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: Objective: To assess the use of Medicare‐subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non‐emergency GP attendances (short [30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs)., The Australian Institute of Health and Welfare estimates that dementia affects almost 1 in 10 (8.8%) people aged 65 and over,[sup.1] and research shows it is increasingly prevalent as populations [...]

Diversity is what makes a person unique, with the intersection of diversity characteristics potentially a strength or a barrier to accessing healthcare, and thereby affecting health and well-being outcomes. Many older people with diverse needs are not accessing appropriate services to meet their needs, leading to suboptimal health and well-being. Community aged care workers are at the frontline, working with diverse older people with complex needs; yet there is a dearth of training available in this sphere. This paper outlines the development and pilot evaluation of a diversity training workshop for managers and frontline community aged care workers. The aim of the workshop was to empower the workforce to support increased participation of older people with diverse needs in their own care, to ultimately lead to their improved health and well-being.Workshop development was underpinned by sound education principles, a competency framework and research evidence. First iteration of the workshop underwent pilot testing with three groups, two in metropolitan Melbourne (n = 31) and one in regional Victoria (n = 10), Australia. Feedback was gathered via an independent observer (field notes), pre- and post-workshop surveys, and phone interviews with participants 3-month post-workshop. Pilot data and feedback informed changes to workshop content (type of knowledge, application of knowledge and skills), workshop structure and androgogical (adult learning) approach.An evidence-informed diversity training workshop was developed through an iterative process, with the aim of enhancing knowledge, skills and attitudes of community aged care workers. This approach has developed a workshop that aims to better meet the needs of an aged care workforce, so that they may better support older people with diverse needs to increase engagement and participation in their care, optimizing their health and well-being.

Population ageing signals the need for a responsive community aged care workforce respectful of older people's diverse healthcare needs. Person-centered care premises individual needs and preferences to enhance participation in health care. Training for diversity does not yet exist for this workforce, but is necessary to ensure appropriate care for diverse community-dwelling older people. This article aims to review the range of research traditions for conceptualizing diversity training, theoretical approaches, and empirical findings to understand the relevance for the community aged care sector. Using a meta-narrative approach, research from health, education, psychology, sociology, and business literature was reviewed for meaningful contribution to supporting training for community aged care workers. Meta-narrative review principles included: planning, searching, mapping, appraisal/synthesis, and recommendations. Six meta-narratives were identified, consolidated into three areas: person-centered and culturally competent health care; human rights approach; and psychological approaches to diversity training. The meta-narratives highlighted diversity within diversity and a move toward intersectionality. Meta-narratives were linked through concepts of inclusion, reduction in bias, and access and equity healthcare policy and practice. Training for community aged care workers is challenging, with this synthesis providing new understandings of diversity training, paramount for provision of responsive and equitable health care for older people.

Inactivity has been identified as a major contributor to the burden of disease among older Australians, particularly those in culturally-diverse communities. This study assessed the facilitators and barriers to physical activity in older people from culturally-diverse communities, and investigated the predictors of physical activity participation by recruiting 333 older people from seven different communities in the western suburbs of Melbourne, Australia. A survey questionnaire that recorded physical activity and the barriers to and facilitators of activity was interviewer-administered in the participants' preferred language. The data were analysed using bivariate and multiivariate inferential statistical methods. Personal barriers to physical activity, such as poor health, lacking the energy to exercise, being too tired and low motivation, were highly prevalent in all groups. Specific factors, such as 'being self-conscious about my looks', were more prevalent among the Vietnamese, as were concerns about the weather among Macedonians and Croatians. Across all groups, perceptions of health and safety strongly influenced physical activity behaviour, more so than the external environment. Some of the barriers can be addressed with a common approach, but others in some communities will require particular strategies. KEY WORDS--older adults, ethnic minorities, cultural diversity, ethnicity, physical activity, barriers. Ageing & Society 29, 2009, 1275-1294. [C] 2009 Cambridge University Press Doi: 10.1017/S0144686X09008617 Printed in the United Kingdom

Inactivity has been identified as a major contributor to the burden of disease in older women. Study aims were: (a) to assess the personal, social, and environmental facilitators and impediments to physical activity in older women from ethnic communities; and (b) to determine the factors associated with physical activity participation. Older women (aged 60-84 years) were recruited from the local Italian (n = 20), Vietnamese (n = 26) and Anglo-Celtic (n = 26) communities. A survey questionnaire was administered in the participants' preferred language. The most common barriers were: 'I am not in good health,' 'I am self-conscious about my looks,' 'I am too tired,' 'I don't have time,' and 'The weather is bad.' When comparing the ethnic groups, the Vietnamese women reported fewer barriers than the Italian women (2.6 vs. 5.9). While the Vietnamese women were much more likely to report being 'self-conscious about my looks,' the Italian women more commonly reported poor health, being too tired, and not liking exercise as barriers. Overall, those living alone were more likely to be active and those who reported fear of injury, less active. Recognizing ethnospecific differences in the prevalence of barriers may be important when devising strategies to increase activity levels of older women. KEYWORDS older women, physical activity, ethnic populations, barriers