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- Creators: Arizona State University
Description
Research has demonstrated that temperature and relative humidity substantially influence overall perceptions of indoor air quality (Fang, Clausen, & Fanger, 1998). This finding places temperature quality as a high priority, especially for vulnerable adults over 60. Temperature extremes and fluctuation, as well as the perception of those conditions, affect physical performance, thermal comfort and health of older adults (Chatonnet & Cabanac, 1965, pp. 185-6; Fumiharu, Watanabe, Park, Shephard, & Aoyagi, 2005; Heijs & Stringer, 1988). The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) and the International Organization for Standardization (ISO) have developed thermal-comfort standards for working-age, healthy individuals. None of these standards address the physiological and psychological needs of older adults (ASHRAE Standard 55, 2010; ISO-7730, 2005). This dissertation investigates the impacts of thermal conditions on self-reported health and perceived comfort for older adults, hypothesizing that warmer and more-table indoor thermal conditions will increase the health and perceived comfort of these adults. To this end, a new set of thermal comfort metrics was designed and tested to address the thermal preferences of older adults. The SENIOR COMFORT Metrics 2013 outlined new thresholds for optimal indoor high and low temperatures and set limits on thermal variability over time based on the ASHRAE-55 2010 model. This study was conducted at Sunnyslope Manor, a multi-unit, public-housing complex in the North Phoenix. Nearly 60% (76 of 118) of the residents (aged 62-82) were interviewed using a 110-question, self-reporting survey in 73 apartment units. A total of 40 questions and 20 sub-questions addressing perceptions of comfort, pain, sleep patterns, injuries, and mood were extracted from this larger health condition survey to assess health and thermal comfort. Indoor environmental thermal measurements included temperature in three locations: kitchen, living area, and bedroom and data were recorded every 15 minutes over 5 full days and 448 points. Study results start to indicate that older adults for Sunnyslope Manor preferred temperatures between 76 and 82.5 degrees Fahrenheit and that lower temperatures as outlined by ASHRAE-55 2010 increases the rate of injuries and mood changes in older adults among other findings.
ContributorsFonseca, Ernesto (Author) / Bryan, Harvey (Thesis advisor) / Ahrentzen, Sherry (Committee member) / Shea, Kimberly (Committee member) / Arizona State University (Publisher)
Created2013
Description
The aim of this study is to test the feasibility of building a storytelling system for older adults to tell and share their life stories based on email. It is measured by the level of participation and people's acceptance of the system. The central goals were to empower people over 60 years old by providing a platform for them to share their wonderful life experience and perspectives on life and lead social services into the digital age by bridging traditional roundtable interaction and modern digital communication. A prototype was built to test the level of participation of the system and follow-up interviews were conducted in order to deeply understand people's acceptance. Content analysis was used to analyze the stories to ascertain what common themes were present. Key design considerations and key factors that affect the feasibility of storytelling system were discussed. This research expands on current research and implementation of Internet-based storytelling system and shed light on the future of combining storytelling with older adults' existing Internet knowledge. Key findings of this research are :(1) Frequency of reminiscence trigger and the number of active participants affect the level of participation collectively. Frequency is considered to be a key determinant. High frequency indicates high level of participation. (2) Categories of topics do not affect the level of participation significantly but serve as key attractions that enhance people's acceptance of the system. (3) Older adults highly accept and get involved in the new email storytelling system. This storytelling program helps them recall their memories and have a profound effect on their own introspection.
ContributorsLi, Yuanyi (Author) / Giard, Jacques R (Thesis advisor) / Margolis, Eric (Committee member) / Larkin, Kyle (Committee member) / Arizona State University (Publisher)
Created2014
Description
Everyday speech communication typically takes place face-to-face. Accordingly, the task of perceiving speech is a multisensory phenomenon involving both auditory and visual information. The current investigation examines how visual information influences recognition of dysarthric speech. It also explores where the influence of visual information is dependent upon age. Forty adults participated in the study that measured intelligibility (percent words correct) of dysarthric speech in auditory versus audiovisual conditions. Participants were then separated into two groups: older adults (age range 47 to 68) and young adults (age range 19 to 36) to examine the influence of age. Findings revealed that all participants, regardless of age, improved their ability to recognize dysarthric speech when visual speech was added to the auditory signal. The magnitude of this benefit, however, was greater for older adults when compared with younger adults. These results inform our understanding of how visual speech information influences understanding of dysarthric speech.
ContributorsFall, Elizabeth (Author) / Liss, Julie (Thesis advisor) / Berisha, Visar (Committee member) / Gray, Shelley (Committee member) / Arizona State University (Publisher)
Created2014
Description
The treatment of individuals with multiple chronic conditions represents the single largest driver of Medicare costs. The use of prescription drugs is a major component in the treatment/management of chronic disease in the United States. Medication nonadherence, however, is a common problem among older adults and leads to significant morbidity and mortality. Whereas, the problem of medication nonadherence has been a primary focus of research for the last thirty years, much is still unknown about which older adults are most at risk for medication nonadherence, as well as what are effective theory-based interventions to improve a person's medication self-management.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
ContributorsO'Brien, Anne Marie (Author) / Marek, Karen D. (Thesis advisor) / Coon, David W. (Committee member) / Evans, Bronwynne C. (Committee member) / Arizona State University (Publisher)
Created2014
Description
The population of older adults and the percentage of people living in urban areas are both increasing in the U.S. Finding ways to enhance city-dwelling, older adults' social integration, cognitive vitality, and connectedness to nature were conceptualized as critical pathways to maximizing their subjective well-being (SWB) and overall health. Past research has found that gardening is associated with increased social contact and reduced risk of dementia, and that higher levels of social support, cognitive functioning, mindfulness, and connectedness to nature are positively related to various aspects of SWB. The present study was a pilot study to examine the feasibility of conducting a randomized, controlled trial of community gardening and to provide an initial assessment of a new intervention--"Mindful Community Gardening," or mindfulness training in the context of gardening. In addition, this study examined whether community gardening, with or without mindfulness training, enhanced SWB among older adults and increased social support, attention and mindfulness, and connectedness to nature. Fifty community-dwelling adults between the ages of 55 and 79 were randomly assigned to one of three groups: Traditional Community Gardening (TCG), Mindful Community Gardening (MCG), or Wait-List Control. The TCG and MCG arms each consisted of two groups of 7 to 10 participants meeting weekly for nine weeks. TCG involved typical gardening activities undertaken collaboratively. MCG involved the same, but with the addition of guided development of non-judgmental, present-focused awareness. There was a statistically significant increase in different aspects of mindfulness for the TCG and the MCG arms. The interventions did not measurably impact social support, attention, or connectedness to nature in this small, high functioning, pilot sample. Qualitative analysis of interview data from 12 participants in the TCG and MCG groups revealed that both groups helped some participants to better cope with adversity. It was concluded that it is feasible to conduct randomized, controlled trials of community gardening with urban older adults, and considerations for implementing such interventions are delineated.
ContributorsOkvat, Heather Audrey (Author) / Zautra, Alex J. (Thesis advisor) / Davis, Mary C. (Committee member) / Knopf, Richard C. (Committee member) / Okun, Morris A. (Committee member) / Arizona State University (Publisher)
Created2011
Enhancing motivation for physical activity to reduce fall risk among community dwelling older adults
Description
Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults.
ContributorsMcMahon, Siobhan (Author) / Fleury, Julie (Thesis advisor) / Belyea, Michael (Committee member) / Shearer, Nelma (Committee member) / Wyman, Jean (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2012
Exploring factors influencing Chinese American older adults' intentions to plan for end-of-life care
Description
This study aimed to understand the factors that influence Chinese American older adults’ advance care planning (ACP) on end-of-life care. The Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were primarily applied to explain Chinese American older adults’ intentions toward two behaviors: 1) discussion of end-of-life care plans with family members and 2) completion of an advance directive (AD). Additionally, acculturation and family cohesion were considered to examine their impacts on the TPB and HBM. A cross-sectional survey was conducted through face-to-face interviews on a sample of 298 community-dwelling Chinese-American adults aged 55 and older living in the metropolitan Phoenix area of Arizona. Based upon random assignment, 161 participants answered questions regarding discussing end-of-life care plans with family members, while 137 participants answered questions related to the completion of an AD. Hierarchical multiple regression analysis was used to focus on the influence of TPB and HBM measures on behavioral intentions toward the two behaviors. Results indicated that both the TPB and HBM had predictive power to explain the target population’s intentions. However, the predictability of TPB and HBM measures varied across the two behaviors. Acculturation moderated the relationship between attitudes and intentions to complete an AD negatively. Family cohesion moderated the relationship between perceived benefits and intentions to discuss end-of-life care plans with family members negatively. These findings would help inform future interventions for improving the target population’s ACP awareness and engagement.
ContributorsLiu, Yanqin (Author) / Roberto, Anthony J. (Thesis advisor) / Mongeau, Paul (Committee member) / Thompson, Marilyn (Committee member) / Arizona State University (Publisher)
Created2018
Description
ABSTRACT
This qualitative descriptive study described caregiver recognition of personal and social contextual resources guiding purposeful participation in self-care and well-being. This research builds on health empowerment theory, which conceptualizes health empowerment as an inherent, relational and ongoing process, expressive of health patterning of well-being (Shearer, 2009). By 2060, Americans 65 years and older will number nearly 98 million, more than double that in 2013. The number of older adults aged 85 and older will double from 6 million in 2003, to 14.6 million by 2040 (Health & Human Services, 2014). Sixty-five million adults serve as informal caregivers, many themselves suffering from chronic conditions (National Alliance for Caregiving & AARP, 2009). Current research has examined the burden of caregiving, but little is known about caregiver strengths and resources that foster personal self-care and well-being. Twenty-one older adult informal caregivers participated in focus groups or individual interviews. Length of time as caregivers ranged from one year to more than ten years; 24% of the participants were men. Seventy-six percent of the participants reported having one or more chronic condition. Themes generated from qualitative content analysis provided a basis for validating and extending the health empowerment theory among older adult informal caregivers. Across participants, empowerment reflected recognition of strengths and resources, as well as growth consistent with valued goals facilitating new health patterns and well-being. The health empowerment theory perspective provided a relevant basis for theory-based intervention focused on promoting strengths, abilities and potential among older adults, limiting vulnerability to diminished health and well-being.
This qualitative descriptive study described caregiver recognition of personal and social contextual resources guiding purposeful participation in self-care and well-being. This research builds on health empowerment theory, which conceptualizes health empowerment as an inherent, relational and ongoing process, expressive of health patterning of well-being (Shearer, 2009). By 2060, Americans 65 years and older will number nearly 98 million, more than double that in 2013. The number of older adults aged 85 and older will double from 6 million in 2003, to 14.6 million by 2040 (Health & Human Services, 2014). Sixty-five million adults serve as informal caregivers, many themselves suffering from chronic conditions (National Alliance for Caregiving & AARP, 2009). Current research has examined the burden of caregiving, but little is known about caregiver strengths and resources that foster personal self-care and well-being. Twenty-one older adult informal caregivers participated in focus groups or individual interviews. Length of time as caregivers ranged from one year to more than ten years; 24% of the participants were men. Seventy-six percent of the participants reported having one or more chronic condition. Themes generated from qualitative content analysis provided a basis for validating and extending the health empowerment theory among older adult informal caregivers. Across participants, empowerment reflected recognition of strengths and resources, as well as growth consistent with valued goals facilitating new health patterns and well-being. The health empowerment theory perspective provided a relevant basis for theory-based intervention focused on promoting strengths, abilities and potential among older adults, limiting vulnerability to diminished health and well-being.
ContributorsBlank, Laura Jeanne (Author) / Fleury, Julie (Thesis advisor) / Kommenich, Pauline (Committee member) / Belyea, Michael (Committee member) / Kennedy, Teri (Committee member) / Arizona State University (Publisher)
Created2018
Description
Background and purpose: Regular physical activity (PA) provides benefits for cognitive health and helps to improve or maintain quality of life among older adults. Objective PA measures have been increasingly used to overcome limitations of self-report measures. The purpose of this study was to investigate the association of objectively measured PA and sedentary time with cognitive function among older adults.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
ContributorsZhu, Wenfei (Author) / Hooker, Steven P (Thesis advisor) / Wadley, Virginia (Committee member) / Ainsworth, Barbara (Committee member) / Der Ananian, Cheryl (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2015
Description
Problems with recruiting and retaining older volunteers have resulted in less than one-quarter of older adults participating in volunteer activities (BLS, 2016). Much emphasis on volunteer motivations have been placed to enhance volunteer engagement among late-midlife and older adults (e.g., Davis et al., 2003). Although career motivations have not been shown to predict late-midlife and older adults’ volunteer participation (Planalp & Trost, 2009), there is some empirical evidence supporting the relevance of career domains in later life (Greller, 2006). By reframing volunteering as a compensatory strategy, the purpose of the current study was to evaluate factors, including career-related interests, that affect volunteer satisfaction and commitment among late-midlife and older volunteers.
A series of hypotheses were posited to examine contributions to volunteer satisfaction and to future volunteer commitment, including volunteer motivation and congruence between career interests of volunteers and characteristics of the volunteer activities (volunteer-activity congruence). The online survey contained measures for study variables, including the Volunteer Functional Inventory (volunteer motivations) and Personal Globe Inventory (career interests). Participants (N = 167) were recruited from community and government volunteer programs with the average age of volunteers being 68.65 years old (SD = 9.36; range 50 to 90 years). The majority of volunteers were female (54.5%), White or Caucasian (90.4%), married (58.2%), reported some college experience (96.5%) and were retired (68.9%).
Results from the current study indicated that time volunteering, volunteer motivations, and volunteer-activity congruence did not significantly predict volunteer satisfaction, accounting for 9.2% of the variance. In contrast, the final model did significantly predict volunteer commitment and accounted for 13.1% of the model variance, with altruistic values remaining a significant contributor to volunteer commitment. Findings from the current study highlight inconsistencies noted in previous research regarding volunteer motivations, satisfaction, and commitment. Possible generational influences on altruistic values and volunteerism were also noted. Although volunteer-activity congruence alone was not predictive of volunteer satisfaction or of commitment, results from the study warrant additional investigations in career interests and volunteering among late-midlife and older adults. Limitations of the current study and implications for volunteer recruitment and retention were also discussed.
A series of hypotheses were posited to examine contributions to volunteer satisfaction and to future volunteer commitment, including volunteer motivation and congruence between career interests of volunteers and characteristics of the volunteer activities (volunteer-activity congruence). The online survey contained measures for study variables, including the Volunteer Functional Inventory (volunteer motivations) and Personal Globe Inventory (career interests). Participants (N = 167) were recruited from community and government volunteer programs with the average age of volunteers being 68.65 years old (SD = 9.36; range 50 to 90 years). The majority of volunteers were female (54.5%), White or Caucasian (90.4%), married (58.2%), reported some college experience (96.5%) and were retired (68.9%).
Results from the current study indicated that time volunteering, volunteer motivations, and volunteer-activity congruence did not significantly predict volunteer satisfaction, accounting for 9.2% of the variance. In contrast, the final model did significantly predict volunteer commitment and accounted for 13.1% of the model variance, with altruistic values remaining a significant contributor to volunteer commitment. Findings from the current study highlight inconsistencies noted in previous research regarding volunteer motivations, satisfaction, and commitment. Possible generational influences on altruistic values and volunteerism were also noted. Although volunteer-activity congruence alone was not predictive of volunteer satisfaction or of commitment, results from the study warrant additional investigations in career interests and volunteering among late-midlife and older adults. Limitations of the current study and implications for volunteer recruitment and retention were also discussed.
ContributorsKeaveny, Maureen Kim (Author) / Robinson Kurpius, Sharon E (Thesis advisor) / Tracey, Terence J G (Committee member) / Kinnier, Richard T (Committee member) / Arizona State University (Publisher)
Created2016