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1.
BMC Public Health ; 24(1): 2574, 2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39304855

RESUMO

BACKGROUND: Neighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship. METHODS: We used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation. RESULTS: Approximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47-0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults. CONCLUSIONS: This study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts.


Assuntos
Isolamento Social , Humanos , Idoso , Masculino , Isolamento Social/psicologia , Feminino , Estudos Longitudinais , Estados Unidos , Idoso de 80 Anos ou mais , Etnicidade/estatística & dados numéricos , Etnicidade/psicologia , Características da Vizinhança/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Grupos Raciais/psicologia
2.
BMC Public Health ; 24(1): 760, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38468204

RESUMO

BACKGROUND: Anxiety disorders are among the most prevalent psychiatric conditions worldwide, and the incidence of anxiety disorders among adults in the U.S. have increased over the last decade. Anxiety disorders can have debilitating effects on multiple areas of functioning and quality of life. Recently, social isolation has emerged as an important public health problem associated with worse health and well-being outcomes. Research on the connection between social isolation and mental health has found that multiple dimensions of social isolation may negatively impact mental health, but few inquiries have focused on the association between social isolation and anxiety. This study examined the relationships between multiple dimensions of social isolation and anxiety disorders in a nationally representative sample of adults aged 18 and older. METHODS: The sample includes 6082 individuals from the National Survey of American Life. This study examined whether three different dimensions of social isolation-subjective, interpersonal, and structural-were associated with 12-month and lifetime anxiety disorders (any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were used to test the associations between the three social isolation variables and the anxiety outcomes. RESULTS: This study found that of the three dimensions of social isolation, subjective isolation was most consistently related to both lifetime and 12-month anxiety disorders. Those who were subjectively isolated had increased odds of meeting criteria for any anxiety disorder, PTSD, GAD, PD, and AG over the past 12 months and throughout their lifetimes. Structural isolation was negatively associated with lifetime and 12-month AG. CONCLUSIONS: Public health approaches should include mental health and primary care providers and need to target social isolation, especially subjective isolation, which may be key in preventing anxiety disorders and the worsening of anxiety disorders. Future public health research is needed on how and in what ways the differing dimensions of social isolation impact mental health.


Assuntos
Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Estados Unidos/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Saúde Mental , Isolamento Social , Comorbidade
3.
Aging Ment Health ; 27(11): 2220-2228, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37231746

RESUMO

OBJECTIVES: Focusing on older African Americans, this study aims to (1) identify 9-year trajectories of depressive symptoms, (2) examine the association between baseline neighborhood characteristics (i.e., social cohesion and physical disadvantage) and trajectories of depressive symptoms, and (3) test whether the effects of neighborhood characteristics on depressive symptoms trajectories differ by gender. METHODS: Data came from the National Health and Aging Trend Study. Older African Americans at baseline were selected (N = 1662) and followed up for eight rounds. Depressive symptom trajectories were estimated using group-based trajectory modeling. Weighted multinomial logistic regressions were conducted. RESULTS: Three trajectories of depressive symptoms were identified: "persistently low," "moderate and increasing," and "high and decreasing" (Objective 1). Objective 2 and 3 were partially supported. Specifically, high perceived neighborhood social cohesion was associated with a lower relative risk of being on the "moderate and increasing" versus the "persistently low" trajectory (RRR = 0.64, p < 0.01). The association between neighborhood physical disadvantage and depressive symptom trajectories was stronger among older African American men compared to women. CONCLUSIONS: High levels of neighborhood social cohesion may protect against increasing depressive symptoms in older African Americans. Compared to women, older African American men may be more vulnerable to negative mental health effects of neighborhood physical disadvantage.


Assuntos
Negro ou Afro-Americano , Depressão , Masculino , Humanos , Feminino , Idoso , Depressão/epidemiologia , Depressão/psicologia , Características da Vizinhança , Características de Residência , Modelos Logísticos
4.
Behav Med ; 49(3): 292-301, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35350953

RESUMO

The present study aims to investigate the relationship between a diagnosis of diabetes and health behavior changes among middle-aged and older adults, and whether self-efficacy and social support moderate the relationship. The study sample was selected from the 2006 to 2016 waves of the Health and Retirement Study (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends was measured separately by a same 3-item scale. Three health behaviors were assessed, including drinking, smoking, and physical activity. Mixed-effects regression models were conducted to test the study aims. Findings showed that participants reduced drinking after a diagnosis of diabetes. A significant interaction between social support from family and a diabetes diagnosis was found in predicting drinking reduction and smoking cessation. These findings suggest that a diagnosis of diabetes may trigger individuals' motivation to initiate health-promoting behaviors. Mobilizing social support from family may help individuals adopt health-promoting behaviors and manage diabetes after a diagnosis.

5.
Telemed J E Health ; 29(12): 1792-1800, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37184869

RESUMO

Purpose: Use of telehealth among older adults increased during the COVID-19 pandemic, but patterns and correlates of its use are poorly understood. The present study uses a representative sample of Medicare beneficiaries to examine rural-urban differences in telehealth utilization during the pandemic and to investigate the associations between the number and type of telehealth services utilized and delayed in-person care. Methods: The study sample (N = 3,257) came from Round 10 of the National Health and Aging Trends Study. Telehealth was measured in three modalities: phone calls, e-mails or portal messages, and video calls. Multivariable Poisson and logistic regressions were performed to test the study aims, adjusting for sociodemographic and health controls. Analytic weights and survey design factors were incorporated to generate population estimates. Findings: Results show that rurality is associated with lower rates (incidence rate ratio = 0.78, p < 0.001) and lower odds of telehealth use compared with urban older adults. Specifically, rural older adults were less likely to use e-mail or portal messages (adjusted odds ratio [AOR] = 0.43, p < 0.001) and video calls (AOR = 0.57, p = 0.004) to communicate with their usual health care provider. Use of any 2 forms of telehealth was associated with greatest increased odds of delayed in-person care among rural and urban populations during the pandemic. Conclusions: Future efforts are needed to expand the utilization of e-mail/portal messages and video call telehealth services among rural older adults. Telehealth may be an important mechanism to support care continuity during and beyond the COVID-19 pandemic for both urban and rural older adults when in-person modalities of care are not feasible.


Assuntos
COVID-19 , Telecomunicações , Telemedicina , Estados Unidos/epidemiologia , Humanos , Idoso , COVID-19/epidemiologia , Pandemias , Medicare
6.
Prev Med ; 155: 106958, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35065973

RESUMO

The present study aims to investigate the relationship between a diagnosis of diabetes and the maintenance of health behaviors, and whether self-efficacy and social support moderate the relationship. The study sample came from the 2006 to 2016 waves of the Health and Retirement Study in the United States (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends were measured separately by a 3-item scale. Three health behaviors were examined, namely alcohol consumption, smoking, and physical activity. Cox proportional hazards regression models were performed to test the study aims. Respondents who reported a diagnosis of diabetes were 1.50 times more likely to fail to maintain physical activity (95% CI = 1.26, 1.77). This relationship was moderated by social support from family, which was related to lower hazards of failure to maintain physical activity among individuals who had a diagnosis of diabetes compared to those without a diagnosis. The study suggests that a diagnosis of diabetes may be a stressful health event that negatively affects physical activity maintenance. In addition, the findings highlight the importance of incorporating strategies to mobilize social support from family, which may help individuals sustain their efforts to maintaining health-promoting behaviors after a diabetes diagnosis.


Assuntos
Diabetes Mellitus , Autoeficácia , Idoso , Diabetes Mellitus/diagnóstico , Exercício Físico , Comportamentos Relacionados com a Saúde , Humanos , Pessoa de Meia-Idade , Apoio Social , Estados Unidos
7.
Ethn Health ; 27(2): 316-328, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-32046530

RESUMO

Objective: African American men have higher lifetime risk of developing prostate cancer (PCa), and face more health burdens from this disease due in part to limited participation in cancer screening. Therefore, it is important to study psychosocial factors associated with screening intention in African American men. Guided by social cognitive theory, the current study aims to examine the role of self-efficacy and importance of participation reasons as predictors of PCa screening intention in African American men.Design: This is a primary analysis using data collected from African American men in northeast Ohio and the Southeastern United States. PCa screening intention and self-efficacy were measured by single-item questions. Importance of participation reasons was measured in four domains: psychological, convenience, awareness, and medical. Hierarchical binary logistic regression was used to predict PCa screening intention in African American men.Results: The sample size was 174. The average age was 46.52. Adding self-efficacy and reasons for participation significantly improved prediction for PCa screening intention in African American men (Δχ2 = 55.28, p < .001). The final model had χ2 = 69.63 (p < .001). Higher self-efficacy (OR = 2.56, p < .05), more perceived importance of psychological reasons (OR = 2.42, p < .001) and medical reasons (OR = 1.10, p < .05) were significant predictors. Also, the perceived chance of developing PCa predicted higher odds of PCa screening intention.Conclusions: Enhancing self-efficacy might be an important intervention focus for African American men to improve PCa screening intention. In addition, the findings suggest that African American men intend to have PCa screening because they experience worries or physical symptoms, and unlikely because it is convenient to get screening or recommended by family members and friends. Thus, intervention efforts could focus on enhancing PCa knowledge and informed decision-making about PCa screening among African American men.


Assuntos
Detecção Precoce de Câncer , Neoplasias da Próstata , Negro ou Afro-Americano , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Intenção , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Autoeficácia
8.
Aging Ment Health ; 26(8): 1558-1563, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34284681

RESUMO

OBJECTIVES: African Americans are differentially affected by most cancers compared to other racial groups. Social participation has demonstrated beneficial effects on mental health in older adults with a history of cancer. The purpose of the present study is to examine and compare the effects of specific social participation activities on depressive symptoms among older African Americans with and without a history of cancer. METHOD: The study sample included 2,000 older African Americans selected from the National Health and Aging Trends Study. Waves from 2011 to 2018 were used. Mixed-effects logistic regressions were applied to examine the effects of four social participation activities on depressive symptoms among older African Americans with or without a history of cancer. RESULTS: Among older African American who had a history of cancer, visiting family and friends and attending religious services were related to lower odds of depressive symptoms. However, among older African Americans without a history of cancer, joining organized activities and going out for enjoyment predicted lower odds of depressive symptoms. CONCLUSION: Older African Americans with a history of cancer tend to benefit from visiting family and friends and attending religious services in coping with depressive symptoms. Mental health services for this group could focus interventions on promoting social participation activities with family, friends, and religious congregants.


Assuntos
Sobreviventes de Câncer , Neoplasias , Negro ou Afro-Americano/psicologia , Idoso , Depressão/psicologia , Humanos , Participação Social
9.
Artigo em Inglês | MEDLINE | ID: mdl-36441993

RESUMO

OBJECTIVES: Discrimination is an urgent public health problem. A number of major cities and counties across the United States has declared racism a public health crisis. While there is a growing body of research on the discrimination-health connection, less is known regarding the social relational consequences of discrimination. The present study addresses this knowledge gap by investigating the relationship between discrimination, skin tone, and objective and subjective social isolation using a nationally representative sample of African Americans. METHOD: This analysis was based upon the African American subsample (N = 3,570) of the National Survey of American Life. Discrimination was assessed with the Everyday Discrimination Scale. Objective and subjective isolation differentiated between respondents who were (a) socially isolated from both family and friends, (b) socially isolated from friends only, (c) socially isolated from family only, and (d) not socially isolated. Skin tone was self-reported. Multinomial logistic regression analyses were used to test the study hypotheses. RESULTS: The analyses indicated that more frequent discriminatory experiences were associated with increased risk for subjective and objective social isolation. Skin tone moderated the association between discrimination and subjective isolation; the discrimination-isolation relationship was stronger among participants with darker skin tones. CONCLUSIONS: These findings shed light on African Americans' nuanced experiences with discrimination and colorism. Further, the data demonstrate heterogeneity in the vulnerability to the adverse effects of discrimination within the African American population; the relationship between discrimination and subjective isolation was stratified by skin tone. This underscores the well-documented and persistent racialized social stratification system in the United States (PsycInfo Database Record (c) 2022 APA, all rights reserved).

10.
Int J Aging Hum Dev ; 94(3): 290-311, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34409865

RESUMO

Neighborhood environment plays an important role in late-life health; yet, the social aspect of neighborhood environment and its impact on mobility limitations have rarely been examined. This nonexperimental, cross-sectional study examines the relationship between neighborhood social cohesion and mobility limitations and the potential mediators (i.e., depressive symptoms, mastery) of this relationship. A total of 8,317 Americans aged 65 years and older were selected from the Health and Retirement Study. Using ordinary least squares regressions, this study shows that neighborhood social cohesion was negatively associated with mobility limitations (B = -0.04, p < .01). A Sobel test of mediation indicated that this relationship was significantly mediated by depressive symptoms (z = -9.10, p < .001) and mastery (z = -8.86, p < .001). Findings suggest that neighborhood cohesion can reduce mobility limitations through mitigating depressive symptoms and increasing mastery. Future research should disentangle the temporal ordering of the mediators.


Assuntos
Vida Independente , Limitação da Mobilidade , Idoso , Estudos Transversais , Depressão/epidemiologia , Humanos , Características de Residência , Coesão Social
11.
Rev Relig Res ; 64(1): 35-54, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35757388

RESUMO

Background: Few studies have examined the effects of discrimination on mental health specifically among older African Americans despite it being a common experience in this population. Further, knowledge on social resources, such as social relationships, that could mitigate the effects of discrimination is limited in this population. Given the historical and contemporaneous importance of the Black church in African American communities, church members are important support network members and a major source of social support for older African Americans. Purpose: To address these knowledge gaps, this study will (1) examine the association between racial discrimination and psychiatric disorders; and (2) determine whether church relationships moderate the impact of racial discrimination on psychiatric disorders. Methods: Data from African American respondents aged 55 and older were drawn from the National Survey of American Life (N = 837). Church relationship variables included receipt of emotional support from, frequency of contact with, and subjective closeness to church members. Regression analyses were used to test the study aims. Results: Analyses indicated that more frequent experiences of racial discrimination were associated with meeting criteria for any DSM-IV disorder and a greater number of DSM-IV disorders. Significant interactions revealed that frequency of contact with and subjective closeness to church members mitigated the association between discrimination and meeting criteria for any 12-month disorder and number of 12-month disorders. Conclusions and Implications: Altogether, these findings support the literature on the detrimental effects of discrimination on the mental health of older African Americans and provide a more nuanced understanding of the role of church members in the lives of older African Americans. The study findings suggest that church relationships are effective stress coping resources for older African Americans dealing with discrimination. Given the importance and relevance of church members, initial clinical assessments should assess clients' level of religious involvement and relationships with church members.

12.
Prev Med ; 143: 106385, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33359017

RESUMO

The global outbreak of the coronavirus disease 2019 (COVID-19) in 2020 has been an international public health threat. Early strong social distancing efforts is needed to stop transmission of the virus. The purpose of the present study is to identify individual and environmental factors related to individuals' compliance with the recommended social distancing, as well as the moderating role of social media in influencing individuals' implementation of social distancing. A total of 2130 Chinese adults were surveyed in March 2020 during the COVID-19 pandemic. Logistic regression analyses were performed to ascertain the predictors of social distancing. Overall, the majority of respondents (95.6%) reported compliance with social distancing. Women were more likely to practice social distancing compared to men (odds ratio [OR] = 3.12, 95% confidence interval [CI] = 1.93-5.02). Psychological distress, depressive symptoms, and social media were significant predictors of social distancing after controlling for other individual and environmental factors. Social media moderated the effects of psychological distress on social distancing (OR = 0.96, 95% CI = 0.94-0.99). Findings from the study indicates that mental health status and social media are influential factors of social distancing, which have significant implications in enhancing the effectiveness of prevention strategies to contain the spread of COVID-19.


Assuntos
Povo Asiático/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias/prevenção & controle , Distanciamento Físico , Adolescente , Adulto , Povo Asiático/estatística & dados numéricos , China/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Transmissão de Doença Infecciosa/estatística & dados numéricos , Feminino , Humanos , Masculino , Pandemias/estatística & dados numéricos , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
13.
J Urban Health ; 98(1): 91-100, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32996025

RESUMO

Intimate partner violence (IPV) remains a public health issue plaguing families and communities in the USA. Despite considerable research devoted to individual-level factors affecting IPV and a smaller body of ecological IPV research, few studies explore the interaction between individual-level protective factors and neighborhood- or community-level factors in predicting the incidents of IPV among women. Moreover, most IPV studies utilize a unidimensional approach for social capital, despite strong empirical and theoretical support for a multi-dimensional conceptualization. In a sample of heterosexual women in the USA (N = 1884), we found that concentrated disadvantage, social and physical disorder, and community violence together significantly predicted increased rates of IPV victimization. Concentrated disadvantage and higher scores on the social capital index independently predicted a lower probability of victimization. Moderating effects were found for social capital: the protective effects of social capital on the probability of IPV were attenuated for those reporting community violence compared with women who did not report it. These findings enhance the field's understanding of the synergistic relationship between individual- and neighborhood-level factors, providing important implications for community-based IPV interventions.


Assuntos
Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Capital Social , Feminino , Humanos , Características de Residência
14.
J Women Aging ; 33(4): 347-361, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33191872

RESUMO

The purpose of this study was to determine whether negative interactions with family and church members are associated with indicators of subjective well-being (SWB) in a nationally representative sample of older African American women. The analytic sample (N = 537) was drawn from the National Survey of American Life. Linear regressions were used to assess the associations between negative interactions with family and church members and happiness, life satisfaction, and self-esteem. The negative interactions with family variable was inversely associated with happiness and self-esteem. Findings underscore the importance of social relationships and the quality of these relationships in women's well-being.


Assuntos
Negro ou Afro-Americano/psicologia , Relações Familiares/psicologia , Família/psicologia , Relações Interpessoais , Idoso , Idoso de 80 Anos ou mais , Família/etnologia , Relações Familiares/etnologia , Feminino , Felicidade , Humanos , Pessoa de Meia-Idade , Satisfação Pessoal , Religião e Psicologia , Autoimagem , Rede Social
15.
Diabetes Spectr ; 33(4): 315-323, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33223769

RESUMO

OBJECTIVE | This study aimed to systematically review the existing literature on the relationship between self-efficacy and diabetes self-management in middle-aged and older adults in the United States and to determine whether the relationship applies across race and ethnicity. METHODS | Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Studies published between 1990 to 2018 that investigated self-efficacy and diabetes self-management in middle-aged and older adults were searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Social Science Citation Index, Cochrane Library, and Academic Search Complete. Only quantitative studies were included. RESULTS | Eleven studies met the inclusion criteria. Ten studies found significant association between self-efficacy and at least one self-management behavior, which included exercise, healthy diet, adherence to medication, blood glucose testing, and foot care. Findings were mixed regarding the role of self-efficacy in exercise and medication adherence. Higher self-efficacy in Mexican Americans predicted better self-management behaviors, whereas no relationship between self-efficacy and diabetes self-management was found in a sample of Black and White participants. The methodological quality of the studies was assessed. In general, the included studies demonstrated moderate methodological quality. Their limitations included inconsistency in the self-efficacy measures, a lack of longitudinal studies, and confounding bias. CONCLUSION | Self-efficacy has significant effects on self-management in middle-aged and older adults, but the effects may differ by race. Efforts to improve self-efficacy and deliver culturally appropriate services could potentially promote self-management behaviors in middle-aged and older adults with diabetes.

16.
Soc Work Health Care ; 59(8): 543-556, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32804046

RESUMO

The objective of the present study is to capture the prostate cancer screening intention, knowledge levels, attitudes, and reasons for participation in screening among African American men. African American men aged from 35 to 65 in Georgia, North Carolina, and Ohio were recruited for study (N = 168). Questionnaires were administered using validated instruments. Findings suggest critical needs for community-based social workers to communicate the importance of prostate cancer screening and risk factors among African American men. Increasing the use of culturally relevant community health education might benefit underserved minority men at risk of having prostate cancer.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Intenção , Neoplasias da Próstata/diagnóstico , Adulto , Negro ou Afro-Americano/psicologia , Georgia , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , North Carolina , Ohio , Neoplasias da Próstata/psicologia , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana
17.
Trauma Violence Abuse ; : 15248380241265379, 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39082145

RESUMO

With the rapid increase in the aging population, more attention has been paid to studying older adults with dementia. Despite the fact that older adults with dementia are more likely to be abused compared to their cognitively intact counterparts, little attention has been paid to abuse within this population. This systematic review, conducted using the PRISMA model, aims to critically examine, evaluate, and synthesize literature on protective factors and adverse effects of elder abuse by informal caregivers among individuals with dementia. A search was undertaken using the Ageline, Medline, CINAHL, and PsycINFO databases for peer-reviewed articles published in English up to June 2023. A total of 291 articles were identified by the systematic search, and 8 articles were included in the review. The results showed that protective factors related to elder abuse are mainly examined at a perpetrator level, including caregiver-related, relational, and contextual factors. Adverse effects, specifically an increased risk of various medical conditions and poor medication adherence, were identified but less frequently discussed. The findings indicated future directions for practitioners, researchers, and policymakers to better serve older adults with dementia and their caregivers.

18.
Gerontologist ; 64(6)2024 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-38416875

RESUMO

BACKGROUND AND OBJECTIVES: Although coordinated care (CC) seeks to improve patient experiences and ultimately health outcomes, evidence from empirical research on the impacts of CC is mixed. This study examined the relationship between CC and healthcare outcomes over a 4-year period among older adults with multiple chronic conditions. RESEARCH DESIGN AND METHODS: This observational cohort study is based on data from the 2016-2020 Health and Retirement Study. Analysis is limited to respondents with 2+ chronic conditions who completed an experimental module on CC in 2016 (n = 906). Three domains of CC were assessed: perceptions, informal (family/friends) and formal (healthcare staff) tangible support, and technical support (using a "patient portal"). The longitudinal relationship between CC and health (e.g., pain, functioning, and self-rated health [SRH]) and healthcare (e.g., doctor visits, hospitalization, and care satisfaction) outcomes was investigated using mixed-effects models. RESULTS: Better perceptions of CC were associated with lower odds of ADL limitations (Odds ratio [OR] = 0.91; 95% CI = 0.84-0.99) and greater satisfaction with care (B = 0.04, 95% CI = 0.02-0.06). Receipt of more informal tangible support was associated with 1.34 higher odds of ADL limitations (95% CI = 1.19-1.51) and 1.74 higher odds of hospitalization (95% CI = 1.07-1.21). Use of technical support was associated with better SRH and greater satisfaction with care. DISCUSSION AND IMPLICATIONS: The longitudinal relationship between CC and health is multifaceted. Although positive perceptions and more technical support have beneficial effects on health outcomes, higher utilization of tangible support may reflect a higher demand among older adults with more complex healthcare needs.


Assuntos
Múltiplas Afecções Crônicas , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Múltiplas Afecções Crônicas/terapia , Satisfação do Paciente , Estudos de Coortes , Nível de Saúde , Idoso de 80 Anos ou mais , Estudos Longitudinais
19.
J Affect Disord ; 350: 247-254, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38232778

RESUMO

BACKGROUND: There is a dearth of scholarship that explicates the effects of religious participation on anxiety disorders among Black Americans. A better understanding of the links between religious participation, a coping resource, and anxiety disorders among Black Americans remains essential, given Black Americans are less likely than their white counterparts to seek professional treatment for mental health problems, leading to greater unmet mental health needs. The aim of this study was to investigate whether religious participation is associated with the prevalence, persistence, and severity of anxiety disorders among Black adults. METHODS: We used a national sample of Black adults (N = 4999) from the National Survey of American Life, a cross-sectional study conducted from 2001 to 2003. Five anxiety disorders were assessed: posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobia. Three dimensions of religious participation were assessed: organizational, non-organizational, and subjective religious participation. Weighted logistic and linear regressions were estimated to examine the associations between religious participation and anxiety disorders. RESULTS: Findings indicate that organizational religious participation and subjective religiosity were associated with lower odds of anxiety disorders and decreased severity. Findings for non-organizational religious participation in relation to the prevalence, persistence, and severity of anxiety disorders were mixed. LIMITATIONS: The study limitations include the utilization of self-reported measures, cross-sectional study design, and age of the data set. CONCLUSIONS: Different dimensions of religious participation have differing effects on anxiety disorders. Religious participation may be an important resource for Black Americans in coping and preventing anxiety disorders.


Assuntos
Negro ou Afro-Americano , Religião , Adulto , Humanos , Estados Unidos/epidemiologia , Prevalência , Estudos Transversais , Transtornos de Ansiedade/epidemiologia
20.
Innov Aging ; 8(8): igae068, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39139381

RESUMO

Background and Objectives: Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education. Research Design and Methods: Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014-2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson-Holm-Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness. Results: In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education. Discussion and Implications: Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness.

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