.

Homeless And Marginally Housed Veteran Perspectives On Participating In A Photo-Elicitation Research Study, Keri L. Rodriguez, Daniel O. Hedayati, Lauren M. Broyles, Melissa E. Wieland, Michael A. Mitchell, James W. Conley, Shaddy K. Saba, Adam J. Gordon

Patient Experience Journal

Photo-elicitation interviewing (PEI) seems a valuable tool for engaging marginalized populations in research despite documented challenges. Given limited data on acceptability of PEI among homeless and marginally housed Veterans, this evaluation aimed to characterize their research experience. Veterans took photographs about health, health behaviors, and health care which facilitated semi-structured interviews. Their research study experience was assessed via a modified Reactions to Research Participation Questionnaire-Revised (RRPQ-R), along with additional survey and open-ended questions. Of the 20 participants who consented and participated, 16 (80%) completed the exit surveys. Most participants (>88%) indicated favorable experiences and limited drawbacks. Respondents disagreed that …

What Are The Most Important Dimensions Of Quality For Addiction And Mental Health Services From The Perspective Of Its Users?, Priscilla Liu, Shawn Currie, Jassandre Adamyk-Simpson

Patient Experience Journal

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with …

Direct Care Nursing Aide Turnover In Long-Term Care Facility, Qilian Luo

Muskie School Capstones and Dissertations

This capstone project, Direct Care Nursing Aide Retention in a Long-Term Care Facility, will uses both qualitative and quantitative analyses to identify the possible contributors to high nursing aide turnover rates in Maine. The quantitative analyses of this project are based on the staffing payroll data of one Maine assisted living facility. The final product of this capstone project will be shared with the study facility, in the hope that they may find uses for its content.

Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd

Long Term Services and Supports

The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.

This study used Medicare Current …

Perceptions Of Chronic Disease Among Older African Americans: A Qualitative Analysis, Karon Phillips, Charles Rogers, Adrienne Morgan

Journal of Health Disparities Research and Practice

Research has documented that African Americans suffer disproportionately from chronic diseases when compared to the general population. Yet, limited research examines older African Americans’ perceptions about having chronic diseases. Accordingly, the first aim of the study provided insight into this disparity with the intent of revealing how older African Americans feel about their overall health, and how much they understand about their individual chronic disease(s). The second aim was to gather information about strategies and coping mechanisms older African Americans use to manage their chronic diseases. The purpose of this aim was to determine if any of the strategies they …

Stratified Multilevel Logistic Regression Modeling For Risk Factors Of Adolescent Obesity In Tennessee, Shimin Zheng, Sheryl Strasser, Nicole Holt, Megan Quinn, Ying Liu, Casey Morrell

ETSU Faculty Works

Background: US adolescent obesity rates have quadrupled over the past 3 decades. Research examining complex factors associatedwith obesity is limited.Objectives: The purpose of this study was to utilize a representative sample of students (grades 6 - 8) in Tennessee to determine theco-occurrence of risk behaviors with adolescent obesity prevalence and to analyze variations by strata. Methods: The 2010 youth risk behavior survey dataset was used to examine associations of obesity with variables related to sampledemographics, risk and protective behaviors, and region. Hierarchical logistic regression analyses stratified by demographics andregion were conducted to evaluate variation in obesity risk occurring on three …

Genome-Wide Interactions With Dairy Intake For Body Mass Index In Adults Of European Descent, Caren E. Smith, Jack L. Follis, Hassan S. Dashti, Toshiko Tanaka, Mariaelisa Graff, Amanda M. Fretts, Tuomas O. Kilpeläinen, Mary K. Wojczynski, Kris Richardson, Mike A. Nalls, Christina-Alexandra Schulz, Yongmei Liu, Alexis C. Frazier-Wood, Esther Van Eekelen, Carol Wang, Paul S. De Vries, Vera Mikkilä, Rebecca Rohde, Bruce M. Psaty, Torben Hansen, Mary F. Feitosa, Chao-Qiang Lai, Denise K. Houston, Luigi Ferruci, Ulrika Ericson, Zhe Wang, Renée De Mutsert, Wendy H. Oddy, Ester A. L. De Jonge, Ilkka Seppälä, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Scope: Body weight responds variably to the intake of dairy foods. Genetic variation may contribute to inter‐individual variability in associations between body weight and dairy consumption.

Methods and results: A genome‐wide interaction study to discover genetic variants that account for variation in BMI in the context of low‐fat, high‐fat and total dairy intake in cross‐sectional analysis was conducted. Data from nine discovery studies (up to 25 513 European descent individuals) were meta‐analyzed. Twenty‐six genetic variants reached the selected significance threshold (p‐interaction <10⁻⁷⁾, and six independent variants (LINC01512‐rs7751666, PALM2/AKAP2‐rs914359, ACTA2‐rs1388, PPP1R12A‐rs7961195, LINC00333‐rs9635058, …

Addressing Health Disparities And Cultural Competency In Reproductive Health Through Active Learning In The University Of Puerto Rico, School Of Medicine, Ines E. Garcia-Garcia, Kary M. Bouet Md, Lourdes Garcia-Fragoso, Juan Rivera-Gonzalez

Journal of Health Disparities Research and Practice

Introduction: Lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights which impact reproductive health. Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian. LGBTQ have higher risk of smoking, use illicit drugs or have alcohol related problems. Methods: A faculty development training addressed methods and skills for teaching cultural competence and eliminate health disparities. Faculty facilitated a small group active learning activity, including a vignette and a reflective self-evaluation, for medical students …

The Humanistic And Economic Burden Associated With Anxiety And Depression Among Adults With Comorbid Diabetes And Hypertension, Kimberly Wallace, Xiaohui Zhao, Ranjita Misra, Usha Sambamoorthi

Faculty & Staff Scholarship

We conducted a retrospective cross-sectional study to estimate the humanistic and economic burden associated with depression and anxiety among adults with comorbid diabetes and hypertension. Pooled data from the 2013 and 2015 Medical Expenditure Panel Survey were used to include adults (≥18 years old) who were alive and diagnosed with both diabetes and hypertension during the observation period. We assessed the humanistic burden with health-related quality of life (HRQoL) and economic burden with the total annual healthcare expenditures. Depending on the presence/absence of depression and anxiety, the study sample was divided into four groups (i.e., no depression/anxiety, depression only, anxiety …

Incidence Of Second Malignancy In Patients With Papillary Thyroid Cancer From Surveillance, Epidemiology, And End Results 13 Dataset, Mayumi Endo, Jessica Liu, Marcelle Dougan, Jennifer Lee

Faculty Publications

Increased risk of second primary malignancy (SPM) in papillary thyroid cancer (PTC) has been reported. Here, we present the most updated incidence rates of second primary malignancy from original diagnosis of PTC by using the data from the Surveillance, Epidemiology, and End Results. In this cohort, 3,200 patients developed SPM, a substantially higher number than in the reference population of 2,749 with observed to expected ratio (O/E) of 1.16 (95% CI; 1.12–1.21). Bone and joint cancer had the highest O/E ratio of 4.26 (95% confidence interval [CI] 2.33–7.15) followed by salivary gland (O/E 4.15; 95% CI 2.76–6.0) and acute lymphocytic …

Gender Disparities In The Association Between Socio-Demographics And Non-Communicable Disease Risk Factors Among Adults With Disabilities In Shanghai, China, Youran Zhang, Gang Chen, Qi Zhang, Jun Lu, Huijiong Yu

Community & Environmental Health Faculty Publications

BACKGROUND. Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China.

METHODS. We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and …

A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life.

AIM: The purpose of this study was to develop a new measure to evaluate end of life planning.

DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine …

Work-Related Values, Preferences, And Expectations Of Millennials: Implications For Long-Term Care Administrators, Cheryl K. Derynck

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research is to examine millennials’ work-related values, preferences, and expectations and to understand the impact for administrators in long-term care (LTC) facilities. Supervisors at LTC facilities must understand millennials’ work behavior, and strive to meet their needs, so as to effectively recruit, train, and retain these millennial employees. Allowing for management understanding of millennials work-related values, preferences, and expectations and how these support or detract from employment within LTC settings may pinpoint how facilities may retain these workers. This study will also provide information about work satisfaction of millennial employees and how employers can improve to …

Social Networks, Social Relationships, And Their Effects On The Aging Mind And Brain, Sato Ashida, Ellen J. Schafer

Public and Population Health Faculty Publications and Presentations

Key Points

• Increasing evidence shows the behavioral, perceptual, and biological pathways by which social relationships and social networks positively impact health outcomes, including those for the aging mind and brain.

•The facilitation of healthy aging, in turn, has been shown to increase social participation among older adults through community-based interventions and contributes to societal well-being.

Fall Risk Behaviors And Intrinsic Risk Factors For Falls In Indigenous And Non-Indigenous Rural Older Adults, Andre Gallegos Bouweraerts

Cal Poly Humboldt theses and projects

The purpose of this study was to examine fall risk behaviors and intrinsic risk factors for falls in rural dwelling indigenous and non-indigenous older adults in California. Methods: Participants included 157 adults 60+ years of age (89 indigenous and 68 non- indigenous) and were recruited from advertisements in local newspapers, senior centers, and health clinics in Humboldt and Del Norte Counties. Fall risk behaviors and intrinsic risk factors for falls were identified through administration of a demographic, fall risk, and physical activity questionnaire as well as the chair stand, functional reach, timed up and go, four-meter walk, and modified clinical …

Older Adult Men’S Emotional Bonds With Their Dogs, Ranell L. Mueller

Theses and Dissertations--Gerontology

Knowledge of the deeper meanings of attachment to companion animals is limited, particularly in terms of older adults. This study employed a modified grounded theory method, a phenomenological lens and a life course perspective to gather and analyze data garnered from individual interviews and panel discussions in order to investigate the multiple dimensions of older adult men’s relationships with their companion animal dogs. Individual audio-recorded in-depth interviews and repeated panel discussions with a sub-group of the participants, convened as a panel over a three-month period, explored behavioral and emotional manifestations of attachment and the emotional bond to their companion animal …

Estimating The Effects Of Z-Drugs On The Risk Of Cognitive Impairment, Xuan Zhang

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Dementia and sleep disorders are two significant health problems in older adults. Studies suggest that sleep disorders and their treatment might associate with the risk of dementia. Z-drugs are one of the most widely used prescription hypnosedatives in the United States (US) for insomnia in addition to benzodiazepines (BZDs). Studies have shown that BZDs are associated with dementia among senior users. Study Aim: The purpose of this study is to evaluate the association between Z-drug initiation and cognitive impairment among the elderly in the US. Study Design and Data Source: We conducted a retrospective cohort study with a new …

Enriching Clinical Learning Environments Through Partnerships: Academic And Practice Partnerships To Strengthen Care For Older Adults In Residential And Assisted Living Settings, Juliana Cartwright, Diana L. White

Institute on Aging Publications

This report was prepared by Oregon Health & Science University (OHSU) School of Nursing and the Institute on Aging at Portland State University to describe an academic-community partnership using the Enriching Clinical Learning Environments through Partnerships (ECLEPs) model. This two-year project was conducted with 34 students in the RN-BSN program in eight assisted living (AL) communities and ElderPlace, a PACE program serving residents in assisted living and other residential settings. Quality improvement was the focus of the project. Features of the ECLEPs model include:

• An intentional partnership between academic and clinical organizations
• Relationship-based; shared decision making
• Long-term commitment between partners …

Coming Out Of "Retirement"-Predictors Of Driving Resumption Among Older Drivers, Kendra Ratnapradipa, Jing Wang, Marla Berg-Weger, Mario Schootman

Journal Articles: Epidemiology

Background and Objectives: Predictors and consequences of driving cessation in older adults have been studied extensively. This study sought to establish the extent to which former drivers resume driving and identify associated factors.

Research Design and Methods: Descriptive analysis of the 2011-2015 National Health and Aging Trends Study data (Round 1:

Results: Among drivers who stopped driving during the study, 17%-28% resumed driving. Age, vehicle ownership, stroke, hospitalization, memory, and perceived transportation barriers were associated with resumption in regression analysis. In multilevel analysis stratified by baseline driving status, poor word recall (OR = 0.62; 95% CI = 0.40, 0.95) and …

Effects Of Medicare Reimbursement Policies On The Quality Of Hospital Care, Monica Aswani

All ETDs from UAB

This dissertation is composed of two papers related to the role of social risk factors in the Hospital Readmissions Reduction Program (HRRP). As value-based initiatives like the HRRP become more commonplace, there is growing need to understand the relationship between performance in these programs and social risk factors, such as race and poverty, which are not incorporated in the program’s risk adjustment methodology. To address this gap in the literature, this dissertation specifically focuses on three areas: 1) how hospital and community factors are related to average HRRP penalties, taking the context of geography into account, 2) how hospital and …

A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak

Walden Dissertations and Doctoral Studies

Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors …

Intergenerational Financial Exchange And Cognitive Well-Being Among Older Adults In China, Ping Xu

Graduate Doctoral Dissertations

Although cognitive loss is part of normal aging, it has unfavorable consequences for older individuals, their family, as well as society. The prevalence of mild cognition impairment is expected to go up in China. How to maintain normal cognition for a longer period of time and to delay impair process is an emerging concern for older Chinese adults. Unlike Western countries, China lacks of formal support system. Intergenerational support between older parents and adult children is a predominant resource when they are in need. This study examines how intergenerational financial exchanges between older parents and their adult children is related …

Multiple-Modality Exercise And Mind-Motor Training To Improve Mobility In Older Adults: A Randomized Controlled Trial, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Michael A. Gregory, John Bocti, Robert Petrella

Lifestyle Research Team

Objective:

To investigate the effects of multiple-modality exercise with or without additional mind-motor training on mobility outcomes in older adults with subjective cognitive complaints.

Methods:

This was a 24-week randomized controlled trial with a 28-week no-contact follow-up. Community-dwelling older adults underwent a thrice -weekly, Multiple-Modality exercise and Mind-Motor (M4) training or Multiple-Modality (M2) exercise with an active control intervention (balance, range of motion and breathing exercises). Study outcomes included differences between groups at 24 weeks and after the no-contact follow-up (i.e., 52 weeks) in usual and dual-task (DT, i.e., serial sevens [S7] and phonemic verbal fluency [VF] tasks) gait velocity, …

Operationalizing Person-Centered Care Practices In Long-Term Care: Recommendations From A “Resident For A Day” Experience, Jennifer L. Johs-Artisensi

Patient Experience Journal

As the senior population continues to age, long-term care is positioned for growth and care recipients are demanding more person-centered care. While long-term care leaders may understand and believe in the value of person-centered care, sometimes operationalizing practices to ensure its delivery can be challenging. Using an ethnographic approach, over three years, 159 long-term care administrator-in-training practicum students each lived as a resident for 24 hours in a nursing home. Following the experience, using the Picker Institute’s framework, each participant identified and justified an Always Experience® – an optimal experience they believed should routinely occur for every long-term care resident. …

When Is Affect Variability Bad For Health? The Association Between Affect Variability And Immune Response To The Influenza Vaccination, Brooke N. Jenkins, John F. Hunter, Marie P. Cross, Amanda M. Acevedo, Sarah D. Pressman

Psychology Faculty Articles and Research

Objectives—This study addresses methodological and theoretical questions about the association between affect and physical health. Specifically, we examine the role of affect variability and its interaction with mean levels of affect to predict antibody (Ab) levels in response to an influenza vaccination.

Methods—Participants (N = 83) received the vaccination and completed daily diary measures of affect four times a day for 13 days. At one and four months post-vaccination, blood was collected from the participants to assess Ab levels.

Results—Findings indicate that affect variability and its interaction with mean levels of affect predict an individual’s immune response. …

Hospice Utilization Of Medicare Beneficiaries In Hawai‘I Compared To Other States, Deborah Taira, Merle Kataoka-Yahiro, Angela Sy

Asian/Pacific Island Nursing Journal

The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian …

Demystifying Research: Accessing & Understanding Evidence For Clinical Practice, Kimberly A. Murphy, Meredith Poore Harold, Mary Huston

Communication Disorders & Special Education Faculty Publications

The demands on clinicians for evidence-based practice (EBP) are great. However, many speech-language pathologists have received little to no training in how to ‘do’ EBP. In this presentation, we aim to describe and provide practical suggestions for two of the steps in EBP—accessing, then reading and interpreting research to inform clinical decision-making. Our goal is to give clinicians the tools and confidence they need to grow into expert clinicians.

Learner Outcome 1: Describe the components of evidence-based practice (EBP)

Learner Outcome 2: Identify ways to access research

Learner Outcome 3: Identify steps in reading and evaluating the …

Pubh 4231 - Health Aspects Of Aging, Kristina Harbaugh

College of Public Health: Faculty Syllabi (2014-2021)

This course is intended to familiarize students with promotion of health in an aging population, the notion that aging is a natural part of the lifecycle, community, state and federal health programs and services for the aged. Students will become acquainted with the process of and problems associated with aging in order to effectively manage this important public health issue. Specific health concerns of the elderly including the increase in life expectancy, current life extending research and technology and successful aging will also be examined. Knowledge and understanding of biological, psychological, and sociological aspects of aging as related to health …