Health Information Seeking Using Tech and Non-Tech Sources Among a Diverse Sample of Caregivers in the Deep South.

Caregivers of people living with dementia (PLWD) are often tasked with making decisions about their loved one's daily care and healthcare treatment, causing stress and decision-making fatigue. Many caregivers engage in health information seeking to improve their health literacy for optimal decision-making, though there is limited knowledge about the strategies used to increase their health literacy. This study involved a survey of caregivers in Alabama, most of whom were African American and/or living in rural communities that have historically underserved. The findings shed light on caregivers' experiences in seeking out health-related information and their perceptions of various sources of information.

ChatGPT vs Google for Queries Related to Dementia and Other Cognitive Decline: Comparison of Results.

BACKGROUND: People living with dementia or other cognitive decline and their caregivers (PLWD) increasingly rely on the web to find information about their condition and available resources and services. The recent advancements in large language models (LLMs), such as ChatGPT, provide a new alternative to the more traditional web search engines, such as Google. OBJECTIVE: This study compared the quality of the results of ChatGPT and Google for a collection of PLWD-related queries. METHODS: A set of 30 informational and 30 service delivery (transactional) PLWD-related queries were selected and submitted to both Google and ChatGPT. Three domain experts assessed the results for their currency of information, reliability of the source, objectivity, relevance to the query, and similarity of their response. The readability of the results was also analyzed. Interrater reliability coefficients were calculated for all outcomes. RESULTS: Google had superior currency and higher reliability. ChatGPT results were evaluated as more objective. ChatGPT had a significantly higher response relevance, while Google often drew upon sources that were referral services for dementia care or service providers themselves. The readability was low for both platforms, especially for ChatGPT (mean grade level 12.17, SD 1.94) compared to Google (mean grade level 9.86, SD 3.47). The similarity between the content of ChatGPT and Google responses was rated as high for 13 (21.7%) responses, medium for 16 (26.7%) responses, and low for 31 (51.6%) responses. CONCLUSIONS: Both Google and ChatGPT have strengths and weaknesses. ChatGPT rarely includes the source of a result. Google more often provides a date for and a known reliable source of the response compared to ChatGPT, whereas ChatGPT supplies more relevant responses to queries. The results of ChatGPT may be out of date and often do not specify a validity time stamp. Google sometimes returns results based on commercial entities. The readability scores for both indicate that responses are often not appropriate for persons with low health literacy skills. In the future, the addition of both the source and the date of health-related information and availability in other languages may increase the value of these platforms for both nonmedical and medical professionals.

Developing a Memory and Communication App for Persons Living With Dementia: An 8-Step Process.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3928/19404921-20210825-02.

Community Asset Mapping in Public Health: A Review of Applications and Approaches.

Though Community Asset Mapping (CAM) has been widely used in community-development and applied to public health interventions, little has been done to synthesize the current state of this approach. This paper reports the findings from a scoping review of research where CAM was applied to public health practice and research initiatives. We identified and reviewed 28 articles featuring studies that used asset mapping for public health purposes. Overall, we found that the purpose and methods related to asset mapping varied widely across studies. Given the potential benefits of asset mapping and its relevance to social work principles, researchers and public health professionals should approach asset mapping with the same level of attention, rigor, and ethics as other research methodologies or intervention design. There is an obligation to engage in asset mapping in ways that promote our ethical principles of service, dignity, integrity, and competence.

Assessing Progress Toward the Vision of a Comprehensive, Shared Electronic Care Plan: Scoping Review.

BACKGROUND: Care plans are central to effective care delivery for people with multiple chronic conditions. But existing care plans-which typically are difficult to share across care settings and care team members-poorly serve people with multiple chronic conditions, who often receive care from numerous clinicians in multiple care settings. Comprehensive, shared electronic care (e-care) plans are dynamic electronic tools that facilitate care coordination and address the totality of health and social needs across care contexts. They have emerged as a potential way to improve care for individuals with multiple chronic conditions. OBJECTIVE: To review the landscape of e-care plans and care plan-related initiatives that could allow the creation of a comprehensive, shared e-care plan and inform a joint initiative by the National Institutes of Health and the Agency for Healthcare Research and Quality to develop e-care planning tools for people with multiple chronic conditions. METHODS: We conducted a scoping review, searching literature from 2015 to June 2020 using Scopus, Clinical Key, and PubMed; we also searched the gray literature. To identify initiatives potentially missing from this search, we interviewed expert informants. Relevant data were then identified and extracted in a structured format for data synthesis and analysis using an expanded typology of care plans adapted to our study context. The extracted data included (1) the perspective of the initiatives; (2) their scope, (3) network, and (4) context; (5) their use of open syntax standards; and (6) their use of open semantic standards. RESULTS: We identified 7 projects for e-care plans and 3 projects for health care data standards. Each project provided critical infrastructure that could be leveraged to promote the vision of a comprehensive, shared e-care plan. All the e-care plan projects supported both broad goals and specific behaviors; 1 project supported a network of professionals across clinical, community, and home-based networks; 4 projects included social determinants of health. Most projects specified an open syntax standard, but only 3 specified open semantic standards. CONCLUSIONS: A comprehensive, shared, interoperable e-care plan has the potential to greatly improve the coordination of care for individuals with multiple chronic conditions across multiple care settings. The need for such a plan is heightened in the wake of the ongoing COVID-19 pandemic. While none of the existing care plan projects meet all the criteria for an optimal e-care plan, they all provide critical infrastructure that can be leveraged as we advance toward the vision of a comprehensive, shared e-care plan. However, critical gaps must be addressed in order to achieve this vision.

Disparities in depression among Chinese older adults with neurodegenerative diseases.

OBJECTIVES: Neurodegenerative diseases (NDs), such as Parkinson's disease and Alzheimer's disease and related dementias, are a leading cause of death and disability in China. Although studies have demonstrated that depression is associated with NDs, little is known about the factors impacting this relationship. This study aimed to explore and identify the risk and protective factors of depression among Chinese older adults with NDs. METHODS: Data selection was based on the behavioral model of late-life depression. Data from the latest wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 1998-2014) in 2014 were analyzed. Among the sample, 334 older adults aged 65 and older with NDs were included in the analysis. A logistic regression analysis was conducted by SPSS 24.0. RESULTS: Participants who lived in urban areas (O.R.= 2.494, p< .05) or needed more support for Activity of Daily Living (O.R.= 1.136, p< .05) were more likely to have depression. Participants who lived with household members (O.R.= .380, p< .05), self-reported their health status as fair (O.R.= .250, p< .01), or believed their health status remained the same (O.R.= .331, p< .01) were less likely to have depression. CONCLUSION: Our findings suggest that policymakers and healthcare professionals should pay specific attention to the regional disparities of healthcare services and the cultural background to understand the relationship between NDs and depression and improve the well-being of ND patients.

Integration of Health Information Technology and Promotion of Personhood in Family-Centered Dementia Care: Intervention Trial.

Alzheimer's disease and related dementias (ADRD) often result in communication deficits that can lead to negative health outcomes as well as complications for caregiving and clinical care. Although augmentative and alternative communication (AAC) devices have demonstrated efficacy in assisting persons living with dementia (PLWD) in communicating, few devices offer customization for the person's care preferences (e.g., clothing, food, activities) or are designed for integration into clinical care and caregiving. To address this issue, our research team is developing a novel electronic AAC prototype with a touchscreen to promote communication and personhood for PLWD. The current article describes the development of this technology and uses the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement to describe the clinical trial that is planned to test its efficacy. TARGETS: PLWD and their care partners. INTERVENTION DESCRIPTION: Use of AAC Plus to promote communication and personhood for PLWD. MECHANISMS OF ACTION: AAC Plus will provide PLWD and care partners a way to communicate PLWD's daily preferences and provide clinical data for health care providers. OUTCOMES: Determine whether enhanced communication of daily preferences of PLWD will improve quality of life of PLWD and their care partners. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04571502 (Date of registration October 1, 2020). [Research in Gerontological Nursing, 14(5), 225-234.].

Chatbots to Support People With Dementia and Their Caregivers: Systematic Review of Functions and Quality.

BACKGROUND: Over the past decade, there has been an increase in the use of information technologies to educate and support people with dementia and their family caregivers. At the same time, chatbot technologies have become increasingly popular for use by the public and have been identified as having benefits for health care delivery. However, little is known about how chatbot technologies may benefit people with dementia and their caregivers. OBJECTIVE: This study aims to identify the types of current commercially available chatbots that are designed for use by people with dementia and their caregivers and to assess their quality in terms of features and content. METHODS: Chatbots were identified through a systematic search on Google Play Store, Apple App Store, Alexa Skills, and the internet. An evidence-based assessment tool was used to evaluate the features and content of the identified apps. The assessment was conducted through interrater agreement among 4 separate reviewers. RESULTS: Of the 505 initial chatbots identified, 6 were included in the review. The chatbots assessed varied significantly in terms of content and scope. Although the chatbots were generally found to be easy to use, some limitations were noted regarding their performance and programmed content for dialog. CONCLUSIONS: Although chatbot technologies are well established and commonly used by the public, their development for people with dementia and their caregivers is in its infancy. Given the successful use of chatbots in other health care settings and for other applications, there are opportunities to integrate this technology into dementia care. However, more evidence-based chatbots that have undergone end user evaluation are needed to evaluate their potential to adequately educate and support these populations.

Correction: Existing Mobile Phone Apps for Self-Care Management of People With Alzheimer Disease and Related Dementias: Systematic Analysis.

[This corrects the article DOI: 10.2196/15290.].

Existing Mobile Phone Apps for Self-Care Management of People With Alzheimer Disease and Related Dementias: Systematic Analysis.

BACKGROUND: Alzheimer disease and related dementias (AD/RD) are progressive neurocognitive disorders that currently affect approximately 50 million people worldwide. Mobile phone apps have been well-integrated into daily lives and can be used to deliver and promote health care. There is an increase in the use of technology to provide care and support to AD/RD patients and their families. OBJECTIVE: This study aimed to review apps designed for AD/RD patients and analyze the benefits of, and challenges to, such technological solutions. METHODS: A systematic approach was applied to review the availability, content, features, and quality of mobile phone apps to support self-care among AD/RD patients. RESULTS: The initial search for this review was conducted in January 2019, and the screening and analysis of the included apps were completed in May 2019. A total of 14 apps were included from an initial search of 245 apps. The top 3 features were alert (9/14, 64%), self-care tips (6/14, 42%), and social networking capacity (5/14, 35%). On average, the readability of the apps was a tenth-grade reading level (SD 3.06). The overall quality was 3.71 out of 5 (SD 1.37). CONCLUSIONS: Our findings suggest that currently available apps for AD/RD patients may not meet complex needs and may be challenging to use, given the possible impaired communication ability associated with AD/RD. Therefore, high-quality apps need to be developed and rigorously evaluated for feasibility and efficacy.

Family-centeredness in dementia care: what is the evidence?

Over the last decade, person-centered practices in care for adults with Alzheimer's disease and related dementias (AD/RD) has received significant attention from the health care and social service literature, though less attention has been paid to family-centered care (FCC). Initially conceptualized for application in pediatric care, FCC is an approach where clinicians develop partnerships with care recipients' family members and views family members as having expertise to contribute to the clinical team. More recently, FCC has been extended to the literature on AD/RD care, though little is known about the extent to which family-centered interventions have been developed for use in AD/RD clinical practice, or the effectiveness of family-centered care for this population. To contribute to gaps in scholarship, this systematic review identified and evaluated intervention studies examining FCC in AD/RD clinical care. Implications for research and practice are discussed.

Does the DSW Practice Doctorate Provide Opportunities for Closing Gaps in Gerontology?

The 2019 annual conference of the Group for the Advancement of Doctoral Education in Social Work (GADE) highlighted the increasing role that the Doctor of Social Work (DSW) degree is playing in social work education. Over the past 15 years, social work has followed suit with a number of other health and helping professions (PsyD, DNP, DPT, etc.) by expanding access to practice doctorate programs for professionals who are interested in doctoral-level training, but primarily have interest to remain working in the field as practitioners, rather than become researchers. As more DSW programs have emerged, questions and concerns persist about the DSW, with most questions pertaining to the meaning of the degree for the overall field and the value of having an additional advanced practice degree in social work beyond the MSW degree. However, I urge readers of the Journal of Gerontological Social Work to consider the opportunities that the DSW may present for advancing gerontological education, research, and practice.

Conducting secondary analysis of qualitative data: Should we, can we, and how?

While secondary data analysis of quantitative data has become commonplace and encouraged across disciplines, the practice of secondary data analysis with qualitative data has met more criticism and concerns regarding potential methodological and ethical problems. Though commentary about qualitative secondary data analysis has increased, little is known about the current state of qualitative secondary data analysis or how researchers are conducting secondary data analysis with qualitative data. This critical interpretive synthesis examined research articles (n = 71) published between 2006 and 2016 that involved qualitative secondary data analysis and assessed the context, purpose, and methodologies that were reported. Implications of findings are discussed, with particular focus on recommended guidelines and best practices of conducting qualitative secondary data analysis.

Smartphone-Based Health Technologies for Dementia Care: Opportunities, Challenges, and Current Practices.

Most of the 5.4 million people affected by Alzheimer's disease and other forms of dementia (AD) are noninstitutionalized, receiving care by unpaid family caregivers and medically managed by a primary care provider (PCP). Health Information Technology has been recognized for its potential in improving efficiency and quality of AD care and support for AD caregivers. Simultaneously, smartphone technologies have become an increasingly common way to deliver physical and behavioral health care. However, little is known about how smartphone technologies have been used to support AD caregiving and care. This article highlights the current need for smartphone-based interventions for AD and systematically identified and appraised current smartphone apps targeting and available for AD caregivers. Findings indicate that individual available apps have limited functions (compared with the complex needs of caregivers) and little has been done to extend AD caregiving apps to Hispanic populations. Implications for research, practice, and policy are discussed.

The Potential of Information Technology to Navigate Caregiving Systems: Perspectives from Dementia Caregivers.

Technologies designed to support caregivers of adults with Alzheimer's disease and related dementias (AD/RD) have been developing at an increasingly rapid pace. However, little remains known about caregivers' perspectives on how technologies can and should help them navigate larger service systems they interact with to engage in caregiving. This study involved in-depth interviews and a beta test of an AD/RD caregiver app to learn more about how they currently use technologies and how potential technological features and functions can best meet their needs. Thematic findings suggest a conceptual model for designing AD/RD caregiver technologies. The findings suggest that eHealth and individual technologies may not fully meet the needs of caregivers as they navigate the larger systems within which they provide care. Findings highlight the need to develop technologies for caregivers that are effective, easy to use, and more widely disseminated - especially for caregivers from disadvantaged backgrounds.

Rural Dementia Caregivers and Technology: What Is the Evidence?

Caregivers of adults with dementia often experience burden and depression as a result of their intensive caregiving activities. Dementia caregivers in rural communities experience additional barriers of large distances from health care providers and/or limited numbers of health care providers, which may further exacerbate burden. Technology has been identified as a platform for reducing dementia caregiver burden and stress, although the extent to which technologically based interventions have been tested with rural dementia caregivers is unknown. The current study involved a systematic review of technologically based interventions to assess the geography of sample populations, scope of interventions, and study outcomes. Of 8,348 articles identified and screened, 30 articles met eligibility guidelines. The current review found that few studies identified their sample population as living in rural communities. In addition, studies were more likely to report improved psychosocial outcomes of intervention groups, with few reporting positive effects on caregiving skills/self-efficacy. Implications for future research are discussed. [Res Gerontol Nurs. 2018; 11(4):216-224.].

Influences of Transportation on Health Decision-Making and Self-Management Behaviors among Older Adults with Chronic Conditions.

Although transportation has been established as a facilitator/barrier to health self-management, little is known about how the context of transportation shapes health self-management behaviors and decision-making among older adults with chronic conditions. This study interviewed 37 older adults with chronic conditions in Florida to examine their perspectives about how transportation influences their chronic care self-management. The data were systematically analyzed for themes. The thematic findings revealed how transportation intersected with participants' everyday experiences with chronic health self-management, how they evaluated transportation as part of the process of making decisions about health, and how creative problem-solving about transportation became an additional health self-management activity for addressing their complex needs. These findings suggest that the context of transportation goes beyond a basic facilitator/barrier for health and enhance our understanding about how transportation services and policies may be changed to better address the needs of older adults with chronic conditions.

Health Self-management Among Older Prisoners: Current Understandings and Directions for Policy, Practice, and Research.

The population of aging prisoners has increased significantly over the past several decades, resulting in concerns about the criminal justice system's ability to address the needs of prisoners and parolees with chronic health conditions. This is troubling, given the health disparities among incarcerated populations. Health self-management has become a strategy within the community-based health care industry to improve health services and outcomes while reducing health care costs for nonincarcerated individuals with chronic conditions. However, to date little research has focused on the practice or promotion of health self-management among current and former incarcerated populations. This article highlights current understandings about chronic health self-management among older prisoners and parolees, with an emphasis on the potential benefits and current challenges in promoting their health self-management practices. Finally, specific recommendations are made for promoting health self-management for these populations through social work practice, policy advocacy, and research to achieve goals in improving health outcomes and reducing healthcare costs.

Transforming mental health services to address gender disparities in depression risk factors.

Depression in older women is a significant and growing problem. Women who experience life stressors across the life span are at higher risk for developing depression than their male counterparts. Research has focused primarily on identifying and reducing the symptoms of depression for the general aging population, disregarding gender-specific differences in the foundational causes of depression. This article examines how women's unique experiences influence the development of depression and highlights how the current mental health system could better meet older women's needs by moving from a gender-neutral model to one that emphasizes women's experiences.

CareHeroes Web and Android™ Apps for Dementia Caregivers: A Feasibility Study.

The purpose of the current feasibility study was to examine the use, utility, and areas for refinement of a newly developed web-based and Android™ application (app) (i.e., CareHeroes) with multiple features to support individuals caring for loved ones with Alzheimer's disease or other forms of dementia (AD). The study was performed over an 11-week period with triads of AD caregivers, assigned home care case managers, and primary care providers (PCP). The study involved quantitative and qualitative methodologies. Eleven AD caregivers (seven daughters, two sons, and two spouses), six case managers, and five PCPs participated. Data demonstrate participants were mostly satisfied with the multiple features and ability to access and use CareHeroes. Barriers for use include concerns about time constraints and not being familiar with technology. Although the study findings are promising, a longer term study to evaluate the impact of the CareHeroes app is indicated.