Social determinants of older adults' awareness of community support services in Hamilton, Ontario.

Community support services (CSSs) have been developed in Canada and other Western nations to enable persons coping with health or social issues to continue to live in the community. This study addresses the extent to which awareness of CSSs is structured by the social determinants of health. In a telephone interview conducted in February-March 2006, 1152 community-dwelling older adults (response rate 12.4%) from Hamilton, Ontario, Canada were made to read a series of four vignettes and were asked whether they were able to identify a CSS they may turn to in that situation. Across the four vignettes, 40% of participants did name a CSS as a possible source of assistance. Logistic regression was used to determine factors related to awareness of CSSs. Respondents most likely to have awareness of CSS include the middle-aged and higher-income groups. Being knowledgeable about where to look for information about CSSs, having social support and being a member of a club or voluntary organisations are also significant predictors of awareness of CSSs. Study results suggest that efforts be made to improve the level of awareness and access to CSSs among older adults by targeting their social networks as well as their health and social care providers.

Where would you turn for help? Older adults' awareness of community support services.

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults aged 50 years and over were read a series of vignettes and asked if they were able to identify a community organization or agency that they may turn to in that situation. They were also asked about their most important sources of information about CSSs. The findings show that, using a vignette methodology, awareness of CSSs is much lower than previously thought. The most important sources of information about CSSs included information and referral sources, the telephone book, doctors' offices, and word of mouth.

Community organized food and nutrition education: participation, attitudes and nutritional risk in seniors.

UNLABELLED: Evergreen Action Nutrition (EAN) is a health promotion program designed to facilitate relatively healthy members of a seniors recreation center to maintain their nutritional health as they age. A main goal of this project was to demonstrate the feasibility and relevance of using the community organization approach to develop a nutrition education program for seniors. METHODS: Using the current membership list, seniors were randomly selected to receive a mailed baseline (n=247) questionnaire. A follow-up survey (n=251) was sent out to randomly selected members three years later to determine participation in EAN and reported behavior change. Although not the same individuals, responses were compared to baseline to determine changes in nutritional risk. Items from the Diet and Health Knowledge survey were compared by EAN participation. RESULTS: The program had a large reach with 162 survey respondents (64.5%) reporting some level of participation and 51% reporting "frequent" participation. Use of informal forms of education predominated (e.g. displays). Significant differences were found between baseline and follow-up for risk attributed to low intake of fruits and vegetables and frequency of eating, with EAN participants having reduced risk of low fruit and vegetable intake. Those participating in formal education (e.g. food workshops) reported more frequent changes in food practices than those participating in informal activities. EAN participants appear to have more healthy nutrition attitudes/beliefs. CONCLUSION: The community organization approach to program planning and delivery leads to the development of diverse and appropriate nutrition education activities for seniors. Informal and formal health promotion activities can be successfully implemented in recreation centers.

Notes for a radical gerontology.

The predominant theoretical perspectives in social gerontology reflect a normative bias toward adjustment of aging individuals to the society. This bias is reinforced through the methodological predelictions of most gerontologists. We outline the premises of a radical scholarship for gerontology which would provide an alternative, illustrating from selected works. A radical scholorship in gerontology would avoid the individualistic and adjustment biases, and would recognize that life in society is characterized by conflict, negotiation and compromise over politico-economic and other interests. Methodologically, it would seek to explicate the interests and aspirations of the aged in their own terms, and as relevant in the socio-historical context.