Journal of Applied Gerontology

This study assessed health-related changes of participants attending A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) model falls-prevention program for older adults based on their residential location. Data were examined from 1,482 older Texans enrolled in AMOB/VLL over a 2-year period and assessed at baseline and postintervention. Results indicate participants significantly increased falls efficacy by an average of 14.4% (p < .01), reduced activity interference due to their health by an average of 6.5% (p < .01), and decreased the number of days limited from usual activity by an average of 28.2% (p < .05). Regression models show that rural participants, despite entering and exiting the program with lower health status, report greater rates of positive change for falls efficacy and health interference compared with their urban counterparts. Findings contribute to the understanding of geographic variation with falls-prevention program outcomes.

Regular exercise lowers the risk of disease progression for many chronic illnesses, but older adults experience relatively low rates of exercise. Although multiple intervention studies indicate that community-based programs can facilitate exercise participation, whether this research has resulted in widespread targeted exercise programs within communities is unknown. This study seeks to understand the ecological context of exercise for older adults through a cross-sectional survey of community exercise facilities within a mid-Atlantic city. The findings highlight the limited nature of the existing exercise infrastructure and reveal gaps in the community translation of research evidence regarding exercise adherence. An expansion in the availability of community exercise programs for older adults and more uniform policies to support older adult exercise are needed.

Nationally, 11,000 senior centers play a vital role in supporting community-dwelling older adults by offering a diverse array of recreational, nutritional, health, and social service programs. The purpose of this study was to identify innovative models of senior centers nationwide and evaluate their impact on the communities they serve. Applying a multiple-case study approach to a national survey sample, six innovative models were identified by members of the New Models Taskforce (NMTF), a project sponsored by the National Institute of Senior Centers (NISC). The NMTF hoped to document the innovative efforts of senior centers to reimagine and reposition themselves within the aging services field. This article will highlight the defining characteristics of each model and discuss their implications for the field. The potential impact of each model on the senior center field will be illustrated.

A Center for Substance Abuse Treatment Knowledge Application Program based on cognitive-behavioral and self-management treatment approaches and targeted to older adults with substance abuse was provided through a community behavioral health center. A sample of 199 adults aged 50 and above participated in the 18-session program. Observations were made at intake and 6 months after intake. Program completers versus noncompleters differed significantly over time, favoring completers with regard to decreased use of nonmedical prescription drugs, improved cognitive functioning, improved mental health, increased vitality, and lack of bodily pain. Significant time effects were noted in participants’ decreased use of alcohol and binge drinking, reduced stress, fewer emotional problems, a decrease in having to reduce important activities, and increased prescription of medication for psychological problems. Participants also reported significant improvement in their social functioning, and their physical health and emotional problems had less impact on what they were able to do.

The objective of this study was to identify contextual factors influencing the degree of integration of the ecological approach in disease prevention and health promotion (DPHP) programming initiatives for older adults in two public health organizations in Québec, Canada. A case study design was used and two organizations presenting contrasting profiles in the degree of integration of the approach in their DPHP programming for older adults were selected. Face-to-face interviews with professionals and managers and archival analysis were conducted. Several factors emerged as constraining the integration of the approach in both organizations, including the lack of data showing the effectiveness of DPHP interventions for older adults and the presence of macro-contextual political factors at odds with the ideology of DPHP. Resources and partnerships with academic milieus emerged as key factors distinguishing the two organizations. These results provide increased understanding of conditions required for planning DPHP programs for older adults.

Medication management is among the most commonly cited reasons for moving to assisted living and is closely associated with resident quality of care and life. Yet the issue has received little research attention. Using data from the statewide study, “Job Satisfaction and Retention of Direct Care Staff in Assisted Living,” this article examines medication management policies and practices across 45 facilities in Georgia. Guided by principles of Grounded Theory Method, we analyzed qualitative data from surveys with 370 direct care workers (DCWs) and in-depth interviews with 41 DCWs and 44 administrators. Our analysis showed that medication managers vary widely in their backgrounds, positions, and training, largely based on home size and resources. Despite identifying common dimensions of the medication management process, we found variation in procedures and regulatory compliance based on facility, staff, and resident factors. Our findings relate to and extend existing work and have practice and research implications.