Factors associated with binge drinking-Findings from 2019 Kansas behavioral risk factor surveillance system.

Background: In the U.S., excessive drinking accounts for one in 10 deaths among adults aged 20-64 years old. Binge drinking is a common form of excessive alcohol consumption that contributes to this chilling statistic. Binge drinking is defined as women consuming four or more drinks or men consuming five or more drinks within a 2-h time span. Examining existing data on risk factors for binge drinking can inform strategies to prevent this deadly practice. Methods: The 2019 Kansas Behavioral Risk Factor Surveillance System (BRFSS) dataset consists of data collected from 11,368 non-institutionalized adults aged 18 years and older with landline or cell phones. The dependent variable in this study was binge drinking status. The independent variables included several sociodemographic variables and risk factors. Data were analyzed using descriptive statistics, bivariate analysis, single logistic regression, and multivariable logistic regression. Results: In the population, 1,447 (17.4%) were reported to be binge drinkers. Significant factors associated with binge drinking in the final model included sex (aOR = 0.53 (0.45-0.63)), age (18-24 years old aOR = 8.77 (6.02-12.79); 25-34 years old aOR = 7.10 (5.35-9.42); 35-44 years old aOR = 6.23 (4.73-8.19); 45-54 years old aOR = 3.87 (2.92-5.14); and 55-64 years old aOR = 2.58 (1.96-3.38)), income ($15,000-$24,999 aOR = 1.00 (0.63-1.58); $25,000-$34,999 aOR = 1.61 (1.04-2.50); $35,000-$49,999 aOR = 1.69 (1.13-2.55); ≥$50,000 aOR = 1.97 (1.34-2.89)), smokeless tobacco use (aOR = 2.09 (1.55-2.82)), and smoking/e-cigarette use (Cigarette user only aOR = 2.11 (1.69-2.65); E-cigarette user only aOR = 2.67 (1.62-3.17); dual cigarette and e-cigarette user = 3.43 (2.21-5.33)). Conclusion: Developing interventions that take into account elevated risk for binge drinking amongst demographic characteristics (i.e., age, sex, income) and lifestyle factors (i.e., smokeless tobacco use, and smoking/e-cigarette use) is crucial to lowering morbidity and mortality related to this form of excessive alcohol consumption.

Evolution of comprehensive cancer control plans and partnerships.

This article explores how comprehensive cancer control plans and partnerships have evolved, over the past 20 years, to meet the ever-changing environment of cancer prevention and control. This evolution has resulted in plans that take a more focused approach in identifying cancer-related priorities and coalitions with structures that have been redesigned to better engage a more wide-ranging group of partners to help address the priorities. Presented in this paper are examples from three states that describe how recognizing the need for change has led to improved processes in updating a cancer plan; strengthened and more diverse partnerships; and coalition sustainment by leveraging and maximizing resources.

International nursing: reflections on working in Sierra Leone.

Registered Nurse, 4626 (AE) Sqn, RAuxAF, RAF Brize Norton/Nurse Practitioner, Center Parcs Sherwood Forest, Nottinghamshire looks back over her time working in A&E in Sierra Leone.

Hospital to community transitions for adults: discharge planners and community service providers' perspectives.

Discharges from the hospital to community-based settings are more difficult for older adults when there is lack of communication, resource sharing, and viable partnerships among service providers in these settings. The researchers captured the perspectives of three different groups of participants from hospitals, independent living centers, and Area Agencies on Aging, which has rarely been done in studies on discharge planning. Findings include identification of barriers in the assessment and referral process (e.g., timing of discharge, inattention to client goals, lack of communication and partnerships between hospital discharge planners and community providers), and strategies for overcoming these barriers. Implications are discussed including potential for Medicaid and Medicare cost reductions due to fewer re-hospitalizations.

Reclaiming joy: pilot evaluation of a mental health peer support program for older adults who receive Medicaid.

PURPOSE: Stigma and lack of access to providers create barriers to mental health treatment for older adults living in the community. In order to address these barriers, we developed and evaluated a peer support intervention for older adults receiving Medicaid services. DESIGN AND METHODS: Reclaiming Joy is a mental health intervention that pairs an older adult volunteer with a participant (older adult who receives peer support). Volunteers receive training on the strengths-based approach, mental health and aging, goal setting and attainment, community resources, and safety. Participant-volunteer pairs meet once a week for 10 weeks. Participants establish and work toward goals (e.g., better self-care, social engagement) that they feel would improve their mental health and well-being. Aging services agencies provide a part time person to manage the program, match volunteers and participants, and provide ongoing support. Outcomes evaluation for this pilot study included pre/postintervention assessments of participants. RESULTS: Thirty-two participants completed the intervention. Pre/postassessment group means showed statistically significant improvement for depression but not for symptoms of anxiety. Quality-of-life indicators for health and functioning also improved for participants with symptoms of both depression and anxiety. IMPLICATIONS: The Reclaiming Joy peer support intervention has potential for reducing depression and increasing quality of life in low-income older adults who have physical health conditions. It is feasible to administer and sustain the intervention through collaborative efforts with minimal program resources and a small amount of technical assistance.

Hoarding cases involving older adults: the transition from a private matter to the public sector.

Hoarding interventions with older adults require significant resources from multiple public agencies, yet recidivism occurs frequently. To improve services through better coordination, some communities have formed multiagency hoarding teams (MAHT), which include aging services. MAHTs requested this mixed methods study to understand the progression of cases through the public sector. Quantitative data collected on 52 cases involving adults ages 60+ identified steps in this process. Qualitative data collected from MAHT members were the basis for case studies illustrating the progression of cases through the public sector. Findings have implications for social workers involved in local service coordination, training, and policy.

Older adults' expectations to move: do they predict actual community-based or nursing facility moves within 2 years?

OBJECTIVE: This study examined the relationship between older adults' expectations to move and actual residential relocation in the community or to a nursing facility within 2 years. METHOD: Two waves of data (2000, 2002) from the Health and Retirement Study were used to compare expectations with subsequent moves. Logistic regression techniques were used to analyze the association between decision outcomes and expectations to move, health and functioning, physical environment, informal supports, and formal services. RESULTS: Findings indicated that expectations to move did predict community-based moves but did not predict moves to nursing facilities. Additional factors had significant effects but did not diminish relationships between expectations and actual moves. DISCUSSION: Results support the residential decision process as a dynamic one based on the cumulative effect of factors from an ecological model. Findings will inform policy makers and practitioners as they work to support older adults' preferences to remain living in their homes.

Motives for residential mobility in later life: post-move perspectives of elders and family members.

This qualitative study delineates motives for residential mobility, describes dynamics between the elder and family members during the move decision process, and locates the move decision within ecological layers of the aging context. Interviews were conducted with 30 individuals and couples (ages 60-87) who experienced a community-based move within the past year, and with 14 extended family members. Reasons for moving (from perspectives of both elders who moved and their family members) were grouped into four themes and eleven issues that influenced the move decision. These themes parallel the ecological context of individual health and functioning, beliefs and attitudes, physical environment, and social pressures. Late-life mobility is a significant life transition that is the outcome of an ongoing appraisal and reappraisal of housing fit with individual functioning, needs, and aspirations. Family members are an integral part of these decision and residential mobility processes.

Measurement of late-life residential relocation: why are rates for such a manifest event so varied?

OBJECTIVES: This methods article examines how characteristics of residential relocation (e.g., housing type) and research design decisions (e.g., level of analysis, geographic scale) influence reported rates for residential relocation among older adults. METHODS: Examination of key studies on late-life residential relocation (1992-2005) revealed a wide range of residential mobility rates and factors that contributed to this variation. These rates were rescaled to a common 5-year time period to allow for a degree of comparison across methodological approaches. RESULTS: We identified a wide range of rates for residential relocation in the literature (from 5% to more than 30% for a 5-year time period). Research design decisions accounted for much of the variation in these rates across studies; geographic scale was associated with the greatest amount of variation. DISCUSSION: We translate the findings into concrete suggestions for investigators. The article provides the background needed to identify the research design best suited to the end purpose of studies on residential relocation (e.g., inform economic policy, understand the individual's aging experience, plan for long-term-care systems). These methodological issues are also relevant to other areas of investigation in which relocation influences the variables being studied (e.g., caregiving, urban planning, neighborhood development).

Family things: Attending the household disbandment of older adults.

When adults move to smaller quarters in later life, family members become involved in the management and disposal of possessions-some cherished, some mundane. Interviews were conducted with 14 family members who had participated in a household disbandment by elders. This qualitative analysis describes the various tasks that were undertaken by family members; how family members asserted themselves in the process; how they were an outlet for possessions; the way that some possessions are shared; and implications for family's story about itself. Household disbandment is a field for all sorts of family practices that can be summarized along three continua that characterize (1) the receiving of goods, (2) the location of agency between elder and family members, and (3) family's self-understanding.

Household disbandment in later life.

OBJECTIVE: This study described activities that older people undertake to reduce the volume of their possessions in the course of a residential move to smaller quarters, a process with practical, cognitive, emotional, and social dimensions. METHODS: Qualitative interviews were conducted with members of 30 households who had moved in the prior year. The disbandment period, typically lasting about 2 months, was a particular focus of the interview. RESULT: The interviews suggested nine reasons why people had accumulated and kept things, which now became problematic for the impending move. The initial steps of disbandment entailed decisions about major furniture and meaningful gifts to family and friends, followed by evaluation of the remaining belongings for retention, sale, further gifts, donation, or discard. Things not divested by one means were reassigned to another strategy. People took pleasure in dispositions that saw their things used, cared for, and valued as they had done, thus fulfilling a responsibility to their belongings. DISCUSSION: Disbandment is an acute episode of a more general, lifelong process of possession management. It is an encounter with things that are meaningful to the self, but as it unfolds, it also makes new meaning for things.