Problem Gambling Risk Among Older Francophones in Ontario Canada: Surprising Results that Contradict Previous Findings of Gambling in Minority Groups.

Gambling is a popular activity among older adults. Despite this increase in popularity little research has examined gambling among this group. This is especially true for minority older adults, like Francophones in Ontario. The purpose of this study was to better understand gambling in a sample of older Francophones from North-Eastern Ontario, the first study to do so. A sample of 181 older (over 55 years) Francophones from Northeastern Ontario (M age = 68.7, SD 7.6) was recruited. This sample was compared to a sample of older adults with English as their native language that had been previously collected (Norris and Tindale in The meaning of gambling among Ontario seniors in small and rural communities, Final report to the Ontario Problem Gambling Research Centre, 2006; Tindale and Norris in Gambling among intergenerational and multi-ethnic families, Final report to the Ontario Problem Gambling Research Centre, 2012). In addition to demographic measures the participants filled out a questionnaire that included measures of gambling behaviours and attitudes the Windsor Screen, The Problem Gambling Severity Index of the Canadian Problem Gambling Inventory, The Center for Epidemiologic Studies Depression Scale and the CAGE Alcohol Screen. Contrary to expectations, the Francophone sample had lower scores on the problem gambling measures with a smaller proportion of the sample in the categories indicating a high risk for problem gambling. This surprising result might be due to the protective effect of a positive ethnolinguistic identity. However, more research will need to be done to better understand these unanticipated results. The findings of this study help us better understand gambling among older adults in a minority group.

Primary care physicians' perspectives on facilitating older patients' access to community support services: Qualitative case study.

OBJECTIVE: To understand how family physicians facilitate older patients' access to community support services (CSSs) and to identify similarities and differences across primary health care (PHC) models. DESIGN: Qualitative, multiple-case study design using semistructured interviews. SETTING: Four models of PHC delivery, specifically 2 family health teams (FHTs), 4 non-FHTs family health organizations, 4 fee-for-service practices, and 2 community health centres in urban Ontario. PARTICIPANTS: Purposeful sampling of 23 family physicians in solo and small and large group practices within the 4 models of PHC. METHODS: A multiple-case study approach was used. Semistructured interviews were conducted and data were analyzed using within- and cross-case analysis. Case study tactics to ensure study rigour included memos and an audit trail, investigator triangulation, and the use of multiple, rather than single, case studies. MAIN FINDINGS: Three main themes were identified: consulting and communicating with the health care team to create linkages; linking patients and families to CSSs; and relying on out-of-date resources and ineffective search strategies for information on CSSs. All participants worked with their team members; however, those in FHTs and community health centres generally had a broader range of health care providers available to assist them. Physicians relied on home-care case managers to help make linkages to CSSs. Physicians recommended the development of an easily searchable, online database containing available CSSs. CONCLUSION: This study shows the importance of interprofessional teamwork in primary care settings to facilitate linkages of older patients to CSSs. The study also provides insight into the strategies physicians use to link older persons to CSSs and their recommendations for change. This understanding can be used to develop resources and approaches to better support physicians in making appropriate linkages to CSSs.

Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.

Learning you are "at risk": seniors' experiences of nutrition risk screening.

Nutrition risk screening can help identify community-dwelling older adults who may benefit from nutrition education and interventions to improve food intake. Research has shown, however, that older adults who are found "at risk" through nutrition screening commonly do not see themselves at risk, and many do not follow through with accessing recommended nutrition services. Thus, the purpose of this qualitative study was to examine older adults' experiences of learning they were at risk through nutrition screening and to identify what influenced their perspectives and responses to their screening results. Face-to-face interviews were conducted with 22 older adults who had screened at risk (SCREEN II© scores < 54) through a nutrition screening process conducted by mail. Participants received their screening results in a personalized letter before the interview, along with some recommendations to help improve food intake and decrease their nutrition risk. Interviews were transcribed and analyzed for themes. When participants reflected about receiving their screening results, some described feeling surprised or even upset by the message that they were at increased risk, whereas others felt unconcerned or reacted with heightened attentiveness to their nutrition. They also began to rationalize their screening score and found ways to explain away their risk. The message that they were at increased risk was poorly understood and not well received because it contradicted their perspective: they felt they were doing the right things, they saw room for improvement rather than seeing themselves at risk, and they tended to make comparisons that helped support the view that they were not truly at risk. Further, even though participants saw room for improvement, they described barriers to change and commonly felt that the recommendations were more applicable for others than themselves. Strategies to improve communication of nutrition screening results and recommendations are discussed to help seniors better understand their risk and take steps to improve their nutrition.

Older adults' awareness of community health and support services for dementia care.

ABSTRACTThe article examines where older adults seek help in caring for a parent with dementia and the factors associated with their identification of community health and support services as sources of assistance. The authors conducted telephone interviews, using random digit dialing, of 1,152 adults aged 50 and over in the city of Hamilton. Respondents received a vignette that raised issues related to parental dementia. In identifying support sources, over 37 per cent of respondents identified their physician, 33 per cent identified informal support such as family and neighbors, and 31 per cent identified home health services. Only 18 per cent identified community support services. Female participants having higher levels of education were more likely to identify their physician as a source of support. Knowing where to find information about community support services was associated with an increased likelihood of mentioning physicians and home health services as sources of assistance.

Process evaluation of the Community Support Connections merger.

Community Support Connections (CSC) is the result of the merger of four private not-for-profit community health care agencies. The purpose of this research project was to evaluate the progress of CSC toward its stated goal: improvement of coordination and accessibility of health services. As of this writing, more than one year into the merger, managers, staff and volunteers believe that the goals of serving more clients more completely through case management are being achieved.