JoAnn Damron-Rodriguez

Educating Social Workers for an Aging Society: A Vision for the 21st Century.

Longevity is one of the great achievements of the 20th century and its implications for the new century will be profound. The unprecedented demographic shift to an increasingly older society will have a dramatic impact on individual choices over the life course, the structure of the family, and multiple social institutions. Social work can make unique professional contributions to older persons and the late-life family. This article asserts, however, that social work is not adequately prepared to practice in the aging society. The authors document the challenges to social work and recommend addressing these challenges through educational innovations.

UNDERGRADUATE INTEREST IN AGING: IS IT AFFECTED BY CONTACT WITH OLDER ADULTS?

Undergraduate student interest in aging was examined in relation to age, gender, and contact with older adults. Interest in aging is conceived of along a continuum, ranging from initial interest-taking an aging course-to substantial interest as evidenced by academic and career interest. Undergraduate students who have taken an aging course (n = 189) and a stratified random comparison group (n = 261) self-assessed their interest in aging. Background information, including the frequency and duration of contact with older family and non-family individuals, was reported. Being female (p < 001) and having frequent contact with older family members (p < .01) significantly explains initial interest in aging. Initial interest in aging (i.e., taking an aging course) significantly contributes to substantial interest in aging (p < .0001) i.e., taking more aging courses, majoring in gerontology, working or planning to work with older adults. Contact with older adults positively affects undergraduate interest in aging...Undergraduate student interest in aging was examined in relation to age, gender, and contact with older adults. Interest in aging is conceived of along a continuum, ranging from initial interest-taking an aging course-to substantial interest as evidenced by academic and career interest. Undergraduate students who have taken an aging course (n = 189) and a stratified random comparison group (n = 261) self-assessed their interest in aging. Background information, including the frequency and duration of contact with older family and non-family individuals, was reported. Being female (p < 001) and having frequent contact with older family members (p < .01) significantly explains initial interest in aging. Initial interest in aging (i.e., taking an aging course) significantly contributes to substantial interest in aging (p < .0001) i.e., taking more aging courses, majoring in gerontology, working or planning to work with older adults. Contact with older adults positively affects undergraduate interest in aging. Interest in aging proceeds along a continuum, from preceding factors to initial interest in aging and then to substantial interest in aging. Aging courses and opportunities for interaction with older adults should be offered at the undergraduate level.

Endurance of Undergraduate Attitudes Toward Older Adults

This cross-sectional study assessed undergraduate attitudes toward older adults and attitude endurance 3 to 18 months after aging coursework. Survey respondents included 349 students who took an aging elective and 430 comparison students. Aging-elective students indicated more positive attitudes than comparison students. Attitudes did not vary across 3 groups staggered by time elapsed from completing the course until testing (3 to 18 months). 4 variables accounted for the variance in attitudes toward elders at a statistically significant level: majoring in biology, having frequent or occasional contact with unrelated older adults, taking an aging course, and post-course knowledge of aging.

Veteran identity and race/ethnicity: Influences on VA outpatient care utilization

Background. “Veteran identity” is defined as veterans’ self-concept that derives from his/her military experience within a sociohistorical context. Veteran identity may vary by race/ethnicity because the sociohistorical context of the military experience varies by race. Objectives. To explore veteran identity and how it varies by race/ethnicity, and to identify aspects of veteran identity that significantly influence preferences for, and use of, VA outpatient care. Research Design. Focus groups were conducted at community sites to explore concepts related to veteran identity, race/ethnicity, military experience, and health services use. The focus groups informed the development of a telephone survey, which was administered to veterans of four racial/ethnic groups in Southern California and Southern Nevada. Subjects. One hundred seventy-eight veterans participated in the focus groups, and 3,227 veterans completed the telephone survey. Measures. Dependent variables include: (1) preference for VA health services, (2) VA-only outpatient use, (3) Any VA outpatient use, and (4) number of outpatient visits within the previous 12 months. Independent variables include veteran identity, sociodemographic, and health-related characteristics. Results. All veteran identity variables were significantly associated with race/ethnicity. Race/ethnicity, eg, being black or Hispanic, in addition to veteran identity factors, significantly influenced preferences for VA outpatient care. Veteran identity factors, however, had less influence on VA outpatient service utilization than socioeconomic factors. Conclusions. Minority veterans who highly identify with their veteran status may prefer the VA to other systems of care. Factors associated with veteran identity may be useful for incorporation into interventions to improve access to VA care.

Developing Geriatric Social Work Competencies for Field Education

Summary Preparing social workers to effectively practice with the growing older population requires the identification of geriatric competencies for the profession. The John A. Hartford Geriatric Social Work Initiative provided the impetus and direction for a national strategy to improve the quality of preparation of geriatric social workers. The Geriatric Social Work Practicum Partnership Program (PPP) is the project with the Hartford Initiative that emphasizes field education. The Geriatric Social Work Education Consortium (GSWEC), one of the PPP programs, initiated the development of competencies for work with older adults. GSWEC utilized Geriatric Social Work White Papers and the pioneering work of the Council on Social Work Educations (CS WE) Strengthening Aging and Gerontology Education for Social Works (SAGE-SW) comprehensive competency list as well as conducted focus groups locally to delineate key competencies for field education. The Coordinating Center for the PPP, located at the New York Academy of Medicine, led in collaboratively developing knowledge based skill competencies for geriatric social work across all 6 demonstration sites (11 universities). The competencies adopted across sites include skills in the following five major domains: values and ethics; assessment (individuals and families, aging services, programs and policies); practice and interventions (theory and knowledge in practice, individual and family, aging services, programs and practice) interdisciplinary collaboration; and evaluation and research. The identified competencies have proven effective in evaluating students (n = 190) pre- and post PPP field education. The implications for further development of competency driven education for geriatric social work are discussed.

Racial/ethnic variations in veterans' ambulatory care use.

OBJECTIVES We assessed racial/ethnic variations in patterns of ambulatory care use among Department of Veterans Affairs (VA) health care-eligible veterans to determine if racial/ethnic differences in health care use persist in equal-access systems. METHODS We surveyed 3227 male veterans about their health and ambulatory care use. RESULTS Thirty-eight percent of respondents had not had a health care visit in the previous 12 months. Black (odds ratio [OR] = 0.5), Hispanic (OR = 0.4), and Asian/Pacific Islander veterans (OR=0.4) were less likely than White veterans to report any ambulatory care use. Alternately, Whites (OR=2.2) were more likely than other groups to report ambulatory care use. Being White was a greater predictor of health care use than was having fair or poor health (OR=1.4) or functional limitations (OR=1.5). In non-VA settings, racial/ethnic minorities were less likely to have a usual provider of health care. There was no VA racial/ethnic variation in this parameter. CONCLUSIONS Racial/ethnic disparities in health and health care use are present among VA health care-eligible veterans. Although the VA plays an important role in health care delivery to ethnic minority veterans, barriers to VA ambulatory care use and additional facilitators for reducing unmet need still need to be investigated.

The Health and Functional Status of US Veterans Aged 65+: Implications for VA Health Programs Serving an Elderly, Diverse Veteran Population:

As the US population is aging, so too is the US veteran population. Chief among the challenges facing the Department of Veterans Affairs (VA) is developing health programs and services that mesh with the needs of an aging veteran population and therefore improve the health status of elderly veterans. Meeting this challenge requires an understanding of the health needs of the older veteran population, including health disparities that exist across racial ethnic populations. This study examines the selfrated health and functioning of a national sample of veterans aged 65+ participating in the National Survey of Veterans. The results show that over one half of elderly veterans report difficulty in functioning and rate their health status as fair or poor. Additionally, elderly African American and Hispanic veterans report worse health than non-Hispanic white veterans across the majority of health indicators. Given the health profile of older veterans found in this study, it would seem necessary that programs serving older veterans be adept at the ongoing medical management of chronic disease and the provision of long-term care services.

Strengthening field education in aging through university-community agency partnership: the Practicum Partnership Program.

Abstract The Practicum Partnership Program (PPP), an innovative field education model developed and implemented by six demonstration sites over four years (2000-2004), uses a structured university-community partnership, or consortium, as the foundation for designing, implementing, and evaluating internships for graduate social work students specializing in aging. This paper describes the site consortia and PPP programs, presents evaluation findings, and identifies future directions for the PPP. Student learning outcomes were positive and both students and consortia agencies reported positive PPP experiences. The PPP model underscores the value of the community agencies as equal partners in educating future geriatric social workers.

Social Work Knowledge of Facts on Aging: Influence of Field and Classroom Education.

Palmores Facts on Aging Quiz (FAQ) was used to measure aging knowledge outcomes of 323 practicum students engaged in aging-focused practica at pre- and posttest across 11 universities. Significant improvement in knowledge scores (p = .0001) was found for graduates of the enhanced field education programs. Taking aging course work was a significant (p = .0001) influence on knowledge outcomes. Combined with coursework, the practicum students experienced increased knowledge of aging. When experiential and didactic learning is combined, increased knowledge about facts of aging occurs.

Social Work Knowledge of Community-Based Services for Older Adults: An Educational Model for Social Work Students

Social workers are often the key link between older adults, their families and community-based services. Thus, knowledge about older adults and community-based care is imperative for social work practice. Evaluation data are provided on a national multisite effort (N = 353) from 35 schools to assure graduate social work students competency related to community services for older adults. Results suggest that the educational model as described in this article sets forth positive outcomes in the education of aging savvy social workers. Ongoing social work education is needed to meet the burgeoning needs of the geriatric population.