Experiences With and Access to Evidence-Based Health Promotion Programs for Older American Indian, Alaska Native, and Native Hawaiian Peoples

Evidence-based programs (EBPs) work effectively for participants whose characteristics match those of the EBP research participants. However, EBPs have been almost exclusively developed and evaluated for the general U.S. population with limited American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) community engagement. Thus, an AI/AN/NH Evidence-Based Program Advisory Council sought to identify AI/AN/NH peoples' experiences with and access to EBPs. We held 20 listening sessions with AI/AN/NH Elder services program staff (n = 118) and with AI/AN/NH Elders (n = 82) and conducted a self-administered online survey with Title VI Directors (n = 63). The six themes that emerged from the listening sessions with staff included misunderstanding community engagement, valuing fidelity over flexibility, lack of cultural awareness, assumptions about available infrastructure, unrealistic implementation timelines, and funding restrictions. Listening session themes with Elders included definitions of aging well, participation motivators, preferred activities, participation barriers, and unmet needs. Survey data indicated that programming of greatest interest for Elders as identified by Title VI Directors and staff included and/or addressed cultural activities (81%), socialization (75%), diabetes (73%), caregiving (68%), and nutrition (68%). Seventy-six percent of survey respondents had heard of EBPs and 24% indicated that EBPs were not being implemented in their community. The Advisory Council developed specific action steps with the goal of improving AI/AN/NH communities' access to culturally appropriate and feasible EBPs. The steps require collective action from federal agencies, national partners, EBP program developers and administrators, local organizations, and Elders to ensure EBPs are accessible and culturally appropriate for AI/AN/NH Elders.

The relationship between diabetes and oral health status, and dental visits among American Indian, Alaska Native, and Native Hawaiian elders

BACKGROUND

American Indian (AI), Alaska Native (AN), and Native Hawaiian (NH) populations report higher rates of diabetes, poorer oral health, and fewer dental visits than their peers. The authors aimed to identify relationships between oral health and dental visits and diabetes diagnosis among AI, AN, and NH elders.

METHODS

Data were obtained from a national survey of AI, AN, and NH elders 55 years and older (April 2014-2017) and included 16,136 respondents. Frequencies and χ2 tests were used to assess the relationship between oral health and dental visits, and diabetes.

RESULTS

Nearly one-half of the elders reported receiving a diagnosis of diabetes (49.2%). A significantly (P < .01) greater proportion of elders with diabetes reported a dental visit in the past year (57.8%) than those without. Differences (P < .01) were found between reported diabetes and need for extraction, denture work, and relief of dental pain. The authors found lower dental visit rates among elders with diabetes who were low income, older, unemployed, not enrolled in the tribe, lived on the reservation, and had only public insurance.

CONCLUSIONS

There is a need to increase oral health literacy and dental visits among elders with diabetes and, more urgently, a need to focus on providing care for subpopulations reporting lower visit rates.

PRACTICAL IMPLICATIONS

Dental providers must serve as a referral resource for at-risk elders and must work with and educate about the importance of oral health those who assist tribal elders with diabetes management, including primary care physicians, certified diabetes educators, nutritionists and dietitians, and public health care professionals.

Reducing Loneliness: The Impact of Mindfulness, Social Cognitions, and Coping

While many facets of loneliness have been explored, research examining the efficacy of loneliness interventions has been overlooked among young adults. The study of loneliness among young adults has become increasingly important considering the current state of isolation and stay-at-home orders issued to prevent the spread of COVID-19. Preliminary reports suggest an increase in loneliness as a result of the current health pandemic, especially among young adults, who have reported feeling lonelier than any other age group. Such findings warrant the study of ways to help reduce loneliness among young adults. The current study examined the efficacy of strategies that might be used to help young adults manage feelings of loneliness. Two hundred and seventy-eight young adults completed the study. Participants read one of four messages: mindfulness, social cognitions, coping behaviors, or a control. Participants in the mindfulness condition felt better equipped to manage future instances of loneliness and held better attitudes toward this intervention. The current research helps to advance understanding of effective ways of helping young adults cope with loneliness.

Loneliness Among College Students: The Influence of Targeted Messages on Befriending

The objective of the current research was to examine the influence of targeted messages in increasing helping behaviors towards lonely individuals. Previous research on loneliness interventions typically focuses on the lonely individual and working to reduce feelings of loneliness. The current study expands on this research by targeting individuals around lonely others to notice and consider helping those who might be lonely. Five targeted messages, based on Latané and Darley's (1970) bystander intervention model, were utilized. These messages included a "notice" condition (increasing awareness of lonely others), an "assume responsibility" condition (awareness and responsibility towards helping lonely others), a "decide" condition (awareness, responsibility, and steps to reach out to lonely others), and two control conditions. Participants in the "decide" condition were significantly more likely to report feeling prepared to help lonely others in the future. Those in the "assume responsibility" and "decide" conditions also reported more awareness of lonely individuals during a one-week follow-up. Overall, findings indicate that it might be advantageous to approach reducing loneliness from the perspective of those around lonely individuals. Future research and implications of these findings are discussed.

[Measurement of venous pressure by the pneumatic captor and transmitter. Experimental study]

The results are reported of experimental testing of a non-invasive method for pressure measurement in esophageal varices. The correlation between measurements of venous pressure by pneumatic captor and electronic manometer and those by water column is excellent for pressure ranging between 13 and 44.5 cm H2O.