scholarly journals Factors that influence implementation at scale of a community-based health promotion intervention for older adults

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joanie Sims-Gould ◽  
Heather A. McKay ◽  
Christa L. Hoy ◽  
Lindsay Nettlefold ◽  
Samantha M. Gray ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Older Adult ◽  
Contextual Factors ◽  
Scale Up ◽  
Project Team ◽  
Successful Implementation ◽  
Evidence Based ◽  
Health Promotion Intervention ◽  
The Impact

Abstract Background Despite the many known benefits of physical activity (PA), relatively few older adults are active on a regular basis. Older adult PA interventions delivered in controlled settings showed promising results. However, to achieve population level health impact, programs must be effectively scaled-up, and few interventions have achieved this. To effectively scale-up it is essential to identify contextual factors that facilitate or impede implementation at scale. Our aim is to describe factors that influence implementation at scale of a health promotion intervention for older adults (Choose to Move). This implementation evaluation complements our previously published study that assessed the impact of Choose to Move on older adult health indicators. Methods To describe factors that influenced implementation our evaluation targeted five distinct levels across a socioecological continuum. Four members of our project team conducted semi-structured interviews by telephone with 1) leaders of delivery partner organizations (n = 13) 2) recreation managers (n = 6), recreation coordinators (n = 27), activity coaches (n = 36) and participants (n = 42) [August 2015 – April 2017]. Interviews were audio-recorded and professionally transcribed and data were analyzed using framework analysis. Results Partners agreed on the timeliness and need for scaled-up evidence-based health promotion programs for older adults. Choose to Move aligned with organizational priorities, visions and strategic directions and was deemed easy to deliver, flexible and adaptable. Partners also noted the critical role played by our project team as the support unit. However, partners noted availability of financial resources as a potential barrier to sustainability. Conclusions Even relatively simple evidence-based interventions can be challenging to scale-up and sustain. To ensure successful implementation it is essential to align with multilevel socioecological perspectives and assess the vast array of contextual factors that are at the core of better understanding successful implementation.

scholarly journals Implementing Effective, Evidence-Based Older Adult Fall Prevention

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 773-774
Author(s):  
Gwen Bergen
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Older Adult ◽  
Fall Prevention ◽  
Patient Adherence ◽  
Medical Costs ◽  
Lessons Learned ◽  
Evidence Based ◽  
Care Providers ◽  
Core Components

Abstract Over one in four older adults (65 years and older) in the US reports falling annually with estimated medical costs of $50 billion. Evidence-based strategies exist that can reduce falls with one of the most promising being multifactorial, clinically-based initiatives such as the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Initiative. STEADI includes three core components for health care providers: screen for risk factors, assess modifiable factors, and intervene to reduce falls with evidence-based strategies. Barriers to implementation include competing patient demands and limited time during patient visits. Efficient, effective implementation of clinical fall prevention is important to increase the use of multifactorial interventions. In addition, understanding older adult attitudes about the preventability of falls is needed to increase patient adherence to prescribed interventions. This symposium will cover:1. Background data on older adult falls over time,2. Description of an initial implementation of STEADI in an outpatient, Southeastern clinical practice including lessons learned,3. Attitudes of older adults toward fall prevention with implications for health promotion,4. Process evaluation of an ongoing implementation of STEADI in New York State with lessons learned. Understanding practical methods of implementing the three core components of fall prevention into practice supports wider dissemination of evidence-based fall prevention, while understanding patient attitudes toward falls informs the design of health promotion approaches to increase patient uptake of prescribed interventions. Wider dissemination and increased patient adherence in combination can reduce older adult falls and their associated medical costs.

The Impact of TimeSlips on Undergraduate Students in Service Learning With Older Adults

2020 ◽  
pp. 1-8
Author(s):  
Sabine Heuer
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Undergraduate Students ◽  
Attitude Scale ◽  
Evidence Based ◽  
Attitudes Toward Older Adults ◽  
Students Attitudes ◽  
Attitude Shift ◽  
The Impact ◽  
Journal Entries

Purpose Future speech-language pathologists are often unprepared in their academic training to serve the communicative and cognitive needs of older adults with dementia. While negative attitudes toward older adults are prevalent among undergraduate students, service learning has been shown to positively affect students' attitudes toward older adults. TimeSlips is an evidence-based approach that has been shown to improve health care students' attitudes toward older adults. The purpose of this study is to explore the change in attitudes in speech-language pathology students toward older adults using TimeSlips in service learning. Method Fifty-one students participated in TimeSlips service learning with older adults and completed the Dementia Attitude Scale (DAS) before and after service learning. In addition, students completed a reflection journal. The DAS data were analyzed using nonparametric statistics, and journal entries were analyzed using a qualitative analysis approach. Results The service learners exhibited a significant increase in positive attitude as indexed on the DAS. The reflective journal entries supported the positive change in attitudes. Conclusions A noticeable attitude shift was indexed in reflective journals and on the DAS. TimeSlips is an evidence-based, patient-centered approach well suited to address challenges in the preparation of Communication Sciences and Disorders students to work with the growing population of older adults.

Increasing Student Empathy Toward Older Adults Using the Virtual Dementia Tour

2014 ◽  
Vol 19 (1) ◽  
pp. S-23-S-40
Author(s):  
Jana Donahoe ◽  
Lisa Moon ◽  
Kathy VanCleave
Keyword(s):  
Older Adults ◽  
Social Work ◽  
Nursing Homes ◽  
Experiential Learning ◽  
Older Adult ◽  
Work Practice ◽  
Social Work Practice ◽  
Evidence Based ◽  
Student Knowledge ◽  
Course Content

Educators know too well the challenges of teaching BSW students about social work practice with older adults. Students hesitate to work with older adults due to personal fears about aging, lack of experiences with this population, or stereotypical misconceptions about older adults and nursing homes. It is apparent that many students have difficulty empathizing with older adults because they have never experienced what it is like to be an older adult with dementia. A solution to this problem is incorporating an immersive experiential learning simulation called the Virtual Dementia Tour (VDT) into BSW course content. The findings indicate that the VDT was an effective evidence-based learning tool for increasing student knowledge about aging and improving their empathy and sensitivity toward older adults with dementia.

scholarly journals Developing a Sexual Health Promotion Intervention With Young Men in Prisons: A Rights-Based Participatory Approach (Preprint)

2018 ◽  
Author(s):  
Michelle Templeton ◽  
Carmel Kelly ◽  
Maria Lohan
Keyword(s):  
Health Promotion ◽  
Health Services ◽  
Sexual Health ◽  
Young Men ◽  
Participatory Approach ◽  
Casual Sex ◽  
Health Promotion Intervention ◽  
Web Based ◽  
Incarcerated Men ◽  
The Impact

BACKGROUND The sexual health of young men in prisons is often among the poorest in any given country. They may have developed sexual behaviors that, from a public health perspective, are considered problematic and burdensome. These include poorer use of condoms and engaging in more frequent casual sex, resulting in higher rates of sexually transmitted infections, including HIV and viral hepatitis. Thus, young incarcerated men are a highly marginalized and socially excluded high-risk group, in greater need of sexual health education and services. OBJECTIVE The aim of this study was to create an innovative sexual health promotion intervention, made for and with young men in prisons, to encourage them to avail of regular sexual health checkups. This included developing a Web-based animated-style sexual health promotion intervention (1.42 min) coupled with upskilling the prison nurses to offer a partnership approach to prison health care. This paper focuses on the development of the intervention and the importance of the underpinning rights-based (RB) participatory intervention design. METHODS We employed an RB participatory approach and recruited 14 participants who attended 3 coproduction workshops held within a prison site in Northern Ireland, United Kingdom. A bespoke 3-day training for nurses beforehand, ensured they gained a deeper understanding of the determinants of poor sexual health. The coproduction team comprised young men, prison nurses, nurse sexual health consultant, media company representatives, and facilitator. Workshops focused on content, design, tone and medium of communication for a Web-based intervention that would be appealing and engaging for young incarcerated men. RESULTS A 1.42-min animation Dick loves Doot was created to promote a positive attitude toward sexual health checkups. The RB approach enabled the young men to participate, have their voices heard and see their stories reflected through the animation. The nurses’ capacities to protect, fulfill, and respect the young men’s rights to appropriate sexual health services and education was also enhanced. Evaluations confirmed that we successfully provided accurate sexual health information in a way that was engaging and accessible and that encouraged the young men to avail of the new prison sexual health services that were set up in the prison and now provided by nurses. CONCLUSIONS The RB participatory approach to health advanced in this study provided a means to (1) gain invaluable insider knowledge to understand the impact of structural determinants on health and health inequalities and strategies by which to target young incarcerated men (2) create inclusive opportunities for developing bespoke targeted interventions, and (3) galvanize collaborative partnerships to disrupt the structures and processes that lead to and encourage health inequities. To reduce future risk, effective treatment, coupled with coproduced interventions that transmit relevant health messages in a relevant and meaningful way, is key to success.

The effect of short-term health promotion intervention on motor function in community-dwelling older adults

2018 ◽  
Vol 31 (4) ◽  
pp. 475-481 ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yoshinori Hiyama ◽  
Satomi Kusaka ◽  
Yasuaki Kusumoto ◽  
Junko Tsuchiya ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Motor Function ◽  
Community Dwelling ◽  
Health Promotion Intervention ◽  
Short Term ◽  
Community Dwelling Older Adults

scholarly journals INTEREST GROUP SESSION—HEALTH BEHAVIOR CHANGE: USING DATA ABOUT PATIENT CHARACTERISTICS TO IMPROVE FALL PREVENTION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S566-S566
Author(s):  
Gwen Bergen
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Fall Prevention ◽  
Fall Risk ◽  
Healthcare Providers ◽  
Patient Characteristics ◽  
Health Behavior Change ◽  
Clinical Aspects ◽  
Evidence Based ◽  
Prevention Strategies

Abstract Over one in four U.S. older adults (age 65+) reports falling each year with fall-related medical costs estimated at $50 billion. The American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons recommends that healthcare providers assess and manage their patients’ fall risk. The Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative helps healthcare providers incorporate these guidelines by providing tools on how to screen, assess, and intervene to reduce risk. Evaluations of fall prevention have focused on the clinical process and outcomes. Understanding clinical activities is important in fall prevention but a better understanding of older adult characteristics that increase fall-risk, and attitudes that may affect their adoption of evidence-based interventions could improve the effectiveness of prevention strategies. The five presentations in this session include: 1. Demographic, health and functional characteristics of older adults with increased fall risk. 2. Caregivers of people with chronic conditions or disability as a group with increased fall risk. 3. The most effective and efficient ways of identifying older adults with increased fall risk. 4. Facilitators and barriers to older adults’ adherence to evidence-based fall interventions. 5. Applying knowledge of older adult attitudes to improving an implementation of STEADI-based fall prevention. Multifactorial fall prevention strategies such as STEADI focus on the clinical aspects of fall prevention but their success depends on understanding and incorporating older adult characteristics and attitudes. The information presented in this session can inform fall prevention strategies and improve health.

scholarly journals Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

2020 ◽  
Author(s):  
Jessica Haughton ◽  
Michelle L. Takemoto ◽  
Jennifer Schneider ◽  
Steven P. Hooker ◽  
Borsika Rabin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Scale Up ◽  
Implementation Strategies ◽  
Barriers And Facilitators ◽  
Physical Activity Program ◽  
Evidence Based ◽  
Church Staff ◽  
Faith Based ◽  
Activity Program

Abstract Background: Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results: Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support.Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

scholarly journals AN ELDERLY’S PERSPECTIVE ON THE IMPACT OF SPIRITUALITY TOWARDS DEATH ACCEPTANCE

2019 ◽  
Vol 5 (6) ◽  
pp. 212-217
Author(s):  
Minnie Besin Mamauag
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Life Experiences ◽  
The Elderly ◽  
Spiritual Beliefs ◽  
Sense Of Security ◽  
Adult Participants ◽  
Old Adult ◽  
The Impact ◽  
Death Acceptance

Objective: This study explored the religious or spiritual beliefs and behaviors of the elderly that could somehow translate to their level of death acceptance or lack thereof.Methods: A total of four (4) elderly participants, ages 60 and above whom meet the criteria set for this study was interviewed to assess their spiritual upbringing and experiences that resulted to their death acceptance. The study involves qualitative approach using thematic analysis. The narrative testimony of the old adult participants in this study which includes cases of older adult that believes in God, older adult having shifted from one religious organization to another, and older adults’ instilled spirituality comes from religious imprint from family members during childhood describes the three important patterns in the religious or spiritual standing of the participants.Results: The themes signified that (1) older adults are inherently religious and this nature is a subsequent factor in (2) their faith in God basing on their life experiences and life’s meaning. Furthermore, this (3) belief or faith in God offers them a sense of security and hope in the afterlife.Conclusion: These themes explain the pattern in the creation of a religious/ spiritual standing that leads to death acceptance among participants as evident in their interview results.

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