Social connectedness in older Urban African-American adults during the COVID-19 pandemic: the roles of education and partnership.

OBJECTIVE: This study examined education, partnership status, and the moderating role of the lockdown period on social connectedness during the COVID-19 pandemic in a sample of urban African-American older adults. METHODS: Five hundred thirty-four African-American adults living in Detroit (91.0% female, Mage = 74.53) reported demographic information pre-pandemic and answered one social connectedness questionnaire between April and December 2020. RESULTS: Participants interviewed after the lockdown (post-June 2020) reported more loneliness than those interviewed during the lockdown (April-June, 2020). Married/partnered participants reported less loneliness and social isolation. Loneliness did not differ between those with high education levels interviewed during the lockdown compared to post-lockdown. However, among individuals with low education levels, those interviewed after the lockdown reported more loneliness than those interviewed during the lockdown period. CONCLUSION: Our findings suggest partnership status is associated with more social connectedness during the pandemic and education accentuates the effects of forced isolation related to loneliness among urban African-American older adults.

Understanding the concept of trust and other factors related to COVID-19 vaccine intentions among Black/African American older adults prior to vaccine development.

Background: Black/African Americans are receiving COVID-19 vaccines at much lower rates than whites. However, research is still evolving that explains why these vaccination rates are lower. The aim of this study was to examine the effects of the pandemic among older Black/African Americans, with an emphasis on trust and vaccine intention prior to vaccine development. Methods: Data were collected between July and September 2020 from 8 virtual focus groups in Detroit, MI and San Francisco Bay Area, CA with 33 older African Americans and 11 caregivers of older African Americans with cognitive impairment, supplemented by one virtual meeting with the project's Community Advisory Board. Inductive/deductive content analysis was used to identify themes. Results: Five major themes influenced the intention to be vaccinated: uncertainty, systemic abandonment, decrease in trust, resistance to vaccines, and opportunities for vaccination. The last theme, opportunities for vaccination, emerged as a result of interaction with our CAB while collecting project data after the vaccines were available which provided additional insights about potential opportunities that would promote the uptake of COVID-19 vaccination among older Black/African Americans. The results also include application of the themes to a multi-layer framework for understanding precarity and the development of an Integrated Logic Model for a Public Health Crisis. Conclusions: These findings suggest that trust and culturally relevant information need to be addressed immediately to accelerate vaccine uptake among older Black/African Americans. New initiatives are needed to foster trust and address systemic abandonment from all institutions. In addition, culturally relevant public health campaigns about vaccine uptake are needed. Thus, systemic issues need immediate attention to reduce health disparities associated with COVID-19.

Understanding the Ephemeral Moment of COVID Avoidance Hotels: Lessons Learned from Acknowledging Housing as Central to Dignified Later Life.

Place and health are intricately bound. COVID has amplified system burdens and health risks within the housing care continuum, in which older adults with chronic illnesses are disproportionately represented. The paper identifies the health experiences of older adults with severe conditions living in and moving through temporary avoidance hotels during the COVID-19 pandemic. An interpretive descriptive approach was taken with qualitative chart data and provider observation to represent the experiences of 14 older avoidance hotel residents living with serious illnesses. Through provider documentation, we illustrate trends pre-pandemic, in the first nine months of the pandemic, and the second nine months. Such trends include strengths and opportunities such as the health-affirming nature of avoidance hotels, their potential in generating continuity of care and permanent housing, and synergy between harm reduction approaches and palliative care. Challenges were also identified in catering to the diverse medical, behavioral, and psychosocial-spiritual needs of older and seriously ill residents and the consequences of geographic dispersion on health care, health behaviors, and informal care networks. Through these strengths and challenges, avoidance hotels present essential lessons in considering future housing and healthcare intervention and implementation that addresses the needs of older seriously ill people facing homelessness and housing precarity.

"It Takes Some Empathy, Sympathy, and Listening": Telephone Outreach to Older Detroiters in a Pandemic as a Modality to Gain an Understanding of Challenges and Resiliency.

This manuscript describes a telephone outreach project for members of a research registry program for older adults in Detroit, Michigan. From April until December 2020, the Healthier Black Elders Center designed and implemented a telephone outreach program, calling 1204 older adults utilizing 15 staff and volunteers. The calls served to check in on registry members and collect data on mental health, coping mechanisms, access to services, masks, testing, and tele-health. This paper details the methods of developing and implementing an innovative engagement program that collected time-sensitive data from older Black adults that has directly been applied to create virtual health education programs, share resource information, and create a program to reduce social isolation.

Building and Sustaining a Community Advisory Board of African American Older Adults as the Foundation for Volunteer Research Recruitment and Retention in Health Sciences.

Older African Americans' participation in health-related research is severely limited; they are not involved in sufficient numbers to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older African Americans' vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of African American older adults in metro Detroit, Michigan to oversee the research recruitment and retention of fellow minority older adult research participants. CAB members develop and support community health programming that provides free resources to older adults and also serves as fertile ground for recruiting participants in a volunteer research registry. CAB members are also provided ongoing training on social and behavioral health research and are supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement. This community-engaged model of sustaining a CAB of African American older adults offers key lessons learned on building relationships and trust, valuing and leveraging community members' expertise and time, sharing decision-making, and fostering genuine community all while promoting research recruitment and retention among underserved populations.

Return Migration in Later Life in Mainland China: Motivations, Patterns, and Influences.

This study focuses on patterns and influences of return migration behavior in mainland China, (n = 468 individuals ages 50 and above) from a life-course perspective, using the 2011 China Health and Retirement Longitudinal Study (CHARLS). Utilizing spatial analysis, we found return migration geographic patterns mainly from the frontier and urban centers to central provinces, involving migrant workers returning to their rural homes. We used logistic linear modeling to examine the correlations between personal attributes (e.g., age, gender, marital status), environmental aspects (e.g., community characteristics, housing conditions, geographic attributes), and return migration. Historical and socioeconomic factors affected return migration, including availability parents to provide care, declining personal health, improved housing infrastructures, and better access to community services. Our findings also show the productive social role of caregiving as a reason for migration, calling for flexible policies in China's social welfare system, comprehensive senior living facilities, and adequate support systems in rural communities.

Conducting secondary analysis of qualitative data: Should we, can we, and how?

While secondary data analysis of quantitative data has become commonplace and encouraged across disciplines, the practice of secondary data analysis with qualitative data has met more criticism and concerns regarding potential methodological and ethical problems. Though commentary about qualitative secondary data analysis has increased, little is known about the current state of qualitative secondary data analysis or how researchers are conducting secondary data analysis with qualitative data. This critical interpretive synthesis examined research articles (n = 71) published between 2006 and 2016 that involved qualitative secondary data analysis and assessed the context, purpose, and methodologies that were reported. Implications of findings are discussed, with particular focus on recommended guidelines and best practices of conducting qualitative secondary data analysis.

Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation.

This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults' health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 ( N = 682) in the Health and Retirement Study (2008-2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites.

Aging in Place in Every Community: Social Exclusion Experiences of Parents of Adult children With Autism Spectrum Disorder.

This article offers an examination of aging processes of lifelong caregivers and the possibilities for social exclusion place experienced by parents of adult children with autism spectrum disorder (ASD). This study of parental caregivers ( n = 51) sheds light on how enduring caregiving roles can lead to social exclusion in three ways: misunderstanding of ASD and stigma, the complexity of the caregiving roles, and impact on daily routines including challenges with long-term planning for both the adult children and the parental caregivers. Implications for practice to address social exclusion include education and building greater communication ties among family member for family members and advocacy for more and higher quality services including respite care. This article concludes with discussion of the impact of this aging, yet caregiving population and the need for knowledge about aging processes and anticipating aging for these caregivers.

Somewhere to be permanent for a minute: Time and space perceptions of older adult men experiencing chronic homelessness in Detroit.

Within the landscape of postwar era Detroit, space is vast, but places are hard to find. As people tumble down the side of Maslow's pyramid into abject homelessness, they attempt to anchor themselves in locations that suspend the otherwise situational free fall. This article analyzes how time and space are perceived by people experiencing chronic homelessness and how those individual perceptions are informed by the objective time and space urban environment. We conducted our community-based participatory research into the experiences of chronic homelessness both from perspectives of chronically homeless older adult men and from front-line service providers. Themes that emerged are as follows: (1) temporary permanence, (2) permanent temporariness, and (3) lostness. The article concludes with policy implications regarding the procedures for measuring the extent of homelessness and the needs of those who live it.

Care networks in play: Understanding death of a parent as a contributing factor to homelessness.

Offering an understanding of specialized service needs of those becoming homeless because of the death of a parent or parental figure, this project is set in Detroit's urban context, where residents face economic hardship and intergenerational poverty. In this study, we analyze the voices of practitioners (n = 5) and men (n = 5) who have experienced parental death as a contributing factor to homelessness in Detroit, Michigan. Findings include the following: (1) the impact of death and dying experiences on these men and (2) the role of care networks in these men's lives, particularly when these men have and lack "default" caregivers after death of a parent. This community-based research project was a result of a partnership between a local agency serving persons experiencing homelessness, where the practitioner initiated the project with the researcher. The paper concludes with implications for social work practice.

Interdependence between the Social and Material Convoy: Links between Volunteering, Widowhood, and Housing Transitions.

Relocation in older adulthood may occur due to triggering events, such as widowhood. Guided by Kahn and Antonucci's convoy model, this study explores the influence of volunteering on decision to relocate following the death of a spouse. Using three waves of data from the Health and Retirement Study (2006, 2008, and 2010), 5,146 community-dwelling married older individuals who were 65 years or older in 2008 were included. Findings from two multinomial logistic regression models showed that widows and widowers who were not volunteering in 2008 were more likely to move out of area in 2010 than their married counterparts, whereas the relationship between widowhood and relocation was not detected among those involved in volunteering. This article emphasizes the interdependency of social relationships and residences, a fundamental of one's material convoy, for older adults. Volunteering experiences may not only affect instrumental and emotional support after the loss of a key anchor in one's social convoy, but may also facilitate a widowed older adult to age in place rather than relocate.

Addressing Heart Failure Challenges through Illness-Informed Social Work.

This article describes the role of social workers in addressing the needs of people with heart failure. Although previous studies have explored the role of social workers in health care settings, few studies have addressed the challenges of specific chronic diseases such as heart failure. To address this gap in the literature, this study used qualitative interviews with health care social workers (n = 8) to obtain in-depth information about activities and challenges related to heart failure care. Findings suggest that health care social workers perceive heart failure as characterized by an uncertain illness trajectory, frequent hospitalizations, and difficulties accessing formal and informal care. These findings suggest the importance of what we term illness-informed social work, a practice that combines heart failure knowledge with social work competencies to address the complex psychosocial issues in heart failure care.

Aging in Place vs. Relocation for Older Adults with Neurocognitive Disorder: Applications of Wiseman's Behavioral Model.

Some older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman's 1980 Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. Understanding Wiseman's model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs.