Digital Literacy Training for Low-Income Older Adults Through Undergraduate Community-Engaged Learning: Single-Group Pretest-Posttest Study.

BACKGROUND: Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults. OBJECTIVE: In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach. METHODS: The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys. RESULTS: Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program. CONCLUSIONS: A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults.

Examining Participation Disparities in Cancer Clinical Trials.

OBJECTIVES: To examine factors that account for disparities in cancer clinical trial participation. SAMPLE & SETTING: Pooled data from Behavioral Risk Factor Surveillance System surveys between 2010 and 2017. METHODS & VARIABLES: Univariate and binary logistic regression analyses were used to examine the associations between participation in clinical trials and demographic and health characteristics, using SAS® procedures to account for complex sample features. RESULTS: Univariate analyses showed that age, race, income, and self-rated health status were significantly associated with the likelihood of participating in cancer clinical trials. Binary logistic analyses showed that Black respondents who were ever diagnosed with cancer were more likely to participate in cancer clinical trials relative to White counterparts. Respondents aged 50-64 years were more likely to have participated in cancer clinical trials compared to those aged 65 years or older. However, respondents who self-rated their health as excellent or very good were less likely to participate in cancer clinical trials. IMPLICATIONS FOR NURSING: Involving properly trained nurses and nurse practitioners from diverse backgrounds in cancer clinical trials to inform people with cancer about trials and ways to reduce personal barriers will increase participation from all people, regardless of socioeconomic and demographic characteristics.

The direct and indirect impact of COVID-19 pandemic on maternal and child health services in Africa: a scoping review.

INTRODUCTION: The novel coronavirus disease 2019 (COVID-19) continues to disrupt the availability and utilization of routine and emergency health care services, with differing impacts in jurisdictions across the world. In this scoping review, we set out to synthesize documentation of the direct and indirect effect of the pandemic, and national responses to it, on maternal, newborn and child health (MNCH) in Africa. METHODS: A scoping review was conducted to provide an overview of the most significant impacts identified up to March 15, 2022. We searched MEDLINE, Embase, HealthSTAR, Web of Science, PubMed, and Scopus electronic databases. We included peer reviewed literature that discussed maternal and child health in Africa during the COVID-19 pandemic, published from January 2020 to March 2022, and written in English. Papers that did not focus on the African region or an African country were excluded. A data-charting form was developed by the two reviewers to determine which themes to extract, and narrative descriptions were written about the extracted thematic areas. RESULTS: Four-hundred and seventy-eight articles were identified through our literature search and 27 were deemed appropriate for analysis. We identified three overarching themes: delayed or decreased care, disruption in service provision and utilization and mitigation strategies or recommendations. Our results show that minor consideration was given to preserving and promoting health service access and utilization for mothers and children, especially in historically underserved areas in Africa. CONCLUSIONS: Reviewed literature illuminates the need for continued prioritization of maternity services, immunization, and reproductive health services. This prioritization was not given the much-needed attention during the COVID-19 pandemic yet is necessary to shield the continent's most vulnerable population segments from the shocks of current and future global health emergencies.