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Garnett A, Northwood M. Recruitment of Community-Based Samples: Experiences and Recommendations for Optimizing Success. Can J Nurs Res 2021; 54:101-111. [PMID: 34841904 PMCID: PMC9109582 DOI: 10.1177/08445621211060935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Recruitment in health and social science research is a critically important but often
overlooked step in conducting successful research. The challenges associated with
recruitment pertain to multiple factors such as enrolling groups with vulnerabilities,
obtaining geographic, cultural, and ethnic representation within study samples,
supporting the participation of less accessible populations such as older adults, and
developing networks to support recruitment. Purpose This paper presents the experiences of two early career researchers in recruiting
community-based samples of older adults, their caregivers, and associated health
providers. Methods Challenges and facilitators in recruiting two community-based qualitative research
samples are identified and discussed in relation to the literature. Results Challenges included: identifying potential participants, engaging referral partners,
implementing multi-methods, and achieving study sample diversity. Facilitators included:
making connections in the community, building relationships, and drawing on existing
networks. Conclusions Findings suggest the need for greater recognition of the importance of having clear
frameworks and strategies to address recruitment prior to study commencement as well as
the need to have clear outreach strategies to optimize inclusion of marginalized groups.
Recommendations and a guide are provided to inform the development of recruitment
approaches of early career researchers in health and social science research.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt School of Nursing, 6221Western University, London, Ontario, Canada
| | - Melissa Northwood
- School of Nursing, 3710McMaster University, Hamilton, Ontario, Canada
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Fetherstonhaugh D, Rayner JA, Solly K, McAuliffe L. 'You become their advocate': The experiences of family carers as advocates for older people with dementia living in residential aged care. J Clin Nurs 2021; 30:676-686. [PMID: 33295051 DOI: 10.1111/jocn.15589] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 12/27/2022]
Abstract
AIMS The aim of this study was to identify features of well-performing residential aged care services (RACS) as experienced by family carers. BACKGROUND Family carers can have an integral role in residential aged care providing social support and are well-placed to engage with staff and monitor care. DESIGN A qualitative descriptive design was used. Semi-structured face-to-face and telephone interviews were conducted with family carers of current or past residents of Australian RACS between November 2018 and January 2019. Interview transcripts were analysed thematically. RESULTS Rather than reporting features of well-performing RACS, participants shared stories of sub-standard care, dysfunctional management and poor resident-staff-family interactions. An overarching theme emerged of 'having to be an advocate' for residents' needs, which covered four major categories: organisational accountability (including transparency and individualised care), good communication, connection and trust. Combined, these constitute what carers perceive are the necessary conditions for determining the features of a well-performing RACS. CONCLUSION Family carers need to feel confident and trust RACS staff when they hand over the role of carer for their relative with dementia. RELEVANCE TO CLINICAL PRACTICE This study provides insight into the needs and challenges of family carers when they relinquish the care of an older relative with dementia. Strategies to build confidence and trust between RACS and family carers are essential. Aged care nurses can play a pivotal role to support this through the development of open communication and relational connections with residents and their families.
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Affiliation(s)
- Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Jo-Anne Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Kane Solly
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
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Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern. Am J Geriatr Psychiatry 2020; 28:226-236. [PMID: 31340887 DOI: 10.1016/j.jagp.2019.06.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/10/2019] [Accepted: 06/15/2019] [Indexed: 11/22/2022]
Abstract
Substance use disorders (SUDs) among older persons are among the fastest growing health problems in the United States. The number of older persons is projected to exceed 72.1 million persons by 2030, following a trend of general population growth in the mid-1940s to 1960s. The generation, known as "baby boomers," who refashioned drug use during their 20-30s, are increasingly continuing drug habits into later life. This review aims to assess the epidemiology, impact, and treatment of geriatric SUDs. Academic databases including PubMed, PsychInfo, Ovid, and Medline, were queried up to December 2018 for terms of "geriatric," "older," "elderly," "substance abuse," "drug," "drug use," "drug abuse," "drug dependency," "illicit drugs," and "geriatric psychiatry." Articles identified included 17 government documents, 29 studies based upon government documents, 43 studies not related to US government surveys, 19 review articles, 9 commentary pieces, 4 newspaper articles, 2 textbooks, and 1 published abstract. Evaluated studies and documents together suggest that older individuals are using illicit drugs and meeting criteria for SUDs at higher rates than previous geriatric cohorts resulting in substantial negative impacts on medical and psychiatric conditions. These findings represent a novel trend since previous cohorts of older individuals were thought to rarely use illicit substances. Current treatment models are inadequate to address the new wave of older individuals with SUDs. The fields of geriatrics, addiction, and geriatric psychiatry must work together to establish comprehensive care models and treatment modalities for addressing this emerging public health concern.
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Leslie M, Khayatzadeh-Mahani A, MacKean G. Recruitment of caregivers into health services research: lessons from a user-centred design study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:17. [PMID: 31139432 PMCID: PMC6528243 DOI: 10.1186/s40900-019-0150-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/08/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND With patient and public engagement in many aspects of the healthcare system becoming an imperative, the recruitment of patients and members of the public into service and research roles has emerged as a challenge. The existing literature carries few reports of the methods - successful and unsuccessful - that researchers engaged in user-centred design (UCD) projects are using to recruit participants as equal partners in co-design research. This paper uses the recruitment experiences of a specific UCD project to provide a road map for other investigators, and to make general recommendations for funding agencies interested in supporting co-design research. METHODS We used a case study methodology and employed Nominal Group Technique (NGT) and Focus Group discussions to collect data. We recruited 25 family caregivers. RESULTS Employing various strategies to recruit unpaid family caregivers in a UCD project aimed at co-designing an assistive technology for family caregivers, we found that recruitment through caregiver agencies is the most efficient (least costly) and effective mechanism. The nature of this recruitment work - the time and compromises it requires - has, we believe, implications for funding agencies who need to understand that working with caregivers agencies, requires a considerable amount of time for building relationships, aligning values, and establishing trust. CONCLUSIONS In addition to providing adaptable strategies, the paper contributes to discussions surrounding how projects seeking effective, meaningful, and ethical patient and public engagement are planned and funded. We call for more evidence to explore effective mechanisms to recruit family caregivers into qualitative research. We also call for reports of successful strategies that other researchers have employed to recruit and retain family caregivers in their research.
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Affiliation(s)
- Myles Leslie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
| | - Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- IMAGINE Citizens Collaborating for Health, Calgary, Alberta Canada
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O'Hare F, Flanagan Z, Nelson M, Curtis A, Heritier S, Spark S, Zoungas S. Comparing two methods for delivering clinical trial informed consent information to older adults: singular versus stepped approach. Clin Trials 2018; 15:610-615. [PMID: 30074410 DOI: 10.1177/1740774518793377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adapting the informed consent process to the needs of older adults may enhance engagement and willingness to participate in a clinical trial. A key aspect of the process is being provided with written clinical trial information and consent documents and having an opportunity to discuss the information with the researcher. However, there are no guidelines on the most appropriate method for delivering this information to older adults and it is not known whether the delivery method is a facilitator or barrier towards clinical trial participation. AIMS To compare two delivery methods of informed consent on recruitment, refusal to continue and randomisation rates in a general practice-based clinical trial involving older adults. METHODS In a matched cohort sub-study as part of the STAtins in Reducing Events in the Elderly clinical trial, 520 participants were allocated into two groups by age, gender and attending general practice location, to receive the trial information and consent form in the mail (Method 1) prior to the first baseline visit or in person (Method 2) at the visit where a comprehensive informed consent process took place. RESULTS Compared with Method 1, potential participants assigned to Method 2 were more likely to agree to attend the first baseline screening visit (refusal rate 20% vs 13.5%, respectively, p = 0.05). However, there was no significant difference in the proportion of participants recruited into the trial by providing written informed consent at the first baseline screening visit. For each informed consent delivery method, similar proportions of participants refused to take part in the trial by the end of the screening phase. Randomisation rates in the two groups were also similar. Time to conduct the informed consent procedure took significantly longer with Method 2 compared with Method 1 (median time 20 vs 15 min, respectively, p < 0.01). Interest in the research trial topic was the main reason cited (33.4%) for considering trial participation. CONCLUSION Later delivery of informed consent documents to potential participants in this trial was associated with a small increase in attendance at the first, in person, screening visit. However, the randomisation rate of participants into the trial was not affected by the method and timing of delivery of informed consent information. Similar randomisation rates occurred whether potential participants were mailed informed consent documents prior to the first in person screening visit or were given the information at the screening visit.
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Affiliation(s)
- Fleur O'Hare
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Zachary Flanagan
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mark Nelson
- 2 Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Andrea Curtis
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephane Heritier
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Simone Spark
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sophia Zoungas
- 1 School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Lorbergs AL, Noseworthy MD, MacIntyre NJ. Magnetic Resonance Imaging and Spectroscopy to Assess Leg Muscle Macrostructure and Microstructure in Healthy Older Women: A Feasibility Assessment. J Med Imaging Radiat Sci 2017; 48:43-54. [PMID: 31047210 DOI: 10.1016/j.jmir.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 08/25/2016] [Accepted: 09/22/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Advanced magnetic resonance (MR) scanning techniques, such as diffusion tensor imaging (DTI) and proton MR spectroscopy (1H-MRS) permit microstructural evaluation of water diffusivity and intramyocellular lipid content, respectively. We aimed to determine the feasibility of performing advanced MR scanning (proton density [PD] weighted imaging, DTI, and 1H-MRS) to evaluate properties of leg muscles in older women with respect to: (1) participant recruitment using three community-based strategies; (2) participant tolerance to the MRI scan acquisition protocol; and (3) scan acquisition and analyses protocols. METHODS Recruitment feasibility was evaluated based on the number of participants enrolled using various strategies. Participant tolerance was feasible if the scanning session was uninterrupted and image artifacts were absent. Optimal PD imaging, DTI, and 1H-MRS acquisition and analyses protocols were established. RESULTS Nine women (mean age = 71 years) were recruited over four months. The acquisition protocol was well tolerated by all participants. Adaptations were required for women with short stature and vertebral fracture risk. PD-weighted image analyses were improved by using the phased array uniformity enhancement filter to increase tissue contrast. CONCLUSIONS It is feasible to use a combination of MR scanning methods to evaluate muscle macrostructure and microstructure in the leg of older women. Our findings suggest that advanced MR scanning methods can be used for future studies interested in quantifying components of muscle structure in older women, but prospective studies are needed to confirm whether change in microstructure can be detected in response to an intervention.
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Affiliation(s)
- Amanda L Lorbergs
- Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School, Boston, Massachusetts, USA; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada; School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Norma J MacIntyre
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
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Abstract
Prescription drug misuse is a public health problem, and older adults are at high risk. The underlying factors associated with this problem in late adulthood are not well understood. Using cross-sectional data from telephone interviews with individuals aged 60 years and older in Arizona and Florida ( N = 2,000), this study tests whether hypotheses derived from general strain and low self-control theories are supported while investigating misusing prescription medication. Results from the regression analyses reveal that the association between poor health (conceptualized as a strain) and misusing prescription drugs (conceptualized as criminal coping) is partially explained by depressive symptoms (conceptualized as negative emotionality). The link between problem drinking and prescription drug misuse is fully attenuated when low self-control is included in the model. The results confirm that both theories provide insight into this public health problem and that treatment strategies should target the underlying mechanisms that lead to misuse.
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de Winter JCF, Dodou D, Hancock PA. On the paradoxical decrease of self-reported cognitive failures with age. ERGONOMICS 2015; 58:1471-1486. [PMID: 25855858 DOI: 10.1080/00140139.2015.1019937] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The science of Human Factors and Ergonomics (HF/E) often relies on self-report. This is a cause for concern because subjective methods are inherently susceptible to bias. Here, we present, examine and discuss a puzzling association between age and self-reported cognitive failures as assessed with Broadbent's Cognitive Failures Questionnaire (CFQ). Despite many well-established age-associated forms of cognitive decline, older persons actually report almost equivalent, or even less, cognitive failures on the CFQ than younger persons. Our present analysis indicates that this paradox may be resolved through the fact that people show age-related learning/adaptation/compensation and by the observation that the CFQ measures peoples' beliefs with respect to an individually idiosyncratic reference. Yet, at the heart of the paradox may be the idea that people cannot remember their own cognitive failures, pointing to even greater concerns with all forms of subjective self-report and its use in HF/E. Practitioner Summary: Scientists and practitioners often try to understand and improve human performance with the help of self-report questionnaires. Our paper discusses the validity of self-reported errors measured with the Cognitive Failures Questionnaire (CFQ). We look to resolve the curious paradox that older persons tend to report fewer failures than younger persons do.
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Affiliation(s)
- J C F de Winter
- a Department of BioMechanical Engineering , Delft University of Technology , The Netherlands
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Dale B, Söderhamn U. Nutritional self-care among a group of older home-living people in rural Southern Norway. J Multidiscip Healthc 2015; 8:67-74. [PMID: 25670905 PMCID: PMC4315559 DOI: 10.2147/jmdh.s75521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Ulrika Söderhamn
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Morrison K, Winter L, Gitlin LN. Recruiting Community-Based Dementia Patients and Caregivers in a Nonpharmacologic Randomized Trial: What Works and How Much Does It Cost? J Appl Gerontol 2014; 35:788-800. [PMID: 24799354 DOI: 10.1177/0733464814532012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 03/22/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the yield and cost of three recruitment strategies-direct mail, newspaper advertisements, and community outreach-for identifying and enrolling dementia caregivers into a randomized trial testing a nonpharmacologic approach to enhancing quality of life of patients and caregivers (dyads). METHOD Enrollment occurred between 2006 and 2008. The number of recruitment inquiries, number and race of enrollees, and costs for each recruitment strategy were recorded. RESULTS Of 284 inquiries, 237 (83%) dyads enrolled. Total cost for recruitment across methodologies was US$154 per dyad. Direct mailings resulted in the most enrollees (n = 135, 57%) and was the least costly method (US$63 per dyad) compared with newspaper ads (US$224 per dyad) and community outreach (US$350 per dyad). Although enrollees were predominately White, mailings yielded the highest number of non-Whites (n = 37). DISCUSSION Direct mailings was the most effective and least costly method for enrolling dyads in a nonpharmacologic dementia trial.
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Affiliation(s)
| | | | - Laura N Gitlin
- Johns Hopkins University, Center for Innovative Care in Aging
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Crist JD, Ruiz MR, Torres-Urquidy OH, Pasvogel A, Hepworth JT. Recruiting hospitalized Mexican American elder adults and caregivers: challenges and strategies. Res Gerontol Nurs 2012; 6:22-8. [PMID: 23244443 DOI: 10.3928/19404921-20121205-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 04/20/2012] [Indexed: 11/20/2022]
Abstract
Minority group members' participation in clinical research is essential for eliminating health disparities. Early recruitment procedures for a randomized control trial involving minority elder adults at local hospitals were unsuccessful, with challenges at the hospital and individual levels. These challenges included referrals for home health care being written late during hospitalization, hospital staff being reluctant to assist recruiters, ill minority elder adults, and protective or unavailable caregivers. We met these challenges with evidence-based strategies, including changing inclusion criteria, increasing study staff, branding our study, using a consistently respectful manner, and pacing our process. After revising our approaches in various ways, we recruited close to our goal, with relatively good retention. Participants reported that benefiting the community, rather than monetary reward, was a strong motivator to join the study. Unexpected recruitment expenditures exceeded the recruitment budget. Our experiences include strategies that can be more cost effective in future studies at both hospital and individual levels.
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Affiliation(s)
- Janice D Crist
- ENCASA Telenovela Research Study, College of Nursing, The University of Arizona, Tucson, Arizona 85721-0203, USA.
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McHenry JC, Insel KC, Einstein GO, Vidrine AN, Koerner KM, Morrow DG. Recruitment of Older Adults: Success May Be in the Details. THE GERONTOLOGIST 2012; 55:845-53. [PMID: 22899424 DOI: 10.1093/geront/gns079] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/02/2012] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Describe recruitment strategies used in a randomized clinical trial of a behavioral prospective memory intervention to improve medication adherence for older adults taking antihypertensive medication. RESULTS Recruitment strategies represent 4 themes: accessing an appropriate population, communication and trust-building, providing comfort and security, and expressing gratitude. Recruitment activities resulted in 276 participants with a mean age of 76.32 years, and study enrollment included 207 women, 69 men, and 54 persons representing ethnic minorities. Recruitment success was linked to cultivating relationships with community-based organizations, face-to-face contact with potential study participants, and providing service (e.g., blood pressure checks) as an access point to eligible participants. Seventy-two percent of potential participants who completed a follow-up call and met eligibility criteria were enrolled in the study. The attrition rate was 14.34%. IMPLICATIONS The projected increase in the number of older adults intensifies the need to study interventions that improve health outcomes. The challenge is to recruit sufficient numbers of participants who are also representative of older adults to test these interventions. Failing to recruit a sufficient and representative sample can compromise statistical power and the generalizability of study findings.
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Affiliation(s)
| | | | - Gilles O Einstein
- Department of Psychology, Furman University Greenville, South Carolina
| | | | | | - Daniel G Morrow
- Department of Educational Psychology, University of Illinois at Urbana-Champaign
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Söderhamn U, Dale B, Sundsli K, Tomstad ST, Söderhamn O. Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people. J Multidiscip Healthc 2012; 5:121-8. [PMID: 22791993 PMCID: PMC3392698 DOI: 10.2147/jmdh.s32502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. Methods A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. Results A Cronbach’s alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of −0.37 (P < 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. Conclusion NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA®) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard.
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Affiliation(s)
- Ulrika Söderhamn
- Center for Caring Research, Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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14
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Dale B, Söderhamn U, Söderhamn O. Self-care ability among home-dwelling older people in rural areas in southern Norway. Scand J Caring Sci 2011; 26:113-22. [DOI: 10.1111/j.1471-6712.2011.00917.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cicero TJ, Surratt HL, Kurtz S, Ellis MS, Inciardi JA. Patterns of prescription opioid abuse and comorbidity in an aging treatment population. J Subst Abuse Treat 2011; 42:87-94. [PMID: 21831562 DOI: 10.1016/j.jsat.2011.07.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 06/29/2011] [Accepted: 07/05/2011] [Indexed: 10/17/2022]
Abstract
Very little is known about the impact of age and gender on drug abuse treatment needs. To examine this, we recruited 2,573 opioid-dependent patients, aged from 18 to 75 years, entering treatment across the country from 2008 to 2010 to complete a self-administered survey examining drug use histories and the extent of comorbid psychiatric and physical disorders. Moderate to very severe pain and psychiatric disorders, including polysubstance abuse, were present in a significant fraction of 18- to 24-year-olds, but their severity grew exponentially as a function of age: 75% of those older than 45 years had debilitating pain and psychiatric problems. Women had more pain than men and much worse psychiatric issues in all age groups. Our results indicate that a "one-size-fits-all" approach to prevention, intervention, and treatment of opioid abuse that ignores the shifting needs of opioid-abusing men and women as they age is destined to fail.
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Affiliation(s)
- Theodore J Cicero
- Washington University Department of Psychiatry, Campus Box 8134, 660 S. Euclid Avenue, St. Louis MO 63110, USA.
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