SELF-REGULATION,SELF-EFFICACY AND HEALTH BEHAVIOR CHANGE IN OLDER ADULTS

Models of self-regulated behavior, based on social cognitive theory, have been applied across a range of settings and with individuals who possess a variety of personal characteristics and needs. One of the most explored applications of self-regulation (SR) has been in the field of health where it has been used as a basis for the development of preventative and rehabilitation programs related to, for instance, cardiovascular disease, asthma, AIDS, arthritis, obesity, and addictions. There is a paucity of information about the application of SR models to subgroups of people such as older adults, ethnic groups, and women. This article focuses on models of SR as they apply to the health-related behaviors of older adults. It begins with a general overview of models described in the literature. It then examines the applicability of those models to health behavior change in older adults. The article also draws on literature from the field of learning in order to assess how useful these models are in designing interventions to help older people to learn about health maintenance and health restoration.     

Investigating older adults’ intention to learn health knowledge on social media

ABSTRACT

Abundant health knowledge resources are available on social media to facilitate technology-enhanced knowledge learning among older adults. The objective of this study is to investigate the predictors and the underlying formation mechanism of older adults’ intention to learn health knowledge on social media. We propose a novel model to examine how older adults’ emotional state (i.e., health anxiety) and cognitive state (i.e., e-health literacy) during knowledge acquisition influence threat appraisal (i.e. perceived severity and perceived susceptibility) and coping appraisal (i.e. self-efficacy and perceived benefits), thereby shaping older adults’ intention to learn health knowledge. Survey data from 337 Chinese older adult users of social media was collected to test the research model. Results reveal that perceived susceptibility, self-efficacy and perceived benefits exert positive effects on older adults’ health knowledge learning intention, while the impact of perceived severity on health knowledge learning intention is not statistically significant; health anxiety is positively correlated with perceived severity and perceived susceptibility, and e-health literacy is a powerful predictor of self-efficacy and perceived benefits. This paper enriches the literature related to technology-enhanced knowledge learning and online health behavior among older adults. Effective strategies are proposed based on the findings for practitioners dedicated to promoting health knowledge via social media and older adults who apply health knowledge to address health-related needs.     

The impact of Age-Tastic! On health literacy about depression among older adults: a pilot study

ABSTRACT

Age-Tastic! is a health and wellness intervention designed for older adults. Incorporating game theory and behavioral activation concepts, this intervention is a board game that engages older adults in an interactive and immersive experience over 8 weeks. This paper reports on a pilot study that evaluated the impact of this intervention on health literacy about depression among community-dwelling older adults from New York City. The sample comprised 123 older adults recruited from 15 senior centers. Participants were tested on their knowledge and awareness of depression prior to the intervention and again at the end of the intervention after eight weeks. Statistically significant gains were made in the knowledge and awareness regarding the relationship of aging to depression, stigma of seeking help and knowing where to seek help. Implications for replication and use of this intervention are discussed.     

Myth-busting is a bust for patient education: Making salient older adults’ misconceptions about osteoarthritis fails to lead to lasting corrections

ABSTRACT

Older adults hold many misconceptions about health and wellness that reduce their health literacy. To counter these misconceptions, health educators commonly turn to educational interventions that include myth-busting—making explicit health-related myths and refuting those myths. Because of typical age-related changes in memory functioning, there is some question as to whether myth-busting is an effective technique for use with older adults. The present work assessed whether making older adults explicitly aware of common myths about osteoarthritis and refuting those myths would effectively debunk those myths and lead to correct beliefs about osteoarthritis. Older adults participated in two data collection sessions separated, on average, by 5 days. During the first session, participants read pamphlets about osteoarthritis that either employed myth-busting techniques or did not. Then after a brief delay, participants completed a quiz that measured adherence to the myths. Adherence to the myths was assessed again during the second data collection session. The analyses revealed that making myths salient significantly reduced adherence to myths immediately after the myth-busting presentation; however, as time passed, the corrective effects of myth-busting dissipated. Medical myth-busting appears to be an ineffective way to induce long-term corrections in older adults. Future research should focus on identifying methods by which health educators could leverage myth-busting’s short-term positive impact to affect long-lasting corrections. Until there is evidence that the positive impact of myth-busting can be maintained over time, health educators should be wary of using this technique with older adult patients.     

Outlook in life of older adults and their health and community condition

ABSTRACT

Positive outlook in life is believed to help safeguard aging people against the negative experiences and considered to reduce the risk of health diseases. We analyzed the health condition, cognition, mobility, and community condition of 4,692 older adults from the National Health and Aging Trends Study based on their outlook in life: positive, negative, and neutral group. The presence of heart disease, high blood pressure, arthritis, and lung disease contributes to older adults’ negative outlook in life. Most older adults who belong to the positive outlook group rated their memory as very good. In contrast, most older adults in a negative outlook group perceived their memory as fair and poor, and mostly need the help of others to leave the house and have trust issues. The findings may provide new opportunities by intervening with policies and practices that generally may intensify a positive outlook in life.     

Determinants of older Korean adults’ participation in life-long learning programmes and life satisfaction

ABSTRACT

Using Korean Longitudinal Study of Aging data, we examined the influence of older adults’ individual characteristics (i.e. marital status, health and economic status) on life satisfaction, with the mediating effect of older adults’ active participation in lifelong learning. As a result, some individual characteristics appeared to significantly determine both learning participation and life satisfaction. Economic status appeared to function as a significant predictor of older adults’ participation in lifelong learning programmes, which ultimately resulted in a significant improvement in their life satisfaction. Marital status and health were also significant contributors to older adults’ life satisfaction. The mediating model was tenable according to model-data fit indices.     

Overcoming ageism: critical reflexivity for gerontology practice

ABSTRACT

Ageism is an age-based form of discrimination that still prevails in our modern society. As other forms of discrimination, older adults may encounter ageist discourses in a variety of contexts, including health care settings. In this paper, we consider critical reflexivity as an approach to challenge ageism within health care contexts. We explore the potential of critical reflexivity to transform the perceptions of older age among students in the health professions who work with older adults. We examine observation, narrative and reflexive writing as fruitful strategies to facilitate dialogue and critically interrogate ageist discourses.     

“How different can we be?”: Using Tuesdays with Morrie and intergenerational interactions to promote positive views of older adults among college students

ABSTRACT

This article reports the results of an Adult Development course assignment. This assignment required that undergraduate students interact with an older adult on two occasions, provide written reflection on these interactions, and read and review the book, Tuesdays with Morrie. The goals of this assignment were for students to comfortably interact with older adults, to recognize the value of intergenerational interactions, and to recognize ageist or stereotyped ideas that they may have held about older adults. The analyses were primarily qualitative, but indicate that these goals were met. Student reactions to this assignment were overwhelmingly positive and insightful. While a number of students expressed initial concern about these interactions, they unanimously reported them to be positive experiences. Students also indicated that it was a learning experience for them, and sometimes for the older adults as well, and several made note of stereotypes or ageist ideas that they had held. Students completed the Fraboni Scale of Ageism after completing these assignments, and scores were significantly below neutral. While pretest, and additional post-test, measures would make the results of this study stronger, the students’ reports indicate that they perceived positive change within themselves, which suggests that this was an effective means of promoting positive attitudes about older adults.     

Diabetes Intrusiveness and Wellness Among Elders: A Test of the Illness Intrusiveness Model

ABSTRACT

Technology use is a common constituent of modern life. However, little is known about older adults’ use of technology. This article presents a subset of data collected via the technology deployed in the iStoppFalls randomized control trial. The primary focus lies on questions about digital device/Internet use, ownership, length, and frequency as well as social networking. Data was collected from participants aged 65 years or older. Seventy-eight participants completed a specifically developed technology survey as part of the baseline assessment. Results showed that the majority of subjects owned a computer with men being its main user. Participants used technological devices on a daily basis for more than 1 year. The main reason for using technology was e-mail communication, search engines, text processing, and online shopping. Only a few participants used social network applications, with Google+ and Facebook being the most popular ones. Future work should consider an in-depth qualitative approach to further increase understanding of technology use in older adults.     

Cognitive-Training Programs for Older Adults: What Are they and Can they Enhance Mental Fitness?

ABSTRACT

People are living longer, and in better physical health, than at any other time in history. But what of their mental health? Does it decline with age, offsetting the gains made in physical health and longevity? Can it be maintained? Can it improve? A review of the literature suggests that cognitive decline is not universal, pervasive, or irreversible. It also demonstrates that older adults can benefit from cognitive training. The challenge, however, is to provide such training in ways that are acceptable to older adults. The answer is to be found, firstly, in research that identifies best practices for cognitive skill development in ecologically valid activities involving older adults, psychologists, and adult educators. These best practices can then serve to assist educators to design continuing education programs and other activities that are readily accessible, affordable, and enjoyable.     

What is the meaning of spiritual health among older adults? A concept analysis

ABSTRACT

The different dimensions of spiritual health among older adults remain unknown to date and no globally acceptable definitions have yet been provided for the concept. To conduct the current study, the databases including Proquest, Medline, CINAHL, Science Direct, Blackwell, Iranmedex, SID, Noor Magazine and Irandoc were searched for the articles published between 1980 and 2014 in both English and Persian using keywords including spirituality, spiritual well-being, spiritual health, geriatric, older adult and old people and their Persian equivalents. The search for articles yielded into 197 titles, 31 of which were repeated and were therefore excluded. The remaining 166 articles were screened based on the inclusion criteria. A total of 29 articles were ultimately selected as the study samples. Rodgers’ evolutionary approach to concept analysis is used to identify the attributes, antecedents, consequences and surrogate terms of “spiritual health” and to provide a more comprehensive definition of the concept. The results obtained showed that spiritual health from the perspective of older adults is a multi-dimensional concept with cognitive, functional, affective and consequential components. Each component was found to be composed of several indicators. The results may help in providing a more thorough definition of spiritual health which can be a solid base for future researchers to develop appropriate tools for the assessment of older adults’ spiritual health and encourage research into this partially neglected subject. Care providers may also benefit from the results through acquiring a better understanding of the concept which can be used in designing appropriate spiritual interventions.     

Literacy activity and health among older adults in the USA

ABSTRACT

Health literacy skills are known to be a key mediator of the relationship between education and health in the general population. However, one aspect of health literacy skills—individuals’ actual literacy activities—remains understudied, especially among older adults. Health disparities that are driven by inequalities in education and level of health literacy skills are particularly problematic for older adults since they are exacerbated in old age by disadvantages that accumulate over the life course. This study examined a nationally representative sample of US adults age 50 years and older (n = 2,573) using data from the 2014 Program for International Assessment of Adult Competencies (PIAAC). Parallel mediation analysis was conducted to examine the partial mediation effects of health literacy skills and literacy activity (i.e., reading at home) on the relationship between education and health. Results showed that both health literacy skills and literacy activity mediated the education–health relationship. On average, literacy skills mediated 31.89% and literacy activities mediated 9.59% of the effect of education of self-rated health. Literacy activity, such as reading, is an easily accessible, autonomous, and sustainable option for promoting health in later life. Policies that support the intersection of public health and education may promote lifelong learning and well-being among US adults.     

Teaching about Islam in Secondary Schools: Curricular and Pedagogical Considerations

Current demographic trends are contributing to a rapid increase in religious, racial, and ethnic diversity in the United States. This article provides a rationale for teaching about religious diversity, particularly Islam, in public schools and the vital role religion has played in American history. The article provides readers with important information regarding pedagogical and curricular issues related to teaching about Islam in social studies courses and information on how teachers can establish positive relationships with Muslim students by understanding the requirements and core beliefs of Islam.     

Malnutrition and its association with functional,cognitive and psychological status among Palestinian older adults in long-term care houses

ABSTRACT

Older adults often suffer from psychological, functional and health-related diseases. Literature has documented the relationship between, malnutrition with adverse health outcomes. This study aims to examine the relationship between malnutrition with the cognitive, functional and psychological status of older adults living in long-term care houses. The study employed a cross-sectional approach in which 99 participants were included from seven nursing homes in six different cities across the West Bank, Palestine. The nutritional status of older adults was assessed using anthropometric measurements and meal patterns. Malnutrition risk was assessed using Mini Nutritional Assessment; the cognitive function using Mini Mental Status Examination; the functional status using the Activity of Daily Living. Results: A total of 99 participants (45.5%) men and (54.5%) women were included in the final data analysis. The results revealed 47% of the participants were at risk of malnutrition, while 23% were malnourished. Variables that were significantly associated with malnutrition; male gender, higher score of depressive symptoms, and impaired cognitive function, p < .05 using chi square test. However, number of meals and hours of overnight fasting were not associated with being malnourished. Greater dependency level was associated with high risk of malnutrition, p < .05 using One Way ANOVA test.

Conclusion: Risk of malnutrition was common among the study sample, and it was associated with impaired cognitive, psychological and functional status. Hence, there is a need to provide older adults living in long-term care houses with health programs to enhance their overall health and decrease the level of dependency. These findings are important to design educational programs targeting the stakeholders in the long-term care facilities to improve the residents' nutritional and functional status.     

Can schools become an inclusive space shared by all families? Learnings and debates from an action research project in Catalonia

ABSTRACT

This article discusses a 2-year action research project carried out in Catalonia using a sample of seven schools with varying degrees of social and ethnic diversity, focusing on the debate and critical perspectives surrounding the question of family–school relationships. It underlines four considerations, which are seen as symbolic, practical and probable barriers to this partnership: unequal power relationships, diversity and inequality of families, the grammar of schooling and how teachers view their professional identity. We present an action research project that involved the critical participation of the teaching staff in these seven schools and designed to answer the following question: under what conditions could family–school relationships be improved with and for all families, pupils and teachers? The conclusion discusses both the limitations of the critical action research and the lessons learnt from it: (a) the true transformation of the grammar of schooling is a slow and complex process; (b) this process is positive for teachers and makes their work better and easier; (c) the evaluation of constructive critical support is relevant and highly valued; and (d) the assessment of improved daily actions is key to making them visible and sustaining the change process.     

Implementation of Health Promotion in the Older Adults in Bangkok,Thailand

ABSTRACT

Effective strategies that bring health promotion messages to older adults in a developing country are needed. To evaluate the impact of various education media upon changes in knowledge and health behavior, a double-blind, randomized controlled trial was conducted involving 1,268 older adults in a southwest Bangkok suburb. Group teaching supplemented by a video program was provided in the communities. A simplified booklet and an audiotape containing the same health education information as in the videotape were given to the older adults for self-study. Health knowledge was assessed before the health education program. Identical assessment was performed again 3 months after the intervention. The quadriceps exercise and Cawthorne-Cooksey head-and-neck-balance exercise—representing changes in health promotion behavior—were also evaluated. Those who attended the group-teaching program had higher test scores than the control group. Only those who both read the booklet and listened to the audiotape in the intervention group gained more knowledge than the control group. The combination of group teaching supplemented by the video program and self-study using the booklet and audiotape was effective in improving health knowledge and behavior.     

A CLASSICAL MNEMONIC FOR OLDER LEARNERS: A TRIP THAT WORKS!

ABSTRACT

This study investigated age preferences for 11 different service providers and the age at which workers in these occupational roles were considered to be “too old” by three age groups: young (18–24), middle-aged (35–55), and older adults (65 +). Results indicate that in comparison to middle-aged and older adults, young adults continue to have unrealistic age preferences and, at a time when the workforce is becoming increasingly older, feel that many workers are too old. The hypothesis of a positive relationship between age group and age preference was not supported; there were few significant differences between the middle-age and older adults.     

Matters of HEARTS: health,experience of abuse,resilience, technology use,and safety of older adults

ABSTRACT

The purpose of this study was to assess the HEARTS (Health, Experience of Abuse, Resilience, Technology use, and Safety) of older adults (OAs). More particularly, we aimed to assess three components of the HEARTS (health, experience of abuse, and resilience) of OAs and explore the relationships among health, resilience, the experience of abuse, and other demographic variables. Forty-two male and female OAs in Pittsburgh, Pennsylvania, USA participated in the study. A correlational design was used in this study. The variables correlated were health, the experience of abuse, and the resilience of OAs. We used a community-engaged research approach in that participants were more than research volunteers but stakeholders in the research project. Findings showed that the means for more positive health features (physical function, and social roles) increased with increases in education, while more negative health features (anxiety, depression, fatigue, sleep disturbance, pain interference, and pain intensity) decreased with higher levels of education. Regression models indicated that above and beyond demographic features, resilience had a significant prediction of anxiety and depression. None of the other health outcomes were significantly predicted by either resilience or older adults’ abuse suspicion.

Adding health to years in older adults is a collaborative effort with healthcare providers, healthcare systems, families, and communities. This study has identified three components of HEARTS (Health, Experience of Abuse, and Resilience) that blend with successful aging and provide data and possible prevention and intervention strategies, and family and community education programs that could add health to years in older adults.     

Age Friendly Universities and engagement with older adults: moving from principles to practice

Abstract

The global society is facing a new burgeoning element: an ageing population. Response to the educational needs and interests of older adults requires innovative pedagogies and practices of teaching, research, and community engagement. While traditionally geared towards provision for younger adults, the case is presented that universities have the potential to play a major role in innovation for later life learning for older adults. This article outlines one approach, the Age Friendly University (AFU) and highlights 10 principles that offer a possible guide for innovation and institutional change. The integration of AFU’s mission and principles into three universities is reflected in stories from three university cases in Ireland, the UK (Scotland) and the USA exploring potential merits and also major challenges. It is argued the AFU has the potential to bring social, personal and economic benefits to older adults and universities alike.