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Browsing College of Public Health by Subject "Aging"
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Item Examining the Role of Social Isolation on Hospitalizations, Nursing Home Entry, and Mortality among Older Adults(2022) Pomeroy, Julia Mary Louise; Gimm, GilbertSocial isolation affects a quarter of older adults in the United States, complicating efforts for Americans who wish to age at home or in the community. Social isolation is a key risk factor for adverse health outcomes and high health care costs, and is expected to have increased during COVID-19 due to social distancing efforts. However, little research has examined the impact of social isolation on health care utilization. Literature in this area tends to be conducted internationally, uses short follow-up times, measures social isolation through single-item variables, and usually does not control for both social isolation and loneliness in the same sample. No prior studies have examined the association between social isolation and nursing home entry in a United States-based sample. This dissertation includes three studies that expand knowledge on the associations between social isolation and hospitalization, nursing home entry, and mortality in a nationally-representative sample of community-dwelling Americans ages 65 and older. Data from the Health and Retirement Study were used to construct a multi-domain measure of social isolation while controlling for loneliness. The first study uses a panel data analysis to examine whether social isolation was associated with overnight hospital stays, nursing home entry, and mortality among older adults tracked between 2006 and 2018. The second study uses a time-to-event analysis to examine whether social isolation is associated with earlier time to long-term nursing home placement (residency of 100+ days) and mortality over ten years. The third study provides an exploratory, cross-sectional analysis to examine whether use of senior services moderates the association between social isolation and nursing home entry among respondents interviewed between 2010 and 2012. Results demonstrate that social isolation is significantly associated with increased nursing home entry and early mortality. Research examining the association between social isolation and health care utilization has important implications for the expansion of home and community-based services under Medicaid and billing codes to cover screening, referral, and treatment under Medicare. Future research should evaluate whether initiatives that enhance social connections in home or community-based settings are effective in offsetting nursing home entry, reducing premature mortality, and curbing health care costs for patients and payers.Item Predictors of Intention for Safer Sex Practice Among Single Women Fifty Years of Age and Older That Date Online(2016) Stepanian, Natalie Alice; Stepanian, Natalie Alice; Davidson, Michele R.This predictive correlational study explores the intention of safer sex practices among single women fifty years of age and older that date online. A literature review discusses the significant recent rise in the diagnosis of sexually transmitted infections (STIs) among this age group along with changing perceptions of aging, availability of performance enhancers, and access to a significant larger pool of possible romantic partners through online dating. Single women fifty years of age and older that date online, were surveyed about their demographics, STI knowledge, and sexual risk behavior through an online survey. A regression model revealed that specifically, as normative belief scores increased, intention to practice safer sex scores also increased at a statistically significant level. Understanding normative beliefs as a driving force of intention to practice safer sex is critical in designing interventions that will move this vulnerable group of women to commit to practicing safer sex.Item Retaining the Wisdom: Deans’ Reflections on Extending the Academic Working Life of Aging Nurse Faculty(2008-07-03T15:03:40Z) Falk, Nancy L.; Falk, Nancy L.Aging nurse faculty members are vital human resources who serve as educators, researchers, and leaders within baccalaureate nursing programs nationwide. On average, aging nurse faculty members are over 50 years of age and face key retirement decisions over the next decade. Yet, there is little evidence that helps to inform education, practice, policy, and research about issues surrounding continued employment of aging nurse faculty. The purpose of this study was to begin to build substantive theory about deans' perceptions of extending the academic working life of aging nurse faculty members. In person and phone interviews were conducted with nine deans from baccalaureate nursing programs nationwide in this grounded theory study. The participants were employed at large, small, public, private, rural, and urban institutions in eight different states. They varied in age, race, and length of employment in the dean's role and at their current universities. Interviews were audiotaped and transcribed. Data were analyzed using constant comparative analysis. Four categories emerged from the interview data: valuing aging nurse faculty, enduring environmental challenges, recognizing stakeholder incongruence, and readjusting. Findings show that baccalaureate nursing programs and faculty members face environmental challenges including pressures, tensions, and ongoing change. Deans' reflections revealed that aging nurse faculty members are highly valued, bringing wisdom, experience, and institutional, historical, and cultural awareness to their many roles. In the ever-changing environment of baccalaureate nursing education however, some aging nurse faculty fail to keep knowledge, skills, and teaching modes current. In such situations, stakeholder incongruence arises as a mismatch develops between the needs of the baccalaureate nursing program and the skills and contributions of aging nurse faculty members. Baccalaureate nursing programs, program leaders, and aging nurse faculty members can lessen the incongruence by re-adjusting to address the pressures, tensions, and ongoing change.