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As the U.S. population ages, Extension's need for associated organizational readiness increases. We conducted a needs assessment with a sample of 1,028 Extension professionals in the Extension North Central Region (NCR) to identify the current scope of aging-related community needs. Health care, chronic disease prevention and management, housing, and transportation emerged from qualitative analysis as top aging-related needs. A rankorder analysis identified finances, healthy aging, and aging-friendly communities as chief community concerns. Additionally, the NCR Extension professionals indicated the importance of resources and programs and need for community capacity building related to aging issues, regardless of their programming area and/or responsibilities.

Higher education resources are increasingly limited due to declining budget revenue and other challenges. Thus, it is vital for Cooperative Extension to synergize efforts of disseminating education to the public. Promoting public scholarship in and beyond Extension is a promising initiative that can foster collaborations by leveraging existing resources in advancing the Extension mission. We highlight a new program aimed at encouraging a culture of public scholarship across academia. The program is intended to increase knowledge about public scholarship and awareness of its benefits to stakeholders, identify barriers to public scholarship, and provide concrete examples of ways Extension and non-Extension faculty can collaborate on research and programming efforts.

Background: Assessing and managing hospice patients' pain is a common source of anxiety among hospice family caregivers (HFCGs), especially caregivers in rural communities who face special challenges including distance, limited access, and concerns about opioid misuse. Objective: To pilot test Ready2Care, a pain management education intervention for rural HFCGs. We sought to determine whether there was a signal of benefit for clinically-relevant outcomes and to identify contextual factors pertinent to conducting a future randomized clinical trial of Ready2Care. Methods: We conducted a multi-method, single-arm study, enabling completion of paired t-tests comparing pre- and post-intervention measures of caregiver anxiety, pain management self-efficacy, barriers to pain management, and reports of patient pain intensity and corresponding patient and caregiver distress. We concurrently conducted an embedded implementation evaluation via calculation of descriptive statistics (recruitment and retention data) and directed content analysis of brief caregiver interviews. Results: Twenty-seven (n = 27) HFCGs participated; 15 completed the study. Among completers, significant improvement was observed in patient pain intensity (average 1.4 points decrease on 0-10 scale) and in overall pain experience. No statistically significant changes were detected in caregiver anxiety, barriers to pain management, or pain management self-efficacy. Facilitators to successful conduct of a future clinical trial included high acceptability of Ready2Care, driven by its perceived clarity and relevance to caregivers' concerns. Barriers included lower-than-anticipated accrual and an attrition rate of nearly 44%. Conclusion: A multisite clinical trial of Ready2Care is warranted; however, its success may require more effective recruitment and retention strategies for rural caregiver participants. [ABSTRACT FROM AUTHOR]

The North Central Region Aging Network (NCRAN) formed out of a need to strengthen the potential for meeting curricular and educational demands related to the topic of aging. By pooling resources, establishing interactive and consistent methods of idea sharing, working collectively to assess community needs, and launching professional development initiatives, network members are able to effectively and efficiently address constituent needs across state lines. Early success and sustainability of NCRAN can be largely attributed to four lessons learned: (a) visioning, (b) shared leadership, (c) connection, and (d) data-driven decision making. Other Extension professionals seeking to address constituent needs may find success in forming similar collaborative networks.

Objective: Investigators sought to determine how family caregivers' psychological and physical wellbeing influenced their perceptions of communication with hospice providers. Methods: Researchers conducted a secondary analysis of quantitative data generated during two multisite randomized clinical trials of supportive interventions for hospice family caregivers. Caregivers' (N = 525) self-reported anxious symptoms, depressive symptoms, physical quality of life, and perceptions of communication with hospice providers were analyzed via a series of linear models that included demographic and contextual controls. Results: Caregivers' anxious symptoms, depressive symptoms, and physical quality of life were largely unrelated to caregivers' perceptions of their communication with hospice providers when adjusted for demographic and contextual factors. Conclusions: Variation in caregivers' perceptions of their communication with hospice providers was not well explained by caregiver wellbeing. Additional research is needed to understand if and how caregivers' perceptions of communication with hospice providers are related to factors not included in this secondary analysis. Provider-related variables may be particularly important to consider. [ABSTRACT FROM AUTHOR]

Transgender older adults have been subject to life-long stigma and marginalization, resulting in significant social and health consequences. Despite these challenges, this population commonly reports thriving in later life. In order to attend to nuanced experiences of older transgender adults, theoretical models of successful aging must reflect complexities presented by gender minority status. In order to address theoretical gaps, a systematic qualitative meta-synthesis was conducted to summarize findings across the body of qualitative transgender aging research. Findings indicated that transgender older adults conceptualize successful aging through the process of embracing gender identity. Themes were identified to conceptualize successful transgender aging such as gender expression, shedding internalized stigma, and championing a resilience mindset. Implications for social work practice are provided, suggesting a more comprehensive understanding of both challenges and resilience factors amongst the aging transgender population. [ABSTRACT FROM AUTHOR]

Objective: We present the protocol of a study aiming to examine the efficacy of a technologically-mediated storytelling intervention called Caregiver Speaks in reducing distress and grief intensity experienced by active and bereaved hospice family caregivers of persons living with dementia (PLWD). Design: The study is a mixed-method, 2-group, randomized controlled trial. Setting: This study takes place in 5 hospice agencies in the Midwest and Northeastern United States. Participants: Participants include hospice family caregivers of PLWD. Intervention: Participants are randomized to usual hospice care or the intervention group. In the Caregiver Speaks intervention, caregivers engage in photo-elicitation storytelling (sharing photos that capture their thoughts, feelings, and reactions to caregiving and bereavement) via a privately facilitated Facebook group. This intervention will longitudinally follow caregivers from active caregiving into bereavement. The usual care group continues to receive hospice care but does not participate in the online group. Outcomes Measured: We anticipate enrolling 468 participants. Our primary outcomes of interest are participant depression and anxiety, which are measured by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder screening (GAD-7). Our secondary outcomes of interest are participants' perceived social support, measured by the Perceived Social Support for Caregiving (PSSC) scale, and grief intensity, which is measured by the Texas Revised Inventory of Grief Present Subscale (TRIG-Present). [ABSTRACT FROM AUTHOR]

Objective: To explore factors that influenced engagement in an online support group (OSG) for family caregivers of hospice patients with cancer. Design: Secondary qualitative data analysis. Sample: 58 family caregivers of hospice patients with advanced cancer. Methods: Template analysis of individual family caregiver interviews. Findings: Emotional isolation and caregiving downtime positively influenced engagement, while reluctance to share personal information, a short timeframe of participation in the OSG, and caregiving commitments were negatively influential. While the group facilitation and secure privacy settings of the OSG were viewed positively, reactions to the OSG platform and group tone were mixed. Information on pain and the dying process was found to be particularly engaging. Practice implications: Providers offering OSGs for family caregivers should maximize factors that promote meaningful member engagement, responding to changes in activity and tone over time. [ABSTRACT FROM AUTHOR]