Self-Management of Heart Disease in Older Adults.

The American Heart Association estimates that 81% of people who die of coronary heart disease are 65 years old or older. The leading risk health behaviors include physical inactivity, poor diet, smoking, and binge drinking. Using the 2011-2012 California Health Interview Survey (CHIS), this study looked at how self-management, which includes a plan developed by a medical professional and the confidence to manage one's disease, may decrease negative risk behaviors in older adults. The presence of a plan and increased self-efficacy decreased engagement in negative dietary behaviors and low physical activity. Implications for strategies that address heart disease and self-management are discussed.

Health and ambulatory care use among Native American veterans.

In 1995, the Veterans Health Administration reorganized its health services structure to emphasize ambulatory care. Successful health care planning and improving access to ambulatory care services now depends upon a better understanding of health care needs and outpatient services. Because the veteran population is heterogeneous, it is important to understand the health, access issues, and utilization of ambulatory care services in order to develop effective strategies and interventions to ensure access to and utilization of ambulatory care. Drawing on a focus group methodology with 86 Native American veterans, representing 34 tribes, this study is a qualitative examination of the health, access, use of the Department of Veterans Affairs Health Care services, barriers to health care, and satisfaction with care experienced by Native American veterans. Results reveal problems in accessing care, receiving appropriate care, and coordinating care within the VA health care system. Policy and program recommendations include increasing outreach and education efforts regarding the availability of benefits and services, improving coordination of services between the Indian Health Service and the VA, and reemphasizing the importance of patient-centered care.

Evaluating a multicomponent caregiver intervention.

There is compelling evidence that caring for an elderly individual with functional limitations is physically and psychologically stressful. The purpose of this study is to test a multimodal caregiver intervention of ethnically and racially diverse caregivers. We sought to examine if caregivers (n=199) of older adults with physical and/or cognitive problems experienced improved depression and caregiver outcomes after participating in a community-based Caregiver Support/Training Program (CS/TP). Using a single group pretest--post-test design, caregiver depression decreased significantly. Specifically, caregivers were more likely to report higher positive affect at post-test. Although caregivers reported decreased caregiver burden, the difference was not statistically significant. One-way ANOVAs were also conducted to look at group differences. The findings of this study will help practitioners understand the importance of developing more targeted interventions that take specific ethnic and cultural characteristics of caregivers into consideration.

A measure of English acculturation stress and its relationships with psychological and physical health status in a sample of elderly Russian immigrants.

This study aims to evaluate the factor structure and criterion validity of the English Language Acculturation Stress (ELAS) scale in a community-based sample of elderly Russian immigrants. The sample consists of 300 Russian immigrants with an equal number of females and males, from 59 to 93 years of age (Mean = 73.26, SD = 7.271). The majority of the respondents were married (72%) at the time the interviews were conducted. On average, the respondents have lived in the U.S. for about 7 years (SD = 3.00). We performed both exploratory and confirmatory factor analyses to ascertain the factor structure or conceptual dimensions of the 11-item ELAS scale. The findings revealed that this 11-item scale encompasses three dimensions: Basic English skills, survival English skills, and social involvement English skills. Correlation analyses of the scale with depression, physical health status, and length of residence suggest that the ELAS has good criterion validity and potential as a screening instrument of language acculturation stress for elderly Russian immigrants. Implications for research and practice are discussed.