Personal and delivery site characteristics associated with intervention dosage in an evidence-based fall risk reduction program for older adults

The objective of this study is to identify sociodemographics of older adults enrolled in a nationally disseminated evidence-based fall risk reduction program, describe different delivery sites, and examine personal and site characteristics associated with intervention adherence. Data were analyzed from 6,922 older adults enrolled in A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) model between 2006 and 2009. Intervention dosage was measured by workshop attendance. Logistic regression analyses examined factors associated with attendance levels. Intervention dosage differed by sociodemographic and delivery site characteristics. Patterns of intervention dose significantly differed between Hispanic and non-Hispanic White participants. Those with less education and living in rural areas were more likely to receive adequate program doses. Although senior services agencies offered the most programs, intervention adherence was more likely in nonaging service sites. Findings may help program administrators better understand and minimize attrition issues within their AMOB/VLL workshops

Adaptation of an Evidence-Based Arthritis Program for Breast Cancer Survivors on Aromatase Inhibitor Therapy Who Experience Joint Pain

Adding aromatase inhibitors (AIs) to adjuvant treatment of postmenopausal women with hormone-receptor–positive breast cancer significantly reduces cancer recurrence. A common side effect of AIs is noninflammatory joint pain and stiffness (arthralgia) similar to arthritis symptoms. An evidence-based walking program developed by the Arthritis Foundation — Walk With Ease (WWE) — reduces arthritis-related joint symptoms. We hypothesized that WWE may also reduce AI-associated arthralgia. However, the potential for different barriers and facilitators to physical activity for these 2 patient populations suggested a need to adapt WWE before testing it with breast cancer survivors. We conducted qualitative research with 46 breast cancer survivors to explore program modification and inform the development of materials for an adapted program (Walk With Ease-Breast Cancer). Our process parallels the National Cancer Institute’s Research-Tested Intervention Programs (RTIPs) guidelines for adapting evidence-based programs for cancer populations. Findings resulted in a customized 8-page brochure to supplement existing WWE materials

The Healthy Aging Research Network: Resources for Building Capacity for Public Health and Aging Practice

There is an urgent need to translate science into practice and help enhance the capacity of professionals to deliver evidence-based programming. We describe contributions of the Healthy Aging Research Network in building professional capacity through online modules, issue briefs, monographs, and tools focused on health promotion practice, physical activity, mental health, and environment and policy. We also describe practice partnerships and research activities that helped inform product development and ways these products have been incorporated into real-world practice to illustrate possibilities for future applications. Our work aims to bridge the research-to-practice gap to meet the demands of an aging population

Breast cancer, cultural beliefs and rural women - racial and age differences in intentions to seek care

This study investigated the influences of an array of socioeconomic, health care utilization, breast cancer awareness and cultural belief factors on rural women's intentions to seek breast health care if they were to detect a breast lump. The underlying conceptual schema was an ecological perspective that provided a framework for the multiple levels of predisposing, reinforcing and enabling influences on women's perceptions about breast cancer and subsequent decision-making. -- A secondary analysis of survey data was conducted from a random sample of 853 White and African women aged 18 to 99 years residing in two counties in rural eastern North Carolina. Bivariate analyses revealed that older African American women, compared to their younger and White counterparts, were the least likely to know or worry about breast cancer and its risks, or to talk to their physicians about the need for screening, or to have been screened, and more likely to subscribe to cultural beliefs that were barriers to seeking breast health care. Yet, older African American women were more predisposed to pursuing health care and physician recommendations than the other subgroups. -- A multi-stage, multivariate logistic regression analysis revealed that socioeconomic characteristics, breast health care utilization, breast cancer awareness, and cultural beliefs influenced intentions, but could not account for racial and age differences. Findings indicated that past screening behavior predicts future screening intention, prior use of the health care system predicts future use if a health problem is detected, breast cancer cultural beliefs that are consistent with mainstream medical knowledge reinforce the use of medical care and screening, and physician communication about breast cancer risk and religious beliefs about God's role in curing cancer are highly influential on women's intentions to watch the lump for changes and to pray. -- Findings highlight the need for public health programs that incorporate information related to women's use of the medical system and their cultural beliefs about breast cancer. Provider-oriented interventions should focus on the relevance of these beliefs for optimal health care and the importance of early detection. Study findings also justify advocacy for community partnerships that promote breast cancer screening for at-risk women

Increasing Use of Mammography Among Older, Rural African American Women: Results From a Community Trial

Objectives. A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older. Methods. A stratified random sample of 801 African American women completed baseline (1993–1994) and follow-up (1996–1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years. Results. The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = –1, 14) in communitywide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by lowincome women in comparison counties. Adjustment for potentially confounding characteristics did not change the results. Conclusions. A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations

The Healthy Aging Research Network: Resources for Building Capacity for Public Health and Aging Practice

There is an urgent need to translate science into practice and help enhance the capacity of professionals to deliver evidence-based programming. We describe contributions of the Healthy Aging Research Network in building professional capacity through online modules, issue briefs, monographs, and tools focused on health promotion practice, physical activity, mental health, and environment and policy. We also describe practice partnerships and research activities that helped inform product development and ways these products have been incorporated into real-world practice to illustrate possibilities for future applications. Our work aims to bridge the research-to-practice gap to meet the demands of an aging population