Pamela A. Yankeelov

Another day in paradise: a photovoice journey of rural older adults living with diabetes.

This article provides the results of a photovoice project conducted with older adults affected by diabetes living in three rural counties in the southern region of the United States. Photovoice is a community-based participatory action methodology that puts the tools of research in the hands of participants. This project was an initial community engagement activity that promoted trust-building and formed part of a larger comprehensive community needs assessment. The process revealed themes of personal and community resilience focused on the daily living with diabetes, formal and informal supports, barriers to taking care of their diabetes, accessibility to fruits and vegetables, changes to food preparation and consumption, and exercise supports and barriers. The impact of the photovoice project on the participants and the implications for practice are discussed.

Understanding the Impact of Intimate Partner Violence Mandatory Reporting Law

Intimate partner violence is a pervasive, complex problem affecting the lives and health of a large percentage of women and children. This report provides data from an evaluation designed to address questions and concerns expressed about possible unintended effects of the mandatory reporting law on victims. Case reviews were completed on 631 adult protective service cases resulting from reports of intimate partner violence. Results indicate that following a report of suspected intimate partner violence made under Kentucky mandatory reporting law, all victims who could be located received at a minimum safety planning and information about community resources. Regardless of official case status, nearly half of all cases received services.

Strength in Process: Using Concept Mapping to Inform Community Coalition Development

This study reports on the use of Concept Mapping to delineate a conceptual framework germane to the planning and initial formation of tri-county rural diabetes coalition in a southeast US community. The focus of the tricounty coalition is to reduce diabetes-related inequalities in vulnerable populations. After a review of pertinent literature on community coalitions, this article explicates Concept Mapping processes utilized to plan and organize the formation of a coalition, offers analyses of the results, and discusses implications for current and future practices pertaining to community coalition work.

Impact of geriatric assessment and self-management support on community-dwelling older adults with chronic illnesses.

Purpose: The purpose of this study was to assess the effectiveness of interdisciplinary geriatric home-based assessment and self-management support services to community-dwelling older adults. Design: A quasi-experimental, pre-post test design tested two types of service delivery models. The first protocol included geriatric assessment services, with a brief self-management care plan intervention. The second protocol added a telephone support intervention. Results: All participants showed significant progress in improved self–efficacy, self-rated health, functional status and physical mobility (specifically lower extremity muscle strength), mental health (specifically reduced depression) and in reduced fall hazards in their physical home environment. The telephone support intervention protocol did not provide additional value to the first protocol. Implications: This study demonstrates the value of non-medical intervention strategies for community dwelling older adults with chronic illnesses.

Innovative interdisciplinary training in and delivery of evidence-based geriatric services: creating a bridge with social work and physical therapy.

With focus on interdisciplinary education models, social work and physical therapy faculty from two proximate universities partnered to create an evidence-based geriatric assessment and brief intervention research, training, and service project for community-dwelling older adults. Assessment tools and interventions were selected from the literature to develop the service protocols. These selected protocol skills were taught to interdisciplinary teams of students and professionals in social work and physical therapy, and learning outcomes were evaluated. This article describes the process of implementing this innovative multipartner project, the obstacles faced, and lessons learned. Adult learning theory and social cognitive theory served to underpin the project. The objectives were achieved, and evaluation noted many positive experiences in training and service delivery. This multipartner, interdisciplinary project concept can be replicated to improve educational outcomes for students and professionals as they prepare and learn to serve community-dwelling older adults.

From “Producing” to “Consuming” Research: Incorporating Evidence-Based Practice Into Advanced Research Courses in a Master of Social Work Program

Schools of social work have begun to explore teaching evidence-based practice (EBP) across their curriculum. Although the current literature offers ideas on how to incorporate EBP in foundation research and practice courses, the literature seems nonexistent on how to teach EBP in an advanced research sequence, which could clearly address the widespread criticism that research courses are unsuccessful in making the practice–research link more apparent. This article describes the transition of one school from a “producing research” curriculum focus to an EBP focus, which embraces consuming research. In the present article, the authors discuss the benefits and struggles associated with these two different approaches.

Loss of passion, intimacy, and commitment: A conceptual framework for relationship researchers

Abstract The authors suggest that the concept of loss may serve as an organizing principle to clarify many of the dynamics of close relationships. Prior to the ultimate loss of the relationship, there may be intermediate losses that undermine relationship stability. Research on social allergies, or extreme responses to minor annoyances, suggests that relatively mild antigens, if frequently repeated, can gradually cause a loss of feelings of idealization of the partner, comfort with the partner, or feelings of being cared about or respected by the partner. Larger problems may cause loss of major elements of love. The loss of physical attractiveness may, depending on the partners attributions, be associated with the loss of passion. The loss of desired levels of social support may lead to the loss of intimacy, whereas the loss of customary levels of interdependent behavior may lead to a loss of commitment. The loss of honesty in the relationship may lead to a cascade of other losses. Finally, the partners...

Intervention Research With Minority Older Adults Challenges Encountered, Solutions Enacted, and Implications for Future Work

Minority older adults are the fastest-growing segment of the older adult population, and a disproportionate number have the greatest psychosocial needs. It is the need to understand and bridge existing racial and ethnic disparities that makes research with minority older adults so necessary. However, these very vulnerabilities may lead to ethical dilemmas in undertaking research with this population, particularly because for many minority older adults, interventions offered through research may be the only treatment option available. This article discusses this and other ethical issues that may arise in the development and implementation of research protocols with minority older adults. By presenting specific examples of research challenges encountered the authors aim to encourage discussion about the clinically and ethically responsible ways of anticipating, preparing for, and addressing ethical research with minority older adults in ways that foster research integrity, best serve study participants, and contribute to greater knowledge and understanding for bridging disparities.

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.

World Cafés Create Healthier Communities for Rural, Older Adults Living With Diabetes:

Our global population is aging at an accelerated pace. While the average life expectancy has seen dramatic increases, chronic disease and disability have also increased, with rural America tending to be older, sicker, and poorer. This article examines the implementation and outcomes associated with the community engagement method of the world café that was instrumental in developing a “culture of health” aimed to reduce diabetes-related inequalities for older adults in rural counties of Kentucky. Older residents and the organizations that serve them participated in world cafés, which resulted in collective action due to the wisdom and capacity that evolve from the core element of the method, conversational sharing via multiple small group interactions. Four world cafés were held to explore the desires of the communities related to healthy eating, exercise, smoking cessation, and diabetes care. The world cafés brought a diverse group of community residents and governmental and business leaders to discuss topics that matter to their community, leading to the development of a strategic plan and a scorecard and, ultimately, community empowerment.