Managing Complexity: Black Older Adults With Multimorbidity.

Background And Objectives: Black older adults have higher rates of multimorbidity and receive less effective multimorbidity support than their white counterparts. Yet little is known about the experiences of Black older adults with multimorbidity that may be at the heart of those disparities and which are central to interventions and improving care for this population. In this study, we aimed to conceptualize the multimorbidity management (MM) experience for Black older adults.

Racial Residential Segregation and the Health of Black Youth With Type 1 Diabetes.

Objectives: Black youth with type 1 diabetes (T1D) are at heightened risk for suboptimal glycemic control. Studies of neighborhood effects on the health of youth with T1D are limited. The current study investigated the effects of racial residential segregation on the diabetes health of young Black adolescents with T1D.

Examining Racial/Ethnic Disparities in Coping and Stress Within an Environmental Riskscape.

Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress.

Health Management Occupations During COVID-19: Experiences of Older African Americans With Multimorbidity.

Older African Americans with multimorbidity are at an especially high risk of adverse outcomes due to synergistic risks conferred by age, chronic disease burden and social determinants of health. Chronic condition self-management is one way older African Americans can use health management occupations and exercise agency to reduce their risk of becoming severely ill, and during the ongoing pandemic, of COVID-19 infection. The objective of this study was to understand how the COVID-19 pandemic shaped health management occupations of older African Americans.

Perceived Social Support and Latent Herpesvirus Reactivation: Testing Main and Stress-Buffering Effects in an Ethnically Diverse Sample of Adults.

Objective: Perceived social support is consistently associated with physical health outcomes, and one potential physiological mechanism underlying this association is immune function. In this study, we tested both the main and stress-buffering effects of perceived social support on cellular immunity measured via latent herpesvirus reactivation.

Methods: Data were collected from a community-based sample of 1443 ethnically diverse adults between the ages of 25 and 90 years.

Effects of family and neighborhood risks on glycemic control among young black adolescents with type 1 diabetes: Findings from a multi-center study.

While individual and family risk factors that contribute to health disparities in children with type 1 diabetes have been identified, studies on the effects of neighborhood risk factors on glycemic control are limited, particularly in minority samples. This cross-sectional study tested associations between family conflict, neighborhood adversity and glycemic outcomes (HbA1c) in a sample of urban, young Black adolescents with type 1 diabetes(mean age = 13.4 ± 1.

Socioeconomic status and differential psychological and immune responses to a human-caused disaster.

Objective: Individuals from different socioeconomic status (SES) backgrounds may respond variably to stressful events, and such differences are likely to contribute to health disparities. The current study leveraged data collected before and after a petrochemical explosion and aimed to investigate how individuals from different SES backgrounds responded to this unexpected stressor in terms of perceived social support, perceived stress, and systemic inflammation.

Methods: Data were drawn from 124 participants (M = 55.

Neighborhood Characteristics and Frailty: A Scoping Review.

Background And Objectives: Frailty is highly prevalent in later life and associated with early mortality and adverse health outcomes. The neighborhood has been identified as an important contributor to individual health, and neighborhood characteristics may contribute to frailty development. A scoping review was conducted of the peer-reviewed literature to better understand how physical and social neighborhood characteristics contribute to frailty.

Socioeconomic Status, Ecologically Assessed Social Activities, and Daily Cortisol Among Older Urban African Americans.

Higher socioeconomic status (SES) individuals report more social activities than their lower SES counterparts. Yet, SES and racial health disparities are often confounded. Here, we tested whether the frequency of engagement in social activities contributed to the association between SES and daily cortisol secretion among urban African American older adults.

How accessible are grocery shops for people with dementia? A qualitative study using photo documentation and focus group interviews.

Background: People with dementia who live in ordinary housing need to perform activities outside the home such as visiting friends, talking walks and doing grocery shopping. This article identifies and examines characteristics that may influence accessibility in the space of a grocery shop as perceived by people with dementia.

Methods: This is a qualitative study with a grounded theory approach.

Stress and health behaviors as potential mediators of the relationship between neighborhood quality and allostatic load.

Purpose: Neighborhood quality is associated with health. Increasingly, researchers are focusing on the mechanisms underlying that association, including the role of stress, risky health behaviors, and subclinical measures such as allostatic load (AL).

Methods: This study uses mixed-effects regression modeling to examine the association between two objective measures and one subjective measure of neighborhood quality and AL in an ethnically diverse population-based sample (N = 2706) from a medium-sized Texas city.

Identity and home: Understanding the experience of people with advanced cancer.

The purpose of this study was to explore how the identity of people with advanced cancer is influenced by their experiences of living at home. A total of 28 in-depth interviews were conducted with 22 people with advanced cancer and four spouses. Grounded theory guided the collection and analysis of data.

Loss of Trust in the Neighborhood: The Experience of Older African Americans in Detroit.

Objective: Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue.

Method: We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 years and older living in neighborhoods of varying quality in Detroit, Michigan.

Brief report: Neighborhood disadvantage and hair cortisol among older urban African Americans.

Previous studies have shown that living in poor neighborhoods is associated with increased morbidity and mortality. However, researchers are now investigating the biological pathways responsible for the deleterious effects of neighborhood disadvantage on health. This study investigated whether neighborhood disadvantage (i.

Using a Smartphone-Based Ecological Momentary Assessment Protocol With Community Dwelling Older African Americans.

Objectives: Little is known about the feasibility of smartphone-based Ecological Momentary Assessment (EMA) approaches to collect psychosocial data from older populations, especially disadvantaged older populations. In response to this gap, this report provides evidence of the feasibility and utility of a smartphone-based EMA approach for real-time assessment with older African Americans. In addition, we share lessons learned about how to improve utility.

Changing neighborhoods and occupations: Experiences of older African-Americans in Detroit.

Neighborhood characteristics are relevant to understanding occupations and associated outcomes, yet few empirical studies have focused on neighborhood as the unit of analysis when examining person-environment-occupation relationships. The purpose of this report is to begin addressing that gap. We present findings from a qualitative investigation conducted as part of a larger mixed methods study of 100 African-Americans aged 55 and older living in a variety of neighborhood contexts.

Processes of developing 'community livability' in older age.

Objective: 'Community livability' is a widely used term that is still under-conceptualized. The purpose of the project was to theorize key dynamics of livability for older adults who are aging in place in their homes and communities.

Methods: Twelve community-dwelling adults (70+) were recruited in a multiple-case study design.

Integrating the Science of Habit: Opportunities for Occupational Therapy.

Chronic diseases are the leading causes of early morbidity and mortality in the United States. Because personal behaviors are the primary risk factors for developing chronic diseases, developing effective strategies to modify personal behaviors remains a national imperative. Occupational therapy can help address this problematic situation through interventions based on an understanding of habit and principles of habit modification.

The Possibilities for Activity Scale (PActS): Development, validity, and reliability.

Background: Laliberte Rudman proposed the concept of occupational possibilities to represent what older adults feel they "should be" and "could be" doing.

Purpose: This study aimed to develop and validate a measure of perceived occupational possibilities: the Possibilities for Activity Scale (PActS).

Method: Two factors of the PActS, activity expectations and activity self-efficacy, were operationalized in a 14-item instrument.

Predicting participation in meaningful activity for older adults with cancer.

Purpose: Participation in activity that is personally meaningful leads to improved emotional and physical well-being and quality of life. However, little is known about what predicts participation in meaningful activity by older adults with cancer.

Methods: Seventy-one adults aged 65 years and older with a diagnosis of cancer were enrolled.

Occupational therapy use by older adults with cancer.

Occupational therapy may significantly improve cancer survivors' ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery.

Primary care availability and emergency department use by older adults: a population-based analysis.

Objectives: To assess the relationship between the number of primary care providers (PCPs) in an area and emergency department (ED) visits by older adults.

Design: Population-based cross-sectional observational study.

Setting: Nonfederal EDs in North Carolina in 2010.

Developing community based rehabilitation for cancer survivors: organizing for coordination and coherence in practice.

Background: Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts.

Methods: Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample.

Reactivation of herpes simplex virus type 1 is associated with cytomegalovirus and age.

Recent studies have shown that cytomegalovirus (CMV) may be an emerging marker of immunosenescence. CMV can affect the immune system by directly infecting leukocytes and hematopoietic cells or by eliciting an expansion of oligoclonal CD8+ T cells/contraction of the naïve T cell compartment that may reduce the host's ability to fight other pathogens. To investigate further CMV-associated changes in immunity, a study was conducted with 1,454 adults (ages 25-91) to determine the association between CMV and reactivation of another latent herpesvirus, Herpes simplex virus type 1 (HSV-1), as indexed by antibody titers.