Balancing Caregiver Resources Provided by Michigan's Area Agencies on Aging.

Timely linkages are necessary for people with dementia and other disabling conditions to reduce caregiver burnout, prevent unnecessary hospitalization, or placement in alternate care settings. To identify needs, the Caregiver Resource Collaborative conducted a needs assessment of Michigan's sixteen area agencies on aging (AAA). Responses by the sixteen AAAs to an online questionnaire provided a point-in-time picture of current caregiver assessment and services conducted by AAAs. Fifteen AAAs responded there would definitely or probably be an increase in the number of caregivers. Fifteen responded that they purchase or contract out respite care services. Fourteen stated that they provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provide training, none of the AAAs provides supportive services. The AAAs anticipate rapidly increasing needs for caregiver supports and services. While each provides different services, demand will continue to grow as the older adult population increases.

Education and Consultation Needs of Social Workers in Practice with Rural Older Adults.

The aging population and shortage of primary care physicians lead to increasing gaps in access to rural geriatric healthcare. Of concern is the lack of access to geriatric expertise, leading to adverse effects on rural older adults' health outcomes and quality of life. The Geriatric Rural Extension of Expertise through Telegeriatric Services (also known as GREETS) project surveyed rural physical and behavioral healthcare practitioners to identify gaps in geriatric competencies in the rural workforce. Using the Qualtrics platform, a survey was distributed to professional membership lists throughout the State of Michigan. A total of 106 responses were completed, of which 50 were from respondents who identified their profession as a social worker. As would be expected based on social workers' scope of practice and the settings in which they provide services, social worker respondents noted a higher need than the other practitioner respondents for education related to (a) managing chronic pain, (b) managing care of patients with multiple chronic conditions, (c) having serious illness conversations, (d) diagnosing dementia, and (e) discussing advance care planning. Having identified these needs provides a basis for identifying and implementing training and resources for social work and other disciplines involved in geriatric care and services.

Rethinking the Digital Divide: Using an Internet Survey in a Flint Water Crisis Medicaid Population.

This project examined the preferred mode of response (internet, phone, mail) to a health services survey. Data were collected via survey responses from a subsample of Flint Water Crisis Medicaid Expansion Waiver enrollees (N=2,584). Analyses were stratified by age, residency, race, and income. Chi-square tests were used to detect categorical differences. The majority of participants responded by internet (55.5%), followed by mail (39.4%), and phone (5.2%). Of those responding by internet, 75% used smartphones for connectivity. Black and White respondents used the internet at a greater rate than Hispanic respondents (p<.01). Respondents at 200% federal poverty level (FPL) or higher used the internet mode at greater rates than those below 200% FPL (p<.01). Our findings suggest greater internet use in a vulnerable population than expected, but the digital divide persists. In the advent of COVID-19, this finding can inform future health programming using digital communication and telehealth.

"It Takes Some Empathy, Sympathy, and Listening": Telephone Outreach to Older Detroiters in a Pandemic as a Modality to Gain an Understanding of Challenges and Resiliency.

This manuscript describes a telephone outreach project for members of a research registry program for older adults in Detroit, Michigan. From April until December 2020, the Healthier Black Elders Center designed and implemented a telephone outreach program, calling 1204 older adults utilizing 15 staff and volunteers. The calls served to check in on registry members and collect data on mental health, coping mechanisms, access to services, masks, testing, and tele-health. This paper details the methods of developing and implementing an innovative engagement program that collected time-sensitive data from older Black adults that has directly been applied to create virtual health education programs, share resource information, and create a program to reduce social isolation.

Building and Sustaining a Community Advisory Board of African American Older Adults as the Foundation for Volunteer Research Recruitment and Retention in Health Sciences.

Older African Americans' participation in health-related research is severely limited; they are not involved in sufficient numbers to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older African Americans' vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of African American older adults in metro Detroit, Michigan to oversee the research recruitment and retention of fellow minority older adult research participants. CAB members develop and support community health programming that provides free resources to older adults and also serves as fertile ground for recruiting participants in a volunteer research registry. CAB members are also provided ongoing training on social and behavioral health research and are supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement. This community-engaged model of sustaining a CAB of African American older adults offers key lessons learned on building relationships and trust, valuing and leveraging community members' expertise and time, sharing decision-making, and fostering genuine community all while promoting research recruitment and retention among underserved populations.

Analytic Training for Junior Investigators in Minority Aging Research: The Michigan Model.

Since 1997, the Resource Centers for Minority Aging Research Program at the National Institute on Aging has been the model for training social and behavioral scientists in minority aging and health disparities research. The latest cycle of these Centers implemented a new structure for the analytic training of junior investigators and for advancing methodologic work relevant to improving the rigor of minority aging research. In this article, we describe the conceptual framework, logistical approaches, challenges, and lessons learned from our experience training junior investigators in methodology through the Michigan Center for Urban African American Aging Research over the past 20 years, with the goal of informing future analytic training efforts for the next generation of scholars focused on minority aging issues.

Angry, Scared, and Unsure: Mental Health Consequences of Contaminated Water in Flint, Michigan.

Natural and manmade crises impact community-level behavioral health, including mental health and substance use. This article shares findings from a larger project about community behavioral health, relevant to the ongoing water crisis in Flint, Michigan, using data from a larger study, involving monthly surveys of a panel of key informants from Genesee County. The data come from open-response questions and are analyzed as qualitative data using grounded theory techniques. Although respondents were not asked about the water issues in Flint, participants commented that the water situation was increasing stress, anxiety, and depression among the city's population. Participants thought these mental health issues would affect the entire community but would be worse among low-income, African American populations in the city. Mental health consequences were related not only to the water contamination but to distrust of public officials who are expected and have the authority to resolve the issues. The mental health effects of this public health crisis are significant and have received inadequate attention in the literature. Public health response to situations similar to the water issues in Flint should include sustained attention mental health.