Prioritizing Age-Friendly Domains for Transforming a Mid-Sized American City.

In May 2019, the city of Akron in the state of Ohio was admitted into AARP's network of age friendly cities and communities. Akron has a long history of aging services initiative that date back to the 1970s. To provide direction for future aging initiatives, an assessment of Akron's current state was conducted in early 2020. A survey designed to capture information on the eight Age-friendly domains was designed and mailed to 3000 randomized individuals in Akron's ten political wards. A total of 656 individuals responded and returned the survey. Akron is rated good to excellent by older Akronites; people want to stay in their neighborhood and in their home. Most Akronites like and use their neighborhood parks, find their streets well-lit, and feel safe walking in their neighborhood. Most respondents rated transportation in Akron as good to very good, but they found sidewalks good to poor. There is a high level of access to social and educational activities and a substantial opportunity to include more people. About two-thirds of respondents participate in faith-based activities, volunteer, and participate in city-sponsored events. Loneliness is not or rarely a problem for three quarters of respondents. Around 56.5% of respondents indicated they disagree they are disconnected from the community. There is high level of access to the Internet and public WiFi in Akron and a substantial opportunity to include more people. Overall, Akron has benefitted from its historical efforts and has the opportunity to impact on more older adults as the older population grows.

Adherence to antidepressant medications: a randomized controlled trial of medication reminding in college students.

OBJECTIVES: To determine if medication reminding via smartphone app increases adherence to antidepressant medications in college students. PARTICIPANTS: College students (N = 57) enrolled at a state-funded institution who had a current prescription for an antidepressant and regularly used a smartphone device. METHODS: Participants were randomized to either a reminder group or a control group. Both groups were asked to complete a survey and undergo a manual pill count at the beginning of the study and 30 days later. RESULTS: There was a strong trend suggesting that the use of a medication reminder app was beneficial for adherence to antidepressant medication regimens. Factors influencing medication adherence in college students included health beliefs, use of illicit drugs, and type of professional care received. CONCLUSIONS: Use of a medication reminder may increase adherence to antidepressant medications in college students.

Randomized controlled feasibility trial of two telemedicine medication reminder systems for older adults with heart failure.

We conducted a feasibility study of a telehealth intervention (an electronic pill box) and an m-health intervention (an app on a smartphone) for improving medication adherence in older adults with heart failure. A secondary aim was to compare patient acceptance of the devices. The participants were 60 adults with HF (65% male). Their average age was 69 years and 83% were Caucasian. Patients were randomized using a 2 × 2 design to one of four groups: pillbox silent, pillbox reminding, smartphone silent, smartphone reminding. We examined adherence to 4 medications over 28 days. The overall adherence rate was 78% (SD 35). People with the telehealth device adhered 80% of the time and people with the smartphone adhered 76% of the time. Those who received reminders adhered 79% of the time, and those with passive medication reminder devices adhered 78% of the time, i.e. reminding did not improve adherence. Patients preferred the m-health approach. Future interventions may need to address other contributors to poor adherence such as motivation.

Geospatial study of psychiatric mental health-advanced practice registered nurses (PMH-APRNs) in the United States.

OBJECTIVE: The objectives of this study were to identify geographic regions with shortages of psychiatric mental health-advanced practice registered nurses (PMH-APRNs), describe rural-urban differences in the distribution of PMH-APRNs, and discuss implications of the uneven geographic distribution. METHODS: The data source was a complete listing, provided by the American Nurses Credentialing Center, of the employment zip codes of certified PMH-APRNs during 2007 (N=10,452). Geographic information science techniques and spatial statistics were used to conduct a cluster analysis of the spatial distribution of PMH-APRNs. RESULTS: After adjustment for population on the basis of U.S. census reports, statistically significant clusters of counties with high and low density of PMH-APRNs, an indicator of uneven accessibility, were identified. Rural-urban differences in the distribution were also illustrated. CONCLUSIONS: The interdisciplinary approach, including both mapping and statistical analyses, identified shortage areas and provided the groundwork for directing future education, clinical practice, and public policy initiatives.

Curriculum design and program to train older adults to use personal digital assistants.

PURPOSE: The aim of this study was to demonstrate that many older adults can share in the potential benefits of using a personal digital assistant (PDA), including using the device as a memory aid for addresses and appointments, to improve medication adherence, and as a useful organizational tool and communication device. DESIGN AND METHODS: A curriculum, designed specifically for older adults, was developed that provided the necessary information and practice to use the technology. The degree to which the curriculum improved user skills was measured by testing participants on basic and advanced features of each of the standard PDA programs. RESULTS: Participants were successful in using the technology and indicated satisfaction with the medication-reminder program specifically designed to accommodate the needs of older adults. IMPLICATIONS: The PDA, supported with well-designed software and well-executed training, can provide unique benefits to older adults.