Area Agencies On Aging Research Articles

Primary care and community partnerships to promote age-friendly care for Hispanic older adults.

Healthcare and community collaborations have the potential to address health-related social needs. We examined the implementation of an educational initiative and collaborative intervention between a geriatric clinic and Area Agency on Aging (AAA) to enhance age-friendly care for a Hispanic patient population. As part of a Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Program, a geriatric clinic partnered with AAA to embed an English- and Spanish-speaking Social Service Coordinator (SSC). The SSC met with patients during new and annual visits or by referral to address What Matters and Mentation in the patient's primary language, provide education, and make social service referrals. Patients aged 60 and older, who received SSC services during a 12-month period, were defined as the intervention group (n = 112). Using a retrospective chart review, we compared them to a non-intervention group (n = 228) that received primary care. We examined available demographic and clinical data within the age-friendly areas of What Matters and Mentation. Measures included cognitive health screenings, advance care planning, patient education, and community referrals. Most of the intervention groups were eligible for AAA services and had the opportunity for service referrals to address identified needs. A higher proportion of patients within the intervention group completed screenings for cognitive health and advance care planning discussions. Interagency partnerships between ambulatory care settings and community-based organizations have the potential to expand access to linguistically and culturally competent age-friendly primary care for older adults.

Social Capital as a Framework to Address Organizational Climate Change Policy.

To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels. Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy. AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies. Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [Journal of Gerontological Nursing, 50(6), 11-15.].

Stakeholders’ Perspectives on an Area Agency on Aging Serving Urban Older Adults

ABSTRACT Area Agencies on Aging (AAAs), authorized by the 1965 Older Americans Act, seek to promote “age-friendly” communities by offering services that help older adults live independently. This study used Qualtrics survey data (n = 94 respondents) to identify unmet needs for AAA services in the Detroit metropolitan area. Descriptive statistical analyses were used for closed-ended items and content analysis was used to identify themes from open-ended questions. This needs assessment aims to provide the opportunity for in-depth, meaningful input from stakeholders about areas relevant to strategic planning efforts that enhance and enrich older adult programming in an urban AAA service area. Key themes included the need to collaborate with transportation providers, partner with healthcare and hospitals, market the agency to enhance visibility, promote aging in place, address demographic changes, and improve access to older adult services and caregiver support. Findings suggest the importance of providing accessible, high-quality services that promote aging in place through community outreach and collaboration activities.

IMPLEMENTING AN AREA AGENCY ON AGING COMMUNITY CARE TRANSITION INITIATIVE: FACILITATORS AND BARRIERS

Abstract The Michigan Region VII Area Agency on Aging (AAA) implemented a Community Care Transition Initiative (CCTI) for rural hospitalized older adults at high risk for readmission. After discharge home, AAA CCTI participants received a home visit by an AAA-trained pharmacy technician community health worker (CHW), a telehealth AAA pharmacist medication review, assessments by the CHW and pharmacist, education, primary care follow-up coaching, and referrals. As part of a program evaluation, we conducted six interviews with AAA key informants (e.g., pharmacist, director, CHWs). A semi-structured interview guide was piloted and revised to assess implementation, processes, impact, and future directions. Interviews were conducted via Zoom, recorded, transcribed, and checked for accuracy. Thematic analysis was used to identify implementation facilitators, barriers, and areas for program refinement. Three researchers coded the transcripts, developed a codebook, and resolved discrepancies by consensus. NVivo 14® was used for data management and analysis. Barriers to AAA CCTI implementation included unknowns at project start and need for procedures, anxiety about entering a client’s house, client’s lack of familiarity with technology, lack of perceived pharmacist benefit, limited personnel, and billing or financial reimbursement. Facilitators identified were the AAA’s reputation and backing, relationships built between healthcare providers, referral processes (e.g., community mental health), and pharmacist telehealth visit efficiency. Program refinements included shortened follow-up time and tailored visits to different client situations and needs. The results provide insights into the design of implementation strategies to disseminate the AAA CCTI to meet rural older adults’ health and social needs after hospitalization.

THE AGING NETWORK AS A CATALYST FOR COMMUNITY GERONTOLOGY AND APPLIED RESEARCH

Abstract The Older Americans Act (OAA) established Area Agencies on Aging (AAAs) fifty years ago as local community-based organizations responsible for planning, coordinating, funding, and delivering nutrition and other supportive services which allow older adults to remain living in their homes and communities. Local control and decision-making, mandated by the OAA, has allowed AAAs to adapt to the evolving needs and demands of their communities The centrality of their role was never more apparent than during the COVID-19 pandemic. As national and societal circumstances have resulted in increased social isolation, housing insecurity, and public health concerns for older adults, AAAs have adapted and expanded beyond traditional OAA services to address the social and health needs of an increasingly diverse older adult population. The Community Gerontology framework provides a useful structure to understand the evolution and impact of AAAs and the broader Aging Network on the health of older adults. Using data from the 2022 National Survey of AAAs and a new qualitative study on Community Care Hubs, academic and Aging Network-based researchers will illustrate the many partnerships and pathways of mutual influence between AAAs and the micro and macro levels to describe how Aging Network services are expanding provision of services for health care partners, public health initiatives, and new housing and homelessness services and partnerships to address emerging needs. The symposium will conclude with an illustration of how applied researchers and Aging Network organizations partnered on research-informed practice to innovate and strengthen services for at-risk older adults.

GERIATRIC WORKFORCE ENHANCEMENT PROGRAMS AS AAA AGE-FRIENDLY INITIATIVES PARTNER

Abstract The Health Resources and Services Administration funded 48 Geriatric Workforce Enhancement Programs (GWEPs) to partner with community-based organizations in addressing gaps in health care for older adults, promoting Age-Friendly ecosystems, and addressing social determinants of health. This paper discusses three GWEPs collaborative projects with Area Agencies on Aging (AAAs) that deliver community-based programs . The University of Utah’s GWEP, a rural AAA, the Alzheimer’s Association, and the Utah Department of Veterans and Military Affairs provided a hybrid Dementia Caregiver Conference to six counties, reaching 65 in-person attendees and 10 senior centers online. Attendees agreed the content met their educational needs, would positively influence care, and was motivation to form a caregiver coalition. The University of Louisville Trager Institute (Trager), AAA, and Kentucky Coalition for Healthy Communities provided focused regional training and sharing of community resources utilizing the Project ECHO training model for 11 AAA regions, reaching 412 home and community-based services professionals. The University of North Texas Health Science Center, AAA, and emergency management services expanded evidence-based programs in falls prevention, medication safety, and dementia caregiving, serving an additional 23 urban postal codes, rural counties, and over 1,900 individuals. These examples utilize unique community relationships and partnership strategies to identify local needs, maximize older adult and family caregiver engagement, measure outcomes, and achieve GWEP goals to educate diverse, underserved and rural communities.

A CRITICAL EXAMINATION OF AAA SERVICES AND SUPPORTS FOR CAREGIVERS IN MICHIGAN: POLICY AND PRACTICE IMPLICATIONS

Abstract To identify the service gaps for family caregivers in Michigan, this study examined the perceptions of stakeholders from the 16 area agencies on aging (AAA). An online questionnaire was administered to assess a point-in-time picture of current caregiver assessments and services in 2020. Fifteen AAAs responded to see definitely or probably an increase in the number of caregivers in their catchment areas. Fifteen AAAs currently purchase or contract for respite care services. Fourteen provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provided caregiver training, none directly provided supportive services. AAAs anticipated rapidly increasing needs for caregiver supports and services. While each provided a different array of services, they anticipated that demand would continue to increase given a rising aging population in Michigan. Results were used to craft a proposal to establish a network of regional caregiver resource centers. Recommendations in the study include creating a task force of stakeholders to identify standardized service definitions, measures and reporting requirements; create a no-wrong-door, multi-prong approach for caregivers to access programs; provide respite care through contracts and referrals to community-based organizations; create a network of trainers to disseminate evidence-based best practices to AAAs and contractors; use untapped resources such as AARP and Alzheimer’s Association; explore forming local healthcare systems and provider collaborations to identify caregivers and triage them. Next steps are to pursue funding from the legislature and other sources to create regional caregiver resource centers across the state.

COMMUNITY COLLABORATOR AND OLDER ADULT EXPERIENCES WITH INTERVENTIONS DELIVERED BY OLDER ADULTS

Abstract This symposium will include researchers, collaborators from healthcare and social service organizations, and older adults serving as volunteer coaches or peer educators; speakers will describe their experiences conducting two randomized controlled trials involving behavioral interventions for older adults delivered by older adults. The first trial is a NIMH-funded three-site RCT for community-dwelling older adults with symptoms of depression, in which participants receive behavioral activation delivered by a masters-level clinician or a streamlined version (“Do More, Feel Better”) delivered by an older adult volunteer. This trial involves close collaboration with senior centers and an Area Agency on Aging (AAA). The second trial is a PCORI-funded RCT to reduce health disparities for Black/African-American and Hispanic/Latino older adults after medical hospitalization, in which participants receive the evidence-based Care Transitions Intervention (CTI), CTI plus a peer educator intervention, or usual care. This trial involves close collaboration with three regional hospital systems and an AAA. First, research investigators will describe the background, rationale, and methodology of each trial. Second, two representatives from the collaborating organizations (one from each trial) will present about their experiences collaborating on these trials – benefits of collaborating, challenges and strategies for overcoming challenges, and recommendations for other researchers engaged in similar community-based research. Third, two representatives from the older adult volunteers and peer educators (one from each trial) will present about their experiences collaborating on these trials – benefits of collaborating, challenges and strategies for overcoming challenges, and recommendations for other researchers engaged in similar community-based research.

RANDOMIZED CONTROLLED TRIAL OF LAY-DELIVERED INTERVENTION FOR OLDER ADULTS DISCHARGED FROM THE HOSPITAL

Abstract The second speaker will describe the background, aims, methods, and progress of a PCORI-funded RCT to reduce rehospitalization for Black/African American and Hispanic/Latino older adults after medical hospitalization. Across three regional hospitals, 402 older adults living with chronic illness (e.g., cardiovascular disease, diabetes, hypertension etc.,) will be enrolled while inpatient at one of our three partnering hospitals and randomized to receive one of three interventions in this comparative effectiveness trial: (1) the evidence-based Care Transitions Intervention (CTI), (2) CTI plus a peer educator intervention (CTI+Peer), or (3) usual care. Participants are assessed at 4 timepoints (baseline, 30 days, 90 days and 6 months) to examine differences in the primary outcomes of 30-day all cause hospital readmissions and emergency department visits. Secondary outcomes including quality of life, self-efficacy managing chronic disease, functioning, perceived social support and mortality. CTI Coaches and Peer educators participate in rigorous trainings which includes both didactic and interactive components to ensure interventionists are able to deliver the intervention with fidelity to the models. After training, CTI Coaches and Peer Educators participate in regular supervision meetings. They receive weekly virtual supervision check-ins from USF study staff and participate in a monthly group-based supervision in person. This trial involves close collaboration with leaders and coordinators at each hospital and an Area Agency on Aging (AAA) for recruitment, engagement of study interventionists and study dissemination. Across sites, 18 CTI Coaches and 11 Peer Educators have been trained and certified, and 145 participants have been enrolled (as of 3/8/2023).

RANDOMIZED CONTROLLED TRIAL OF LAY-DELIVERED INTERVENTION FOR DEPRESSED OLDER ADULTS

Abstract The first speaker will describe the background, aims, methods, and progress of an ongoing NIMH collaborative R01, three-site RCT. Across three sites (University of Washington, Cornell Weill Medicine, and University of South Florida), 288 depressed older adults will be enrolled, randomized to receive 9 sessions of BA from clinicians (e.g., social worker or mental health counselor) or 9 sessions of DMFB from a trained older adult volunteer coach, and assessed on primary outcomes (Behavioral Activation for Depression Scale [BADS], Hamilton Rating Scale for Depression [Ham-D]) and other outcomes at baseline, 3-, 6-, 9-, 24-, and 36-weeks. Clinician BA training and certification involves two 2-hour training workshops including didactics, demonstration, and role play; followed by delivering the intervention with one “certification” client reviewed and approved by external raters. Coach DMFB training and certification follow a similar process, except that training is longer (4 2-hour workshops) with more didactics, demonstrations, and role plays. After training, clinicians and coaches participate in regular weekly supervision, and all client sessions are audio-recorded, with at least one session per client randomly selected for independent review. This trial involves close collaboration with representative of a county lead aging service agency, numerous senior centers and organizations, and an Area Agency on Aging (AAA) for recruitment, outreach events, engagement of clinicians and volunteer coaches, and study dissemination. Across sites, 24 clinicians and 23 volunteers have been trained and certified, and 124 participants have been enrolled (as of February 15, 2023).

Early identification of cognitive impairment among vulnerable older adults living at home

AbstractBackgroundAfrican Americans are twice as likely as Caucasians to develop Alzheimer’s Disease and Related Dementias (AD/ADRD) and less likely to seek a diagnosis before experiencing a crisis. This study evaluated the impact of adding Mini‐Cog© screenings to Area Agency on Aging (AAA) assessments on early detection of cognitive impairment among low‐income older adults.MethodMini‐Cog™ assessments were offered to new and existing clients of a AAA Neighborhood Advisor. Clients with scores indicating impairment were referred to an academic geriatric practice for comprehensive evaluation. Inclusion criteria were age 65 or older, English speaking, living at home in the Advisor’s service area, and not previously diagnosed as AD/ADRD. Data collected over 9 months included Mini‐Cog™ scores, age, race, ethnicity, and geriatric referrals. Quantitative analysis included bivariate descriptive statistics (significance alpha of .10) and simple linear regression (significance alpha of .05).ResultsOf 69 study participants, 84% were female, 54% African American, and 93% non‐Hispanic. Mean age was 74.7 years and mean Mini‐Cog™ score was 3.61 (range: 0‐5). Independent t‐tests show that African American participants had lower Mini‐Cog™ scores than Caucasians (3.35±.23 vs 3.91±.22, p = .092). Caucasian males were younger with higher cognition scores than Caucasian women and African American males were younger with lower scores than African American females. Participants qualifying for referral (18 or 26%) were significantly older than those who did not (74.4 vs 70.0, p<.05). Of 11 participants offered referrals, all Caucasians (3) declined and 5 of 8 African Americans (62%) accepted. Regression analysis determined that Mini‐Cog™ scores were associated with older age (β* = ‐0.255, SE = 0.02, p<.05) and being African American (β* = ‐0.261, SE = .344, p<.05) but not with sex, ethnicity, or living alone.ConclusionResults show that 25% of participants were identified with previously undetected cognitive impairment and that trained social service providers can effectively administer the Mini‐Cog™ instrument to assess cognitive impairment. Large scale studies are needed to further evaluate use of the Mini‐Cog™ instrument in early detection of cognitive impairment in minority and economically vulnerable older adults in non‐clinical settings.

Impact of an Area Agency on Aging pharmacist-led Community Care Transition Initiative

BackgroundRural older adults are at risk of readmissions and medication-related problems after hospital discharge. ObjectivesThis study aimed to compare 30-day hospital readmissions between participants and nonparticipants and describe medication therapy problems (MTPs) and barriers to care, self-management, and social needs among participants. Practice descriptionThe Michigan Region VII Area Agency on Aging (AAA) Community Care Transition Initiative (CCTI) for rural older adults after hospitalization. Practice innovationEligible AAA CCTI participants were identified by an AAA community health worker (CHW) trained as a pharmacy technician. Eligibility criteria were Medicare insurance; diagnoses at risk of readmission; length of stay, acuity of admission, comorbidities, and emergency department visits score more than 4; and discharge to home from January 2018 to December 2019. The AAA CCTI included a CHW home visit, telehealth pharmacist comprehensive medication review (CMR), and follow-up for up to 1 year. Evaluation methodsA retrospective cohort study examined the primary outcomes of 30-day hospital readmissions and MTPs, categorized by the Pharmacy Quality Alliance MTP Framework. Primary care provider (PCP) visit completion, barriers to self-management, health, and social needs were collected. Descriptive statistics, Mann-Whitney U, and chi-square analyses were used. ResultsOf 825 eligible discharges, 477 (57.8%) enrolled in the AAA CCTI; differences in 30-day readmissions between participants and nonparticipants were not statistically significant (11.5% vs. 16.1%, P = 0.07). More than one-third of participants (34.6%) completed their PCP visit within 7 days. MTPs were identified in 76.1% of the pharmacist visits (mean MTP 2.1 [SD 1.4]). Adherence (38.2%) and safety-related (32.0%) MTPs were common. Physical health and financial issues were barriers to self-management. ConclusionAAA CCTI participants did not have lower hospital readmission rates. The AAA CCTI identified and addressed barriers to self-management and MTPs in participants after the care transition home. Community-based, patient-centered strategies to improve medication use and meet rural adults’ health and social needs after care transitions are warranted.

“The Real Impacts That AAAs are Making:” Developing Measures of Area Agency on Aging Success

ABSTRACT The more than 600 Area Agencies on Aging (AAAs) throughout the U.S. are as diverse as the communities they serve, making it challenging to establish indicators of success that are not simply compliance-focused. This study builds agreement among AAAs to identify impactful, feasible, and measurable indicators of success. A mixed methods study was conducted with two surveys of AAA experts to identify indicators of success; assessments of those indicators’ impact, feasibility, and measurability; and virtual focus groups to interpret findings. Most indicators that had the potential for high impact received low feasibility and measurability scores. AAAs want more technical assistance, funding, and staffing resources from their states and the Administration on Aging to make data collection and analysis less burdensome and more outcome-oriented. State Units on Aging and the Administration on Aging can use the study findings to improve assessments of AAAs without placing undue burdens on staff attempting to demonstrate their impact. This study can help to identify future priorities regarding AAA assessments and innovations.

Sustaining Area Agency on Aging Services During a Pandemic: Innovation Through Community-Based Partnerships.

Area Agencies on Aging (AAAs) have funded, coordinated, and provided services since the 1960s, evolving in response to changes in policy, funding, and the political arena. Many of their usual service delivery programs and processes were severely disrupted with the onset of the coronavirus disease 2019 pandemic. Increasing evidence suggests the importance of partnerships in AAA's capacity to adapt services; however, specific examples of adaptations have been limited. We sought to understand how partnerships may have supported adaptation during the pandemic, from the perspectives of both AAAs and their partners. We conducted a secondary analysis of qualitative data from an explanatory sequential mixed-methods parent study. Data were collected from 12 AAAs diverse in terms of geographic region, governance structure and size, as well as a range of partner organizations. We completed 105 in-depth interviews from July 2020 to April 2021. A 5-member multidisciplinary team coded the data using a constant comparative method of analysis, supported by ATLAS.ti Scientific Software. AAAs and their partners described strategies and provided examples of ways to rapidly transform service delivery including reducing isolation, alleviating food insecurity, adapting program design and delivery, and leveraging partnerships and repurposing resources. AAAs and partner organizations are uniquely positioned to innovate during times of disruption. Findings may enhance AAA and partner portfolios of evidence-based and evidence-supported programs.

THE BLACK BOX OF CARE MANAGEMENT IN MANAGED LONG-TERM SERVICES AND SUPPORTS

Abstract Within Ohio’s MyCare demonstration, two distinct care management models were selected by the participating MyCare Ohio health plans (MCOPs): fully-delegated waiver care management and waiver service coordination. The purpose of this presentation is to describe the components of care management operating in MyCare Ohio. Qualitative interviews with n=91 Area Agency on Aging (AAA) and n=131 MCOP care management personnel were audio-recorded, transcribed, and checked for accuracy prior to thematic coding in Dedoose. Results indicate that comprehensive care management is the core element of MyCare Ohio. Fully-delegated care management models were viewed by participants as beneficial to reducing confusion for members however ‘scope creep’ challenged the already strained AAAs. Effective teamwork was identified for waiver service coordination models but the division of labor and communication needed between the AAA and MCOP care management personnel created tensions. The discussion will focus on practice recommendations for training, caseloads, and support staff.

BEFORE IT WAS COOL: THE AGING NETWORK’S ROLE IN ADDRESSING SOCIAL NEEDS AND REDUCING DISPARITIES

Abstract Decades before social determinants of health (SDOH) became such a focus of attention across health and social care, Area Agencies on Aging (AAAs), Title VI Native American Aging Programs, and their Aging Network partners had developed local systems of coordinated services and supports to assess and address health-related social needs. Every service and program provided by an AAA or Title VI program addresses a need related to SDOH risks. The Older Americans Act mandates that funded services such as congregate and home-delivered meals, support for caregivers, transportation, and housing supports are targeted to older adults with the greatest economic or social need. Using the foundational study on “ACL’s Impact on the Social Determinants of Health” as a framework, this symposium will demonstrate how OAA-funded programs map to SDOH pathways. Presenters will describe specific programs and new practices within the Aging Network that identify and address social needs of older adults from historically marginalized and underserved communities. These initiatives, many of which were born through COVID response, include analyses and partnerships to advance health equity and care integration. Presenters will describe how Aging Network practices and partnerships have altered community environments to make community living accessible to older adults who have been traditionally underserved, and current workforce challenges that threaten continued progress. The session will conclude with an interactive discussion about gaps, strategies, and next steps to reinforce, articulate and demonstrate the value of Aging Network services in addressing SDOH risks and needs.

Balancing Caregiver Resources Provided by Michigan’s Area Agencies on Aging

ABSTRACT Timely linkages are necessary for people with dementia and other disabling conditions to reduce caregiver burnout, prevent unnecessary hospitalization, or placement in alternate care settings. To identify needs, the Caregiver Resource Collaborative conducted a needs assessment of Michigan’s sixteen area agencies on aging (AAA). Responses by the sixteen AAAs to an online questionnaire provided a point-in-time picture of current caregiver assessment and services conducted by AAAs. Fifteen AAAs responded there would definitely or probably be an increase in the number of caregivers. Fifteen responded that they purchase or contract out respite care services. Fourteen stated that they provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provide training, none of the AAAs provides supportive services. The AAAs anticipate rapidly increasing needs for caregiver supports and services. While each provides different services, demand will continue to grow as the older adult population increases.

It's Time We Looked Under the Hood: An In-Depth Examination of Five Public California Area Agencies on Aging.

As the older adult population grows, it is important to understand the effectiveness of service delivery systems that support aging in place. Studying service delivery processes and organizational structures of Area Agencies on Aging (AAAs) is essential for future efforts to understand service delivery outcomes and innovations. We conducted site visits with 5 government-run California AAAs. We used a template and constant comparative analysis to analyze transcripts from site visits and focus groups with key informants. AAA representatives discussed how their organizational structure was related to (a) which services and programs they provided; (b) administrative cost savings and access to funding sources; (c) inter- and intra-agency coordination; and (d) visibility among clients and community partners. These findings can be used to guide decisions surrounding how changes in AAA structure may affect funding, coordination, service delivery, and visibility, among other factors. Consolidating the AAA with other departments and programs facilitates coordination and shared administrative costs, yet consolidation may reduce standalone AAAs' visibility and ability to innovate. AAA structure should be tailored to fit community resources, local government organization, and the needs of older residents.

Implementing CAPABLE With Care Partners Through an Area Agency on Aging: Identifying Barriers and Facilitators Using the Consolidated Framework for Implementation Research.

Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an evidence-based intervention to promote aging in place. Although CAPABLE has been implemented in more than 40 community sites, wide variation in implementation exists. Guided by the Consolidated Framework for Implementation Research (CFIR), this study sought to determine key barriers and facilitators that may influence CAPABLE implementation with older adult and care partner dyads through an area agency on aging (AAA). A formative evaluation was completed using qualitative data from the pilot of a Hybrid Trial Type 1 study implementing CAPABLE in an AAA. Multiple sources of data were collected, including 2 focus groups, field notes, a tracking log, and meetings with CAPABLE interventionists. Data were analyzed using a framework method and validated through a negative case analysis approach in NVivo 12 Pro. Fourteen dyads enrolled in the pilot and 6 completed the CAPABLE intervention. Key themes aligned with 10 constructs from 5 domains of the CFIR. Facilitators included adaptability of the intervention, cost, networks and communication, and knowledge and belief of individuals. Barriers included intervention complexity, client needs and resources, and executing the planned process. Results enhance understanding of contextual factors that can influence the implementation of CAPABLE with care partners. Strategies to overcome barriers include simplifying recruitment materials and targeting older adults with recent onset of disability. The CFIR is a valuable resource for planning and evaluation of the implementation of evidence-based interventions to promote aging in place.

Meeting Older Adults’ Food Needs: Interviews with Area Agency on Aging Staff, Food Bank Staff, and Older Adults

Area Agencies on Aging (AAAs) and food banks provide nutritious food for in-need older adults. The objective of this study was to identify successes, challenges, and opportunities associated with meeting the food needs of older adults. We used semi-structured telephone interviews with AAA nutrition staff (n = 5), food bank program coordinators (n = 5) and executives (n = 6), and older adults (n = 60) in Iowa. AAAs and food banks identified providing healthy food and client satisfaction as successes and funding and staff/volunteer capacity as challenges. Before the pandemic, the relationships between these organizations were limited, but both saw opportunities for collaboration. Older adults described coordination between AAAs and food banks during the COVID-19 crisis. AAAs and food banks play an important role in meeting older adults’ food needs, but their effectiveness is limited by challenges related to funding and capacity. There is a need to identify feasible and sustainable strategies for collaboration past this crisis.