Senior Community Research Articles

Addressing ‘difficulty in dining’ among older adults: optimizing community senior dining halls from external and internal built environments

Many developed and developing countries, including China, are facing the challenges of the aging population. One such challenge is the difficulty for some older adults to access nutritious hot meals to maintain their health and well-being. Community-based senior dining halls (CSDHs) providing low-cost meals for older adults are a widespread model across China and neighboring countries, which aim to cater to the dining needs of older adults within local communities. However, most CSDHs face financial difficulties due to low dining volume. Hence, understanding how built environment characteristics are associated with the dining volume can potentially increase the dining volume and financial sustainability of CSDHs in the long run. This study analyzed the association between the dining volume and both the external and internal built environment of 50 CSDHs in Guangzhou, China. By using multiple linear regression models with three different buffer sizes (400 m, 600 m, and 800 m), we found that 1) among the external built environment characteristics, floor area ratio (FAR) and distance to the nearest subway station are negatively linked to the dining volume; 2) among the internal built environment characteristics, floor level is negatively associated with dining volume, whereas availability of dine-in seating and water dispenser, and number of seats are positively associated with it. Hence, a well-designed external and internal built environment of CSDHs may increase dining volume, enhance social interaction among older adults, and support community-based senior care.

Community Senior Center Intervention to Address Factors Related to Memory Screening Engagement.

There are many individual and societal benefits to screen older adults for memory problems. Four theoretically derived psychosocial factors are predictive of dementia screening intention: perceived benefits, perceived susceptibility, self-efficacy, and knowledge about memory. The current study tested whether these factors could be modified with an educational memory screening intervention given in community senior centers. An educational presentation was designed to address these factors by increasing knowledge about memory and aging, discussing the benefits of screening and older adults' susceptibility to memory issues, and increasing self-efficacy by teaching about the memory screening process, discussing a vignette, and fielding participants' questions. The educational presentation was offered four times at three community senior centers. Quantitative data on the psychosocial factors were collected before and after the presentation from 44 older adult participants (age M = 78.70, SD = 7.21). Narrative data on satisfaction and feedback about the intervention were collected. Hierarchical linear modeling analyses were performed to measure change from pre- to post-presentation and follow-up 1 to 2 weeks after the intervention. The educational presentation effectively increased knowledge about aging memory, perceived benefits of screenings, and self-efficacy to seek screening. The presentation intervention was well received by community participants. Results provide guidance about how an intervention based in community senior centers can be refined to address factors predictive of memory screening intention in older adults.

Eliciting Clinician Perspectives on Asymptomatic Bacteriuria to Identify Targets for Antimicrobial Stewardship Education and Decision Support.

The aim of this study was to elicit clinicians' perspectives to help reduce antibiotic prescribing for asymptomatic bacteriuria and improve a patient-centered educational brochure for older adults with urinary tract infections or asymptomatic bacteriuria. Between October 2023 and April 2024, we conducted semi-structured qualitative interviews of clinicians who treat patients aged ≥65 years for urinary tract infections or bacteria in the urine, at infectious disease clinics, community senior living facilities, memory care clinics, and general practice. We developed an interview guide based on a behavior change framework and thematically analyzed written transcripts of audio-recorded interviews using inductive and deductive coding techniques. We identified several common themes surrounding management of asymptomatic bacteriuria from clinicians. These included an emphasis on ordering and interpreting urine tests, tension between guidelines and individual patient care for older adults, use of epidemiologic data to influence prescribing practices, pre-prepared communication talking points, and interest in educational materials for patients and clinical teams. Education about the need for symptoms to supplement urine testing, data about the impact of overuse of antibiotics, and oral and written communication strategies should be addressed to reduce antibiotic prescribing for asymptomatic bacteriuria.

Revisiting the Extended IoT Use Behavior Model Among Senior NCD Patients for Smart Healthcare in Malaysia

The growth of the senior population and the rise in chronic illnesses such as non-communicable diseases (NCDs) are placing significant strain on modern healthcare systems. The demand for resources from hospital beds to doctors and nurses is high in Upper-Middle-Income countries like Malaysia. The use of IoT technologies can give aged people at home uninterrupted access to healthcare resources and better control over their health. This study aims to analyze the key antecedents of the actual behavior of IoT technologies among aged NCD patients in Malaysia under a framework covering the unified theory of acceptance and use of technology model, technology acceptance model, and theory of planned behavior. This cross-sectional study used a purposive sampling technique and data were analyzed using SmartPLS. The outcome is expected to help the government and healthcare policymakers develop awareness among the senior community on the use of IoT-based smart wearables for routine self-monitoring of NCDs.

The Effects of Tai Chi Rouli Ball Exercise on Bone Mineral Content and Bone Metabolism Indicators in Perimenopausal Women

Background Perimenopause is associated with a decline in estrogen levels, leading to decreased bone mineral density (BMD) and altered bone metabolism, increasing the risk of osteoporosis. Tai Chi Rouli Ball, a traditional Chinese sport, is thought to have beneficial effects on physical health, but its impact on bone health in perimenopausal women is not well understood.Methods This study involved a randomized controlled trial with 52 perimenopausal women aged 45–55 years from community senior centers. Participants were divided into two groups: the Tai Chi Rouli Ball group and the control group. Baseline assessments of bone density, bone mineral content (BMC), and bone metabolism markers, including estrogen levels, were conducted. The Tai Chi Rouli Ball group underwent regular training for a specific period, while the control group did not receive any intervention. Post-experiment assessments were then compared to the baseline.Results Post-intervention, the Tai Chi Rouli Ball group showed a significant increase in spine bone density and BMC in various body parts, including the whole body, trunk/torso, and spine, compared to the control group. Bone metabolism indicators also improved, with increased levels of estrogen and a decrease in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Calcium levels showed a significant increase, while other markers like alkaline phosphatase (ALP), phosphorus (P), and magnesium (Mg) had non-significant changes.Conclusions Tai Chi Rouli Ball exercise may positively influence bone health by improving bone density, BMC, and altering bone metabolism markers in perimenopausal women. These findings suggest that Tai Chi Rouli Ball could be a viable non-pharmacological approach to prevent osteoporosis in this demographic.

Knowledge interface co-design of a diabetes and metabolic syndrome initiative with and for Aboriginal people living on Ngarrindjeri country

ObjectivesThis research program involves two phases to identify enablers and barriers to diabetes care for Aboriginal people on Ngarrindjeri country; and co-design a strength-based metabolic syndrome and Type 2 Diabetes (T2D) remission program with the Ngarrindjeri community. Study designA study protocol on qualitative research. MethodsThe study will recruit Aboriginal people living on Ngarrindjeri country above 18 years of age with a diagnosis of metabolic syndrome or T2D. Recruitment for phases one and two will occur through the Aboriginal Health Team at the Riverland Mallee Coorong Local Health Network. The lived experiences of T2D will be explored with 10–15 Aboriginal participants, through an Aboriginal conversational technique called ‘yarning’ (60–90 min) in phase 1. Elders and senior community representatives (n = 20–30) will participate in four co-design workshops (2–4 h) in phase 2. Qualitative data will be transcribed and thematically analysed (NVivo version 12). The analysis will focus on protective factors for the Cultural Determinants of Health. Ethics approval was obtained from Aboriginal Health Research Ethics Committee in South Australia (04-22-1009), and Flinders University Human Research Ethics Committee (5847). ResultsThis work will be used to pilot the co-designed diabetes remission trial. Outcomes will be published in peer-reviewed journals, presented at conferences, focusing on following best practice guidelines from the Australian Institute of Aboriginal and Torres Strait Islander Studies and National Health and Medical Research Council. Research translation will occur through digital posters, manuals, and infographics. ConclusionsThe findings will be summarised to all Aboriginal organisations involved in this study, along with peak bodies, stakeholders, Aboriginal Services, and interested participants.

Social participation among residents of serviced housing for older people versus community-dwelling older people in Japan: a propensity score matching analysis

Abstract Aim Housing has a significant impact on the health, safety, and social participation of older individuals. Japan’s Serviced Housing for Older People (SHOPs) is one such model that provides supportive services and accessible living spaces. Method This cross-sectional study examined the relationship between living in SHOPs with social activity programs (SAPs) and levels of social participation. We conducted a self-reported survey of SHOP residents and compared the proportions of participants who participated in social activities in the SHOP with a control group of community-dwelling older people selected from the Japan Gerontological Evaluation Study using propensity score matching. Results The survey obtained responses from 189 eligible participants. SHOP residents were primarily female, older, educated, unmarried, and had a better financial status than the control group. SHOP residents (n = 143) were 2.57 times more likely to exercise (p < 0.001), 1.62 times more likely to participate in hobbies (p = 0.004), and 4.37 times more likely to participate in learning activities (p < 0.001) than the control group (n = 398). However, volunteering, senior citizen clubs, neighborhood associations, and community gathering places participation did not differ significantly between the SHOP and control groups. Conclusion The findings suggest that SHOPs with SAPs have the potential to promote social participation and healthy aging among older people.

Unemployed, Immigrant, and Older Asian Workers in a U.S.-Based Job-Training Program: Their Experiences and Well-Being, and Strategies for Reaching This Important Population

ABSTRACT The Senior Community Service Employment Program (SCSEP) is a U.S.-based job-training program that serves unemployed workers aged 55 and older with incomes at or below 125% of the federal poverty level. While federal funds are set aside to serve Asian workers in SCSEP, little is known about their characteristics and experiences. In response, this pilot study aimed to document the health, well-being, and experiences of older Asian SCSEP participants in Massachusetts through the completion of a survey. Respondents (N = 39) ranged in age from 58 to 73 and identified as either Chinese (72%) or Vietnamese (28%). All were immigrants, and almost all spoke a language other than English at home. Most reported “good” health as well as financial difficulties. They also stated that their supervisors in their placements were supportive. On average, respondents noted moderate interest in searching for a paid job after exiting SCSEP, although more reported interest in searching for a volunteer role. Key to the success of this study was a robust collaboration with a local human services organization with strong ties to the Chinese and Vietnamese communities. The findings highlight the importance of this growing group of older workers.

Senior Community Service Employment Program National Grants Competition (DOL)

Senior Community Service Employment Program National Grants Competition (DOL)

Recruiting a prospective community cohort to study Alzheimer's disease and structural and social determinants of health among adults racialized as Black: The ARCHES cohort.

This ongoing, prospective study examines the effectiveness of methods used to successfully recruit and retain 238 Black older adults in a longitudinal, observational Alzheimer's disease (AD) study. Recruitment strategies included traditional media, established research registries, speaking engagements, community events, and snowball sampling. Participants were asked to complete an annual office testing session, blood-based biomarker collection, optional one-time magnetic resonance imaging (MRI) scan, and community workshop. Within the first 22 months of active recruitment, 629 individuals expressed interest in participating, and 238 enrolled in the ongoing study. Of the recruitment methods used, snowball sampling, community events, and speaking engagements were the most effective. The systemic underrepresentation of Black participants in AD research impacts the ability to generalize research findings and determine the effectiveness and safety of disease-modifying treatments. Research to slow, stop, or prevent AD remains a top priority but requires diversity in sample representation. Provide flexible appointments in the evening or weekends, offering transportation assistance, and allowing participants to complete study visits at alternative locations, such as senior centers or community centers.Continuously monitor and analyze recruitment data to identify trends, challenges, and opportunities for improvement.Implement targeted strategies to recruit participants who are underrepresented based on sex, gender, or education to increase representation.Diversify the research team to include members who reflect the racial and cultural backgrounds of the target population, to enhance trust and rapport with prospective participants.

Predicting the Intention to Adhere to Hypertensive Medication among Seniors: A Cross-Sectional Survey

Non-adherence to hypertension treatment is a wide problem, especially among senior citizens. Several approaches are needed to improve adherence, including identifying and prioritizing problems related to adherence. A formative study employing Theory of Planned Behavior (TPB) has revealed some salient beliefs underlying the intention to adhere to hypertension medication among seniors. To be the priority in a medication adherence strategy, the correlation of these beliefs on adherence needs to be further investigated. This study aims to determine which beliefs correlate most to the intention to hypertension medication adherence among seniors. A cross-sectional survey was conducted to seniors with hypertension in Yogyakarta and its surroundings. A questionnaire based on TPB was developed and utilized in this study. The questionnaire was distributed conveniently through two senior communities (offline) as well as Google Form link to some WhatsApp group of seniors (online) during September-October 2023. The data were analyzed using multiple linear regressions. Thirty-seven seniors completed the offline questionnaire, and 60 seniors completed the online questionnaire. The age of participants was 64.70 ± 7.123 years. Subjective norms and perceived behavioral control accounted significantly (p<0.001) for 59,3% of the variance in the adherence intention, but not attitude. Perceived behavioral control had the strongest correlation on intention. Participants’ beliefs of knowing how high their blood pressure was had the highest correlation to perceived behavioral control. Understanding which belief correlates most with intention to adherence provides insight to develop strategy to improve adherence among seniors.

Enriching Museum Collection with Virtual Design Objects and Community Narratives: Pop-up-VR Museum

In the Pop-up-VR Museum, a selection of design objects from the Design Museum collection can be explored as virtual reality experience together with stories and comments collected in workshops organized with senior communities and museum visitors amongst others. The collaboration between the museum and the Aalto University Department of Art and Media in the EU Horizon 2020 project SPICE (2020–2023), seeks to increase social cohesion and inclusion through cultural heritage. Using semantic tools designed and developed in the project, it studies ways to promote novel forms of “citizen curation” activities. The article discusses the co-design process between media designers, heritage professionals, and different user communities, with varying understandings and needs regarding museum data and Finnish design heritage. In the museum, community-based data raises practical as well as ethical issues. Also the new digital artifacts challenge existing systems: what and how should be preserved in the museum collection from the dialogue with the user that takes place in the Pop-up VR Museum and does this new data demand re-assessing earlier information and, how does should the process of creating new digital artifacts be documented and described.

Subjective memory complaints and medication adherence among hypertensive Korean older adults with multimorbidity: mediating effect of depression and social support

Background & Aim(s)Medication adherence (MA) is a key factor in maintaining adequate blood pressure and preventing complications. However, some older adults experience difficulties in taking medicine properly due to declines in cognitive function. Although subjective memory complaints (SMC) are recognized as early markers of cognitive impairment, previous studies concerning the relationship between MA and cognitive function have focused only on objective cognitive function. Furthermore, while depression has a high correlation with SMC, low MA, and social support, there is limited evidence on their relationship. This study aims to understand the effect of SMC on MA and the mediating effect of depression and social support.Method(s)This study is a descriptive cross-sectional investigation. A sample of 195 community-dwelling hypertensive older adults with multimorbidity from 3 community senior centers in Gwangju, South Korea were recruited through convenience sampling. Data was collected through face-to-face survey from January to March 2018. The PROCESS macro v4.2 program [Model 6] was used to analyze the mediating effect of depression and social support in the relationship between SMC and MA. Data analysis was performed using SPSS/WIN 26.0 and STATA MP 17.0.ResultsThe average MA was 6.74. There were significant differences in MA according to awareness of prescribed drugs, awareness of side effects, insomnia, and healthcare accessibility. SMC was positively correlated with depression, while social support and MA were negatively correlated. While depression was a significant mediator of the effect of SMC on MA, the mediating effect of social support was not significant. The multiple mediation effect of depression and social support was not significant.ConclusionThe results suggest that medication management of older adults in community settings should be accompanied by a comprehensive health assessment of associated factors. Health professionals should explore strategies to improve memory as well as prevent and alleviate depression to increase MA among hypertensive older adults with multimorbidity.

IT support for Senior Community Service Employment State and Territorial Grantees (DOL)

IT support for Senior Community Service Employment State and Territorial Grantees (DOL)

Mixed reality technology for older adults: Evaluating the impact of a novel virtual humanoid coach in a community-based physical exercise program in the Philippines.

Physical inactivity among older adults remains a global burden, leading to a variety of health challenges and even mortality. This study evaluated the impact of a novel virtual humanoid coach-driven physical exercise program among older adults. A non-randomized (quasi) experimental research was conducted in two community senior centers. The recruited participants (n = 130) were primarily female older adults with a mean age of 66.40 and agreed to be purposively assigned either experimental or control groups. Trained healthcare providers performed health assessments in three time points using valid and reliable tools. Descriptive statistics, t-tests, and RM-ANOVA were used to quantitatively analyze the data using SPSS version 22. There are significant mean differences between the groups across all functional capacity assessments and Time 2-3 assessment of sleep quality. RM-ANOVA revealed significant differences in physical assessment over time between the two groups. The analyses of time and group interaction revealed significant improvement in health assessments among the members of the mixed reality group compared to the traditional groups. The impact of virtual coaches in community-based enhancing physical activity programs is comparable to the traditional mode and introduces a novel approach to promoting physical activity among older adults.

Implementing a Senior Community Care Model: An Italian Top‐Down Cohousing Project and Nursing Home

Not ageing in place is an increasing reality for many older Europeans. For several decades societies have applied different care models in developing initiatives to provide safe and age-friendly spaces. This article presents the community care model implemented by the Italian service provider ISRAA in Treviso (Italy) in one of its nursing homes and senior cohousing projects. The aim of our study was to analyse this senior community care model and find out how residents have responded to it. Participants were both the older adult residents in the two ISRAA facilities and professionals responsible for their social attention. A qualitative methodology was used: questionnaire, interviews, and focus groups with professionals and care facility residents. Results reveal the care philosophy implemented, residents’ experiences, the main barriers to creating a community, and how this model could be improved by following community development principles, with the older people’s help, participation, and engagement. The conclusions highlight the importance of applying principles of self-determination and social inclusion in a preventive care model for the senior community. In addition, a key factor in promoting community development is for professionals to act as community development practitioners and to allow older adults to be part of the change.

Integrating Physical Media Education into Elderly Care Programs: A Case Study of Enhancing Well-being and Promoting High-Quality Life

This study examined the impact of media education for elderly care programs in China on the well-being and quality of life of elderly population. This study investigated how media education turned older population in techno-savvy and improved the well-being and quality of life of the elderly population. The objectives of the study were to bring forth the role played by media awareness of social media, to examine the challenges associated with it, and to recommend efficient strategies to promote the engagement of older adults in media education of social media and usage of media gadgets that helps them to be techno-savvy and improve their well-being. The qualitative methodology was used and data was collected through semi-structured interviews from a sample of 8 informants comprising caretakers working at Chinese old age homes and senior community centers. Following a thematic analysis, it was revealed that media education in elderly care programs potentially benefits older by improving their self- efficacy, social connectedness, and overall well-being. It was also found that media awareness of older adults significantly assisted them to be techno-savvy and enhanced high-quality life in them. Limited equipment, unwillingness, and inefficient technological knowledge were some significant challenges that hindered the proper integration of media education in elderly care programs. It was recommended that training sessions, workshops, and proper allocation of resources should be enhanced to get the potential benefits of media education for older adults. These outcomes have significant contributions for policy-makers and practitioners of old-age institutions. In addition, this study offers novel contributions to relevant literature within the context of China.

“Like a family”: Social relationships in senior community center

Resumen: El objetivo es analizar las relaciones sociales resignificadas “como en familia” en centros comunitarios. El estudio es una etnografía realizada en Paysandú, Uruguay, con 84 personas ancianas quienes viven solas, y que participaron en entrevistas individuales y en grupos focales. Para el análisis de las narrativas se utilizó análisis de discurso, análisis de metáforas y análisis de contenido. Los resultados muestran un proceso de resignificación de las relaciones entre compañeros en términos de relaciones familiares, cuyo sentido se sustentan en los significados y prácticas del sistema de parentesco consanguíneo. Esta resignificación es realizada por las mujeres ancianas, pero no por los ancianos varones. En base a los hallazgos, la familia continúa como un fuerte referente cultural entre estas mujeres ancianas, al resignificar relaciones entre extraños en términos de familia.

Usability and acceptance as facilitators of behavioral intention to use a mixed reality exercise program in older adults: A structural equation model

BackgroundStaying active has been one of the mainstays in promoting health in older adults. Despite the potential of innovative health technologies for fitness, there is limited understanding of the factors influencing older adults’ behavioral intention to engage in mixed reality physical exercise. PurposeTo develop a theoretical model of technology usability and acceptance influencing behavioral intention to use a mixed reality physical exercise program among older adults. DesignA cross-sectional study was conducted to develop a virtual exercise coach in a mixed-reality environment. Older adults (n = 64) were purposively selected from a community senior center in the Philippines and participated in the exercise program. Their responses were analyzed using a partial least square approach to structural equation modeling. ResultsThe generated measurement model demonstrated valid and reliable estimates. Its structural model (R2 = 0.64) had a good fit (GoF = 0.56) with consistent quality indices. It also indicated that performance expectancy, facilitating conditions, and information quality are significant (p < 0.05) factors explaining behavioral intention to use the virtual coach system among older adults. ConclusionThe belief in technology usefulness, trust, data quality, and the value of shared responsibility between the technology promoters and users significantly facilitates behavioral intention to use mixed reality virtual coach systems. The study results are valuable in developing technologies and improving older adult participation in technology-driven community health programs.

Exploration of Smart Elderly Service Supply and Demand Matching for Multi-source Data

Abstract Under the background of population aging, the rational use of resources for senior care services has more difficulty, leading to increasingly prominent conflicts between supply and demand. This paper uses the Gini coefficient, cohort effect, and other methods to build a matching supply and demand model for innovative senior care services based on the multi-source data of senior care services. The probabilistic linguistic term set is used for evaluation and a calculation method is proposed to match satisfaction. The model’s feasibility is demonstrated by analyzing arithmetic examples. Five types of senior care demand groups can be obtained through clustering analysis, with three kinds of intelligent senior care, namely, competent institutions, smart communities, and smart homes, in which the Gini coefficient value of community senior care facilities in X city is 0.4203, and there is an imbalance between supply and demand. The method proposed in this paper identifies five types of elderly groups, which can be matched with different innovative senior care services for elderly groups with distinct characteristics.