Senior Centers Research Articles

BEST PRACTICES FOR COMMUNITY-ENGAGED RESEARCH AND PRACTICE WITH CBOS THAT ENGAGE DIVERSE OLDER ADULTS

Abstract PEARLS partner organizations will share best practices on integrating PEARLS into routine service delivery to reach historically marginalized older adults, and how they have partnered with researchers to strengthen study feasibility, equity and sustainability to translated learnings into practice. The PEARLS Equity Study guided new dissemination and implementation strategies that aligned with the strengths, priorities, and needs of community-based social service organizations (CBOs) including cultural organizations, area agencies on aging, senior centers, and family and human services agencies. New communication approaches included proactive group and 1:1 outreach to organizations; a new peer-to-peer video with PEARLS organizations sharing how they have reached underserved communities; and updated PEARLS messaging that resonated with values of CBO leadership, staff and clients. For example, new messaging included downplaying “evidence-based program” which has often been used to promote programs that were not designed with diverse older adults, and instead amplifying stories of impact that highlight both quantitative and qualitative changes in outcomes that mattered. New supports for program adoption included 1:1 support calls for tailored guidance for different CBO, staff, and community contexts; distance on-demand training with trainers from diverse CBOs to improve accessibility and sustainability; and Zoom webinars and community conversations co-led by PEARLS partners (including local partners featured during this GSA Symposium) and our research center that targeted what CBOs are looking for to address depression and disconnectedness in their communities. Our community-academic partnership and PEARLS community of practice continues to engage regularly to share adaptations as an implementation strategy for health equity.

DEPLOYING TELEWELLNESS PROGRAMS IN THE COMMUNITY: BARRIERS, FACILITATORS, AND POTENTIAL

Abstract ‘Telewellness’ programs use technology (e.g., video conferencing software) to facilitate remote participation in exercise classes. These programs hold great potential to expand access to physical and mental health benefits of group exercise classes for older adults, especially those with mobility disabilities. We translated the Tai Chi for Health Institute’s in-person, evidence-based tai chi program, Tai Chi for Arthritis, to be a virtual experience (via Zoom) that is both socially engaging and inclusive of people with a mobility disabilities. The ‘Tele Tai Chi’ clinical trial (NCT04696887) explored to what extent this program may increase social interaction and positive health behaviors among older adults with long-term mobility disabilities; data analysis is in progress. The next phase of this project is focused on delivering our Tele Tai Chi program in real world, community-based settings (e.g., senior centers, senior living communities). This session will present findings from interviews with subject matter experts (e.g., senior center coordinators, administrators from Area Agencies on Aging, tai chi instructors) on perceived barriers to delivering Telewellness classes (e.g., safety, staffing, demands, technical support), as well as potential facilitators to address them. We will also discuss the need for different models of Telewellness (e.g., hybrid classes with attendees both in-person and online) that align with the community’s unique characteristics, preferences, and support needs.

FROM THE PERSPECTIVES OF PROVIDERS TO OLDER ADULTS: CONVERSATIONS ABOUT BEHAVIORAL HEALTH SERVICES IN OREGON

Abstract The Older Adult Behavioral Health Initiative (OABHI) is an innovative program funded by the Oregon Health Authority to address gaps in services for older adults and people with physical disabilities with behavioral health (BH) issues. The Initiative consists of 24 Behavioral Health Specialists who work with community partners across Oregon to improve BH services through workforce development, health and wellness promotion, complex care consultations, and promoting coordination and collaboration between aging and BH agencies. The Institute on Aging (IOA) at Portland State University (PSU) has evaluated the effectiveness of the Initiative since its establishment in 2015. Prior evaluation efforts included interviews and surveys from key community partners, staff from Area Agencies on Aging (AAA), Aging and Disability Resource Centers (ADRC), Aging and People with Disabilities (APD), and Community Mental Health Programs (CMHPs). As the Initiative comes upon nearly ten years of existence, the evaluation team conducted a new evaluation approach by facilitating focus groups with these key community partners in addition to primary care providers, older adults (65+) with lived experience, and senior centers representing 25 rural and urban Oregon counties (n=54). Participants were asked about the top challenges in their communities and how the Initiative can better address their biggest needs when supporting older adults and people with physical disabilities living with behavioral health issues. Findings from these data identify recommendations to address systems-level barriers and opportunities to promote intra-agency collaboration and outreach to community partners and consumers.

Multi-Scale Network Analysis of Community-Based Senior Centers: Exploring the Intersection of Spatial Embeddedness and Accessibility in Nanjing, China

As critical infrastructure of age-friendly cities, senior centers are designed to be embedded in communities and facilitate service accessibility for older adults. However, their underutilization is widely documented, suggesting a need to reassess their effectiveness. Existing studies often analyze the issue focusing on socio-demographic factors, overlooking the spatial contexts in which senior centers are embedded and their impacts on older people’s access. This study aims to address the research gap by investigating the spatial embeddedness of senior centers using Space Syntax methods and examining its influence on older people’s access patterns. Using a geo-behavioral dataset collected in Nanjing, China, we find that about 70% of the senior centers in the research area are embedded in highly localized settings with limited connections to global street networks, which significantly restricts the access of older people from wider spatial contexts. This spatial segregation may force senior centers to incur higher costs to attract users, thereby reducing the effectiveness of community-based services. This study introduces a novel spatial perspective to evaluate community-based services, highlighting the critical influence of the spatial context on service accessibility. The findings provide valuable empirical insights for policymakers and planners striving to create age-friendly cities and communities.

Disparities Between Older Adults’ Potential and Realized Access to Community-Based Care: A Multilevel Analysis of Geo-Referenced Check-In Data from Senior Centers in Nanjing, China

Community-based care services offered by senior centers are vital for supporting older adults’ independent living. The number of senior centers has escalated in China in recent years. Despite scholarly interest in the potential accessibility of senior centers, research on older adults’ realized access remains scarce. Using the geo-referenced check-in data of 2382 users of senior centers in Nanjing, China, this study aims to fill this gap by examining the disparities between older adults’ potential and realized access to senior centers and the influence of multilevel spatial and non-spatial factors. This study indicates that potential access is often significantly overestimated compared with the actual accessibility of senior centers, with older adults’ distances of realized access (mean = 1319 m) being considerably greater than potential access (mean = 325 m). Spatial and regression analyses confirm that older adults living in newly built, lower-priced houses in the inner city are more likely to travel longer distances to reach senior centers. Spatial proximity is less effective in predicting realized access for those living further from senior centers. Instead, the location and service quality of senior centers play a more prominent role. These findings enrich our understanding of older adults’ access to community-based care, informing planning and policy interventions for the development of age-friendly communities.

Glaucoma Screening and Referral Risk Factors in a High-Risk Population: Follow-up Study of the Manhattan Vision Screening Study (NYC-SIGHT).

Community-based eye health screenings that incorporated fundus photography and optometric exams in a high-risk NYC population effectively identified a higher than average number of participants that required an in-office glaucoma evaluation. To report glaucoma screening rates and risk factors associated with referral for in-office glaucoma evaluation in the Manhattan Vision Screening and Follow-up Study (NYC-SIGHT). In this 5-year, cluster-randomized clinical trial, eligible individuals aged 40 and older were recruited from affordable housing developments and senior centers. Visual acuity with correction, intraocular pressure (IOP) measurements, and non-mydriatic fundus photography were conducted. Images were graded by a glaucoma specialist; those with an abnormal image were referred; those who failed the screening or had an unreadable fundus image were examined by the study optometrist. Chi-squared tests and stepwise multivariate logistic regression analyses were conducted to determine factors associated with glaucoma referral. 708 participants were screened; 189 (26.6%) were referred for an in-office glaucoma evaluation due to an abnormal optic disc image (n=138) or abnormal optometric exam (n=51). Those referred had a mean age 68.5 ±11.7 years and were 60% female, 57% Black, and 37% Hispanic. Stepwise multivariate logistic regression showed participants with self-reported glaucoma (OR 8.096, 95% CI 4.706-13.928, P=0.000), IOP>23mmHg at the screening (OR 3.944, 95% CI 1.704-9.128, P=0.001), or wore prescription eyeglasses (OR 1.601, 95% CI 1.034-2.48, P=0.035) had higher odds of being referred for an in-office glaucoma evaluation. Of those referred, 106 (56%) attended, 36 participants (34%) were diagnosed with glaucoma and 38 participants (35.8%) as glaucoma suspects. Our findings support public health approaches that focus community-based eye health screenings on high-risk populations and prioritize underserved communities.

Is It All That Positive? An Exploratory Study of Emotions in the Older Adult In-Person and Online EFL Classrooms

Late-life foreign language education (i.e., FL geragogy, FLG) is said to be related to the de- lay of age-related cognitive changes in healthy individuals and has been shown to positively affect the quality of life of older adults, the fastest-growing age group worldwide. These are also the two main reasons which seem to be behind the high enrolment rates for FL courses at the Universities of the Third Age (U3A) and senior centres alike. Nowadays, following the outbreak of COVID-19 pandemic and months spent in the emergency remote teaching, some of the older learners decided to continue their ed- ucation online, others came back to the classrooms. In both cases, the research on third age learner emotions remains rather scarce, despite a gradually increasing interest of applied linguists in this age group. The aim of this paper is thus to bridge the gap between FLG and Positive Language Education (Mercer et al.) by discerning the reasons behind the learners’ choice of in-person or online classes and investigating the emotions experienced in both modes. To this end, the qualitative research was conducted in two groups of older adult English as a FL learners in the in-class (n = 11) and online mode (n = 6). The data was collected via open-ended questionnaire and a thematic analysis of the dataset was done to identify patterns of meaning. The results indicate that although the emotions in both modes are similar, and learning English in later life is a source of pride, satisfaction, and self-fulfilment irrespective of the form of classes, the online experience is decidedly more negative and causes greater anxiety, frustration, and boredom. In addition, face-to-face social interaction seems to play a vital role in the learners’ overall perception of the course.

Prioritizing Energy Performance Improvement Factors for Senior Centers Based on Building Energy Simulation and Economic Feasibility

This study examined energy performance improvement factors by analyzing both energy performance and the economic impacts to reduce energy costs for senior centers. A fact-finding survey was conducted on 20 senior centers in a metropolitan area, identifying key energy improvement factors. Energy simulations of the buildings were performed using ECO2, an officially certified energy assessment program in Korea, comparing the energy requirements before and after the improvements. The energy demand, energy consumption, and floor area were analyzed, with the J, K, and S standard models selected based on the median values of these factors. To assess the impact of the improvements, blower door tests were conducted on two senior centers before and after window upgrades. Based on the ECO2 simulations and the blower door test results, improvement priorities were identified in the following order: windows, exterior walls, boilers, roofs, and doors. Finally, an economic feasibility analysis applied the construction and heating costs to the standard models. Over a 40-year period, only boiler improvements generated a net profit. Without government support, this study recommends prioritizing boiler upgrades when selecting energy performance improvements.

Keeping Community During a Pandemic

The purpose of this qualitative exploratory study was to better understand how LGBTQ+ senior centers created virtual communities and implemented organizational adaptation in the earliest stages of the pandemic. Three focus groups (n=22) were conducted with program facilitators and senior center employees to better understand how these key stakeholders contributed to the transition from in person senior center to virtual senior center programming in March of 2020. The experiences of LGBTQ+ program facilitators and senior center staff varied based on the nature of their assigned roles. Latent pattern content analysis of the focus groups unveiled both shared and divergent categories and themes from the two cohorts. Themes identified for program facilitators included: adaptation, interconnectedness, some not served, and virtual preference. Themes identified for senior center staff included: communication, the blurring of the personal/professional, urgent needs, and future planning.

Vaccines are coming closer to you: the experience of the Corporate Healthcare Company (ASL) Rome 4

Abstract Issue The post-Covid period is characterised by vaccine fatigue and declining coverage, especially among children. Access to vaccination for adults and the elderly, outside of the influenza vaccination campaign, has historically been very low due to limited awareness of opportunities and difficulties in accessing vaccination centres. Description of the problem ASL Roma 4 is characterised by a dispersed population across a large territory of 28 municipalities, many of which are small and predominantly populated by elderly people. In order to reach this population, ‘proximity clinics’ were opened in 6 small municipalities in 2023, where the vaccination service offers a wide range of vaccines every 1-2 months. Since June 2023, two mobile vaccination units have also been used to extend the reach of vaccination activities. Results In 2023, vaccination activities at nearby clinics reached 343 people (166 males and 177 females), with a total of 473 vaccines administered. More than 70% of those vaccinated were over 65 years of age, including 47% over 80 years of age. Between September and December 2023, vaccination vans were deployed in high-traffic areas such as markets, supermarkets, squares, or in locations with hard-to-reach populations such as migrant reception centres, volunteer centres, and senior centres. As a result, 1183 people (585 men and 557 women) with an average age of 49 years were reached and 1699 vaccines were administered. 62% were over 65, 37% over 80, 41 were homeless and 87 were migrants. 56% of the vaccines administered were influenza and covid, but all types were provided. Lessons Although this method of vaccine delivery is still being implemented, its value lies mainly in vaccinating people who would not have voluntarily sought vaccination services, demonstrating the need to bring prevention as close to the user as possible. Key messages • The post-Covid period is characterised by vaccine fatigue and declining coverage. • It is necessary to bring vaccination prevention as close to the user as possible.

A student-community partnership to enhance cancer research training

BackgroundDespite the importance of community involvement in research, little formal training in community outreach and engagement (COE) is offered to cancer research trainees. A collaboration between the Office of COE and the Office of Cancer Research Training and Education Coordination (CRTEC) at the Sidney Kimmel Comprehensive Cancer Center at Jefferson led to the COE-CRTEC Trainee Working Group, a unique program in which trainees in cancer research each created a novel COE initiative.MethodsFour cancer research trainees were selected to serve as COE Program Liaisons (CPLs), each aligned with one of the four cancer center research programs. Each CPL developed, implemented, and evaluated a project that enhanced the bidirectional relationship between their research and the community. Trainees were provided a modest budget, support from the Office of COE, and a requirement to complete the project within one academic year.ResultsProjects included a cancer education seminar for older adults at a senior center, a prostate cancer education and screening event at a predominantly African American church, a video demonstrating a day in the life of a skin cancer researcher, and a podcast that featured SKCCC investigators answering research questions from community members.ConclusionStudents who would not typically be exposed to COE training gained experience developing, implementing, and evaluating community-based initiatives. Projects were diverse in topic and approach, reflecting the diversity of the trainees and the community. Allowing trainees, those who are the next generation of cancer researchers, to design community-based research may lead to more patient-centered research in the future.

Mapeo de tendencias en estudios sobre modelos de gestión administrativa en Centros de Adulto Mayor

The study conducted a mapping of the forms, models, or trends used in the administrative management of senior care centers. The objective of this research was to identify its evolution over time, as well as the countries, journals, articles, and representative authors, and the thematic connections and areas of knowledge, considering the concepts present in the scientific literature. Methodologically, it was approached based on the principles of the PRISMA statement through bibliometric analysis. The results of the search and application of inclusion and exclusion criteria allowed the identification of 93 articles extracted from Scopus in English. The results indicate that research published on the topic has shown two slight increases, one in 1997 and another in 2019, highlighting the United States as the leader in academic contributions. Three clusters were identified, which could guide future research by identifying scientific trends. Among the conclusions, bibliographic coupling stands out, presenting three important research streams that guide the scientific community, the productive sectors, and governments: greenhouse, mental health, and the evaluation of geriatric service delivery.

Association Between Level of Pain and Depression Among Chronically Ill Older Adults in Rural Alabama: A Pilot Study

There is a paucity of research on pain and depression among older adults in rural communities. To address such a gap, this study examined the association between pain and depression among older rural-community-dwelling adults. Recruited from rural senior centers, 100 chronically ill older adults (age 55 or older) experiencing pain completed a cross-sectional survey. Data were collected on their level of depression (a five-item version of the Center for Epidemiologic Studies Depression scale), pain (the six-item Philadelphia Geriatric Center Pain scale), and sociodemographic factors. A multiple linear regression was conducted. With sociodemographic variables controlled, those reporting higher pain scores were significantly more likely to have higher depression scores (p < .05). Older participants had lower depression scores than younger participants (p < .05). In view of poorer health outcomes and limited health care access in rural areas, our findings warrant interventions to promote better access to pain management and mental health services for rural older adults.

Changes in Oral Frailty and Suggestions for Clinical Use according to Age and Sex

Objective: This study aimed to identify and report the changes in oral frailty diagnosis among older Korean adults according to age and sex. Methods: The study included 217 individuals aged 60 years or older who visited senior centers. The final analysis included 100 individuals with complete data on the diagnostic items of oral frailty. After subdividing by age and sex, the average of each age group for diagnostic items was analyzed. Results: The items with oral hypofunction tended to increase sequentially with oral dryness, tongue pressure, occlusal force, and chewing ability as the age group increased. Individuals aged 65-69 years old were considered pre-orally frail and those over 70 years old were determined to be orally frail. The diagnosis of oral frailty and decline in oral function in females was observed to be much faster than in males. Conclusions: This study confirmed that the number of items with decreased oral function increased sequentially with age in older adults and these characteristics also differ according to sex. These findings can be used to prevent deterioration into oral hypofunction and serve as primary data for the phased early detection of oral frailty.

Infrastructure distribution in cities and the improvement of the well-being of citizens in Japan: evidence from the quantile regression

ABSTRACT Urban construction under the aging society needs to provide efficient services for residents. We investigated the heterogenous relationship between various types of municipality-level critical infrastructure and park construction and the subjective well-being of citizens based on quantile regression using original survey data and the Japanese government statistics bureau of 2015-2017. Positive relationships were found in the low-and middle-level life satisfaction regions owing to the construction of museums or libraries, government branches, government services, health centers, police stations, fire stations, schools, hospitals, post offices, disabled and senior centers, and parks. Moreover, citizens were more likely to feel safe if the living community had comprehensive government-related institutions, including government offices, police stations, fire stations, schools, and post offices, among others. Our results indicated that the number of favorable infrastructures should be increased in areas with low levels of life satisfaction and less-safe communities to improve the citizens’ overall well-being.

Adoption, Implementation, and Maintenance of Evidence-Based Falls Prevention Programs.

We evaluate the implementation of evidence-based falls prevention programs (EBFPPs) of the Administration for Community Living (ACL) Grantees by (1) describing adoption; (2) evaluating implementation through participant adherence; and (3) describing program maintenance. Secondary data analysis of a national data repository included forty-four ACL grantees spanning 31 states who were funded between September 2014 and December 2019 and provided information on over 80,000 older adult participants. Descriptive statistics including frequencies, percentages, and means were used to describe adoption, implementation (adherence), and maintenance of EBFPPs. Senior centers were the most common organizations to adopt EBFPPs. Most programs were maintained at their respective organizational site through repeat offerings, with several programs (60%) being offered greater than 10 times. Information regarding adoption, implementation, and maintenance of EBFPPs is valuable in identifying the best programs suited for different organizations and their clientele, which can inform policy for scaling and sustaining EBFPPs across the nation.

Intrarater and Interrater Reliability of Quantitative Ultrasound Speed of Sound by Trained Raters at the Distal Radius in Postmenopausal Women.

Quantitative ultrasound (QUS) performed at the distal radius shows potential as an effective tool for evaluating fracture risk, especially in postmenopausal women, but the reliability of this tool has not been reported in this patient population. This study investigated the within-day intrarater and interrater reliability of trained raters performing QUS measures at the distal radius of postmenopausal community-dwelling women. Eighteen women between the ages of 56 and 87years were recruited from senior centers in the Greenville area of South Carolina and consented to participate. A QUS bone sonometer was used in this study; the trained raters performed 3 repeated speed of sound (SOS) measures at the nondominant radius of each participant on the same day. Intraclass correlation coefficients (ICCs) were calculated (model 3,1 for intrarater and 2,3 for interrater reliability) to determine the reliability within and between raters. In addition, we calculated the standard error of measurement (SEM) and the minimal detectable change at 95% confidence interval (MDC 95 ). The within-day intrarater reliability was excellent for both physical therapist raters (ICC (3,1) ranging from 0.93 to 0.91). The SEM and MDC for the within-day intrarater reliability measures were small for both raters (SEM=36.79-38.75 or 0.92%-0.97% of the pooled mean; MDC 95 =101.99-107.40). The interrater reliability for SOS measurements using radial QUS was good with an ICC (2,3) of 0.77 (95% CI, 0.36-0.92) for 3 averaged measures. The SEM and MDC were larger for the interrater reliability measures (SEM=62.79 or 1.57% of the pooled mean; MDC 95 =174.05). Quantitative ultrasound SOS measurement at the distal radius showed excellent within-day intrarater and good interrater (when 3 measures were averaged) reliability in community-dwelling postmenopausal women. The SEM and MDC 95 were also low for interrater reliability when a mean of 3 trials was used. This study is the first to demonstrate that this particular QUS device at the radius may be a reliable fracture risk screening tool for postmenopausal women.

Experiences managing behavioral symptoms among Latino caregivers of Latino older adults with dementia and memory problems: a qualitative study

BackgroundLatinos are more likely than non-Latino Whites to develop dementia and be prescribed antipsychotics for dementia-related behavioral symptoms. Antipsychotics have significant risks yet are often overprescribed. Our understanding of how Latino caregivers of Latino older adults living with dementia perceive and address behavioral issues is limited, impeding our ability to address the root causes of antipsychotic overprescribing.MethodsWe interviewed Latino older adults’ caregivers and community-based organization workers serving older adults with cognitive impairment (key informants), focusing on the management of behavioral symptoms and experiences with health services.ResultsWe interviewed 8 caregivers and 2 key informants. Caregivers were the spouses, children, or grandchildren of the older adult living with cognitive impairment; their ages ranged from 30 to 95. We identified three categories of how caregivers learned about, managed, and coped with behavioral symptoms: caregivers often faced shortcomings with dementia care in the medical system, receiving limited guidance and support; caregivers found community organizations and senior day centers to be lifelines, as they received relevant, timely advice and support, caregivers often devised their own creative strategies to manage behavioral symptoms.ConclusionIn-depth interviews suggest that the healthcare system is failing to provide support for behavioral symptoms from dementia; caregivers of Latino older adults rely on community organizations instead.

Gerotranscendence, Hope, and Coherence in the Face of Life Adversity.

Background and Purpose: Older adults are living longer and becoming more diverse. The current study examined the relationship between traumatic life events, hope, coherence, and successful aging in Black and White older adults with at least one chronic health condition, and the influence of life events on gerotranscendence. Methods: Fifty older adults from two senior centers participated. Participants completed the Successful Aging Inventory, Life Events Checklist, Herth Hope Index, and Sense of Coherence Scale. Results: Significant correlations were found between successful aging and gerotranscendence (r = .290; p = .048) and hope (r = .585; p = <.001). Simple linear regression found that Successful Aging Index (SAI) scores significantly predicted gerotranscendence (R2 = .10, F(1, 46) = 5.157, p = .028) and Herth Hope Index scores (R2 = .36, F(1, 46) = 25.850, p <.001). Higher Sense of Coherence (SoC) and Gerotranscendence Scale scores among those with no firsthand trauma experience suggest that experiencing traumatic events firsthand may adversely affect the aging process. Implications: Therefore, exploration of trauma experiences, with mental health referrals as appropriate are clinical implications to consider.

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.