Activity disengagement: Understanding challenges and opportunities for reengagement

Although maintaining engagement in activities has a positive influence on our health and wellbeing as we age, many programs that serve older adults struggle with getting participation in the programs they offer. This study sought to explore activity disengagement among older adults in a senior housing community and identify the challenges and opportunities for reengagement with the aim of informing future intervention development and testing. Fifty-one adults over the age of 60 participated in structured interviews. Findings highlighted that many older adults have activities patterns that are not optimal for health. Many reasons given for disengaging in activities (e.g., no opportunity) were surprising given that participants lived in a setting where a variety of programs were offered. Programs need to more purposively address social challenges to participating in activities and consider a more person-centered approach when developing interventions for the older adults they serve

Productive Engagement of Older Adults: Effects on Well-Being

Productive Engagement of Older Adults: Effects on Well-Bein

Evaluation Report of Vital Visionaries: Medical Student and Older Adult Outcomes

Evaluation Report of Vital Visionaries: Medical Student and Older Adult Outcome

Youth Service and Elder Service in Comparative Perspective

Youth Service and Elder Service in Comparative Perspectiv

Patient active time during therapy sessions in postacute rehabilitation: Development and validation of a new measure

BACKGROUND AND PURPOSE: The accurate measurement of therapy intensity in postacute rehabilitation is important for research to improve outcomes in this setting. We developed and validated a measure of Patient Active Time during physical (PT) and occupational therapy (OT) sessions, as a proxy for therapy intensity. METHODS: This measurement validity study was carried out with 26 older adults admitted to a skilled nursing facility (SNF) for postacute rehabilitation with a variety of main underlying diagnoses, including hip fracture, cardiovascular diseases, stroke, and others. They were participants in a randomized controlled trial that compared an experimental high-intensity therapy to standard-of-care therapy. Patient Active Time was observed by research raters as the total number of minutes that a patient was actively engaging in therapeutic activities during PT and OT sessions. This was compared to patient movement (actigraphy) quantified during some of the same PT/OT sessions using data from three-dimensional accelerometers worn on the patient’s extremities. RESULTS: Activity measures were collected for 136 therapy sessions. Patient Active Time had high interrater reliability in both PT (r = 0.995, p < 0.001) and OT (r = 0.95, p = 0.012). Active time was significantly correlated with actigraphy in both PT (r = 0.73, p < 0.001) and OT (r = 0.60, p < 0.001) and discriminated between a high-intensity experimental condition and standard of care rehabilitation: in PT, 47.0 ± 13.5 min versus 16.7 ± 10.1 min (p < 0.001) and in OT, 46.2 ± 15.2 versus 27.7 ± 6.6 min (p < 0.001). CONCLUSIONS: Systematic observation of Patient Active Time provides an objective, reliable, and valid index of physical activity during PT and OT treatment sessions that has utility as a real-world alternative to the measurement of treatment intensity. This measure could be used to differentiate higher from lower therapy treatment intensity and to help determine the optimal level of active therapy time for patients in postacute and other settings

The Psychiatrization of Poverty: Rethinking the Mental Health-Poverty Nexus

The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality

Expand Paid Family and Medical Leave

This policy action statement was developed by members of the network engaged in the Grand Challenge to Advance Long and Productive Lives. The Grand Challenges initiative’s policy action statements present proposals emerging from Social Innovation for America’s Renewal, a policy conference organized by the Center for Social Development at Washington University in collaboration with theAmerican Academy of Social Work & Social Welfare, which is leading the Grand Challenges for Social Work initiative to champion social progress through a national agenda powered by science

Informing Policy on Volunteer Service Through Agency-Based Evaluations

This working paper describes the evidence-based policy making process. We focus on what information is needed to inform policy development and decision-making on volunteer service and then how this information can be most effectively disseminated to policy makers, outlining a range of specific strategies. Existing volunteer service research is used as illustration. Implications are drawn for the capacity of agency staff to implement the research methods and strategies that are discussed

Policy Recommendations for Meeting the Grand Challenge to Advance Long and Productive Lives

This brief was created forSocial Innovation for America’s Renewal, a policy conference organized by the Center for Social Development in collaboration with the American Academy of Social Work & Social Welfare, which is leading theGrand Challenges for Social Work initiative to champion social progress. The conference site includes links to speeches, presentations, and a full list of the policy briefs

Profile of Older Adults Participating IDAs: Findings from the American Dream Demonstration

This research report is the first of a three-part series aimed at developing a greater understanding of older adults and their use of Individual Development Accounts (IDAs). The intent of this first report is to answer the following three questions: 1) Who are the older adults participating in IDAs? 2) What are they saving for? and 3) What do we know about IDAs and saving for retirement? These questions are answered using data from the American Dream Demonstration (ADD), the first nation-wide evaluation of IDAs as tools for asset building and community development. In this report, comparisons are made between older (50 years or older) and younger (49 years or younger) adults for the purpose of identifying variations in IDA participation by age