Multilevel Analysis of Child and Adolescent Subjective Well-Being Across 14 Countries: Child- and Country-Level Predictors.

This study tests an ecological, relationship-based model of children's subjective well-being with 9- to 14-year-old children (n = 25,906) from 14 countries across Africa, Asia, Europe, North America, and South America. Children completed the Children's Worlds survey, a self-report measure of contextual and well-being indicators. Multilevel modeling was used to predict children's well-being (life satisfaction and self-image) at two levels, child (age, gender, home context, family relationships, peer relationships, school context, teacher relationships, and neighborhood quality), and country (gross domestic product and income inequality). Findings indicated that intercepts varied significantly across countries. The majority of variance in children's well-being was attributed to child-level rather than country-level factors. Country-level factors did not strongly predict well-being but marginally improved model fit.

Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors.

Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.

An Evaluation of the Counseling on Access to Lethal Means (CALM) Training with an Area Agency on Aging.

Firearms are a significant risk factor in suicide and older adults are disproportionately impacted in suicide by this means. This study investigated the impact of Counseling on Access to Lethal Means (CALM) training with geriatric case managers at an Area Agency on Aging. A concurrent mixed methods approach was used to explore 1) geriatric case managers' attitudes, beliefs, and behavioral intentions about counseling on access to lethal means following CALM training, and 2) perceived barriers to assessing for suicidality and counseling clients on access to firearms. The CALM evaluation data was collected immediately posttest at CALM training, at three-month follow up. Results indicated that 38% of respondents reported they had, since CALM training, discussed reducing access to lethal means with clients and/or families. At three-month follow up, data showed that most beliefs, attitudes, and behavioral intentions about counseling clients and families on this topic increased. Focus group findings indicated that training had a positive effect on participants' attitudes, beliefs, and behavioral intentions about counseling on access to lethal means.The findings of the present study offer additional evidence and implication for trainings of this type.

Predicting personal self-care in informal caregivers.

Caregiver research often focuses on negative health outcomes, yet little is known about the self-care practices of caregivers. The present study investigates self-care practices among family caregivers and the relationships between personal self-care, perceived stress, and other health variables. Data were collected from informal caregivers through self-administered Internet and paper surveys that included the Medical Outcomes Study Short Form 36-item Health Survey, Perceived Stress Scale, and Self-Care Practices Scale. Personal self-care was most strongly associated with emotional well-being, pain, perceived stress, and general health. The relevance of study findings to strengthening family caregiver programs and future research is discussed.

Living with Low Vision: Strategies Supporting Daily Activity.

The purpose of this research was to describe the strategies that older adults with low vision use to support daily living. A descriptive qualitative study of 10 older adults with low vision was conducted using semistructured, audio-recorded interviews. The data was coded and grouped into categories, and the findings were summarized. Four major themes were identified: (a) device nonuse; (b) sensory strategies and devices; (c) environmental strategies; and (d) resourcefulness. Older adults with low vision try many devices and strategies to find the ones that allow them to participate in meaningful activity within their physical and social environment. These findings support the use of a client-centered, multicomponent, problem-solving approach to low vision rehabilitation to maximize performance of daily activity despite declining vision.

Validation of the eHEALTH Literacy Scale (Eheals) With Military Service Members.

INTRODUCTION: Medical readiness of individual service members (SMs) is an integral component of operational readiness. Electronic Health (eHealth) literacy, here defined as the ability to seek out, find, evaluate, and appraise, integrate, and apply what is gained in electronic environments toward solving a health problem, is a key skill to enhance individual medical readiness. The World Health Organization (WHO) has identified health literacy as an important social determinant of health. The Internet enables individuals to access information virtually anywhere, at any place, any time, which is especially beneficial for SMs who serve around the globe, often isolated from modern health care facilities. MATERIALS AND METHODS: This study examined the utility of the eHealth literacy scale (eHeals) as a potentially valuable tool to assist commanders and medical teams for assessing the health literacy of SMs. The main objective of our study was to examine the validity of the three-factor eHEALS measure for an active duty sample, using confirmatory factorial analysis. RESULTS: Our findings support the validity of the eHEALS measure of electronic health literacy among military SMs, potentially identifying a means of measuring SMs' health literacy, and a target for intervention to increase medical readiness, well-being, and overall quality of life for individual SMs. CONCLUSIONS: The study highlights a brief 6-item assessment tool that can quickly and efficiently be added to the current validated health and well-being measures for military personnel. This brief assessment can provide a measure of knowledge, skills, and confidence regarding ehealth information leading to better-informed health care decisions in the military context. These findings are especially relevant given the military's current emphasis on modernization and the need to put people first in order to build the overall team and improve unit effectiveness.

Exploring Challenges and Strategies in Partnering With Community-Based Organizations to Advance Intervention Development and Implementation With Older Adults.

Minoritized older adults face multiple health inequities and disparities, but are less likely to benefit from evidence-based health care interventions. With the increasing diversity of the U.S. aging population, there is a great promise for gerontology researchers to partner with racial/ethnic minority organizations and underrepresented communities to develop and implement evidence-based health interventions. Community-Based Participatory Research and Implementation Science offer guidance and strategies for researchers to develop and sustain community partnerships. However, researchers partnering with community organizations continue to face challenges in these collaborations, study outcomes, and sustainability. This may be especially true for those junior in their career trajectory or new to community-engaged research. The purpose of this forum article is to detail critical challenges that can affect gerontology researcher-community partnerships and relationships from the perspective of researchers. Seven challenges (pre- or mid-intervention design, implementation, and postimplementation phases) described within the Equity-focused Implementation Research for health programs framework are identified and discussed. Potential solutions are also presented. Planning for potential obstacles of the researcher-community partnerships can inform innovative solutions that will facilitate successful partnerships, thereby promoting the advancement of collaborative research between academic institutions and community organizations to improve older adult health outcomes.

Validating the eHealth Literacy Scale in Rural Adolescents.

PURPOSE: Given that the recent eHealth literacy literature supports the properties of the 3-factor eHealth literacy scale (eHEALS) model in samples with millennials, adults, and older adults, the appropriate next step is to establish whether the model can be reproduced in a rural adolescent sample. The purpose of this study was to evaluate the recent 3-factor model by Paige and associates with a sample of seventh-grade students. METHODS: This cross-sectional study included a subsample of students (n = 146) from 3 school districts in Appalachian Kentucky. We used confirmatory factor analysis (CFA) procedures and small sample model fit guidelines to evaluate our model, and the 1-sample bootstrap algorithm with bias-corrected and accelerated 95% confidence intervals to estimate associations among eHEALS and health and technology variables. FINDINGS: A total of 137 students, or 61% of enrolled seventh-grade students, completed the study. CFA results showed eHEALS 3-factor loadings-information awareness, information seeking, and information engagement-were high (≥0.63) and statistically significant. We observed evidence of a good model fit (root mean square error of approximation [RMSEA] = 0.07, standardized root mean square residual [SRMR] = 0.03, comparative fit index [CFI] = 0.99) and results are comparable with Paige and associates' model fit (RMSEA = 0.06, SRMR = 0.08, CFI = 0.98). Correlations showed that students with more access to technology were associated with higher information seeking (r = 0.31) and higher information engagement (r = 0.23). eHealth literacy scores did not differ by level of rurality or gender. CONCLUSIONS: The 3-factor eHEALS is a reliable and valid instrument in assessing eHealth literacy in a group of rural seventh graders from Appalachian Kentucky.

Gender in the time of COVID-19: Evaluating national leadership and COVID-19 fatalities.

In this paper we explore whether countries led by women have fared better during the COVID-19 pandemic than those led by men. Media and public health officials have lauded the perceived gender-related influence on policies and strategies for reducing the deleterious effects of the pandemic. We examine this proposition by analyzing COVID-19-related deaths globally across countries led by men and women. While we find some limited support for lower reported fatality rates in countries led by women, they are not statistically significant. Country cultural values offer more substantive explanation for COVID-19 outcomes. We offer several potential explanations for the pervasive perception that countries led by women have fared better during the pandemic, including data selection bias and Western media bias that amplified the successes of women leaders in OECD countries.

Older adults' privacy considerations for vision based recognition methods of eldercare applications.

This study aims to explore older adults' privacy considerations for technology based monitoring applications in eldercare that use video systems. It specifically aims to introduce alternative vision based tools and identify whether distorting or "anonymizing" captured images affect older adults' privacy concerns and willingness to allow such an application to be installed in their residence. Ten residents of an independent retirement community were recruited to participate in a series of scenarios. Each scenario involved a daily activity such as sitting in the living room and having a visitor, or preparing a snack. These sessions were video-recorded using different image processing and extraction approaches. Follow-up in-depth interviews with participants were conducted after a demonstration of the captured images. Findings indicate that shape extraction can alleviate privacy concerns associated with the use of cameras. Participants expressed no privacy concerns with silhouette images and emphasized the importance of anonymity in the video sequences. They furthermore expressed the desire to control system operation by being able to turn a vision-based system off and on, and also determine who has access to the collected information.

Development of the Older Adult Prescription Drug Assessment Questionnaire for Case Workers.

Instruments assessing geriatric case managers' perceptions of prescription abuse are limited. Based on a review of current literature and pilot testing feedback, 22 items were initially assembled to form an older adult Prescription Drug Assessment Questionnaire (PDAQ). Case managers ( N = 161) at an older adult agency located in a Midwestern state were surveyed using the instrument. Data were subjected to exploratory factor analysis using principal axis factoring (PAF) and Promax rotation, and Horn's parallel analysis determined the number of extracted factors. PAF generated a final 11-item three-factor model accounting for 51% of total variance explained: Standard Assessment (Factor 1; four items; ∞ = .83), Assessment Belief (Factor 2; three items; ∞ = .74), and Problem Scope (Factor 3; four items; ∞ = .62). The older adult PDAQ is a brief, data-driven instrument with acceptable psychometric properties for assessing perceptions of prescription drug abuse and misuse assessment and counseling.

The need to know caregiver perspectives toward using smart home technology.

This article reviews the literature on adults with serious mental illness, their caregivers, and smart home technology. The article provides compelling evidence for social workers to undertake research aimed at investigating caregivers' perceptions toward using smart home technology for care of adult family members or friends with a serious mental illness. Empirical support for using smart home technologies with adults with serious mental illness is provided, and recommendations for future social work research are offered.

Testing an in-home gait assessment tool for older adults.

In this paper, we present results of an automatic vision-based gait assessment tool, using two cameras. Elderly residents from TigerPlace, a retirement community, were recruited to participate in the validation and test of the system in scripted scenarios representing everyday activities. The residents were first tested on a GAITRite mat, an electronic walkway that captures footfalls, and with inexpensive web cameras recording images. The extracted gait parameters from the camera system were compared with the GAITRite; excellent agreement was achieved. The residents then participated in the scenarios, with only the cameras recording. We found that the residents displayed different gait patterns during the realistic scenarios compared to the GAITRite runs. This finding provides support of the importance and advantage of continuous gait assessment in a daily living environment. Results on 4 elderly participants are included in the paper.

A real-time system for in-home activity monitoring of elders.

In this paper, we propose a real-time system for in-home activity monitoring and functional assessment for elder care. We describe the development of the whole system which could be used to assist the independent living of elders and improve the efficiency of eldercare practice. With this system, data is collected, silhouettes extracted, features further analyzed and visualized into graphs from which eldercare professionals are able to understand massive video monitoring data within a short period of time. Our experimental results demonstrate that the proposed system is efficient in indoor elder activities monitoring and easily utilized by eldercare professionals.