Caregiver Health Research Articles

Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review.

Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.

Caregivers' Burden and Mental Health of the Caregivers of β-Major Thalassemia Patients: Mediating Role of Religious Coping

Background: Caregiver burden among those caring for patients with thalassemia major in Pakistan poses significant psychological challenges. The role of religious coping mechanisms in alleviating psychological distress and enhancing well-being among caregivers has been highlighted in prior research, suggesting a complex interplay between caregiver strain, coping strategies, and mental health outcomes. Objective: This study aims to investigate the relationships between caregiver burden, positive religious coping, and mental health outcomes, specifically psychological well-being and distress, among caregivers of thalassemia patients in the Twin cities of Islamabad and Rawalpindi. Methods: Employing a cross-sectional design, the study included 180 caregivers of thalassemia patients, recruited through non-probability purposive sampling from major thalassemia centers and hospitals in Islamabad and Rawalpindi. Data were collected using the Zarit Caregiver’s Burden Scale, the Brief Religious Coping Scale, and the Mental Health Inventory. Structural Equation Modeling (SEM) was utilized to analyze the data, using SPSS and AMOS software, with a focus on the mediating role of positive religious coping between caregiver burden and mental health outcomes. Results: The analysis revealed that caregiver burden significantly predicted the use of positive religious coping (β = .32, p < .001) and was negatively associated with psychological well-being (β = -.33, p < .001) while positively associated with psychological distress (β = .23, p < .01). Positive religious coping positively influenced psychological well-being (β = .28, p < .01) and negatively influenced psychological distress (β = -.21, p < .05). The model explained 38.2% of the variance in psychological well-being and 34.1% in psychological distress. Conclusion: The findings underscore the significant impact of caregiver burden on the mental health of caregivers, with positive religious coping serving as a beneficial mediating factor. Enhancing positive religious coping among caregivers may be a viable intervention strategy to improve their mental health outcomes.

Caregiver and Child Mental Health During 3 Years of the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19) lockdowns (stay-at-home orders) had significant mental health consequences in 2020 to 2021 for caregivers and children. Little is known about "postlockdown" periods in 2022 to 2023. We investigated the mental health experiences of Australian families throughout the 3 years of the COVID-19 pandemic (2020-2023), by demographic characteristics and lockdown length. A total N = 12 408 caregivers (N = 20 339 children, aged 0-17 years) completed Australia's only representative, repeated, cross-sectional, National Child Health Poll across 6 waves (June 2020-April 2023). Caregivers reported mental health for themselves (Kessler-6, poor versus not) and each child (self-rated mental health, poor/fair versus good/very good/excellent), and perceived impacts of the pandemic on own/child mental health (negative versus none/positive). Binary logistic models were fitted to predict marginal probabilities of each mental health measure by state/territory group (proxy for lockdown length), over time, adjusted for potential demographic confounders. Poor caregiver Kessler-6 was similar between genders but more common for sole caregivers, and those with a home language other than English and lower education. Poor/fair child self-rated mental health was similar between genders and increased with child age. Perceived negative impacts were more common for females and socially advantaged caregivers. Overall, negative mental health experiences increased with lockdown length, peaking with the height of lockdown in July 2021, before declining. Negative mental health experiences of Australian caregivers and children decreased during postlockdown periods of 2022-2023; however, social gradients persisted. These data can inform more precise mental health policies that enable better use of limited mental health infrastructure.

Impact of Children with Disability on Caregivers: A Cross-sectional Study in Rural Area of Jammu, UT of Jammu and Kashmir, India

Introduction: Children who are born with disability, more so intellectual disability are dependant on their parents for their daily needs. The presence of disabled child in the family adds to the caregiver burden which may read to emotional distress manifesting as anger, depression, stigma, etc. The study aimed to assess both the positive and negative impacts of having a disabled child in the family on caregivers. Methodology: The present, cross-sectional study was conducted in a rural area of Jammu district using simple random sampling, two health zones out of eight were selected for the conduct of the study. All the disabled children were identified and their parents were interviewed using National Institute of Mental Health-Disability Impact Scale Scale after taking an informed consent from them (IECGJ)(NO: IEC/GMC/2019/892). Results: During the course of the study, a total of 101 caregivers of disabled children were interviewed. Both negative and positive impact on the caregivers was found to be in close approximation to the tune of 15%–16%. Among the negative impacts, financial burden was the most dominant domain followed by physical care of the child and caregiver health being affected. Conclusion: It would be pertinent to conclude that we need to empower the caregivers as an important step for the inclusion of these special children in the society. In this context, few recommendations have been discussed in the present study.

Families' Perspectives on Social Services Navigation After Pediatric Urgent Care.

Interest is growing in clinic-based programs that screen for and intervene on patients' social risk factors, including housing, food, and transportation. Though several studies suggest these programs can positively impact health, few examine the mechanisms underlying these effects. This study explores pathways through which identifying and intervening on social risks can impact families' health. This qualitative study was embedded in a randomized clinical trial that examined the health impacts of participation in a social services navigation program. We conducted semi-structured interviews with 27 English or Spanish-speaking caregivers of pediatric patients who had participated in the navigation program. Interviews were analyzed using thematic analysis. Caregivers described 3 pathways through which the navigation program affected overall child and/or caregiver health: 1) increasing families' knowledge of and access to social services; 2) helping families connect with health care services; and 3) providing emotional support that reduced caregiver isolation and anxiety. Participants suggested that navigation programs can influence health even when they do not directly impact resource access. Social care programs may impact health through multiple potential pathways. Program impacts seem to be mediated by the extent to which programs increase knowledge of and access to social and health care services and support positive relationships between families and program personnel.

Assessing the mediating role of family resilience between caregiver burden and caregiver capacity: a cross-sectional study among Chinese stroke survivors and family caregivers in a real-world setting

ObjectivesTo investigate the relationships among caregiver burden, family resilience, and caregiver capacity in the care of stroke survivors. We hypothesised that family resilience would mediate the relationship between caregiver burden...

The benefits of mobile caregiver support team consultations

While it's obvious these days to turn to a healthcare professional in the event of suffering, it's less so when the caregiver (or family) accompanying a sick person is experiencing difficulties. Indeed, those close to the patient often don't think about seeking help, or don't know where to turn for support. This article looks at the situation of Mr. N., his journey and the questions raised by the new role he has taken on, and describes the work of the mobile caregiver support team. Through its consultations, this team aims to promote caregiver health through prevention.

Individual and systemic variables associated with prolonged grief and other emotional distress in bereaved children.

Most children confronted with the death of a loved one do not experience persisting psychological problems. However, for some, acute grief reactions develop into prolonged grief disorder (PGD) and other mental health problems. Research findings suggest that bereavement outcomes in children are associated with negative cognitions and avoidant coping and with different parenting behaviours. However, knowledge about factors influencing grief in children is still limited and few studies have examined the relative impact of psychological (individual-level) variables and systemic (family-level) variables in affecting their responses to loss. The aim of the current study was to examine the association of different bereavement outcomes in 8-18 year old children (including levels of self-rated PGD, depression, and posttraumatic stress (PTS)) with sociodemographic variables, individual-level variables (including negative cognitions and anxious and depressive avoidance), and family-level variables (including the severity of caregiver's PGD, depression, and anxiety, and indices of parenting behaviours, rated both by children and by their caregivers). Questionnaire data were used from 159 children plus one of their caregivers, gathered as part of the pre-treatment assessment in a randomized controlled trial. Results showed that most of the children's bereavement outcomes, including PGD severity and PTS severity, were associated with indices of negative cognitions and avoidance behaviours. Caregiver's depression and anxiety showed a very small, yet significant, association with two children's outcomes. Caregiver-rated reasoning/induction (one index of parenting behaviours) showed a small association with children's PTS-related functional impairment. Exploratory analyses indicated that the linkage between parenting behaviour and children's outcomes may be moderated by whether the behaviour comes from father or mother. This is one of the first studies examining how individual cognitive behavioural variables plus the mental health of caregivers and indices of parenting may affect PGD and other outcomes in bereaved children. The findings provide tentative indications that individual and family-level variables influence these outcomes, albeit that more research is urgently needed.

Decision support framework for home health caregiver allocation using optimally tuned spectral clustering and genetic algorithm

Population aging is a global challenge, leading to increased demand for health care and social services for the elderly. Home Health Care (HHC) is a vital solution to serve this segment of the population. Given the increasing demand for HHC, it is essential to coordinate and regulate caregiver allocation efficiently. This is crucial for both budget-optimized planning and ensuring the delivery of high-quality care. This research addresses a fundamental question in home health agencies (HHAs): “How can caregiver allocation be optimized, especially when caregivers prefer flexibility in their visit sequences?”. While earlier studies proposed rigid visiting sequences, our study introduces a decision support framework that allocates caregivers through a hybrid method that considers the flexibility in visiting sequences and aims to reduce travel mileage, increase the number of visits per planning period, and maintain the continuity of care – a critical metric for patient satisfaction. Utilizing data from an HHA in Tennessee, United States, our approach led to an impressive reduction in average travel mileage (up to 42%, depending on discipline) without imposing restrictions on caregivers. Furthermore, the proposed framework is used for caregivers’ supply analysis to provide valuable insights into caregiver resource management.

Preliminary Impact of Group-Based Interventions on Stigma and the Mental Health of Caregivers of Adolescents Living with HIV in Uganda.

This study examined the preliminary impact of group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family groups (MFG-FS) on HIV stigma, parenting stress, and the mental health of caregivers of adolescents living with HIV. We analyzed data from the Suubi4Stigma study (2020-2022), a two-year pilot randomized clinical trial for adolescents and their caregivers (N = 89 dyads), recruited from nine health clinics in Uganda. Adolescent-caregiver dyads were randomized to three intervention conditions delivered over three months, with data collected at baseline, three and six-months follow-up. We fitted mixed-effects linear regression models to test the effect of the interventions on caregiver outcomes over time. At six months, caregivers randomized to the MFG-FS condition reported lower levels of stigma by association (mean difference = -1.45, 95% CI = -2.52 - -0.38, p = 0.008), and stigma and discrimination attitudes (mean difference = -3.84, 95% CI = -4.63 - -3.05, p < 0.001), compared to Usual care condition. In addition, caregivers of adolescents randomized to the G-CBT condition reported lower levels of stigma and discrimination attitudes at three months (mean difference = -5.18, 95% CI = -9.13 - -1.22, p = 0.010), and at six months (mean difference = -6.70, 95% CI = -9.28 - -4.12, p < 0.001). Caregiver mental health and parenting stress significantly reduced over time regardless of intervention condition. Findings point to the importance of incorporating stigma reduction components within psychosocial interventions targeting adolescents and families impacted by HIV.

Health literacy as mediator between perception of illness and self-medication behaviour among outpatients in the Kingdom of Saudi Arabia: implication to primary healthcare nursing

IntroductionPerception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA).MethodsThis study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023.ResultsThe mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001).ConclusionHealth literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it.

Mental health of family caregivers: does the complimentary roles of personality trait, social support and resilience matter?

Mental health of family caregivers: does the complimentary roles of personality trait, social support and resilience matter?

A peer mentoring program for Chinese American dementia caregivers: a pilot randomized controlled trial

Objectives A large gap exists in the development of culturally sensitive interventions to reduce stress related to dementia care among Chinese Americans, one of the fastest growing minority populations in the United States. We developed and pilot tested the feasibility and preliminary efficacy of a peer mentoring program for Chinese American dementia caregivers. Method A pilot randomized controlled trial was conducted among 38 Chinese American caregivers in New York City. Four outcome variables—caregiving competence, loneliness, caregiver burden, and depressive symptoms—were measured at baseline and 3-month and 9-month follow-ups. The study protocol and preliminary results are available at clinicltrial.gov [NCT04346745]. Results The feasibility of the intervention was high, as indicated by an acceptable retention rate, fidelity, and positive feedback from caregivers and mentors. Compared with the control group, the intervention group had greater reductions in scores for loneliness at 3-month follow-up and for caregiver burden and depressive symptoms at 9-month follow-up. We did not find significant differences in caregiving competence between the two groups. Conclusion The results indicated the high feasibility and potential efficacy of empowering existing human resources of experienced caregivers in the same ethnic community to improve the mental health of Chinese caregivers. Further research is needed to test the efficacy in a larger sample of this population.

Kinship and Care: Racial Disparities in Potential Dementia Caregiving in the United States From 2000 to 2060.

Although the family plays a pivotal role in older adults' care, there is limited research on how evolving demographic trends affect older adults' support networks and how the trends vary by race. To fill this gap, we examine the influence of shifting family demographics on future care needs for older adults with dementia, emphasizing the unequal health and potential caregiving burdens by race in the United States. Using demographic models of kinship, we estimate the availability of potential caregivers, and dementia prevalence among one's kin by race, kin type, and the age of a focal person from 2000 to 2060. We introduce an index called the Dementia Dependency Ratio to assess dementia caregiving demands at the population level, taking into account the age and kinship structure of the population. Our findings suggest that Black individuals tend to have more children, grandchildren, and nieces/nephews as they age. However, Black individuals also tend to have more kin with dementia compared to their White counterparts. This elevated prevalence of dementia among Black kinship networks counterbalances the advantage of having more kin as potential caregivers. A further projection analysis suggests that the racial gap in caregiving demand within the kinship network will widen in the next 4 decades if the racial gap in dementia prevalence remains unchanged. These findings emphasize the urgency of reducing racial inequality in dementia prevalence rates and increasing public support for families with extended members affected by dementia. With the shrinkage of nuclear families and population aging in the next few decades, extended family members may undertake more caregiving responsibilities for dementia. We call for a kinship perspective in understanding dementia care in future research.

Opportunities in Mental Health Support for Informal Dementia Caregivers Suffering from Verbal Agitation

People with dementia (PwD) often present verbal agitation such as cursing, screaming, and persistently complaining. Verbal agitation can impose mental distress on informal caregivers (e.g., family, friends), which may cause severe mental illnesses, such as depression and anxiety disorders. To improve informal caregivers' mental health, we explore design opportunities by interviewing 11 informal caregivers suffering from verbal agitation of PwD. In particular, we first characterize how the predictability of verbal agitation impacts informal caregivers' mental health and how caregivers' coping strategies vary before, during, and after verbal agitation. Based on our findings, we propose design opportunities to improve the mental health of informal caregivers suffering from verbal agitation: distracting PwD (in-situ support; before), prompting just-in-time maneuvers (information support; during), and comfort and education (social &amp; information support; after). We discuss our reflections on cultural disparities between participants. Our work envisions a broader design space for supporting informal caregivers' well-being and describes when and how that support could be provided.

Relationship between Depressive Symptoms, Caregiver Strain, and Social Support with Dementia Grief in Family Caregivers.

Background and Objectives: Dementia grief in family caregivers of people with dementia refers to grieving prior to the death of the care recipient. It is related to psychosocial risk factors that may have a negative impact on the health of these family caregivers. This study aimed to describe the relationship between depressive symptoms, caregiver strain, and social support with dementia grief in family caregivers of people with dementia. Materials and Methods: A descriptive correlational cross-sectional study was conducted. A total of 250 family caregivers of people with dementia participated. Dementia grief was the main variable, and depressive symptoms, caregiver strain, and social support were assessed. Additionally, socio-demographic data were collected. Descriptive statistics were calculated, and a bivariate correlation analysis and a multiple linear regression analysis were performed for dementia grief. Results: Higher scores for dementia grief were found in women, in family caregivers of patients at advanced stages of dementia, and in family caregivers with a low level of education. High levels of depressive symptoms and caregiver strain and low levels of social support indicated greater intensity of dementia grief. Depressive symptomatology was the variable with the greatest influence on dementia grief. Caregiver strain and social support also related to dementia grief, but to a lesser extent. Conclusions: In family caregivers, depressive symptoms, caregiver strain, and social support are related to the intensity of dementia grief, with a greater influence of depressive symptoms. Moreover, being female, having a low level of education, and caring for a care recipient at an advanced stage of dementia are factors associated with increased dementia grief. Concerning study limitations, the sample was restricted, belonging to a specific region of Spain and to a Provincial Federation of associations. It is necessary to exercise caution in generalizing results due to the sociodemographic and geographical characteristics of the sample.

The Olera.care Digital Caregiving Assistance Platform for Dementia Caregivers: Preliminary Evaluation Study.

The increasing prevalence of Alzheimer disease and Alzheimer disease-related dementia in the United States has amplified the health care burden and caregiving challenges, especially for caregivers of people living with dementia. A web-based care planning tool, Olera.care, was developed to aid caregivers in managing common challenges associated with dementia care. This study aims to preliminarily evaluate the quality and usability of the Olera.care platform and assess the preferences of using the technology and interests in learning about different older adult care services among caregivers. For interview 1, we aim to understand caregiving needs and let the participants start engaging with the platform. After they engage with the platform, we schedule the second interview and let the participants complete the Mobile Application Rating Scale. The survey also included sociodemographic characteristics, caregiving experiences, communication preferences in technology adoption, and older adult care service use and interests. Descriptive statistics were used to describe the quality and usability of the platform and characteristics of the participants. We conducted 2-sample 2-tailed t tests to examine the differences in the Mobile Application Rating Scale evaluation scores by caregiver characteristics. Overall, 30 adult caregivers in Texas completed the evaluation. The majority were aged ≥50 years (25/30, 83%), women (23/30, 77%), White (25/30, 83%), and financially stable (20/30, 67%). The Olera.care platform evaluation showed high satisfaction, with an overall mean rating of 4.57 (SD 0.57) of 5, and scored well in engagement (mean 4.10, SD 0.61), functionality (mean 4.46, SD 0.44), aesthetics (mean 4.58, SD 0.53), and information quality (mean 4.76, SD 0.44) consistently across all participants. A statistically significant difference (P=.02) was observed in functionality evaluation scores by duration of caregiving, with caregivers dedicating more hours to care rating it higher than those providing less care (mean 4.6, SD 0.4 vs mean 4.2, SD 0.5). In addition, caregivers with less caregiving experience reported significantly higher evaluation scores for aesthetics (P=.04) and information quality (P=.03) compared to those with longer years of caregiving. All participants expressed a willingness to recommend the app to others, and 90% (27/30) rated the app overall positively. Most of the participants (21/30, 70%) favored anonymous interactions before receiving personalized feedback and preferred computer browsers over mobile apps. Medical home health services were the most used, with a diverse range of services being used. Caregiver support groups, medical providers, memory care, meal services, and adult day care were among the most desired services for future exploration. The Olera.care web-based platform is a practical, engaging, easy-to-use, visually appealing, and informative tool for dementia caregivers. Future development and research are essential to enhance the platform and comprehensively evaluate it among a broader population.

Family/caregiver influence on osteoporosis management for older people: an integrative review.

An integrative literature review was conducted to understand family/caregiver influence on osteoporosis management for older people. Findings include caregivers' overprotection, caregivers' risks for fragility fractures due to caregiving role, poor bone health in caregivers, and caregivers' burden and facilitators. Caregivers should be included in bone health and discharge planning. Literature on family/caregiver influence on osteoporosis management for older people is sparse. Older people are prone to osteoporosis and fragility fractures due to their age, often triggering the need for a caregiver after experiencing a fragility fracture. These fractures pose significant costs to the patient and health systems and are projected to increase with the aging population. This study applied an integrative literature review methodology to key literature findings on family/caregiver influence on osteoporosis management for older people. Key findings include caregivers' tendency to overprotect persons who experience hip fracture by limiting mobilization, thus impeding recovery, caregivers' risks for their own fragility fractures due to the demands of their caregiving role, risks of poor bone health in caregivers, and caregivers' experience of significant burden for which facilitators have been identified. Family caregivers of older people with osteoporosis have unique needs and require support and resources, especially after their loved one experiences a hip fracture. Informal caregivers must be considered in bone health education and discharge planning. They should be considered in the creation of osteoporosis guidelines and within the work of fracture liaison services. More research is needed to increase understanding about family caregiver influence on osteoporosis management.

Interventions Effective in Decreasing Burden in Caregivers of Persons with Dementia: A Meta-Analysis.

Introduction: Chronic non-communicable diseases, including diseases of mental origin such as Alzheimer's, affect all age groups and countries. These diseases have a major impact on the patient and their family environment. It is interesting that different questionnaires are measured in the same direction, given that different health questionnaires are used to measure caregiver burden. Objectives: To identify which type of intervention is the most appropriate to improve the health of the primary caregiver in patients with dementia. To understand the role played by the nurse within multidisciplinary teams and to know whether the different questionnaires used in the studies measure caregiver health in the same direction. Methods: A systematic search of the published and gray literature was carried out without restriction of the language used in the studies. Caregiver burden of patients with dementia, receiving an intervention to improve caregiver burden, was assessed. Standardized mean difference was used as the effect size measure, and there were possible causes of heterogeneity in the effect size. Results: In total, 1512 records were found, and 39 articles with 4715 participants were included. We found individual information with an effect of 0.48 (CI95%: 0.18; 0.79; I2 = 0%); group therapy with an effect of 0.20 (CI95%: 0.08; 0.31; I2 = 6%); workshops with an effect of 0.21 (CI95%: 0.01; I2 = 48%) and 0.32 (CI95%: 0.01; 0.54; I2 = 0%) when a nurse intervenes; respite care with an effect of 0.22 (CI95%: 0.05; 0.40; I2 = 66%); individual therapy with an effect of 0.28 (CI95%: 0.15; 0.4; I2 = 68%); and support groups with an effect of 0.07 (CI95%: 0; 0.15; I2 = 78%). Conclusions: The magnitude of the effects of the interventions has been low-moderate. Different instruments are not associated with the magnitude of the effect. The presence of nurses improves the effect of the intervention on caregivers when it is carried out in the form of workshops.

Understanding the implementation and sustainability needs of evidence-based programs for racial and ethnic minoritized older adults in under-resourced communities with limited aging services

BackgroundEvidence-based programs (EBPs) for older adults effectively improve health outcomes. However, there is a limited understanding of the unique needs of service providers as they consider adopting, implementing, and maintaining programs for older minority adults in low-income communities with limited aging services.MethodsWe conducted semi-structured interviews with key informants of community-based organizations (CBOs) to understand implementation and sustainability needs of CBOs within four racial and ethnically diverse Los Angeles County geographic areas. We performed thematic analysis of interview transcripts.ResultsInterviews were conducted with representatives from 25 senior-serving agencies providing aging-related EBPs. CBO representatives reported implementing EBPs in 8 domains: Falls Prevention (68%), Mental Health (64%), Caregiver Health (48%), Chronic Disease Management (48%), Diabetes Management (36%), Arthritis Management (28%), Physical Activity (24%), and Multiple Conditions Management (8%). Themes are presented using the six domains of the Bass and Judge framework for factors impacting successful and sustained EBP implementation. CBOs in low-income and diverse communities described unique challenges with tailoring interventions based on local community context (literacy, language), cultural context, and locally available resources (technology, safe community spaces, transportation) and faced resource-intensive administrative burdens through staff turnover, data collection, sustainable funding, and networking.ConclusionsServing racial and ethnic communities has unique challenges that require tailored approaches and additional resources to ensure equitable access to EBPs for all communities. We describe suggestions for enhancing the effective adoption of EBPs among service agencies in under-resourced and diverse aging communities serving populations with aging-related health disparities.