Jarod T. Giger

Remote patient monitoring acceptance trends among older adults residing in a frontier state

We examine remote patient monitoring acceptance for older adults in a frontier state.Family and friends may influence technology acceptance-promoting behaviors.Monitoring technology could translate into higher levels of patient engagement.Our methodology is promising for geographically isolated populations. This pilot study aims to present a methodological approach for investigating remote patient monitoring system acceptance trends for older adults residing in a frontier state. For this purpose, extended Technology Acceptance Model (TAM) variables, which included subjective norm, perceived usefulness, perceived ease of use, and behavioral intention were investigated using growth curve methods and modern resampling techniques. Results revealed our methodological and analytical approach shows promise for investigating technology acceptance over time on subjects where little literature exists and where recruiting adequate sample sizes for statistical power purposes may be challenging. Results of the data analysis showed there was a significant and reliable linear trend on subjective norm. Time did not predict perceived usefulness, perceived ease of use, or behavioral intention, indicating the levels of these factors were high and stable over the course of the study. Older adults accepted remote patient monitoring, and family and friends may influence technology acceptance promoting behaviors. The longer participants used the technology, the more they perceived those important to them would want them to use it. Attention to social influence to optimize the implementation of in-home health monitoring among this population is warranted. Recommendations for future research are provided.

Subjective Well-Being for Children in a Rural Community

ABSTRACT. This study examined indicators of rural childrens subjective well-being and the prediction of well-being indicators from person variables as well as home, life, neighborhood, school, and peer-group contexts. Seventh-grade children (Mage = 13 years, age range = 12–14 years) in a rural Midwestern U.S. community (N = 149) completed an adapted version of an international survey measuring childrens subjective well-being and ecological contexts in childhood and adolescence. Indicators of childrens subjective well-being (including life satisfaction, mental health, and self-image) were significantly correlated with all home, life, neighborhood, school, and peer contexts except life stress. Regression and bootstrap analyses suggest that the strongest predictors of both life satisfaction and mental health were school satisfaction and family, teacher, and peer relationships. The strongest predictors of self-image were gender, number of residences, school satisfaction, and teacher and peer relationships. Findings suggest that a model of subjective well-being that accounts for relational factors, as well as person and other environmental factors, is potentially useful for understanding childrens subjective well-being. Results are discussed in the context of ecological, relationship-based interventions from early childhood through school-age years. Future studies should test this model with samples diverse in child age, culture, and geographical locations.

Overrepresentation of Native American Children in Foster Care: An Independent Construct?

National foster care disparity rates for Native American, African-American, and Hispanic children were examined using correlational and linear regression models confirmed by bootstrapping procedures. African-American disparity and Hispanic disparity were predicted by disparity of the other groups, but Native American disparity was not predicted by other groups. Findings support the hypothesis that an independent construct is operating for Native American disparity, suggesting the need for unique policies and practices to address Native American overrepresentation in foster care.

Evaluating a Training Intervention to Prepare Geriatric Case Managers to Assess for Suicide and Firearm Safety.

ABSTRACT The purpose of this article is to report on the implementation and initial evaluation of a 1-day training intervention targeting direct care providers in the Ohio aging services network. A primary objective is to describe the training intervention that consisted of two parts: (a) a gatekeeper training for assessing suicide risk among older adults, and (b) CALM (Counseling on Access to Lethal Means)—a brief training that teaches effective strategies to talk with clients about reducing access to lethal means. A second objective of this study is to report on changes in providers’ knowledge, attitudes, and practices immediately posttraining related to suicide and firearm assessment and safety counseling with community dwelling older adults. Sixty-six employees in one regional office participated in the study. Results indicated that training increased participants’ perceived knowledge, preparedness, and efficacy regarding suicide assessment. Training also positively impacted knowledge and attitudes of firearm assessment and safety counseling among participants. At posttest, however, gatekeeper reluctance did not demonstrate a significant decrease. This study is unique in its contribution to literature on suicide prevention training with its focus on geriatric care providers and attention to measuring firearm assessment and safety counseling.

An Evaluation of the Counseling on Access to Lethal Means (CALM) Training with an Area Agency on Aging

ABSTRACT Firearms are a significant risk factor in suicide and older adults are disproportionately impacted in suicide by this means. This study investigated the impact of Counseling on Access to Lethal Means (CALM) training with geriatric case managers at an Area Agency on Aging. A concurrent mixed methods approach was used to explore 1) geriatric case managers’ attitudes, beliefs, and behavioral intentions about counseling on access to lethal means following CALM training, and 2) perceived barriers to assessing for suicidality and counseling clients on access to firearms. The CALM evaluation data was collected immediately posttest at CALM training, at three-month follow up. Results indicated that 38% of respondents reported they had, since CALM training, discussed reducing access to lethal means with clients and/or families. At three-month follow up, data showed that most beliefs, attitudes, and behavioral intentions about counseling clients and families on this topic increased. Focus group findings indicated that training had a positive effect on participants’ attitudes, beliefs, and behavioral intentions about counseling on access to lethal means.The findings of the present study offer additional evidence and implication for trainings of this type.

Development of the Older Adult Prescription Drug Assessment Questionnaire for Case Workers.

Instruments assessing geriatric case managers’ perceptions of prescription abuse are limited. Based on a review of current literature and pilot testing feedback, 22 items were initially assembled to form an older adult Prescription Drug Assessment Questionnaire (PDAQ). Case managers (N = 161) at an older adult agency located in a Midwestern state were surveyed using the instrument. Data were subjected to exploratory factor analysis using principal axis factoring (PAF) and Promax rotation, and Horn’s parallel analysis determined the number of extracted factors. PAF generated a final 11-item three-factor model accounting for 51% of total variance explained: Standard Assessment (Factor 1; four items; ∞ = .83), Assessment Belief (Factor 2; three items; ∞ = .74), and Problem Scope (Factor 3; four items; ∞ = .62). The older adult PDAQ is a brief, data-driven instrument with acceptable psychometric properties for assessing perceptions of prescription drug abuse and misuse assessment and counseling.

Predicting personal self-care in informal caregivers

ABSTRACT Caregiver research often focuses on negative health outcomes, yet little is known about the self-care practices of caregivers. The present study investigates self-care practices among family caregivers and the relationships between personal self-care, perceived stress, and other health variables. Data were collected from informal caregivers through self-administered Internet and paper surveys that included the Medical Outcomes Study Short Form 36-item Health Survey, Perceived Stress Scale, and Self-Care Practices Scale. Personal self-care was most strongly associated with emotional well-being, pain, perceived stress, and general health. The relevance of study findings to strengthening family caregiver programs and future research is discussed.

Living with Low Vision: Strategies Supporting Daily Activity

ABSTRACT The purpose of this research was to describe the strategies that older adults with low vision use to support daily living. A descriptive qualitative study of 10 older adults with low vision was conducted using semistructured, audio-recorded interviews. The data was coded and grouped into categories, and the findings were summarized. Four major themes were identified: (a) device nonuse; (b) sensory strategies and devices; (c) environmental strategies; and (d) resourcefulness. Older adults with low vision try many devices and strategies to find the ones that allow them to participate in meaningful activity within their physical and social environment. These findings support the use of a client-centered, multicomponent, problem-solving approach to low vision rehabilitation to maximize performance of daily activity despite declining vision.

Direct and Indirect Links Between the Couple Relationship and Child School Outcomes

ABSTRACT This study measured aspects of the couple relationship to examine direct and indirect relations with parental involvement in education and childrens school outcomes. The sample (n = 100) consisted of families that have at least one child between the ages of 8 and 11 in urban central Taiwan. Findings indicated that couple relationship quality is related to parent involvement and parent involvement is related to child school outcomes. Aspects of the couple relationship were also related to childrens negative attitudes toward school. Path analyses showed a direct path from dyadic consensus to school success and an indirect path from coparenting strategy use to child school success through parental involvement in education. Bootstrap analyses confirmed the reliability of the models.