Special Issue "Wellness and Health Promotion for the Older Adults"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: 31 March 2022.

Special Issue Editor

Dr. Nina Tumosa
E-Mail Website
Guest Editor
Health Resources and Services Administration, Rockville, MD 20857, USA
Interests: health management; aging; health policy; dementia

Special Issue Information

Dear Colleagues,

Promotion of health and wellness interventions for older adults is important in controlling the onset and progression of disabilities and disease. An initial step in determining how to promote health and wellness is to consult with older adults directly. This core principle of what matters most to the individual, added to the other three principles of the 4Ms of age-friendly healthcare—medications, mentation and mobility—defines the core topics that must be addressed in order to effectively promote health and wellness in older adults. Health promotion topics under the 4Ms rubric that are particularly important to older adults include sleep, nutrition, isolation, oral health, exercise and elder justice (freedom from abuse, neglect, exploitation or discrimination due to intentional or negligent acts). Overarching approaches needed to achieve effective health and wellness promotion include interprofessional team care; communication; social determinants of health; fostering health equity; and acknowledging and addressing health disparities. Many of these topics will be presented in this Special Issue with the intent of showing healthcare providers, students, faculty, patients and their families how to identify evidence-based practices that support wellness and good health in the older adults for whom they provide care.

Dr. Nina Tumosa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • older adult
  • wellness
  • health promotion
  • 4Ms
  • what matters
  • medication
  • mentation
  • mobility
  • health disparities
  • health equity

Published Papers (9 papers)

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Research

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Article
System Redesign: The Value of a Primary Care Liaison Model to Address Unmet Social Needs among Older Primary Care Patients
by , , , , , , , , , and
Int. J. Environ. Res. Public Health 2021, 18(21), 11135; https://doi.org/10.3390/ijerph182111135 (registering DOI) - 23 Oct 2021
Viewed by 179
Abstract
Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling [...] Read more.
Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling to identify unmet needs, and mapping referral services through cross-sectoral partnerships. A PCL worked with three patient-centered medical homes (PCMHs) that are part of a large integrative health system. A mixed-methods approach using a post-training survey and a patient tracking tool, was used to understand the reach, adoption, and implementation of the PCL model. From June 2020 to May 2021, the PCL trained 61 primary care staff to assess and address unmet social needs of older patients. A total of 327 patients, aged 65 years and older and within 3–5 days of acute-care hospital discharges, were counseled by the PCL. For patients with unmet needs, support services were arranged through community agencies: transportation (37%), in-home care (33%), food (16%), caregiver support (2%), legal (16%), and other (16%). Our preliminary results suggest that the PCL model is feasible and implementable within PCMH settings to address unmet social needs of older patients to improve their health outcomes. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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Article
What Makes Chinese Adult Children Behave Differently during Parents’ End of Life: A Discriminant Analysis of Macao Chinese
Int. J. Environ. Res. Public Health 2021, 18(20), 10737; https://doi.org/10.3390/ijerph182010737 - 13 Oct 2021
Viewed by 334
Abstract
The daily practice of filial piety (FP) is well prescribed under the traditional filial norms in the Chinese community. However, exploration of FP practices at the end of parents’ lives is limited. The current study explored the FP representation and good death preferences [...] Read more.
The daily practice of filial piety (FP) is well prescribed under the traditional filial norms in the Chinese community. However, exploration of FP practices at the end of parents’ lives is limited. The current study explored the FP representation and good death preferences of Macao Chinese. A cross-sectional web-based survey was conducted and discriminant analysis was used to identify possible predictors of FP representation in the context of parents’ end of life. Results showed that Macao Chinese were inclined to perform most of the filial duties in the last journey of their parents. Among 705 participants, 150 (21.3%) tended to practice authoritarian FP, and 555 (78.7%) tended to practice reciprocal FP. Age, education, religion, and good death preferences were identified as predictors of different FP representation groups. The findings could help clinicians to obtain a preliminary perception of FP representation of Chinese patients and to determine the appropriate approach for end-of-life care from a family perspective. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
Article
Applying the Pender’s Health Promotion Model to Identify the Factors Related to Older Adults’ Participation in Community-Based Health Promotion Activities
Int. J. Environ. Res. Public Health 2021, 18(19), 9985; https://doi.org/10.3390/ijerph18199985 - 23 Sep 2021
Viewed by 481
Abstract
Aging societies have garnered global attention regarding issues related to older adults’ health promotion. This cross-sectional study aimed to identify factors associated with older adults’ participation in community-based health promotion activities. The Older Adults’ Health Promotion Activity Questionnaire was developed to collect data, [...] Read more.
Aging societies have garnered global attention regarding issues related to older adults’ health promotion. This cross-sectional study aimed to identify factors associated with older adults’ participation in community-based health promotion activities. The Older Adults’ Health Promotion Activity Questionnaire was developed to collect data, and a total of 139 older adults were recruited from a community care center in Taoyuan City. Participants’ mean age was 72.7 years (SD = 6.0 years), 74.8% were females, 64.7% were married, 59% had a lower level of education, 51.8% had lower income, 59% reported their health status not good, and 76.3% had chronic disease. Our findings indicated that age, perceived benefits, and self-efficacy were identified as significant predictors of participation in health promotion activities. Among them, perceived benefits were found to have the strongest association with participation in health promotion activities (β = 0.305; p < 0.05). The findings showed that the Pender’s Health Promotion Model is useful to provide information for predicting and detecting significant factors related to older adults’ participation in community-based health promotion activities. By using this model as a framework, researchers can design more specific studies that are directed towards improving healthy lifestyles and detecting the key components of health-related behaviors among different age groups. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
Article
Spatial Accessibility Assessment of Prehospital EMS with a Focus on the Elderly Population: A Case Study in Ningbo, China
Int. J. Environ. Res. Public Health 2021, 18(19), 9964; https://doi.org/10.3390/ijerph18199964 - 22 Sep 2021
Viewed by 398
Abstract
The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address [...] Read more.
The spatial accessibility of prehospital EMS is particularly important for the elderly population’s physiological functions. Due to the recent expansion of aging populations all over the globe, elderly people’s spatial accessibility to prehospital EMS presents a serious challenge. An efficient strategy to address this issue involves using geographic information systems (GIS)-based tools to evaluate the spatial accessibility in conjunction with the spatial distribution of aging people, available road networks, and prehospital EMS facilities. This study employed gravity model and empirical Bayesian Kriging (EBK) interpolation analysis to evaluate the elderly’s spatial access to prehospital EMS in Ningbo, China. In our study, we aimed to solve the following specific research questions: In the study area, “what are the characteristics of the prehospital EMS demand of the elderly?” “Do the elderly have equal and convenient spatial access to prehospital EMS?” and “How can we satisfy the prehospital EMS demand of an aging population, improve their spatial access to prehospital EMS, and then ensure their quality of life?” The results showed that 37.44% of patients admitted to prehospital EMS in 2020 were 65 years and older. The rate of utilization of ambulance services by the elderly was 27.39 per 1000 elderly residents. Ambulance use by the elderly was the highest in the winter months and the lowest in the spring months (25.90% vs. 22.38%). As for the disease spectrum, the main disease was found to be trauma and intoxication (23.70%). The mean accessibility score was only 1.43 and nearly 70% of demand points had scored lower than 1. The elderly’s spatial accessibility to prehospital EMS had a central-outward gradient decreasing trend from the central region to the southeast and southwest of the study area. Our proposed methodology and its spatial equilibrium results could be taken as a benchmark of prehospital care capacity and help inform authorities’ efforts to develop efficient, aging-focused spatial accessibility plans. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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Article
Death Anxiety and Loneliness among Older Adults: Role of Parental Self-Efficacy
Int. J. Environ. Res. Public Health 2021, 18(18), 9857; https://doi.org/10.3390/ijerph18189857 - 18 Sep 2021
Viewed by 555
Abstract
Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an [...] Read more.
Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an unexplored variable among older adults, namely, parental self-efficacy. A convenience sample of 362 Israeli parents over the age of 65 was recruited through means of social media. Participants completed self-reported questionnaires, which included background characteristics, death anxiety, parental self-efficacy, and loneliness measures. The findings showed that death anxiety was positively associated with loneliness among older adults. The findings also confirmed that parental self-efficacy moderated this association in this population. We concluded that the combination of death anxiety and low parental self-efficacy identified a group of older adults that are at higher risk of developing increased loneliness levels. Mental health professionals should consider intergenerational relationships as a fundamental component of older adults’ daily lives, focusing on parental self-efficacy in old age, as this appears to be a resilience resource. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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Article
Social Support and Cognitive Impairment: Results from a Portuguese 4-Year Prospective Study
Int. J. Environ. Res. Public Health 2021, 18(16), 8841; https://doi.org/10.3390/ijerph18168841 - 22 Aug 2021
Viewed by 463
Abstract
(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of [...] Read more.
(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of older Portuguese people. (2) Methods: From the Portuguese EpiPorto cohort study, we followed a sample of participants with 60 to 85 years (N = 656) between 2009 and 2015 (4.63 mean years of follow-up). The participants’ perception of social support from family, friends and significant others was evaluated. Cox’s regression models were used to investigate the association between this and sociodemographic variables. (3) Results: It was found that social support from friends reduces the risk of cognitive impairment. Men, participants aged 60 to 64 and those not married have a lower risk of cognitive impairment after adjusting for other variables. Participants between 80 and 85 years old (p = 0.021), those with less than four years of education (p < 0.001), and those with cognitive impairment (p = 0.007) have perception of less social support from friends. (4) Conclusions: A social support network from friends reduces the risk of cognitive impairment for older people. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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Article
Prevalence and Predictors of Willingness to Make Advance Directives among Macao Chinese
Int. J. Environ. Res. Public Health 2021, 18(15), 7942; https://doi.org/10.3390/ijerph18157942 - 27 Jul 2021
Viewed by 700
Abstract
While advance directives (ADs) are considered to be part of government’s healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public’s views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese [...] Read more.
While advance directives (ADs) are considered to be part of government’s healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public’s views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese people’s willingness to make ADs. Data were collected from 724 residents aged 18 years and above. Results showed that 533 respondents (73.6%) claimed that they were willing to complete an AD if the document was recognized legally. The experience of caring for relatives or friends with terminal illnesses, palliative care as the preferred end-of-life treatment option, and scoring higher in the Hospice Care Attitude Scale were the predictors of willingness to make ADs. Results of the study suggested that there was a relatively high number of people who would consider setting up ADs. Our study recommends that healthcare professionals should equip themselves to raise ADs-related discussions with patients. Moreover, the Macao Government is responsible for facilitating the introduction and implementation of ADs in order to improve overall end-of-life care quality in Macao. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
Article
The Association between Health and Culture: The Perspective of Older Adult Hospital In-Patients in Israel
Int. J. Environ. Res. Public Health 2021, 18(12), 6496; https://doi.org/10.3390/ijerph18126496 - 16 Jun 2021
Viewed by 599
Abstract
People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective [...] Read more.
People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective of Israeli older adult hospital in-patients regarding the association between health and culture and to understand the meaning of the participants’ experiences with regards to the medical staff’s attitude towards them. This study was carried out using qualitative methodology that followed the interpretive interactionism approach. The research participants were 493 (mean age 70.81, S.D.: 15.88) in-patients at internal care departments at a hospital in Israel who answered an open-ended question included in the questionnaire as part of a wide study held during 2017 to 2018. Two main themes were found: (1) a humane attitude of respect and the right to privacy and (2) beliefs, values, and traditional medicine that are passed down through generations. The findings highlighted the issue of the patients’ cultural heritage and ageist attitudes they ascribed to the professional staff. This study provided recommendations for training the in-patient hospital workforce on the topic of cultural competence, beginning from the stage of diagnosis through treatment and to discharge from the hospital, in order to improve the service. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)

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Concept Paper
A New Interprofessional Community-Service Learning Program, HATS (Health Ambassador Teams for Seniors) to Improve Older Adults Attitudes about Telehealth and Functionality
Int. J. Environ. Res. Public Health 2021, 18(19), 10082; https://doi.org/10.3390/ijerph181910082 - 25 Sep 2021
Viewed by 549
Abstract
Senior population health often is underrepresented in curricula for medical and allied health students. Furthermore, entrenched and dense curricular schedules preclude interprofessional teams from clinical experiences related to senior population health. Community service learning potentially offers the opportunity to engage interprofessional students with [...] Read more.
Senior population health often is underrepresented in curricula for medical and allied health students. Furthermore, entrenched and dense curricular schedules preclude interprofessional teams from clinical experiences related to senior population health. Community service learning potentially offers the opportunity to engage interprofessional students with a panel of older adults to assess health promotion metrics over time. To test this educational concept, we created Health Ambassador Teams for Seniors, also known as HATS. Utilizing a telehealth platform, interprofessional student teams were tasked with older adult wellness promotion. The annual Medicare wellness exam served as a template for patient encounters which was enhanced with key elements of geriatric assessment such as gait and balance, cognition, and functional evaluations. The objective was to have dyads of interprofessional students conduct telehealth visits and gather healthcare data to be used for serial patient encounters and track functional trajectories over time. As a proof of concept, pilot telehealth encounters with medical, physical therapy, nursing and occupational therapy students revealed that data on older adult functional performances such as gait speed, Timed Up and Go test (TUG), and Mini-Cog test could be acquired through telehealth. Equally importantly, trainees received diverse feedback from faculty, peers and volunteer patients. A Research Electronic Data Capture (REDCap) data repository allows trainees to track patient trends relative to their health promotion recommendations as well as handoff their patient panel to the next set of trainees. The HATS program promises to strengthen the Geriatric Workforce, especially with senior population health. Full article
(This article belongs to the Special Issue Wellness and Health Promotion for the Older Adults)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Communication Disparities Affecting Certified Nursing Assistants in Long Term Care Teams
Authors: Timothy Farrell et.al.
Affiliation: University of Utah Health

Title: Implementing a primary care liaison model to assess and address unmet social, behavioral, and economic needs among geriatric primary care patients
Authors: Jungyoon Kim et.al.
Affiliation: University of Nebraska Medical Center

Title: CREATING INTERPROFESSIONAL READINESS TO ADVANCE AGE-FRIENDLY HEALTHCARE
Authors: L. Waters 1, P. Slattum 1, E. Ansello 1, K. Grunden 1, S. Marrs 1, M. McIntyre 1, E. Ihara 2, C. Tompkins 2, P. Parsons 3, J. Winship 4, S. Finucane 5Winship
Affiliation: 1. VirginiaCenter on Aging, Virginia Commonwealth University, Richmond, Virginia, UNITED STATES 2. College of Health and Human Services, George Mason University, Fairfax, Virginia,UNITED STATES 3. School of Nursing, Virginia Commonwealth University, Richmond, Virginia, UNITED STATES 4. Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, UNITED STATES 5. Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, UNITEDSTATES

Title: A Mixed-Methods Formative Evaluation of a Dementia Friendly Congregation Program for Black Churches
Authors: Janelle Gore, MPH; Jamilla Toliver, MPH; Mia Chester, MA; Miranda Moore, PhD; Dawn Aycock, PhD, RN; Fayron Epps, PhD, RN
Affiliation: Nell Hodgson Woodruff School of Nursing

Title: Promoting Older Adult Health and Interprofessional Education Through Community Based Health Screening
Authors: Ostertag, Susan; Hudgins, Gayle; Brooksbank, Renee; Zins, Rachael
Affiliation: University of Montana

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