Anna E. Price

Older adults' concerns about cognitive health: Commonalities and differences among six United States ethnic groups

ABSTRACT We studied concerns about cognitive health among ethnically diverse groups of older adults. The study was grounded in theories of health behaviour and the representation of health and illness. We conducted 42 focus groups (N=396, ages 50+) in four languages, with African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos (hereafter, Whites) and Vietnamese Americans, in nine United States locations. Participants discussed concerns about keeping their memory or ability to think as they age. Audio recordings were transcribed verbatim. Constant comparison methods identified themes. In findings, all ethnic groups expressed concern and fear about memory loss, losing independence, and becoming ‘a burden’. Knowing someone with Alzheimers disease increased concern. American Indians, Chinese Americans, Latinos and Vietnamese Americans expected memory loss. American Indians, Chinese Americans and Vietnamese Americans were concerned about stigma associated with Alzheimers disease. Only African Americans, Chinese and Whites expressed concern about genetic risks. Only African Americans and Whites expressed concern about behaviour changes. Although we asked participants for their thoughts about their ability to think as they age, they focused almost exclusively on memory. This suggests that health education promoting cognitive health should focus on memory, but should also educate the public about the importance of maintaining all aspects of cognitive health.

Experiences and concerns of family caregivers providing support to people with dementia: A cross-cultural perspective

Abstract: We examined experiences and concerns among caregivers of community-dwelling people with dementia from two ethnic groups. We conducted a thematic analysis of responses to the question, ‘What is your life like as a caregiver?’ in nine focus groups (n = 75) with Filipino and non–Hispanic White caregivers. Constant comparison methods identified themes by ethnicity. Experiences and concerns expressed across groups were related to care recipient symptoms commonly associated with dementia, including severe memory loss and behavioral changes. Participants in both ethnic groups described strategies that help them cope, such as receiving help from family and friends, receiving respite support, and participating in support groups. Filipino caregivers more often emphasized positive aspects of caregiving, whereas Whites often expressed that others do not understand the daily experiences of caregiving. Filipinos more commonly described caregivers as a ‘good person’ or ‘saint’ and emphasized that caregiving made them stronger.

Older Adults’ Perceptions of Physical Activity and Cognitive Health: Implications for Health Communication

Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined older adults’ perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men (N = 55), ages 65 to 74 in South Carolina. Constant comparison methods compared themes by gender and race/ethnicity groups. Most participants perceived cognitive decline as a severe threat, and they were primarily concerned about losing their independence. Most reported feeling susceptible to cognitive decline. Although most recognized the link between PA and CH, several White men said the association was not clear. Participants recommended a wide range of PA amounts needed to achieve CH benefits. Many suggested that evidence of PA benefits for CH would enhance message credibility. Participants suggested messages be paired with social support to increase PA. Results suggest a need for evidence-based, credible communication promoting PA and CH.

How do older people describe others with cognitive impairment? A multiethnic study in the United States

ABSTRACT We studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. Many participants attributed dementia to stress. Terms describing others with dementia included ‘Alzheimers’, ‘dementia’, ‘senile’ and ‘crazy’. Euphemisms were common (‘senior moment’, ‘old timers disease’). Responses focused on memory, with limited mention of other cognitive functions. Differences among ethnic groups in descriptions of cognitive health and cognitive impairment underscore the need to tailor public health messages about cognitive health to ways that people construe its loss, and to their interest in maintaining it, so that messages and terms used are familiar, understandable and relevant to the groups for which they are designed. Health promotion efforts should develop ethnically sensitive ways to address the widely held misperception that even serious cognitive impairment is a normal characteristic of ageing and also to address stigma associated with cognitive impairment.

Trail User Demographics, Physical Activity Behaviors, and Perceptions of a Newly Constructed Greenway Trail

To better understand and promote physical activity on a newly constructed trail, the present study examined the demographic characteristics and physical activity behaviors of trail users; the demographic characteristics of trail users compared to the demographic profile Greenville County, South Carolina residents; trail users’ purpose for using the trail; the distance trail users traveled to access the trail from their homes; channels through which trail users learned about the trail; and trail characteristics liked by trail users. Using a valid and reliable intercept survey, 1,148 trail users were interviewed. Trail users were mostly white (93.1%), male (59.1%) adults (84.2%) who reported using the trail for exercise (91%). Significant associations were identified between trail user demographic characteristics and how trail users learned about the trail and trail characteristics liked by trail users. The findings may contribute to the development of targeted health promotion efforts to promote physical activity on this and similar trails.

A Content Analysis Of Cognitive Health Promotion In Popular Magazines

Health behaviors, particularly physical activity, may promote cognitive health. The public agenda for health behaviors is influenced by popular media. We analyzed the cognitive health content of 20 United States magazines, examining every page of every 2006–2007 issue of the highest circulating magazines for general audiences, women, men, African Americans, and the health conscious (n = 178). Diet was the greatest focus. Physical activity coverage was limited. Important behavior-related cognitive health risks, including hypertension and diabetes, were not mentioned. Publications for African Americans had little cognitive health content. Coverage of cognitive health was not commensurate with growing evidence that health behaviors may help to maintain it. Findings may be useful to public health officials, health care providers, non-profit organizations that promote cognitive health, individuals evaluating cognitive health information in popular media, and those responsible for magazines or other media.

Primary Care Providers' Sources And Preferences For Cognitive Health Information In The United States

In most countries, physicians and other health-care providers play key roles in promoting health. Accumulating scientific evidence suggests that providers may soon want to include cognitive health among the areas they promote. Cognitive health is the maintenance of cognitive abilities that enable social connectedness, foster a sense of purpose, promote independent living, allow recovery from illness or injury and promote effective coping with functional deficits. The US Centers for Disease Control and Prevention has established health promotion about cognitive health as a policy priority, with health providers included as one key group to participate in this effort. This study presents results from focus groups and interviews with primary care physicians (n = 28) and midlevel health-care providers (physician assistants and nurse practitioners, n = 21) in three states of the US. Providers were asked about their sources of information on cognitive health and for their ideas on how best to communicate with primary care providers about research on cognitive health. In results, providers cited online sources, popular media and continuing medical education as their most common sources of information about cognitive health. Popular media sources were used both proactively and reactively to respond to patient inquiries. Differences in sources of information were noted for physicians as compared with midlevel providers, and for rural and urban providers. Several potential ways to disseminate information about cognitive health were identified. Effective messaging is likely to require multiple strategies to reach diverse groups of primary care providers, and to include continuing medical education.

Beliefs About Promoting Cognitive Health Among Filipino Americans Who Care For Persons With Dementia

We examined beliefs about promoting cognitive health among Filipino Americans who care for persons with dementia, their awareness of media information about cognitive health, and their suggestions for communicating such information to other caregivers. We conducted three focus groups (25 participants). The constant comparison method compared themes across focus groups. Caregivers most frequently described cognitive health benefits of social engagement and leisure; next in emphasis were benefits of healthy diets. There was less emphasis on physical activity. Participants had heard from television that avoiding smoking, alcohol, and drugs might promote cognitive health. Ways to inform others about cognitive health included information in Filipino newspapers, and handouts in Filipino languages, distributed in Filipino stores, workplaces, community organizations, and health care facilities. Findings suggest an opportunity to develop public health messages promoting cognitive health that are in-language, published in ethnic-specific media, and that are culturally appropriate for Filipino and other Asian Americans.

Travel to, and use of, twenty-one Michigan trails.

OBJECTIVE AND METHODS This study examined trail use among 857 trail users on 21 trails in Michigan from 2008 to 2011 using a valid and reliable intercept survey. RESULTS Most of the 857 participants traveled to the trail from their home (92.6%), lived within 15 min of the trails (74.8%), and used active transport to travel to the trails 69.7%. The odds of active transport to the trails were greater among those who had not graduated high school (OR=3.49; 95% CI=1.02, 11.99) and high school graduates (OR=7.432; 95% CI=2.02, 27.30) compared to college graduates. Whites and adults also had greater odds of active transport than non-Whites (OR=3.160, 95% CI: 1.65, 6.05), and older adults (OR=1.75; 95% CI: 1.20, 2.54). The majority of respondents (89.7%) reported using trails for recreational purposes. A significantly greater proportion of females (73.3%) compared to males (64.7%) reported using the trail with others. CONCLUSIONS The findings from this study might enable health and parks and recreation professionals to better promote physical activity on trails.

Use and Nonuse of a Rail Trail Conversion for Physical Activity: Implications for Promoting Trail Use

Background There is limited research examining both use and nonuse of trails for physical activity. Purpose Such research might enable health educators to better promote physical activity on trails. Methods We used random digit dialing methods to survey 726 respondents in 2012. Results The majority (75.1%) of respondents reported not using the trail in the previous 6 months. The odds of using the trail were greater among adults compared to older adults and those with a high school degree or college degree compared to those with less than a high school degree. Fifteen percent of trail users reported using the trail regularly (i.e., at least 30 minutes, 3 days/week). Trail characteristics preferred by trail users and reasons for not using the trail among nonusers were also examined. Discussion These findings might be useful for health educators promoting physical activity on trails. Translation to Health Education Practice Persons promoting physical activity on trails should highlight those trail characteristics preferred by trail users, including the trails’ convenient location, beauty, and design. There is an opportunity to promote trail use among older adults and those with low education levels; promoting active transportation on trails might be especially useful among those with low education levels.