Understanding the implementation and sustainability needs of evidence-based programs for racial and ethnic minoritized older adults in under-resourced communities with limited aging services.

BACKGROUND: Evidence-based programs (EBPs) for older adults effectively improve health outcomes. However, there is a limited understanding of the unique needs of service providers as they consider adopting, implementing, and maintaining programs for older minority adults in low-income communities with limited aging services. METHODS: We conducted semi-structured interviews with key informants of community-based organizations (CBOs) to understand implementation and sustainability needs of CBOs within four racial and ethnically diverse Los Angeles County geographic areas. We performed thematic analysis of interview transcripts. RESULTS: Interviews were conducted with representatives from 25 senior-serving agencies providing aging-related EBPs. CBO representatives reported implementing EBPs in 8 domains: Falls Prevention (68%), Mental Health (64%), Caregiver Health (48%), Chronic Disease Management (48%), Diabetes Management (36%), Arthritis Management (28%), Physical Activity (24%), and Multiple Conditions Management (8%). Themes are presented using the six domains of the Bass and Judge framework for factors impacting successful and sustained EBP implementation. CBOs in low-income and diverse communities described unique challenges with tailoring interventions based on local community context (literacy, language), cultural context, and locally available resources (technology, safe community spaces, transportation) and faced resource-intensive administrative burdens through staff turnover, data collection, sustainable funding, and networking. CONCLUSIONS: Serving racial and ethnic communities has unique challenges that require tailored approaches and additional resources to ensure equitable access to EBPs for all communities. We describe suggestions for enhancing the effective adoption of EBPs among service agencies in under-resourced and diverse aging communities serving populations with aging-related health disparities.

Prediction of psychopathology during the COVID-19 pandemic using linear and non-linear methodologies: importance of COVID-19 threat perception, emotional competencies and resilience.

The presence of a mental or physical illness prior to the pandemic, the perceived threat from COVID-19, resilience or emotional intelligence may influence the onset or increase of psychopathology during the COVID-19 lockdown. The aim was to assess predictors of psychopathology by comparing two statistical methodologies (one linear and one non-linear). METHOD: A total of 802 Spanish participants (65.50% female) completed the questionnaires independently after signing informed consent. Psychopathology, perceived threat, resilience and emotional intelligence were assessed. Descriptive statistics, hierarchical regression models (HRM) and fuzzy set qualitative comparative analysis (fsQCA) were conducted. RESULTS: The data obtained through the HRM showed that the presence of a previous mental illness, low resilience and emotional clarity, high emotional attention and repair, and COVID-19 threat perception predicted 51% of the variance in psychopathology. Results obtained from QCA showed that different combinations of these variables explained 37% of high levels of psychopathology and 86% of low levels of psychopathology, highlighting how the presence of prior mental illness, high emotional clarity, high resilience, low emotional attention and low perceived COVID-19 threat play a key role in explaining psychopathology. CONCLUSIONS: These aspects will help promote personal resources to buffer psychopathology in lockdown situations.

La présence d'une maladie mentale ou physique avant la pandémie, la menace perçue du COVID-19, la résilience ou l'intelligence émotionnelle peuvent influencer l'apparition ou l'augmentation de la psychopathologie pendant le confinement lié au COVID-19. L'objectif était d'évaluer les prédicteurs de la psychopathologie en comparant deux méthodologies statistiques (linéaire et non linéaire).Méthode: Un total de 802 participants espagnols (65,50% de femmes) ont rempli les questionnaires de manière indépendante après avoir donné leur consentement éclairé. La psychopathologie, la menace perçue, la résilience et l'intelligence émotionnelle ont été évaluées. Des statistiques descriptives, des modèles de régression hiérarchique (HRM) et une analyse qualitative comparative floue (fsQCA) ont été effectués.Résultats: Les données obtenues grâce au HRM ont montré que la présence d'une maladie mentale antérieure, une faible résilience et une clarté émotionnelle réduite, une attention et une réparation émotionnelles élevées, ainsi que la perception de la menace COVID-19, ont prédit 51% de la variance de la psychopathologie. Les résultats obtenus à partir de QCA ont montré que différentes combinaisons de ces variables expliquaient 37% des niveaux élevés de psychopathologie et 86% des niveaux faibles de psychopathologie, mettant en évidence l'importance de la présence d'une maladie mentale antérieure, d'une clarté émotionnelle élevée, d'une résilience élevée, d'une attention émotionnelle réduite et d'une menace perçue de COVID-19 faible dans l'explication de la psychopathologie.Conclusions: Ces aspects aideront à promouvoir les ressources personnelles pour atténuer la psychopathologie dans les situations de confinement.

Compassion in Spanish-speaking health care: A systematic review.

Altought compassionate care is an important factor in health care, remains an unmet need in patients. The studies have been carried out in Anglo-Saxon countries with cultural environments and health systems that are very different from Spanish-speaking contexts. The aim of this study to understand the conceptual, evaluation and clinical application nuances of compassion and compassionate care in Spanish-speaking health care settings, through a systematic review. A search of the scientific literature was carried out following the PRISMA guidelines in ProQuest Central, PubMed and Web Of Science, resulting in 295 studies, of which 27 were selected, based on the following inclusion criteria: the article studied or analyzed the construct of compassion in healthcare setting and the participants were Spanish speakers or the authors spoke of the construct in Spanish. Two blinded evaluators performed the study selection process using the Covidence tool. The agreement between evaluators was in all cases satisfactory. Different definitions of the construct have been identified, that they generally share: the recognition of suffering and the attempt to alleviate it. There are few studies that focus solely on the analysis of compassion, since other concepts appear that are associated with it, such as empathy and self-compassion. Further research is needed to obtain a better and greater understanding of compassionate care adapted to the perceptions of patients and health professionals in different socio-cultural contexts. In this way, instruments that measure compassionate care can be better developed and adjusted, and interventions aimed at promoting compassion can be properly assessed.

Predicting health-related quality of life in Spanish adolescents with allergic rhinoconjunctivitis and bronchial asthma.

This study analyzed the predictive power of sociodemographic (age, sex) and medical variables (months since diagnosis and in treatment, immunotherapy, number of environmental allergens, food allergies or atopic dermatitistypes) on the quality of life of patients with rhinoconjunctivitis and bronchial asthma, using models based on comparative qualitative fuzzy analysis to compare them according to the pathology(s).Retrospective cross-sectional design.Sixty-four adolescents (65.60% boys) diagnosed with rhinoconjunctivitis and/or bronchial asthma aged between 12 and 16 years old (M= 14.02; SD = 1.45).The data were collected between February 2019 and January 2020 using the Brief Disease Perception Questionnaire (B-IPQ), the Adolescent Rhinoconjunctivitis Quality of Life Questionnaire (AdolRQoLQ) and the Respiratory Disease Questionnaire Self-administered and Standardized Chronicle (CRQ-SAS). Qualitative comparative analysis models (QCA) were used.In the QCA models, the various combinations indicated that the variables that predicted a higher quality of life for both rhinocojuntivitis symptoms and respiratory symptoms were receiving longer-term immunotherapy and a perceived lower threat of the disease. The consistencies of the models vary between 23-29%. In conclusion, the patients' QoL was explained by the presence of longer-term immunotherapy and a less threatening perception of the disease.Therefore, early multidisciplinary diagnosis and treatment is important.

Psychological aspects of pre-adolescents or adolescents with precocious puberty: A systematic review.

PROBLEM: Precocious puberty (PP) is an illness that appears when puberty, begins some years earlier than usual, provoking inferences in preadolescents and adolescents and their families. Therefore, the aim is to analyze if psychological consequences can be observed in groups of preadolescents or adolescents with PP. METHOD: A bibliographic search of the scientific literature was made following the PRISMA guide in the following databases: ProQuest, Psychinfo, Web Of Science, and Scopus. 592 studies were found, were uploaded to Covidence to make a screening, of which finally 6 were included for the revision according to the inclusion and exclusion criteria. Two independent evaluators made the search, selection, data extraction and quality evaluation of studies independently. The agreement degree between both was excellent in all of the cases. RESULTS: 211 preadolescents participated in total in all studies, of which 99 were preadolescents with PP, with a mean age of 8,94 years old. Studies evaluated so heterogeneous variables, such as psychopathology, self-image, neuropsychological and cognitive variables, and reasons to delay or stop PP. The quality of studies was moderated especially due to the low quality of the studies design, which were mostly transversal, and the representativity of the sample, being selected by convenience. CONCLUSIONS AND IMPLICATIONS: More research is needed to evaluate the psychological consequences of the PP diagnosis in pediatrics, and its protection factors, because none of the studies approached this question. We consider that it is necessary to increment the quality of these studies, and that these take a biopsychosocial perspective.

Scale of self-efficacy in oral hygiene (OHSE): analysis of psychometric properties in Spain.

AIM: Oral self-efficacy has been shown to be an important variable in predicting successful treatment, preventing health risks and encouraging health-promoting behaviour. In the context of oral health, it is of paramount importance to facilitate the use of the Oral Hygiene Self-Efficacy Scale (OHSE) in clinical practice. The aim of this study was to analyze the psychometric properties of the OHSE scale in a sample of Spanish adults and offer standards for interpreting the scale. METHOD: A sample of 360 people aged from 18 to 75 years was assessed using the OHSE scale. The scale was culturally adapted and translated, reliability tests, construct validity, comparison of means by sex and age group were carried out, and scales for evaluating the responses were prepared. RESULTS: After eliminating six items, the reliability and validity analyses showed adequate psychometric properties. There were no differences between sex or age group. CONCLUSION: The OHSE scale for a Spanish adult population has sufficient empirical support to be considered a valid and useful instrument with solid psychometric properties and it offers an opportunity for oral health education intervention programs aimed at the adult population.

Analysis of predictors of stress during confinement by COVID-19 in Spain.

Confinement has had a great emotional impact on the population, especially in terms of stress. Factors such as the presence of previous mental or physical illness, resilience or emotional intelligence may influence the occurrence or increase of stress. The aim was to assess predictors of stress by comparing two statistical methodologies (one linear and one non-linear).

Adolescence and short stature: factors in adjustment to the diagnosis.

PURPOSE: Adolescence is a time of change when suffering from a medical condition such as short stature can impact the emotional well-being of adolescents. Our objective was to study the adjustment of adolescents with short stature (SS), analyzing the factors influencing it. METHOD: In this cross-sectional study, we evaluated 101 adolescents with SS from different hospitals in Valencia, Spain, using instruments validated for the sample: anxious and depressive symptomatology (as a diagnostic adjustment measure), psychopathology, self-esteem, physical self-concept, psychological well-being, and parenting styles. Descriptive analyses, t-tests for independent samples, Pearson correlations, hierarchical regressions, and fuzzy set qualitative comparative analysis models (fsQCA) were performed. RESULTS: Emotional (ß = 0.44; p = 0.001) and hyperactive (ß = 0.20; p = 0.001) symptoms predicted anxiety, emotional symptomatology (ß = 0.25; p = 0.022), self-esteem (ß = - 0.37; p = 0.001), and promotion of autonomy (ß = 0.30; p = 0.001) predicted depression, and hyperactivity (ß = 0.45; p = 0.001), self-esteem (ß = - 0.43; p = .001), and humor (ß = - 0.36; p = 0.001) predicted emotional distress. The fsQCA results show that none of the variables is a necessary condition for anxiety, depression, or emotional distress. However, different combinations of these variables are sufficient conditions to explain 85% of the high levels of anxiety, 81% of the low levels, 62% of the high levels of depression, 64% of the low levels of depression, and 74% of the high levels of emotional distress and 61% of the low levels. The most important variables in the fsQCA models were symptomatology, self-esteem, and parental styles. CONCLUSION: The patient's family dynamics, self-esteem, and emotional difficulties were the most relevant factors in predicting adjustment.

Psycho-emotional adjustment in parents of adolescents: A cross-sectional and longitudinal analysis of the impact of the COVID pandemic.

PURPOSE: adolescence is a time of change and it generally entails a greater family vulnerability thus; the aim of this study was to identify the risk factors for poor emotional adjustment to COVID among parents of adolescents. DESIGN AND METHODS: 94 parents of adolescents (11-18 years old, M = 13.90, SD = 1.85) participated at different times during the state of alert in Spain. 91.5% were mothers. Their ages ranged from 35 to 63 years (M = 46.54; SD = 5.09). The variables assessed were anxiety, depression and stress (DASS), moods (MOOD), somatization (SCL) and resilience (CD-RISC). Descriptive analyses, t-tests, ANOVAs, correlations, and hierarchical regressions were performed. All this by means of a cross-sectional and longitudinal study design. RESULTS: at the beginning of the confinement parents showed low levels of emotional distress and moderate levels of positive emotionality and resilience. However, those with a prior psychological problem, who had lost their job, or had lost someone to the pandemic, showed worse emotional adjustment. Resilience was relevant in predicting anxiety-depressive symptoms, and a low level of happiness was relevant in predicting stress. Emotional symptoms improved over time, and resilience remained stable. CONCLUSIONS: the emotional impact of COVID over time is influenced by mood, mental health, and resilience. In addition, parents who had a previous health problem, had lost their job or a loved one, had a worse adjustment. PRACTICAL IMPLICATIONS: it is important to carry out intervention programs that increase resilience, treating parents who require it, since their emotional adjustment has repercussions on the emotional adjustment of family system.

Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice.

BACKGROUND: The purpose was to analyse the associations between dental and trait anxiety, fear of COVID-19 and the duration and frequency of spontaneous hand-to-face contact (self-contact). METHODS: A cross-sectional design was carried out with 128 adult patients from four dental clinics in Madrid, during the confinement, from March 15 to May 15. The patients' movements in the waiting room were monitored with Microsoft Kinect Software, also completed the Trait anxiety subscale of the STAI, the COVID-19 Fear and the S-DAI questionnaire. RESULTS: Associations were observed between the duration and frequency of facial, mask and eye contact with trait anxiety and dental fear was determined only by the frequency of this self-contact. Trait anxiety is associated with dental anxiety and with fear of COVID-19. Although facial self-contact is higher in women, it also rises in men as dental fear increases. Moreover, dental anxiety is a good predictor of trait anxiety and the incidence of facial self-contact. CONCLUSIONS: Understanding the possible associations between biopsychosocial factors, such as trait anxiety, dental anxiety and self-contact is important. It may help to prevent the spread of COVID-19 in the population as well as enabling the formulation of effective interventions to improve oral health care through the implementation of dental care programmes.

Is mHealth a useful therapy for improving physical or emotional health in adolescents with cystic fibrosis? A systematic review.

Cystic fibrosis (CF) is a rare disease that severely compromises health and interferes with the lives of those who suffer from it and is especially challenging in adolescence. The use of tools such as MHealth may benefit the physical and psychological health of adolescents with CF. Therefore, this study aims to examine the benefits of MHealth in adolescents with CF through a systematic review. A search of the scientific literature following the PRISMA guidelines was conducted in the ProQuest Central, PubMed, Web Of Science, Embase and ínDICE databases, resulting in 186 studies, of which seven were selected (based on inclusion and exclusion criteria). Two blinded evaluators conducted the searches, the selection and data extraction process and the quality evaluation of the studies. The agreement between evaluators was excellent in all cases (Kappa ranged from .78 to .96). 214 pediatric CF patients (61.71% female) participated in the final analysis. The mean age was 12.76 years. The studies evaluated different types of mHealth tools, with greater homogeneity in the independent and dependent variables. The quality of the studies analyzed was poor, since these had small samples selected for convenience, conducted non-experimental and low-quality designs, recorded few variables, and their statistical analyses were not sufficiently robust. Further research is needed in this field, improving research designs and considering physical and psychological adjustment variables, as well as patients and family members in the process of health improvement.

Social Workers Must Address Intersecting Vulnerabilities among Noninstitutionalized, Black, Latinx, and Older Adults of Color during the COVID-19 Pandemic.

Scant attention has been paid to intersecting vulnerabilities experienced by Black, Latinx, and older adults of color (BLOAC) that increase COVID-19 related risks. Structural inequities have resulted in disproportionate rates of chronic conditions and limited access to care. Media coverage, focused on COVID-19 mortality among institutionalized older adults (OA), has overlooked community-dwelling OA, leaving their unique risks unaddressed in research and intervention efforts. Key vulnerabilities impacting noninstitutionalized BLOAC exacerbating adverse health outcomes during COVID-19 are discussed, and recommendations are given for gerontological social work (GSW) education, training, and practice to meet the needs of BLOAC during the COVID-19 pandemic.

Let's walk! Age reattribution and physical activity among older Hispanic/Latino adults: results from the ¡Caminemos! Randomized trial.

BACKGROUND: Many older Hispanics/Latinos are physically inactive and suffer the harmful health consequences associated with prolonged periods of inactivity. Negative age attributions that equate getting older with "slowing down" reinforce this inactive behavior. We implemented a community-based exercise intervention among insufficiently active older Hispanics/Latinos with a randomized trial of an attribution-retraining program, ¡Caminemos! (Let's Walk!), and measured the effect of the program on walking behavior. METHODS: Five hundred and seventy-two older Hispanics/Latinos (≥60 years) were enrolled in an exercise program that randomly assigned participants to the exercise class and one of two conditions: (a) treatment (attribution retraining to dispel the notion that physical activity inevitably ceases with age) or (b) control (generic health education). Data were collected at baseline and follow-up (1, 12, and 24 months). Physical activity was determined through pedometer data and the Yale Physical Activity Survey. We also measured the intervention effects on age-expectations, self-efficacy expectations, and outcome expectations for physical activity. Mixed-effects regression models were used to determine intervention effects on prospective measures of physical activity and intrapersonal expectations. RESULTS: The sample had a mean age of 73 years (SD = 6.8) and was 77% female, and 76% of the sample reported income <$20,000. At baseline, control and treatment groups walked about 3000 steps/day. By 24 months, participants in both arms of the intervention maintained greater than 10,000 mean steps/day, but the difference between the groups was not statistically significant. In analyses adjusted for age, sex, education, income, health status, and acculturation, participants in both trial arms increased their mean numbers of steps at 12 and 24 months, with the treatment group showing a greater number of mean steps compared to the controls at 12 months. CONCLUSIONS: In this group of physically inactive older Hispanics/Latinos, attribution retraining in combination with an exercise class was superior to the exercise class alone with regard to increasing walking behavior. This success was sustained at 12 months (the pre-defined primary study outcome) but not at 24 months. For older Hispanics/Latinos, enrollment in an attribution-retraining exercise program can improve an inactive lifestyle. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT00183014 .

Characterizing Beliefs about Stroke and Walking for Exercise among Seniors from Four Racial/Ethnic Minority Communities.

We described and compared seniors' stroke-related health beliefs among four racial/ethnic communities to inform a culturally-tailored stroke prevention walking intervention. Specific attention was paid to how seniors combined pathophysiology-based biomedical beliefs with non-biomedical beliefs. We conducted twelve language-concordant, structured focus groups with African American, Chinese American, Korean American, and Latino seniors aged 60 years and older with a history of hypertension (n = 132) to assess stroke-related health beliefs. Participants were asked their beliefs about stroke mechanism and prevention strategies in addition to questions corresponding to four constructs from the Health Belief Model: perceived susceptibility, perceived severity, and benefits and barriers to walking for exercise. Using thematic analysis, we iteratively reviewed and coded focus group transcripts to identify recurrent themes within and between racial/ethnic groups. Participants across all four racial/ethnic groups believed that blockages in brain arteries caused strokes. Factors believed to increase susceptibility to stroke were often similar to biomedical risk factors across racial/ethnic groups, but participants also endorsed non-biomedical factors such as strong emotions. The majority of participants perceived stroke as a serious condition requiring urgent medical attention, fearing paralysis or death, but few mentioned severe disability as a stroke consequence. Participants largely believed stroke to be preventable through physical activity, dietary changes, and medication adherence. Perceived benefits of walking for exercise included improved physical health, decreased bodily pain, and ease of participation. Perceived barriers to walking included limited mobility due to chronic medical conditions, increased bodily pain, and low motivation. While seniors' stroke-related health beliefs were often similar to biomedical beliefs across racial/ethnic groups, we also identified several non-biomedical beliefs that were shared across groups. These non-biomedical beliefs regarding perceived stroke susceptibility and severity may warrant further discussion in stroke education interventions. Patterns in non-biomedical beliefs that vary between groups may reflect cultural differences. Stroke education could potentially increase cultural relevancy and impact by addressing such differences in health beliefs as well as perceived benefits and barriers to walking for exercise that vary between different racial/ethnic groups.

Population genetic analysis and bioclimatic modeling in Agave striata in the Chihuahuan Desert indicate higher genetic variation and lower differentiation in drier and more variable environments.

PREMISE OF THE STUDY: Is there an association between bioclimatic variables and genetic variation within species? This question can be approached by a detailed analysis of population genetics parameters along environmental gradients in recently originated species (so genetic drift does not further obscure the patterns). The genus Agave, with more than 200 recent species encompassing a diversity of morphologies and distributional patterns, is an adequate system for such analyses. We studied Agave striata, a widely distributed species from the Chihuahuan Desert, with a distinctive iteroparous reproductive ecology and two recognized subspecies with clear morphological differences. We used population genetic analyses along with bioclimatic studies to understand the effect of environment on the genetic variation and differentiation of this species. METHODS: We analyzed six populations of the subspecies A. striata subsp. striata, with a southern distribution, and six populations of A. striata subsp. falcata, with a northern distribution, using 48 ISSR loci and a total of 541 individuals (averaging 45 individuals per population). We assessed correlations between population genetics parameters (the levels of genetic variation and differentiation) and the bioclimatic variables of each population. We modeled each subspecies distribution and used linear correlations and multifactorial analysis of variance. KEY RESULTS: Genetic variation (measured as expected heterozygosity) increased at higher latitudes. Higher levels of genetic variation in populations were associated with a higher variation in environmental temperature and lower precipitation. Stronger population differentiation was associated with wetter and more variable precipitation in the southern distribution of the species. The two subspecies have genetic differences, which coincide with their climatic differences and potential distributions. CONCLUSIONS: Differences in genetic variation among populations and the genetic differentiation between A. striata subsp. striata and A. striata subsp. falcata is correlated with differences in environmental climatic variables along their distribution. We found two distinct gene pools that suggest active differentiation and perhaps incipient speciation. The detected association between genetic variation and environment variables indicates that climatic variables are playing an important role in the differentiation of A. striata.

Study protocol of "Worth the Walk": a randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in community senior centers.

BACKGROUND: Stroke disproportionately kills and disables ethnic minority seniors. Up to 30 % of ischemic strokes in the U.S. can be attributed to physical inactivity, yet most Americans, especially older racial/ethnic minorities, fail to participate in regular physical activity. We are conducting a randomized controlled trial (RCT) to test a culturally-tailored community-based walking intervention designed to reduce stroke risk by increasing physical activity among African American, Latino, Chinese, and Korean seniors with hypertension. We hypothesize that the intervention will yield meaningful changes in seniors' walking levels and stroke risk with feasibility to sustain and scale up across the aging services network. METHODS/DESIGN: In this randomized single-blind wait-list control study, high-risk ethnic minority seniors are enrolled at senior centers, complete baseline data collection, and are randomly assigned to receive the intervention "Worth the Walk" immediately (N = 120, intervention group) or in 90 days upon completion of follow-up data collection (N = 120, control group). Trained case managers employed by the senior centers implement hour-long intervention sessions twice weekly for four consecutive weeks to the intervention group. Research staff blinded to participants' group assignment collect outcome data from both intervention and wait-list control participants 1 and 3-months after baseline data collection. Primary outcome measures are mean steps/day over 7 days, stroke knowledge, and self-efficacy for reducing stroke risk. Secondary and exploratory outcome measures include selected biological markers of health, healthcare seeking, and health-related quality of life. Outcomes will be compared between the two groups using standard analytic methods for randomized trials. We will conduct a formal process evaluation to assess barriers and facilitators to successful integration of Worth the Walk into the aging services network and to calculate estimated costs to sustain and scale up the intervention. Data collection is scheduled to be completed in December 2016. DISCUSSION: If this RCT demonstrates superior improvements in physical activity and stroke knowledge in the intervention group compared to the control group and is found to be sustainable and scalable, Worth the Walk could serve as a primary stroke prevention model for racial/ethnic communities across the nation. TRIAL REGISTRATION: ClinicalTrials.gov NCT02181062 ; registered on June 30, 2014.

Perceptions from latino and african american older adults about biological markers in research.

Although older adult minorities face disparities in health and health care, they continue to be underrepresented in health research. Studies with biological markers of health often lack representation of older minority adults. The purpose of this study was to describe perceptions of biomarkers among ethnic minority seniors who might participate in studies of biological markers of health and to document barriers and facilitators to acceptance of biomarkers. Six focus groups (3 of Spanish-speaking Latinos and 3 of African Americans) were conducted in three community senior service organizations (two senior centers and one church). Ten semi-structured interviews were conducted to support and augment focus group data. Seventy-two community dwelling minority older adults aged 62 years and older and 10 community stakeholders participated. A community-based partnered research approach was used and two community partners participated in the analysis and interpretation of results. Standard qualitative content-analysis methods were used to identify and organize themes in domains. Focus group participants were 49% Latino and 51 o/o African American. Results included barriers: 1) mistrust, 2) fear of specimen collection/storage, 3) perceived harms, 4) competing demands, and 5) costs. Older Latinos cited issues of language as barriers to awareness and acceptance of biomarkers. African Americans had concerns over perceived harms of biomarkers. Facilitators to acceptance of biomarkers were community engagement through church and community leaders. Older Latino and African Americans identified many barriers and facilitators to the collection and storage of biomarkers. Participants identified community-partnered recommendations to overcome barriers to the acceptance, collection, and storage of biomarkers.

A Systematic Review on Assessing Assessments: Unveiling Psychometric Properties of Instruments for Reactive Attachment Disorder and Disinhibited Social Engagement Disorder in Minors under Protective Measures.

BACKGROUND: Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) manifest in individuals facing attachment system challenges, particularly observed in minors under protective measures. The lack of standardized tools for assessing these difficulties and uncertainty about the most effective instruments from a psychometric perspective prompted this study. AIM: Using the COSMIN checklist, we systematically reviewed instruments assessing RAD, adhering to PRISMA. METHODOLOGY: Examined tools included the Disturbance Attachment Interview, Preschool Age Psychiatric Assessment, Relationship Patterns Questionnaire, Assessment of RAD and DSED, Development and Well-Being Assessment, and Reactive Attachment Disorder Questionnaire. RESULTS: Of the 10 articles analyzed, the results highlight a research emphasis on internal consistency and structural and construct validity, sidelining other properties. CONCLUSION: Most articles review structural validity and internal consistency. These measures are satisfactory but insufficiently evaluated. It is necessary to evaluate these tools using other indicators such as cross-cultural validity, measurement error, or responsiveness in adolescents under protective measures.

An Organizational Assessment of 34 Home Delivered Meals Programs that Engaged and Assisted Homebound Individuals With Obtaining the COVID-19 Vaccine During the Pandemic.

Vaccinating homebound individuals during the COVID-19 pandemic presented several challenges, including time and cost of engaging this group. In Los Angeles County, the departments of Public Health and Aging and Disabilities turned to home delivered meals programs (HDMs) for help with this public health priority. A mixed-method organizational assessment of 34 HDMs was conducted during March-April 2022 to describe these efforts. Most HDMs were nonprofit (67.6%) and had <25 staff (58.8%). Overall, they served a large catchment area before and during COVID-19, providing services to an estimated total of 24,995 clients/week and delivering 19,511 meals/day. A majority (82.4%) reported engaging their clients to facilitate COVID-19 vaccinations. As of early 2022, <6% of these HDMs' homebound clients were unvaccinated. These programs' efforts to assist older individuals who were homebound during the pandemic represent a potentially underutilized model of public-nonprofit/not-for-profit partnership for improving vaccine delivery and uptake in this hard-to-reach population.

Reactive Attachment Disorder and Its Relationship to Psychopathology: A Systematic Review.

This study aimed to determine, through a systematic review, the relationship between Reactive Attachment Disorder (RAD) and the presence of psychopathology in children and adolescents, and to determine the existence of differences in terms of internalising and externalising psychological problems between the RAD group and groups with other disorders or with typical development. Following the PRISMA methodology, a search was carried out in the Web of Science, PubMed and Scopus databases. The search yielded 770 results, of which only 25 met the inclusion criteria. The results indicate a relationship between the presence of RAD and/or disinhibited social engagement disorder (DSED), with the presence of internalising and externalising problems. These difficulties are more present in children with RAD compared to children without personal difficulties, or children with DSED, children with autism, children with intellectual disabilities or children with hyperactivity. It can be concluded that the presence of RAD has negative consequences on the mental health of children and adolescents, with these being greater in the inhibited group than in the disinhibited group, and with respect to children with autism or hyperactivity.