Theory-Based Community Practice for HIV Prevention in Midlife and Older Women

ABSTRACT

In the last decade there has been a significant increase in HIV transmission among midlife and older women, particularly those from racial/ethnic minority communities. Although the number of women aged 50 and older diagnosed with HIV infection in the United States is increasing, they are rarely included in community HIV prevention strategies. This article presents integrating social capital with social justice themes into a socioecological framework for community practice that can significantly impact the efficacy of HIV prevention programs for midlife and older women. It also reviews the research and program implications for including midlife and older women in community interventions to halt the spread of HIV infection in this at-risk group. Suggestions for HIV prevention community practice with this underserved population are presented.     

Sustainability Processes among Naturally Occurring Retirement Community Supportive Service Programs

ABSTRACT

Sustainability remains a concern for community models to better support older adults’ aging in place in their own homes and communities. Based on qualitative data from leaders of 53 Naturally Occurring Retirement Community (NORC) Supportive Service Programs, which is among the most prominent community practice models in aging, we aimed to develop an empirically-grounded framework on sustainability processes. Results indicated that programs use funding, staff members, interorganizational partnerships, and volunteers to offer services to attract older adults, and that older adults’ participation, in turn, is perceived as influencing the accrual of additional resources. Across themes, respondents discussed the importance of being responsive to the community and facilitating consumer participation.     

Intergenerational Community Action and Youth Empowerment

Abstract

Empowerment theory can provide a useful framework for the design and evaluation of intergenerational community-building programs. Using an intervention research approach that draws heavily on empowerment theory, the author designed, facilitated, and evaluated an innovative model for intergenerational community engagement involving undergraduate students and older adult residents of an assisted living facility. This “Intergenerational Community Action Group” met at the assisted living facility throughout a school year to engage in group-building activities, to discuss and choose an issue of concern to them in the community, and to plan and implement an action project to address the issue. This article discusses the use of empowerment theory in intergenerational community action and similar programs, and reviews the empowerment outcomes for youth participants in the Intergenerational Community Action Group.     

An Intergenerational Approach to Informal Science Learning and Relationship Building

ABSTRACT

One of the challenges that affect educators in many fields is how to achieve and sustain participation in active learning throughout the life span. The SPRY (Setting Priorities for Retirement Years) Foundation addressed this challenge by creatively combining inquiry-learning techniques from informal (out of school/free choice) science education (ISE) with specially designed intergenerational programs that brought together youth and older adults for co-learning experiences. SPRY explored this concept by applying knowledge and techniques from SPRY's previous research in older adult learning to ISE topics. The results show impressive yields in social and cognitive benefits both for youth and older adult participants. doi:10.1300/J194v05n03_03     

Time to ask and tell: Voices of older gay and bisexual male veterans regarding community services

ABSTRACT

This participatory action study involved lesbian, gay, bisexual, transgender, and queer (LGBTQ) veterans in determining community-based service needs for health and wellness, illuminating perspectives of older LGBTQ veterans regarding community services. This study explored veterans' perceptions of being LGBTQ later in life. The study included data from interviews with gay and bisexual male veterans ages 51 to 87. Participants valued engagement as part of community. Their recommendations for action included communal meals, transportation, housing, and the coming-out process. Community services facilitated community engagement to support health and wellness for LGBTQ older veterans. The authors used participatory action research (PAR), a method of systematic inquiry integrating the perspective of persons living the experience, to organize the study. Further PAR is recommended to implement community services to meeting health and wellness needs of participants.     

An Approach to Community Outreach Practice in the 21st Century

ABSTRACT

This article presents the findings of a study about knowledge, attitudes and beliefs about AIDS held by older Hispanic adults. Members of the convenience sample provided responses that identify concerns about effective practice in outeach and information provision to older adults with regard to risky sexual practices. Intervention to prevent the spread of HIV/AIDS among older adults needs to be culturally competent and to be attuned to social practices, traditions, community concerns, and generational perspectives with regard to serious health problems related to sexual behavior. The sample composition was primarily Hispanic (97.4%); Catholic, (92.1%) and female (84.2%) with a mean age of 73.7 years. Approximately 28.2% of those surveyed stated that they felt that AIDS was an important problem for older adults. The majority, (76.3%) were aware of locations where health information and services were available if AIDS were a problem. Even though the majority indicated knowledge that AIDS is spread through sexual intercourse, more than one third, (36.8%) thought that sexually active adults 55 and over never use condoms. A discussion of the implications for disease prevention programs and community practice is presented emphasizing the importance of empowerment strategies in health promotion programs and the strengthening of multidisciplinary collaborative efforts to effect positive community health changes.     

Older Adults' Perceptions of Well-Being after Intergenerational Experiences with Youth

Abstract

Drawing upon Ryff's (1995) positive dimensions of well-being in older adulthood, thisstudy investigated older adults' perceptions of well-being following participation in anintergenerational program. Specifically, we examined the relationship between age, years of volunteer service, and sense of well-being among older adults (n= 46; 55 to 100 years of age) participating in intergenerational programs at 10 sites in Midwestern, agriculturally based communities. Using a mixedmethods design, results revealed that olderadults perceive a heightened sense of well-being from intergenerational interactions wit youth. Older adults reported successful aging included staying active, not worrying aboutone's problems, feeling young, and keeping up with the children and community. Adults aged 74-85 experienced significantly greater satisfaction and enjoyment than their older counterparts, particularly in anticipating working with youth and positive self-perception. No relationship emerged between years of involvement in the program and well-being. Implications for research and program development are discussed.     

Intergenerational Programs and Practices in China: Results Based on a Web Search Method

ABSTRACT

In the midst of an aging population trend and increased concerns about elder care, the Chinese government has developed policies that aim to strengthen family support systems and ensure older adult engagement in community life. One domain of related intervention that has received relatively little attention and systematic study in China is in the area of intergenerational programming. To gain a sense of the breadth and types of intergenerational programs emerging in China, the authors employed a web search method utilizing Google and Baidu search engines. Findings indicate a fair amount of program innovation and diversity as well as a need for additional programmatic and policy measures to strengthen and support intergenerational relationships in family and community contexts.     

Applying RE-AIM to evaluate two community-based programs designed to improve access to eye care for those at high-risk for glaucoma

IntroductionGlaucoma is a leading cause of vision loss and blindness in the U.S. Risk factors include African American race, older age, family history of glaucoma, and diabetes. This paper describes the evaluation of a mobile eye health and a telemedicine program designed to improve access to eye care among people at high-risk for glaucoma.MethodsThe RE-AIM (reach, efficacy, adoption, implementation, and maintenance) evaluation framework was used to harmonize indicators. Both programs provided community-based eye health education and eye services related to glaucoma detection and care. Each program reported data on participants and community partners. An external evaluator conducted site visit interviews with program staff and community partners. Quantitative and qualitative data were integrated and analyzed using the RE-AIM dimensions.DiscussionBy targeting high-risk populations and providing comprehensive eye exams, both programs detected a large proportion of new glaucoma-related cases (17–19%) – a much larger proportion than that found in the general population (<2%). The educational intervention increased glaucoma knowledge; evidence that it led people to seek eye care was inconclusive.ConclusionsEvaluation findings from the mobile eye health program and the telemedicine program may provide useful information for wider implementation in public health clinics and in optometrist clinics located in retail outlets.     

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college

Objective: To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. Participants: 184 community college students (ages 18–19) participated in the study from April–December 2015. Methods: Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Results: Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. Conclusions: The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Evaluating Social Integration and Psychological Outcomes for Older Adults Enrolled at a University Intergenerational Program

Abstract

Intergenerational programs are proliferating. The basic assumption of such programs is that pairing older and younger people in various activities and contexts such as educational programs will produce positive developmental benefits for all participants. Educational programs appear to help adults to remain socially active and connected. The University of Valencia (Spain) initiated in 1999–2000 a “University Program for Seniors” for adults age 55 and over, entitled “Nau Gran.”The goal of this paper is to present baseline results on the benefits and impacts for older adults enrolled at the program during 2002. Results from a sample of 212 sophomore and junior older adult participants are presented. The questionnaire included socio-demographic information and items regarding health, social integration, and psychological outcomes. Results indicated that older adults attending courses at the University increased their level of social integration.     

Adult Literacy Education and Community Development

SUMMARY

This article responds to the concern that low-literate community residents often are marginalized in community development processes. They are unable to give voice to their concerns, interests and their vision for their community. Perspectives and approaches in the fields of adult literacy education and community development are explored to determine how adult literacy education might be used to further the goals of community development. While there are parallels between these two disciplines, there are also barriers to overcome if an integrated approach to dealing with community issues is realized. This article reflects an interest in advancing a comprehensive approach to community development in communities with limited economic resources, low-level literacy and limited access. It seeks to address the issue of whether adult literacy education programs have a meaningful role to play in community development. The strengths of participatory approaches such as community-based literacy, and community development principles such as collective action, shared values, participation, social justice, political awareness and action, comprehensiveness, empowerment, and learning and reflection, facilitate an interdisciplinary approach.     

Elder Abuse: The Canadian Experience

ABSTRACT

Abuse and neglect of older adults occurs in all Canadian communities and solutions require the coordinated efforts of society at large. Amelioration entails more than a legislative approach. Prevention of this growing problem is a social responsibility that requires networking and collaboration between different disciplines in all sectors of the community. This article will discuss elder abuse in Canada from a historical perspective, as well as current legislation, model programs, and research initiatives. It is intended to allow for comparison from the various countries presented in this volume. Hopefully, readers will find some models, or ideas, they may wish to explore or even replicate within their own jurisdictions.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.     

Realities and Hopes for Older Gay Males

Abstract

Data about gay men in the Midwest over the age of 50 are extracted from a larger study of gay men and lesbian women. Information is sought regarding the role of sexual orientation, social networks, and social programs and activities in personal assessments of both the aging process and life satisfaction. The sample was divided into two groups: men 60 years of age and older, and men between the ages of 50 and 60. Differences were found between these subgroups, especially regarding acceptance of the aging process; yet these men were more similar than different in most aspects of life. Participation in gay community activities, social and religious, was found to be important for the quality of life of these men. Those integrated into the community, formally and informally, were also more likely to believe that their sexual orientation had helped their aging process.     

Intergenerational Activities that Promote Engaging Conversations are Preferred among Young and Older Adults

ABSTRACT

Loneliness negatively affects young and older adults. Intergenerational activities foster social connectedness. Using quantitative and qualitative methods, this study explored which intergenerational activities are most enjoyable for college students and retirement community residents. Demographics, loneliness, enjoyment, conversation level, and type of activity were analyzed. The enjoyment and conversation variables were positively correlated (r = .59, p < .001) which was supported by participants’ narratives. Both populations most enjoyed the activities with higher conversation levels, with the first being committees, followed by meals, one on one activities, and transportation. Retirement communities and universities should promote intergenerational activities, which include meaningful conversations.     

Chapter 10: Ceridian's Experience in the Integration of EAP,Work-Life and Wellness Programs

SUMMARY

This article considers EAP services, work-life and wellness programs and the implications of integrating these services. The concept of how wellness programs enter into this equation is explored as well as how Web-based services have played a significant role. Ceridian's experience in providing these services is explored through a case study, anecdotal information, and other data. This article reviews why integrated EAP services, work-life and wellness programs offer more value when compared to programs that contain individual components. It is concluded that wellness and the Internet continue to play a key role in programs becoming more integrated. It is also suggested that integration is now larger than traditional EAP, work-life, and wellness programs. Other human resource services are becoming more important components of integrated services.     

Older Gays and Lesbians

Summary

This article discusses the impact that coming of age in the Pre-Stonewall era has had on older gays and lesbians. Anti-gay hate and violence, within a historical context of homophobia and heterosex-ism, are examined. Risk factors, as well as coping capacities, for older lesbians and gays are explored. Research on the psychological adjustment and well-being of older gays and lesbians is reviewed, and suggestions for intervention with this population are proposed.