Family Care Partners and Paid Caregivers: National Estimates of Role-Sharing in Home Care.

Background And Objectives: We describe "role-sharing" in home care, defined as family care partners and paid caregivers assisting with the same task(s).

Research Design And Methods: We studied 440 participants in the 2015 National Health and Aging Trends Study (NHATS) receiving paid help with self-care, mobility, or medical care. We describe patterns in receiving paid help only, help from care partners only, and role-sharing.

The influence of photobiomodulation on upper body muscular performance in collegiate athletes.

Background: Photobiomodulation (PBM), has been shown to improve muscular performance during single-joint resistance exercises. It is unclear whether this benefit extends to multiple-joint exercises, such as the barbell bench press.

Methods: In a within-group design, 15 collegiate athletes (mean±SD; age 20.

Factors that Facilitate Informal Advance Care Planning Conversations With Family: A Cross-Sectional Survey of Black Adults With Kidney Failure.

Advance care planning in adults with kidney failure has been understudied and limited to written advance directives. Many Black adults prefer informal conversations with family, and yet this form of advance care planning is underexplored in research. In this study, we aimed to identify the multilevel factors that facilitate informal advance care planning with family among Black adults with kidney failure.

A Mixed Methods Effectiveness Study of a Peer Support Intervention for Older Adults During the COVID-19 Pandemic: Results of a Randomized Clinical Trial.

Objective: Low-income white older adults and those of color are at greater risk for depression but less likely to receive care. We evaluated the impact of a one-to-one peer support intervention compared to active control delivered by nonpeers for this population.

Design: Mixed methods, single-blind randomized controlled trial.

Going virtual: mixed methods evaluation of online versus in-person learning in the NIH mixed methods research training program retreat.

Background: Despite the central role of mixed methods in health research, studies evaluating online methods training in the health sciences are nonexistent. The focused goal was to evaluate online training by comparing the self-rated skills of scholars who experienced an in-person retreat to scholars in an online retreat in specific domains of mixed methods research for the health sciences from 2015-2023.

Methods: The authors administered a scholar Mixed Methods Skills Self-Assessment instrument based on an educational competency scale that included domains on: "research questions," "design/approach," "sampling," "analysis," and "dissemination" to participants of the Mixed Methods Research Training Program for the Health Sciences (MMRTP).

Evaluation of Dynamic Effects of Depressive Symptoms on Physical Function in Knee Osteoarthritis.

Objective: To assess how changes in depressive symptoms influence physical function over time among those with radiographic knee osteoarthritis (OA).

Methods: Participants from the Osteoarthritis Initiative with radiographic knee OA (n = 2,212) and complete data were identified at baseline. Depressive symptoms were assessed as a time-varying score at baseline and the first three annual follow-up visits using the Center for Epidemiological Studies Depression Scale (CES-D) Scale.

Duloxetine plus exercise for knee osteoarthritis and depression: A feasibility study.

Objective: To assess the feasibility of a 24-week, center-based, aerobic exercise program plus duloxetine to treat symptomatic knee osteoarthritis (OA) and major depression.

Design: Patients with symptomatic knee OA and major depression were recruited between August 2021 and November 2022 from the University of Maryland and VA Maryland Health Care Systems and Baltimore metropolitan area using medical records and advertisements. The intervention included 1) supervised treadmill walking 3 times weekly and 2) duloxetine starting at 30 ​mg each day and titrating up to the optimal dosage of 60 ​mg daily.

Time-varying treatment effect modification of oral analgesic effectiveness by depressive symptoms in knee osteoarthritis: an application of structural nested mean models in a prospective cohort.

Background: Depressive symptoms are common in knee osteoarthritis (OA), exacerbate knee pain severity and may influence outcomes of oral analgesic treatments. The aim was to assess whether oral analgesic effectiveness in knee OA varies by fluctuations in depressive symptoms.

Methods: The sample included Osteoarthritis Initiative (OAI) participants not treated with oral analgesics at enrolment (n = 1477), with radiographic disease at the first follow-up visit (defined as the index date).

"Caregiving is teamwork…" Information sharing in home care for older adults with disabilities living in the community.

Aim: We examined information sharing between direct care workers, family caregivers, and clinicians involved in the care of older adults with disabilities.

Methods: Semi-structured interviews with N = 11 representatives of home care agencies ("residential service agencies" in Maryland).

Results: Work system and process characteristics relevant to information sharing included: (1) using electronic management systems and patient portals to communicate within agencies and with clinicians, (2) implementing tools to gather information about client goals, preferences, and routines, and (3) relying on family members for information about clients' needs.

Decision Making for Patients With Severe Dementia Versus Normal Cognition Near the End of Life.

Background And Objectives: The clinical progression of severe dementia frequently leads to situations where surrogate decision makers must quickly make choices about potentially burdensome treatments that offer limited clinical benefit. We examined whether the number of decision makers and their access to advance directives were related to treatment choice for patients with severe dementia in comparison to those with normal cognition.

Research Design And Methods: We retrospectively linked survey responses about end-of-life treatment decisions to Medicare claims for Health and Retirement Study respondents dying between 2002 and 2015 whose next-of-kin reported a need for surrogate decision making.

Mobile Health School Screening and Telemedicine Referral to Improve Access to Specialty Care in Rural Alaska: Integrating Mixed Methods Data to Contextualize Trial Outcomes.

Objectives: To understand factors associated with outcomes in a cluster-randomized controlled trial that evaluated a telemedicine specialty referral intervention for school hearing screenings in 15 rural Alaskan communities.

Design: Hearing Norton Sound was a mixed methods cluster-randomized controlled trial that compared a telemedicine specialty referral pathway (intervention) to a standard primary care referral pathway (control) for school hearing screenings. As a mixed methods trial, both quantitative and qualitative data were collected, analyzed, and integrated.

Prevalence of Childhood Hearing Loss in Rural Alaska.

Objectives: Childhood hearing loss has well-known lifelong consequences. Certain rural populations are at higher risk for infection-related hearing loss. For Alaska Native children, historical data on hearing loss prevalence suggest a higher burden of infection-related hearing loss, but updated prevalence data are urgently needed in this high-risk population.

Intersection of multiple factors shape Korean American caregiver experience in dementia caregiving.

Background And Objectives: Studies have shown that cultural norms such as filial responsibility and familism operate in the Korean American caregiving context. The purpose of our study is to understand the practice of Korean American caregivers who provide care to a family member living with dementia and their dementia care support needs.

Materials And Methods: We conducted 2 focus groups and individual semi-structured interviews with a total of 20 Korean American caregivers.

Telemedicine Referral to Improve Access to Specialty Care for Preschool Children in Rural Alaska: A Cluster-Randomized Controlled Trial.

Objectives: Preschool programs provide essential preventive services, such as hearing screening, but in rural regions, limited access to specialists and loss to follow-up compound rural health disparities. We conducted a parallel-arm cluster-randomized controlled trial to evaluate telemedicine specialty referral for preschool hearing screening. The goal of this trial was to improve timely identification and treatment of early childhood infection-related hearing loss, a preventable condition with lifelong implications.

Racial Disparity in Outcomes Among Prostate Cancer Patients in the Post-Affordable Care Act Period.

Introduction: Our objective was to assess whether Medicaid expansion is associated with reduced racial disparity in quality of care measured as 30-day mortality, 90-day mortality, and 30-day readmission in prostate cancer patients receiving surgery.

Methods: We used the National Cancer Database to extract a cohort of African American and White men diagnosed with prostate cancer between 2004 and 2015 and surgically treated. We used 2004-2009 data to observe preexisting racial disparity in outcomes.

The Context of Caregiving in Heart Failure: A Dyadic, Mixed Methods Analysis.

Background: Caregiving for persons with heart failure (HF) varies based on the individual, family, and home contexts of the dyad, yet the dyadic context of HF caregiving is poorly understood.

Objective: The aim of this study was to explore dyadic perspectives on the context of caregiving for persons with HF.

Methods: Family caregivers and persons with HF completed surveys and semistructured interviews.

Analysis of action planning, achievement and life purpose statements in an intervention to support caregivers of persons with heart failure.

Background: Caregivers of persons living with heart failure (HF) experience uncertainty related to heart failure trajectory and caregiving demands. Caregiver Support is a nurse-led intervention consisting of a well-being assessment, development of a life purpose statement, and action planning related to self-care and support for caregivers.

Objectives: The goal of this study was to describe the caregivers' action plans, action plan achievement and life purpose statements.

Trajectory of Depression among Prostate Cancer Patients: A Secondary Analysis of a Randomized Controlled Trial.

While psychological difficulties, such as depression, among prostate cancer patients are known, their longitudinal burden remains understudied. We assessed the burden of depression across low-, intermediate- and high-risk prostate cancer groups, and the association between regret and long-term depression. Secondary analysis of data from a multi-centered randomized controlled study among localized prostate cancer patients was carried out.

Continuity of care and advanced prostate cancer.

Background: Continuity of care is an important element of advanced prostate cancer care due to the availability of multiple treatment options, and associated toxicity. However, the association between continuity of care and outcomes across different racial groups remains unclear.

Objective: To assess the association of provider continuity of care with outcomes among Medicare fee-for-service beneficiaries with advanced prostate cancer and its variation by race.

Community Perspectives on Hearing Loss in Rural Alaska.

Objectives: The aim of this study is to present an explanatory model of hearing loss in the Bering Strait region of Alaska in order to contextualize the results of a cluster randomized trial and propose implications for regional hearing-related health care.

Design: To promote ecological validity, or the generalizability of trial findings to real world experiences, qualitative methods (focus groups and interviews) were used within a mixed methods cluster randomized trial evaluating school hearing screening and follow-up processes in 15 communities in the Bering Strait region of Alaska. Focus groups were held between April and August 2017, and semistructured interviews were conducted between December 2018 and August 2019.