Senior Centers Research Articles

SENIOR CENTER RESPONSE TO COVID-19: INVOLVEMENT WITH VACCINE DISTRIBUTION

Abstract In early 2021, access to a COVID-19 vaccine was prioritized for older adults and people with multiple co-morbidities. Between high demand, emerging supply, and new systems for booking a vaccine appointment, many people had challenges getting an appointment. Senior centers became a crucial resource for access to the vaccine and additional information about its efficacy and safety. This poster presents survey data collected from 282 senior centers in Massachusetts regarding their involvement with the COVID-19 vaccine distribution in 2021. Nearly all senior centers reported making vaccine appointments on behalf of residents and were responsible for over 166,000 appointments made. Nearly 100,000 hours were spent by senior center staff or volunteers to make appointments. About a third of senior centers participated in hosting nearly 2,000 vaccine clinics, which vaccinated over 175,000 adults. Respondents reported challenges faced during the booking process, including the length of time and the developing technologies to book an appointment. Almost two-thirds of senior centers reported assisting community members under age 60, operating beyond the traditional scope of their services. Other assistance provided by senior centers included providing information about eligibility and guidelines (84%), information about vaccine efficacy and safety (62%), offering transportation to appointments (70%), and providing physical assistance for appointments (31%). Evidence from this poster emphasizes the important role that senior centers play in the community, not just for older adults but also for the community at large.

‘THEY ASKED ME TO JOIN; I JOINED:’ LESSONS FOR SENIOR CENTERS ON SUPPORTING PHYSICAL ACTIVITY

Abstract Among older adults, physical activity (PA) remains a foundation for maintaining and improving health. However, over 25% of adults aged ≥ 50 engage in no physical activity outside of work hours (CDC 2016). PA does correlate with senior center participation but little is known about the social factors that contribute to sustaining senior center PA routines. We report on findings from qualitative interviews conducted with Black older adults (Nf22) on the “story” of their senior center involvement, particularly their PA participation. Interviews were recorded and transcribed verbatim; co-authors independently conducted a line-by-line analysis to identify themes. They then reconciled and sorted themes. Four themes provided insights on participants’ PA engagement: 1) Retirement as opportunity; 2) Invitation and welcome; 3) Physician messaging; and 4) Sense of community. Participants strongly connected retirement with the opportunity to engage in regular PA; work and family obligations previously prevented PA in daily life. Participants also linked trying new PA programs to the senior center’s culture of extending one-to-one invitations. Physician messaging specifically “to exercise” provided additional validation for prioritizing senior center PA within daily schedules. Finally, a sense of community, of being missed if not attending, provided further incentive to sustain PA routines. These findings provide guidance and simple lessons that senior centers can employ to encourage participation in their PA programming. The themes may also inform the design of survey research examining patterns of PA among older adults.

SENIOR CENTER INVOLVEMENT WITH DEMENTIA-FRIENDLY COMMUNITIES: COMMUNITY AND ORGANIZATIONAL FACTORS

Abstract As local hubs for aging services, senior centers are well-positioned to engage in dementia-friendly community (DFC) work. Yet centers vary in their engagement, especially as the DFC concept has been introduced only recently in the US. Using a mixed-methods approach, we drew on data from a survey of senior centers in Massachusetts, the US Census, and qualitative interviews with senior center staff to examine factors associated with DFC engagement. Centers that reported greater engagement were in municipalities with higher proportions of older residents from vulnerable groups (e.g., adults ages 80+, limited English proficiency, with a disability, living alone). They also reported greater programmatic, social service, funding, and staff capacity. Qualitative findings elucidated how senior center leaders drew on intrapersonal, interpersonal, organizational, and community assets to support local DFC efforts. We discuss implications for policies and practices to cultivate senior centers and other community-based organizations as leaders and partners toward DFCs.

KEEPING COMMUNITY DURING A PANDEMIC: LGBTQ+ OLDER ADULTS AND THE VIRTUAL SENIOR CENTER

Abstract During the initial stages of the pandemic, 96% of all senior centers ceased in-person programming, leaving many older adults without resources for meals, socialization, and critical services (NCOA, 2020). As a result of this shutdown, risk factors such as being a member of the underserved LGBTQ+ community, identifying as part of a racial or ethnic minoritized group, and/or experiencing poverty contributed to an increased likelihood of experiencing difficulties in meeting basic needs, reduced immunity to COVID and experiencing isolation (Berg-Weger and Morley, 2020; Kuehn, 2021). Despite the closure of many senior centers, some organizations were well positioned to strategically utilize pre-existing resources to help the community (Pendergrast, 2021). One organization, SAGE Advocacy and Services for LGBTQ+ Elders, the first publicly funded senior advocacy organization for LGBTQ+ older adults in the US, was one of the first to effectively transition to becoming a virtual senior center within days after the start of the pandemic (NYC DOA, 2020). Having a group of front-line workers who were highly embedded in their community, helped facilitate effective organizational adaptation and transition to a virtual senior center. This presentation seeks to describe how staff and program facilitators became vital resources for maintaining connection to the community of LGBTQ+ older adults. Focus groups with SAGE senior center employees and program facilitators were conducted in summer of 2021. Data identified resiliencies and barriers for maintaining community, providing vital services, and mitigating isolation with LGBTQ+ elders. Lessons learned and implications for organizations facing crises will be shared.

ENGAGING OLDER ADULTS IN HEALTH PROMOTION: PILOT STUDY OF TEAM GAMEPLAY OF AN EDUCATIONAL EXERGAME IN A SENIOR CENTER

Abstract Digital health games offer one innovative approach to engage older adults to support healthy aging. Multiple reviews have described the positive impact of health games. Limited research has examined multi-focus health games implemented in senior centers. Informed by healthy aging theory and community-engaged methods, our multi-disciplinary team developed/refined an educational exergame with a combined focus on educating about healthy lifestyle behaviors (i.e., physical activity, healthy eating), stimulating cognitive functioning, and engaging movement to support healthy aging. A pilot study (Nf13; mean age = 78, 100% female) examined team gameplay (4 sessions in two weeks) in a senior center. Teams (2–3 members) worked together to answer knowledge, trivia, and cognitive challenge questions and competed for the highest score. A post-gameplay survey asked about acceptability, usability (i.e., adapted System Usability Scale), and perceived game impact. Preliminary results suggest team gameplay was engaging and nearly all (>90%) agreed/strongly agreed that they enjoyed playing with others (i.e., on teams); were comfortable doing the physical movements during gameplay; were satisfied with game educational, trivia, and cognitive questions; enjoyed the social part of team gameplay; would recommend the game to others; and the game increased their knowledge and motivation regarding physical activity and healthy eating. The System Usability Scale was above 70, on average, suggesting above average usability for the game. Findings support use of this educational exergame as an innovative way to engage older adults in health promotion. Presentation will describe game development/refinement, senior center pilot, and implications for future research and senior center translation.

INCREASING MEDICATION SAFETY AWARENESS IN RURAL OLDER ADULTS

Abstract Compared to urban populations, rural residents have a higher incidence of chronic diseases and poorer health outcomes. Most medications in the United States are consumed by older adults who are more susceptible to adverse drug events due to the presence of multiple chronic conditions and physiologic changes in the body. This community-based project evaluated the impact of an interdisciplinary medication education intervention on medication knowledge and adherence to medications and refills. The study was a quasi-experimental pretest/posttest design with a convenience sample. The project was marketed via a multi-media approach. Most participants reported learning of the event at a senior center. Each participant received a private educational session for their specific medications with a nurse practitioner, pharmacist, or pharmacy resident. Forty-nine older adults participated in the study with 48 (97.9%) completing both the pretest and posttest. The average age of participants was 71.4 years and the average number of medications per participant was 5.4. There was a statistically significant difference in the adherence to medication and refills subscale score (p = .003). There was no statistically significant difference in the medication knowledge subscale (p = .192), however, the scores did trend upward indicating an increase in medication knowledge. Forty-four (89.8%) participants reported they were more comfortable understanding their medication since participating in the program and 48 (98%) reported they would recommend the program to others. The results of this study suggest community-based outreach medication educational programs can increase adherence to medication and refills for older adults residing in rural areas.

THE ROLE OF THIRD PLACES IN REDUCING LONELINESS AMONG CAREGIVING SPOUSES

Abstract Loneliness is a public health concern that is associated with poor mental and physical health. Caregiving spouses of community-dwelling older adults often have high levels of caregiving burden, which make them more vulnerable to social isolation and loneliness. There has been a growing interest in third places as mediums for social interaction. Research on third places shows a positive association of greater access to third places with social networks and social health. However, this has not been tested in the context of caregiving. In this paper, we examined the role of various types of third places in reducing loneliness among caregiving spouses. We used the 2006-2016 Health and Retirement Study and the National Neighborhood Data Archive to examine the relationship between the availability of third places per square mile and loneliness. Third places include food outlets (e.g. grocery stores), eating and drinking places (e.g., restaurants, coffee shops), commercial establishments (e.g., department stores), entertainment organizations (e.g., museum), exercise facilities (e.g., fitness), religious organizations (e.g., churches), civic and social organizations (e.g., social clubs), personal care services (e.g., barbershops, beauty salons), and social services for older adults (e.g., senior centers). We found that caregiving spouses living in neighborhoods with greater availability of third places had lower levels of loneliness. We also found gender differences in the association. For instance, greater availability of eating and drinking places was associated with loneliness only among females. Increasing access to places that provide opportunities for social interactions may prevent social isolation and reduce loneliness among caregiving spouses.

EFFECTIVENESS OF A HUMAN RIGHTS–BASED APPROACH ONLINE PROGRAM FOR GERONTOLOGICAL SOCIAL WORKERS

Abstract The human rights perspective is emphasized through the social work code of ethics and practice principles. However, the efforts to improve the human rights perspective of social workers were insufficient in gerontological social work education in South Korea. Thus, the study aimed to prove the effects of a human rights-based approach intervention for gerontological social workers, which consisted of nine online sessions using Zoom. PI developed the program based on McPherson’s integrated framework for Human Rights Practice in Social Work. A quasi-experimental design was used. The experimental group consisted of 36 social workers, and the control group was 31 social workers at senior centers. The pre-post tests for the experimental group and posttest for the control group were conducted. The socio-demographic characteristics of the two groups were equivalent. The key measure was the Human Rights Lens in Social Work (HRLSW) scale consisting of two sub-dimensions: social problems as rights violations and clients as experiencing rights violations.The effect sizes of the online program’s effects on the social worker’s rights-based perspective were large over .90. In addition, the degrees two dimensions of the HRLSW at the posttest were significantly higher than those of the control group (social problems as rights violations: d = 1.04, p < .001; clients as experiencing rights violations: d=0.98, p<.001). Based on the findings of this study, the implications of human rights education and training were discussed to improve the human rights-based perspective of gerontological social workers.

CONTEXTS OF COGNITIVE DECLINE: MAPPING NEIGHBORHOOD OPPORTUNITIES AND BARRIERS FOR HEALTHY AGING IN PLACE

Abstract Stark geographic variation in later-life health outcomes suggests that local built and social environments are critical in shaping disease and disability, physical and cognitive function, and engagement in everyday life among older adults. This paper presents a community-engaged mapping project aiming to depict the uneven distribution of hazards and amenities relevant to cognitive aging across the United States. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for Alzheimer’s disease. We assembled a community advisory board to translate research findings into a pilot website and interactive map that assesses neighborhoods for cognitive aging resources and amenities. The objective is to increase public awareness and inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.

Effect of a Community Health Worker–Delivered Personal Sound Amplification Device on Self-Perceived Communication Function in Older Adults With Hearing Loss

Age-related hearing loss that impairs daily communication is associated with adverse health outcomes, but use of hearing aids by older adults is low and disparities exist. To test whether an affordable, accessible hearing care intervention, delivered by community health workers using over-the-counter hearing technology, could improve self-perceived communication function among older adults with hearing loss compared with a wait-list control. Open-label randomized clinical trial conducted between April 2018 and October 2019 with 3-month data collection completed in June 2020. The trial took place at 13 community sites, including affordable independent housing complexes (n = 10), senior centers (n = 2), and an older adult social club (n = 1) in Baltimore, Maryland. A total of 151 participants aged 60 years or older with hearing loss were randomized. Participants were randomized to receive a community health worker-delivered hearing care intervention (n = 78) or to a wait-list control group (n = 73). The 2-hour intervention consisted of fitting a low-cost amplification device and instruction. The primary outcome was change in self-perceived communication function (Hearing Handicap Inventory for the Elderly-Screening Version [HHIE-S]; score range, 0-40; higher scores indicate poorer function) from baseline to 3 months postrandomization. The average treatment effect was estimated using the doubly robust weighted least squares estimator, which uses an outcome regression model weighted by the inverse probability of attrition to account for baseline covariate imbalance and missing data. Among 151 participants randomized (mean age, 76.7 [SD, 8.0] years; 101 [67.8%] women; 65 [43%] self-identified as African American; 96 [63.6%] with low income [<$25 000 annual household income]), 136 (90.1%) completed 3-month follow-up for the primary outcome. In the intervention group, 90.5% completed the intervention session and reported at least 1 hour of daily amplification use at 3 months postrandomization. Mean scores for the HHIE-S were 21.7 (SD, 9.4) at baseline and 7.9 (SD, 9.2) at 3 months (change of -13.2 [SD, 10.3]) in the intervention group, and 20.1 (SD, 10.1) at baseline and 21 (SD, 9.1) at 3 months (change of 0.6 [SD, 7.1]) in the control group. Self-perceived communication function significantly improved in the intervention group compared with the control group, with an estimated average treatment effect of the intervention of a -12.98-point HHIE-S change (95% CI, -15.51 to -10.42). No study-related adverse events were reported. Among older adults with hearing loss, a community health worker-delivered personal sound amplification device intervention, compared with a wait-list control, significantly improved self-perceived communication function at 3 months. Findings are limited by the absence of a sham control, and further research is needed to understand effectiveness compared with other types of care delivery models and amplification devices. ClinicalTrials.gov Identifier: NCT03442296.

A PILOT ASSESSMENT OF A TABLET-BASED INTERVENTION FOR HOMEBOUND OR SOCIALLY ISOLATED OLDER ADULTS WITH DEPRESSION

Abstract Older adults who are homebound or socially isolated have high rates of loneliness and depression with fewer opportunities for treatment. Our team extended an existing psychotherapy intervention (Engage &amp; Connect) to improve access to mental health care for older adults who are homebound. We iteratively created a tablet-based application (Engage PRISM) leveraging a user-centered design approach to provide older adults, particularly those with limited technology experience, an easy-to-use application to support social reward. Engage PRISM connects clients with the psychotherapy intervention and additional features to increase social reward exposure virtually. All eligible participants received a K92 ZTE tablet, equipped with the Engage PRISM application, internet service, Zoom, and access to Selfhelp’s Virtual Senior Center. Participants were then enrolled in the 9-week Engage &amp; Connect intervention delivered by a licensed mental health counselor via Zoom on the tablet each week. We evaluated feasibility of the intervention and preliminary effect on depressive symptoms through a weekly PHQ-9. Feasibility was assessed through participants’ ability to use the tablet to access mental health treatment. We provided tablets to eight participants ages 67 to 84; participants demonstrated 100% feasibility of use of the tablet intervention. We dropped two participants from the study due to a greater level of care needed. All participants were provided with referrals prior to ending the study. Preliminary evidence indicates that four of the six remaining participants had experienced a reduction in depressive symptoms (i.e., had lower PHQ-9 scores) three weeks into the study reporting over a 30% reduction on average.

SEVEN YEARS OF IMPLEMENTING AN INTERGENERATIONAL PROGRAM WITH UNIVERSITY/COMMUNITY PARTNERSHIPS

Abstract The University of Rhode Island Engaging Generations Cyber-Seniors Program was first implemented in the fall semester of 2015. URI students from 15+ majors have supported the digital competency of older adults in Rhode Island each semester and summer session since its inception. Gradually over time, we modified and expanded this in-person program to meet student, older adult, community partner, and faculty needs. The pandemic led to our program expanding exponentially due to new grant funding opportunities, new partnerships, and student interest. This presentation will address strengths and challenges of implementing this program state-wide in a small, mostly urban state with community partners, mostly involving senior centers. We will describe moving from in-person to phone/virtual and now to a hybrid model. Last, we will explain the program’s efforts to conduct formative and summative evaluation research to assess program output and examine outcomes for students and older adults in the program.

ENHANCING TELEHEALTH CLINICAL SERVICES AND CHRONIC DISEASE SELF-MANAGEMENT FOR OLDER ADULTS DURING COVID-19

Abstract During the pandemic, providers shifted to telemedicine to ensure patient safety. Under a federally funded cooperative agreement, the Florida State University College of Medicine’s Department of Geriatrics partnered with a Federally Qualified Health Center to assess rural older adults’ perceptions about telehealth and identify potential barriers. The quality improvement study used a convenience sample to survey patients aged ≥ 65 (n=62) at one rural clinic. 54.8% of respondents indicated they would not use telehealth for any care or preferred to receive most or all care in person. Conversely, 32.8% indicated a willingness to receive some care via telehealth. The survey also assessed the need for self-management devices, including blood pressure cuffs. There was not a consistent positive relationship between persons requesting devices and those who were telehealth willing. Devices were distributed to enhance telehealth visits and at-home monitoring. Clinic staff provided patients hands on training for device use and connection to EMR. Informal qualitative reports suggest patients are more empowered to utilize telehealth services and self-manage conditions. COVID-19 also limited access to community blood pressure screenings. The Tallahassee Senior Center and FSU Physician Assistant program distributed devices to community-dwelling older adults. PA students provided hands on training to aid in device familiarity and digital connectivity. Almost all older adult participants aged &amp;gt;60 strongly agreed “after the presentation I feel ready to use the blood pressure cuff at home.” Clinical and community-based activities can help older adults who lack digital fluency feel more confident in using telehealth services and self-management devices.

NEIGHBORHOOD IMPACTS ON KOREAN OLDER ADULTS’ DEPRESSION

Abstract Older adults are more influenced by their neighborhood than young adults, however neighborhood impacts on older adults are little known. In response to the increasing depression of older adults in Korea, this study aims to identify the effect of perceived and objective neighborhood characteristics in depression and find differences between rural and urban areas. This study uses the Korean Elderly Survey conducted in 2020 on 10,097 older adults aged 65 and over residing in 17 states, and Korean administration data by connecting them. Multilevel modeling results show that after controlling individual characteristics, depression decreases when older adults perceive their housing condition (b=-.64, p&amp;lt;.001), interaction with neighbors (b=-.29, p&amp;lt;.001), overall neighborhood environment (b=-.26, p&amp;lt;.001) positively. Although objective neighborhood characteristics do not significantly reduce depression in older adults living in urban area, for older adults living in rural areas, the number of social worker (b=- .42, p &amp;lt;.001), the number of senior center (b=-6.70, p&amp;lt;.001), and home care services (b=-49.5, p &amp;lt;.001) are negatively associated with depression in older adults. This study discusses that neighborhood characteristics may play an important role in older adults’ depression, and that their effects may differ between rural and urban areas. This study encourages policy makers to consider neighborhood characteristics to improve the mental health of Korean older adults.

USING RESEARCH TO ADVANCE THE DEMENTIA-FRIENDLY COMMUNITY MOVEMENT AT THE LOCAL, NATIONAL, AND INTERNATIONAL LEVEL

Abstract It is estimated that more than 55 million people worldwide are living with dementia. To address the social and health needs of individuals living with dementia and their care partners, researchers, policymakers and advocates have championed dementia-friendly communities (DFCs) as a population-level response. DFCs promote the well-being of those living with dementia, empower all members of the community to celebrate the capabilities of persons with dementia, and encourage individuals living with dementia to engage in their communities. The objective of this symposium is to describe the ways in which research can help to advance the dementia-friendly movement at the local, national, and international levels. First, Scher &amp; Greenfield will describe the dimensions of implementation of DFCs in Massachusetts with implications for program monitoring and process evaluation. Second, Epps &amp; colleagues will discuss the process of developing a person-centered tool to evaluate the impact of dementia-friendly programs in faith-based communities. Third, Somerville &amp; colleagues will present findings from a study of community and organizational factors related to dementia-friendly readiness in community-based senior centers. Finally, Sun &amp; colleagues will discuss the barriers and facilitators to implementation of DFCs in the USA during the COVID-19 pandemic. Taken together, these studies demonstrate the utility of quantitative and qualitative research methodologies to elucidate how and to what extent DFCs are implemented. Findings have implications for examining the population health impact of DFC efforts, as well as for attending to issues of health disparities and aging equity in the uptake, implementation, and sustainability of DFC initiatives.

A nurse-led mHealth intervention to alleviate depressive symptoms in older adults living alone in the community: A quasi-experimental study

BackgroundThe prevalence of geriatric depression has increased worldwide, becoming a major contributor to the burden of health care costs. Geriatric depression is difficult to detect in daily life because of its atypical presentation for each person. Therefore, there is an emerging need to develop personalised mHealth interventions for older adults with depression based on data from an ecological momentary assessment. ObjectiveTo develop and evaluate the effect of a nurse-led mHealth intervention of geriatric depression in older adults living alone. DesignA quasi-experimental research design was used, and the study followed the transparent reporting of evaluations with a nonrandomised design statement. SettingThe nurse-led mHealth intervention was developed and evaluated in a community senior centre in Seoul, Korea. ParticipantsSixty-four older adults living alone with depressive symptoms were recruited between 1 October 2018 and 1 October 2019. MethodsStudy participants were randomly assigned to the intervention or control groups by drawing lots. In the intervention group, nurses repeatedly assessed older adults' depressive symptoms using an ecological momentary assessment via a mobile tablet. The intervention consisted of weekly sessions, which included (1) standardised mHealth device training, (2) a nurse-led mHealth programme, and (3) art activities. The control group received care as usual. Intra- and inter-group differences were evaluated using paired t-tests and analysis of covariance was used to assess subjective depression symptoms. A linear mixed-model was used to analyse the relationship between groups and momentary scores over time. ResultsThe average age of the final sample was 76.2 years (SD = 6.06), 63.6 % (28/44) of whom were female. Compared with the control group (n = 23), the intervention group (n = 21) showed a decreased depression score (t = 4.041, p = .027). There was no statistical difference between the intervention and control groups based on traditional scales and the ecological momentary assessment. However, our data from the ecological momentary assessment captures clear fluctuating patterns across the days during the study, which traditional scales could not measure. ConclusionsMost of the older adults successfully participated in a nurse-led mHealth intervention that included multiple components of a non-pharmacological approach to address depression. Mental health nurses should perform critical roles to personalise mHealth activities considering the older adult's autonomy and supportive decision-making, specifically when using high-technological intervention. Future research should maximise the methodological and clinical advantage of an ecological momentary assessment of geriatric depression. RegistrationClinical Research Information Service number KCT0005073.

Culturally and linguistically appropriate home visit intervention for underserved dementia family caregivers: Preliminary results from a randomized controlled trial

AbstractBackgroundFamily caregivers of persons with dementia (PWD) suffer from stress and negative health outcomes related to round‐the‐clock caregiving responsibilities. Often caregivers lack awareness of community resources. Community Health Workers (CHW) have proven effective in educating families and can implement interventions that aim to reduce the impact of stress on their health. To alleviate caregiver burden among dementia family caregivers, this study has CHWs’ visit family caregivers’ homes offering education, stress reduction, and compassionate support/listening.MethodsParticipants were recruited from Southern California via non‐profit organizations, senior centers, and adult day services. Participants were randomly assigned to CHW home‐visit intervention group (IG) or control group (CG) with resource information only. The intervention includes stress reduction techniques of mindful breathing and compassionate support/listening, (2) education on dementia caregiving skills to handle difficult behaviors of PWD, and (3) resource information. The 3‐month intervention is given by bilingual CHWs who speak English, Spanish, Vietnamese, or Korean. A linear mixed model was used to compare differences from baseline to 3‐month on each outcome (caregiver burden, PWD behaviors ‐ memory, distress, disruption) between IG and CG. Exit interviews were conducted for IG participants.Results26 family caregivers participated in the study (12 Korean, 9 Vietnamese, 3 Hispanic, 2 Caucasian); 14 spouses (54%), 12 off‐spring (46%); 18 females (69%), age from 34 to 89 (mean = 66.8 sd = 12.6). IG Participants showed a significant decrease in caregiving burden compared to CG (coefficient = ‐7.68, p = .0041). PWD behaviors were significantly decreased from baseline to 3 months but no difference by group. However, there was a trend for improvement of PWD’s memory problems in the IG compared to the CG (coefficient = ‐2.43, p = .056). Language specific exit interviews showed that educational materials were valuable and communication skills training was helpful as was CHW home visits. Most participants reported the benefit of mindful breathing and practiced it when overwhelmed or having sleep problems. The overall satisfaction of the intervention was high (mean = 4.4 of 5). Recruitment is on‐going but challenging during the pandemic.ConclusionPreliminary results showed the CHW led home‐visit intervention helped improve burden and PWD memory problems and was acceptable by the family caregivers of PWD.

It Is Time to Rethink Adult Glaucoma Screening Recommendations.

It Is Time to Rethink Adult Glaucoma Screening Recommendations.

Implementing DASH-Aligned Meals and Self-Measured Blood Pressure to Reduce Hypertension at Senior Centers: A RE-AIM Analysis.

Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. The study enrolled congregate meal program participants, provided training and support for SMPB, and nutrition and BP education. DASH-aligned meals delivered 40% (lunch) or 70% (breakfast and lunch) of DASH requirements/day. Primary outcomes were change in BP, and BP control, at Month 1. Implementation data collected included client characteristics, menu fidelity, meal attendance, SMBP adherence, meal satisfaction, input from partner organizations and stakeholders, effort, and food costs. We used the RE-AIM framework to analyze implementation. Study Reach included 94 older, racially diverse participants reflecting neighborhood characteristics. Effectiveness: change in systolic BP at Month 1 trended towards significance (-4 mmHg, p = 0.07); change in SMBP reached significance at Month 6 (-6.9 mmHg, p = 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations.

Relationship between Intergenerational Emotional Support and Subjective Well-Being among Elderly Migrants in China: The Mediating Role of Loneliness and Self-Esteem.

With the augmentation of family migration, the number and proportion of elderly migrants have increased dramatically in China. The well-being of this group has a profound impact on the whole society. Subjective well-being is a comprehensive reflection of whether a person's needs are met. In this cross-sectional study, we established a multiple mediation model to evaluate the mediating effects of loneliness and self-esteem on intergenerational emotional support and, consequently, on subjective well-being in elderly migrants. The study population consisted of 728 elderly migrants living in Nanjing (Jiangsu, China), including 219 men (30.1%) and 509 women (69.9%). The participants' loneliness and self-esteem were measured using the R-UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale, and the Philadelphia Senior Center Confidence Scale. Multiple regression analyses revealed a significant correlation between intergenerational emotional support and subjective well-being, and mediation analysis revealed that intergenerational emotional support indirectly influenced subjective well-being through three mediators: loneliness (mediating effect, 0.149), self-esteem (mediating effect, 0.136), and loneliness and self-esteem (mediating effect, 0.041). We conclude that loneliness and self-esteem mediate the relationship between intergenerational emotional support and subjective well-being in elderly migrants and can be regulated to improve elderly migrants' subjective well-being. Great attention should be paid to the emotional needs of elderly migrants, and communication and exchange with elderly migrants should be emphasized to enhance their subjective sense of well-being.