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Cognitive-behavioral self-management strategies are recommended for older adults with chronic pain. The goal of this study was to explore how pet ownership promotes use of these strategies in everyday life. We conducted four focus groups (N = 25) with dog and cat owners aged ≥70 years with persistent pain. Participants described how their pets affect their daily routines and health, including pain and its management. We analyzed transcripts for salient themes, categorizing them according to their alignment with recommended pain self-management strategies: Mood Management (e.g., increases positive affect), Relaxation/Distraction (e.g., soothing presence), Physical Activity (e.g., dog-walking), Behavioral Activation (e.g., motivates activity even when pain present), Social Activation (e.g., facilitates socializing), and Sleep (e.g., encourages routine). Some participants described negative impacts of pet ownership. Having pets can facilitate behaviors and thoughts that may enhance coping with pain. Testing formal ways of leveraging pets' role may expand nonpharmacological options for chronic pain management. [ABSTRACT FROM AUTHOR]

Heart disease is the leading cause of death in the United States. African Americans and people of low socioeconomic status suffer disproportionately from heart disease–related morbidity and mortality. In Detroit, Michigan, a primarily African American and low-income urban area, heart disease mortality is at twice the national rate. Despite evidence for the effectiveness of self-management support interventions in reducing chronic disease burden for older adults, few are adapted for communities most in need. This article describes the process of adapting Take PRIDE, an evidence-based heart disease self-management intervention, for older adults in Detroit via the Replicating Effective Programs (REP) framework. Working within a community–academic partnership, we found REP useful in facilitating the identification of diverse stakeholders, core versus adaptable elements of the intervention and barriers to implementation. We also made several modifications to the REP framework in order to better fit our project needs. Overall, we found REP to be an effective, flexible tool that allowed us to successfully adapt a disease-management intervention for this setting. Processes, lessons learned, and recommendations offered in this article may help researchers and practitioners working to expand access to self-management support for populations most affected by chronic disease. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this study was to examine gender differences in engagement in physical activity over time among older U.S. adults with diabetes. Method: Using data from the Health and Retirement Study, we investigated physical activity between 2004 and 2010 among 1,857 adults aged 65 years and above with diabetes. Results: Less than half of adults were physically active at baseline. The probability of physical activity declined over the 6-year period, with no significant gender variation in the effect of time. Because the odds of physical activity were lower for women at baseline and the effect of time did not vary by gender, the trajectory of physical activity was less favorable for women than men. Discussion: The women in this cohort of older Americans started and remained less active than their male counterparts. Investigations covering a larger portion of the life course and those examining the impact of life events and transitions on physical activity among adults with diabetes are needed. [ABSTRACT FROM AUTHOR]

Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings—school district, clinic or health care system, and community—and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team. [ABSTRACT FROM AUTHOR]

Despite the importance of self-care for dementia caregivers, few interventions have included a focus on health behaviors. This study reports outcomes of a telephone-based exercise intervention designed for women caring for a spouse with dementia. Caregivers (N = 137) were randomized to intervention or control conditions. Participants with at- or below-median exercise scores at baseline had a significantly greater increase in exercise at 6-month follow-up compared with their control counterparts. At 6 months, participants had greater reductions in perceived stress relative to controls. Participants also reported significantly greater increases in exercise self-efficacy than caregivers in the control group at both follow-up points. Results indicate that spouse caregivers are able to increase their physical activity and that a focus on exercise in multicomponent interventions may be beneficial. Debate and discussion are needed to inform expectations for program effects and their maintenance and to explore the interface between enhanced selfcare and caregiving perceptions. [ABSTRACT FROM AUTHOR]

In studies that have explored pet ownership in families affected by dementia, reported benefits have ranged from improvements in patient behavior to reduction in caregiver blood pressure. In this exploratory study, the impact of dementia on relationships among pets, caregivers, and care recipients was examined using content analysis of open-ended questions included in a telephone survey. Female spouse caregivers who owned pets were asked how their (and their husband's) relationship with their pets changed since they started caring for their husband. Most caregivers reported that they felt closer and more attached to their pets than previously. However, some caregivers reported that their pets created an additional burden and that they and their spouse had less time to care for the pets since the onset of illness. Findings highlight the need for further research to explore the unique benefits and burdens of owning a pet for families affected by dementia. [ABSTRACT FROM AUTHOR]

With the aging of the population, an increasing number of older adults are diagnosed with Alzheimer's disease or a related disorder. Most people with a dementing illness will be cared for at home by a family member, who may experience a variety of physical, emotional, financial, and social burdens associated with the caregiving role. The purpose of this article is to (a) examine the physical and psychological effects of providing care to a family member with a dementing illness, (b) describe the factors that help determine the nature and magnitude of these effects, and (c) discuss several approaches to caregiver intervention designed to reduce the negative impact of this challenging role. Sociodemographic characteristics (e.g., gender, relationship to the patient, culture, race, ethnicity), caregiver resources (e.g., coping, social support, availability of a companion animal), and personal characteristics (e.g., personality, health behaviors) shape the dementia caregiving experience and have implications for interventions designed to prevent or lessen the stress and burden that often accompany the role. [ABSTRACT FROM AUTHOR]

Cross-national comparison of the social relations-physical health association in the elderly can broaden our understanding of the implications of social relationships in this age group. Using representative cross-sectional samples of adults aged 60-93 years from metropolitan areas in the United States and Japan (n = 1005), we used analysis of variance to examine between-country differences in the association of illness with measures of network structure, social support, and negative relations. One significant between-country difference in this association was found: in Japan only, ill women reported more available financial help from their child than did non-ill women (p < .05). Ill women in both countries reported less sick care available from their spouse than did ill men (p < .05) and more negative relations with their child than did non-ill women (p < .05). These results suggest the primacy of gender, rather than cultural context, in shaping the association between social relations and health. [ABSTRACT FROM AUTHOR]