Adult Community Research Articles

Bridging the Access Gap: A Decade of Narrowing the Digital Divide for Hispanic Older Adults in the United States.

Objectives: This study examines the digital divide between Hispanic and non-Hispanic White older adults in the United States from 2011 to 2021, using an intersectionality perspective. Methods: Eleven waves of data from the National Health and Aging Trend were analyzed through multilevel logistic regression, focusing on the intersection between race/ethnicity and time (measured by survey waves) within gender, education, and income subgroups. The digital divide was measured by Internet access. Results: Despite the enduring digital access gap, the longitudinal analysis revealed a narrowing digital divide between Hispanic and non-Hispanic White older adults, especially those with low education and income. Discussion: The observed trend signifies progress in digital inclusivity initiatives yet highlights ongoing challenges in fully bridging the divide for the Hispanic older adult community. Future efforts should not only focus on access but also on enhancing the effective usage of digital technologies to promote health equity and well-being.

Barriers to engagement with testing for sexually transmitted infections within a UK-based young adult Black Caribbean community: a qualitative study.

The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs) compared with other ethnic groups. The aim of this study was to explore barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Semi-structured interviews were carried out with 14 young adults from the Black Caribbean community and six sexual healthcare professionals. Data were analysed thematically. A focus group of five young adults was conducted to refine themes. Data analysis generated three themes: (1) culturally embedded stigma; (2) historically embedded mistrust; and (3) lack of knowledge. Perceived as 'dirty', particularly for females, infection with STIs was stigmatised by religious conceptions of 'purity' and shame. This presented challenges in terms of cultural acceptability of talking about STI testing with partners, friends, and family. Legacies of colonialism, medical racism and malpractice compromised young people's trust in medical intervention and confidentiality of data management. A lack of knowledge related to STIs and their treatment, and in how to access and perform STI tests further served as a barrier. Culturally tailored interventions targeting these factors and delivered by radio, podcasts and social media were highlighted as having potential to improve engagement with STI testing. Engagement with STI testing by young adults from the Black Caribbean community is impacted by historically and culturally embedded teachings, practices and beliefs inherited through generations. Targeting these factors within culturally tailored interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population.

Perfectionism, Feelings of Not Mattering, and Suicide Ideation: An Integrated Test of the Perfectionism Social Disconnection Model and the Existential Model of Perfectionism

The Perfectionism Social Disconnection Model (PSDM) and the Existential Model of Perfectionism and Depressive Symptoms (EMPDS) are promising models of perfectionism and psychopathology. However, research examining suicide ideation within the PSDM is scarce, and no research has examined suicide ideation as an outcome in the EMPDS. Moreover, tests of the PSDM and EMPDS have been conducted separately and most research has examined the PSDM and EMPDS using cross-sectional or two-wave longitudinal designs, which do not provide a satisfactory test of mediation. In the current study, we addressed these limitations by testing whether perfectionism confers vulnerability to suicide ideation via feelings of mattering and anti-mattering (from the PSDM) and via difficulty accepting the past (from the EMPDS) in a three-wave longitudinal design in two independent samples of undergraduate students and community adults. Participants completed measures on three occasions over 6 weeks. Findings revealed that socially prescribed perfectionism indirectly predicted suicide ideation via difficulty accepting the past in both samples. In addition, in the undergraduate sample only, socially prescribed perfectionism indirectly predicted higher suicide ideation via anti-mattering, and self-oriented perfectionism indirectly predicted higher suicide ideation via mattering. Based on our findings, we advocate for future research to include suicide ideation in the PSDM and EMPDS, to integrate explanatory models, and to examine a mattering-specific EMPDS.

The impact of community music therapy intervention in older adults’ care home communities: Assessing community music therapists’ views

Community music-therapy (CMT) service evaluation in older adults’ care home communities is an important process to enhance the quality of therapists’ outputs and the development of client-centred approaches to meet the needs of residents and community. However, administrative limitations that could affect therapists’ contact time with clients may lead to the underestimation of service evaluation within the system. This study aims to explore community music therapists’ perceptions of the impact of their services in older adults’ care home communities using a qualitative approach based on semi-structured interviews. The therapists were asked to reflect on specific aspects of their community music therapy service, potential cognitive-behavioural and physiological effects of therapy, best-practices for assessment in MT and challenges experienced in this particular setting. Participants highlighted the unique value of CMT in care home communities. They demonstrated the ability to detect and assess impacts of CMT using clinical analysis methods, which can improve care plans for the residents. However, certain limitations, such as reduced hours, inadequate funding and a lack of recognition of CMT’s benefits by care home staff, were identified. Moreover, the analysis shed light on how COVID-19 impacted the CMT service in this context, emphasizing the need for adaptability and resilience in providing care. The implications of the results in an Italian community context are further analysed and discussed, stressing the importance of supporting CMT as a fundamental service in care home communities for older adults. By addressing the highlighted limitation and embracing the perspectives of community music therapists, care homes can optimize their services and enhance the well-being of their residents.

Correlates of post-traumatic stress disorder among adult residents of conflict-affected communities in Cross River State, Nigeria: a cross-sectional study

BackgroundConflict-affected communities in Nigeria experience a range of problems. These experiences have been associated with different types of mental disorders, most notably, post-traumatic stress disorder (PTSD).AimThis study sought to assess...

Connectedness to the young adult cancer community and post-traumatic growth: A young adults with cancer in their prime study.

For young adults (YAs) with cancer, connecting with peer cancer survivors can provide a unique sense of community and may enhance post-traumatic growth (PTG). This study examined the relationship between connectedness to the YA cancer community and PTG among YAs, independent of overall social support. Data were obtained from the young adults with cancer in their prime study, a cross-Canada survey of YA cancer survivors. Participants were stratified by level of social support into two groups (low/high). Multivariable logistic regression was used to examine the association between PTG and connectedness to the YA community adjusting for respondent characteristics, and the interaction between support and connectedness. Of 444 respondents, mean age was 34.2 (SD=6.0), time-since-diagnosis was 4.8years (SD=5.4), and 87% were female. Over two-thirds of respondents (71%) reported feeling connected to the YA community. Level of connectedness to the YA community did not differ by social support group, and interaction between social support and connectedness to the YA community was not significant. In the adjusted regression, connectedness to the YA community (aOR=2.29, 95% CI: 1.10-4.91), high social support (aOR=2.98, 95% CI: 1.36-6.74), greater time-since-diagnosis (aOR=1.09, 95% CI: 1.04-1.15) and female sex (aOR=2.21, 95% CI: 1.23-4.04) were associated with greater odds of moderate-to-high PTG. Feeling connected to a community of YA cancer peers was associated with moderate-to-high PTG among YAs, independent of overall perceived social support. Future efforts should increase access to YA cancer communities and foster a sense of connectedness among YAs with cancer.

Evaluating the effectiveness of trauma-informed care training delivered to staff in community Older Adult Mental Health Services

PurposeBy older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.Design/methodology/approachTIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.FindingsThere were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.Practical implicationsTraining was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.Originality/valueTo the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

Pathways to professional mental care in the Swiss young adult community: a case-control study.

Treatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the 'Bern Epidemiological At-Risk' (BEAR) study on 16-40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the 'WHO pathway-to-care questionnaire', from which the outcome 'most intensive MH professional contact' was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The 'most intensive MH professional contact' was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, 'substance misuse' and 'central-vegetative problems' increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome.

Enriching Thinking Through Discourse.

Great effort is invested in identifying ways to change people's minds on an issue. A first priority should perhaps be enriching their thinking about the issue. With a goal of enriching their thinking, we studied the views of community adults on the DACA issue-young adults who entered the United States illegally as children. A dialogic method was employed, offering dual benefits in providing participants the opportunity to further develop their own ideas and to consider differing ideas. Yet, participants engaged in dialog only vicariously by observing the talk of a pair of actors who held opposing positions on DACA. The effect on participants' thinking was greatest in the condition in which they viewed a dialog between the two actors, rather than a comparison condition in which the actors individually expressed their positions. In control conditions, no presentation was observed. Probing questions included in all conditions encouraged a participant to examine and clarify for themselves their own position, potentially enriching it. This condition proved unsuccessful in enriching thinking; participants' justifications for their own positions in fact became simpler and less qualified. In contrast, observing a video of a like-minded and opposing other did enrich observers' thinking, yet to a greater degree in the dialogic than nondialogic condition. The findings thus suggest observed dialog as a promising practical approach in promoting deeper thinking.

ANALISIS STRATEGI PENDIDIK TERHADAP PENGEMBANGAN KARAKTER SISWA DI ERA DIGITAL

Character education is an effort to instill religious, ethical and moral values ​​in students through science, with the help of parents, teachers and the community. This is very important for the formation and development of students' personalities. All children are born with extraordinary potential. However, to exploit this potential, they need proper learning and socialization. Each child's personality will be formed and develop optimally. In this digital era, children have easy access to digital media. This digital era, which has positive and negative influences, is the responsibility of teachers, parents and instructors. Therefore, it is the duty of teachers, parents and the adult community to monitor and control children's use of digital media

Relational Complexity of the Near-Age Peer Support Provider Role in Youth and Young Adult Community Mental Health Settings.

Increasingly, US community mental health settings are integrating professional near-age youth peer support providers to improve youth service engagement and outcomes. Youth peer specialists (YPS) use their lived and living experiences with a mental health diagnosis to validate, empathize, and provide individualized support, while also improving their program's overall responsiveness to young people's needs. Although promising, these roles tend to lack clarity-responsibilities vary immensely, and turnover is high. Examining near-age youth peer on-the-job experiences is needed to design effective on-the-job supports. Using community-based participatory action research methods, young adults with lived experience worked in partnership with a PhD-level qualitative researcher to design, recruit, conduct, and analyze in-depth-interviews with current and former near-age youth peer providers. Ten young adult peer mentors in Massachusetts completed interviews that revealed near-age youth peer role relational complexity. Five relational aspects were identified requiring relational practice skills and self-awareness, including relationships with (1) self, (2) clients, (3) supervisors, (4) non-peer colleagues, and (5) other near-age peer providers. Near-age peers experience relationship-related struggles with non-peer identified colleagues who do not understand nor value the near-age peer role. Findings expand on current near-age peer practice and associated on-the-job challenges. Training, supervision, and professional development activities that target these five relational areas may improve YPS on-the-job wellbeing, decrease YPS turnover, and improve youth client outcomes.

Use of the Buffalo Concussion Treadmill Test in community adult patients with mild traumatic brain injury.

The Buffalo Concussion Treadmill Test (BCTT) is used to establish exercise tolerance for rehabilitation and identify injury subtypes for youth athletes after mild traumatic brain injury (mTBI). Its utility in adult community members is unknown. Primary: To describe how adults with and without mTBI tolerate the BCTT. Secondary: To explore relationships between baseline factors, mTBI-related symptoms, and BCTT duration. Prospective, observational, longitudinal. Academic medical center. Thirty-seven adults treated in a level 1 trauma center emergency department with mTBI; 24 uninjured controls (UC). N/A. Participants completed two visits 3 weeks apart (1 week and 1 month after mTBI) including a 15-minute BCTT, the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and preinjury International Physical Activity Questionnaire. Analyses characterized BCTT response and associations between baseline factors, RPQ scores, and BCTT duration. Persons with mTBI discontinued earlier than UC at 1-week postinjury using standard discontinuation criteria for exercise intolerance. The percentage of mTBI participants with signs of possible mTBI-related intolerance was 55.6% at 1 week (36.1% for mTBI-related symptom exacerbation, 19.4% for exertion/fatigue before reaching 85% of one's age-predicted maximum heart rate [HR]) and 48.0% at 1 month (40.0% mTBI-related symptom exacerbation, 8.0% exertion without reaching the target HR). Thirty percent of UCs completed the BCTT at both assessments. UCs met discontinuation criteria for increased nonspecific symptoms (eg, pain/general discomfort and increased Visual Analog Scale ratings; 39-61%) and physical exertion (9-26%). Shorter duration was associated with higher body mass index (r = -0.42 - -0.45), shorter height (r = 0.22-0.29), female gender (r = -0.26 - -0.27), and greater RPQ symptoms (r = -0.28 - -0.47). The BCTT exacerbates mTBI-related symptoms in adult community members. Participant characteristics and noninjury factors influence performance. The findings imply the BCTT could be useful in clinical assessments of adults with mTBI. Interpretation should account for the unique characteristics of nonathletes.

Factors contributing to subjective well-being and supporting successful aging among rural Japanese community-dwelling older adults: A cross-sectional and longitudinal study.

We aimed to identify the factors contributing to subjective well-being in community-dwelling older adults in rural Japan. This study explored the relationship among physical and mental health, socioeconomic status, and activity levels with regard to the subjective well-being of older adults. In the Frail Elderly in the Sasayama-Tamba Area study, a cohort investigation of independent older adults in a rural Japanese community, 541 of 844 participants completed a 2-year follow-up survey. Subjective well-being was assessed as a binary based on three factors - "happiness," "satisfaction with life" and "meaning in life" - using a subset of the World Health Organization's Quality of Life questionnaire. The improvement group transitioned from not having subjective well-being during the baseline survey to having subjective well-being during the follow-up survey. Furthermore, we used multivariable log-Poisson regression models to calculate the prevalence ratios of subjective well-being. The cross-sectional study showed that sleep satisfaction, health services access satisfaction and having a higher-level functional capacity were positively associated with having "happiness" and "satisfaction with life." Furthermore, being aged 80 years and having financial leeway were positively associated with having "meaning in life." The longitudinal study showed that having a higher-level functional capacity was positively associated with improving "happiness" and "satisfaction with life." Being female was positively associated with improving "happiness" and "meaning in life," and health services access satisfaction and alcohol drinking were positively associated with improving "satisfaction with life" and "meaning in life," respectively. These findings offer promising avenues for enhancing the subjective well-being of older adults. Geriatr Gerontol Int 2024; 24: 311-319.

Good (virtual) grief: The potential of online communities for bereaved older adults during Covid-19

During the pandemic, older adults were at risk of heightened social isolation and bereavement overload. However, engagement in online grief communities can facilitate meaningful social connections and promote healthy bereavement practices. This paper highlights the benefits of engaging in meaning-making, community building, and griefwork in later life. We engage with recent literature on virtual bereavement practices and discuss the ongoing potential for bereaved older adults to engage in online grief communities amid the new realities of Covid-19. We consider what it means to process grief in a virtual space and how this may shape approaches to death, dying, and bereavement during and after a global pandemic. We conclude with a call to action to develop accessible and affordable online engagement technologies for older adults to help mitigate a decline in well-being and promote healthy bereavement practices.

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province

Bringing Dance to Older Adults: Program Experts' Perspectives on the Role of Community Dance Classes to Support Older Adults.

Dancing offers several health and wellness benefits for older adults: it may promote physical literacy (PL) and positively influence the aging process. Yet, limited research considers the perspectives of those with experience working with older adults and in community dance programming. The purpose of this study was to understand program experts' perspectives on how older adult community dance can promote PL and contribute to age-friendly cities and community initiatives. Four themes were identified from semi-structured interviews with five program experts: (1) expert instructors tailor classes to participants' needs and interests; (2) the heart of what draws us to dancing: authentic experience and social connection; (3) elitist, ableist, and gendered assumptions of dance prevent social inclusion of older adults in dancing spaces; and (4) collaboration across sectors is needed to offer accessible, sustainable, and valued dance programming. Recommendations for developing and implementing older adult community dance programming are described.

A test of pre-exposure spacing and multiple context pre-exposure on the mechanisms of latent inhibition of dental fear: A study protocol

BackgroundLatent inhibition occurs when exposure to a stimulus prior its direct associative conditioning impairs learning. Results from naturalistic studies suggest that latent inhibition disrupts the learning of dental fear from aversive associative conditioning and thereby reduces the development of dental phobia. Although theory suggests latent inhibition occurs because pre-exposure changes the expected relevance and attention directed to the pre-exposed stimulus, evidence supporting these mechanisms in humans is limited. The aim of this study is to determine if two variables, pre-exposure session spacing and multiple context pre-exposure, potentiate the hypothesized mechanisms of expected relevance and attention and, in turn, increase latent inhibition of dental fear.MethodsIn a virtual reality simulation, child and adult community members (ages 6 to 35) will take part in pre-exposure and conditioning trials, followed by short- and long-term tests of learning. A 100ms puff of 60 psi air to a maxillary anterior tooth will serve as the unconditioned stimulus. Pre-exposure session spacing (no spacing vs. sessions spaced) and multiple context pre-exposure (single context vs. multiple contexts) will be between-subject factors. Stimulus type (pre-exposed to-be conditioned stimulus, a non-pre-exposed conditioned stimulus, and an unpaired control stimulus) and trial will serve as within-subject factors. Baseline pain sensitivity will also be measured as a potential moderator.DiscussionIt is hypothesized that spaced pre-exposure and pre-exposure in multiple contexts will increase the engagement of the mechanisms of expected relevance and attention and increase the latent inhibition of dental fear. It is expected that the findings will add to theory on fear learning and provide information to aid the design of future interventions that leverage latent inhibition to reduce dental phobia.

Individual and Community-Contextual Level Factors Associated With Wellbeing Among Older Adults in Rural Zambia.

Objective: This article aims to identify individual and community-contextual level factors associated with the wellbeing of older adults (50years and older) in rural Zambia. Methods: Data from the nationally representative 2015 Living Conditions Monitoring Survey (LCMS) was used. Employing multilevel mixed effects, the individual and community-contextual factors on wellbeing were determined. Results: Overall, 31.7% of rural older adults perceived their wellbeing as good. Both individual and community-contextual level factors are associated with the wellbeing of older adults in rural communities. At the individual level, wellbeing was associated with higher education attainment. Community-contextual factors significantly associated with wellbeing included improved housing, access to piped tap water within the premises, own charcoal or income to purchase firewood. Conclusion: The findings foreground the imperative to analyse both individual and community-contextual level factors of wellbeing to generate and present evidence for investments in education across the life course and for the development of infrastructure towards increasing the wellbeing of rural older adults. Additionally, the results provide a basis for planning by devising policies and programmes for older people to thrive and for no one to be left behind regardless the setting.

Social support mediates the effects of childhood unpredictability on anhedonia: A retrospective investigation in an online adult community sample

Increasingly, research is highlighting the implications of exposure to unpredictable environments during childhood (i.e., “childhood unpredictability”) on outcomes in adulthood. Converging evidence from preclinical and clinical studies has implicated childhood unpredictability in disrupted reward processing and anhedonia. From the stress generation literature, altered social support has emerged as a possible mechanism by which this effect may occur. In the current study, our goal was to understand whether the pathway from childhood unpredictability to anhedonia occurs through reduced perceptions of social support. Toward this end, we recruited an online community sample of adults in the US (N = 242) to complete surveys assessing childhood unpredictability, depressive symptoms, anhedonia, and social support, as well as a novel online version of the Probabilistic Reward Task. We found that childhood unpredictability was associated with increased depressive symptoms and anhedonia (but not objective measure of anhedonia), and reduced perceptions of social support in adulthood. Mediation analyses revealed a significant indirect effect of perceived social support on the association between childhood unpredictability and anhedonia, controlling for age, sex, and non-anhedonic depressive symptoms. Unexpectedly, measures of reward responsiveness from the behavioral task were not related to childhood unpredictability. The current findings replicate previous reports linking childhood unpredictability and self-reported anhedonia, and extend them to incorporate the potential mediating pathway of reduced social support. Implications for treatment for anhedonia are discussed.

Mobilizing faith-based COVID-19 health ambassadors to address COVID-19 health disparities among African American older adults in under-resourced communities: A hybrid, community-based participatory intervention.

The COVID-19 pandemic disproportionately affected older adults, particularly those with pre-existing chronic health conditions. To address the health disparity and challenges faced by under-resourced African American older adults in South Los Angeles during this period, we implemented a hybrid (virtual/in-person), pre-post, community-based participatory intervention research project utilizing a faith-based lay health advisor model (COVID-19 Health Ambassador Program (CHAP)). We recruited COVID-19 Health Ambassadors (CHAs) and African American older adults (participants) from faith-based organizations who partook in CHA-led meetings and follow-ups that educated and supported the participants. This paper seeks to evaluate this intervention's implementation using the Consolidated Framework for Implementation Research (CFIR) as a reporting tool with an emphasis on fidelity, challenges, and adaptations based on data collected via stakeholder interviews and surveys. CHAP was delivered to 152 participants by 19 CHAs from 17 faith-based organizations. CHAs assisted with chronic disease management, resolved medication-related challenges, encouraged COVID-19 vaccination, reduced psychological stress and addressed healthcare avoidance behaviors such as COVID-19 vaccine hesitancy among the participants. Challenges encountered include ensuring participant engagement and retention in the virtual format and addressing technological barriers for CHAs and participants. Adaptations made to better suit the needs of participants included providing communication tools and additional training to CHAs to improve their proficiency in using virtual platforms in addition to adapting scientific/educational materials to suit our participants' diverse cultural and linguistic needs. The community-centered hybrid approach in addition to our partnership with faith-based organizations and their respective COVID-19 health ambassadors proved to be essential in assisting underserved African American older adults manage chronic health conditions and address community-wide health disparities during the COVID-19 pandemic. Adaptability, cultural sensitivity, and teamwork are key to implementing health interventions especially in underserved populations.