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Objectives Chronic Disease Self-Management Program (CDSMP) has been demonstrated effective in addressing the self-management of chronic conditions among older adults. With a higher attrition rate, this study investigated whether attending with family members influenced completion of and benefits accrued from the CDSMP. Methods The baseline data were collected from CDSMP participants in New York State (n = 4184), and the follow-up data were collected from completers (attended 4+ sessions) (n = 293). Multi-level logistic regression was employed to predict the association between family accompany and program completion. Paired sample t-test was used to compare the differences in benefits from CDSMP after six months. Results Attending with family members was associated with a higher likelihood of completing the CDSMP (OR = 1.626, p Discussion Engaging family members may increase CDSMP participants’ motivation to complete the program. CDSMP providers should encourage participants to attend with their family members.

This literature review was designed to establish the effects of sedentary behaviour on the physical health of adults with an intellectual disability. Sedentary behaviour is defined as any waking behaviour characterized by an energy expenditure of ≤1.5 METs while in a sitting, lying or reclining posture. An extensive search was executed in six databases: EMBASE, Medline, CINAHL, PsycINFO, ASSIA and Web of Science. Following screening, 18 articles remained for inclusion in the review. A thematic analysis using the Braun and Clarke six step process resulted in the identification of seven broad health areas. Studies showed a prevalence of obesity, multimorbidity and metabolic syndrome as well as elevated levels of sedentary behaviour in adults with an intellectual disability. This literature review demonstrated that sedentary behaviour could be a contributor to the poor health which is common in adults with an intellectual disability. However to date the body of evidence does not confirm a cause-and-effect relationship.

Diabetes affects upward of 30% of South Bronx residents. The Centers for Disease Control and Prevention's National Diabetes Prevention Program (NDPP) reduces risk of progression to diabetes, yet implementation has been elusive within health disparities populations.This community-based, collaborative project piloted the NDPP in the South Bronx and evaluated implementation challenges and enablers. The New York State training group prepared community peer lifestyle coaches recruited by a community organization. A professional society trained academic detailers from local faculty. An interview process evaluated community needs and public health officials' beliefs. A portal managed by the New York State training group collected demographic and biometric data from the community participants and facilitated online registration. Data from interviews and observations were coded systematically using a thematic analysis framework.We were successful at recruiting and training 14 lifestyle coaches and 7 academic detailers, as well as recruiting members of the health disparities population in the South Bronx into the program. Fifty-two individuals completed the first 6 months of the yearlong program, attending an average of 12.7 of 16 sessions. By week 16, weight loss averaged 7.4 lbs and many had doubled their minutes of physical activity. Local electronic referral and feedback systems were developed.Health professionals, their teams, public health centers, and communities can work together to prevent diabetes by enhancing the reach of the NDPP to health disparities populations. Peer education using lifestyle coaches can provide a trustworthy process for crossing the boundaries between health teams and community support groups.

Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.

Study aims were to explore differences in predictors of respite care use between older (aged 65+) and younger caregivers (aged 18-64 years), and associations between caregiving load and respite care use using multivariate logistic regression analysis and unpaid caregiver (n= 10,500) data from the 2009 California Health Interview Survey. Caregiving load comprised number of care recipients, weekly hours in caregiving, and caregiving duration. Variables with a significant association with respite care for older caregivers were female gender, income, and health insurance. For younger caregivers, respite care use associations were with ethnicity, caregiving relationship, education, and availability of substitute help.

This paper reports on a collaborative process to create an "aging prepared community" in a four county region. The process benefited from a generous grant from the John A. Hartford Foundation that supported an 18 month planning period which included input from service providers and a vast array of aging persons and their families, including particular efforts to reach underserved populations from multicultural, inner- city and rural communities. Under the umbrella of the Elder Network of the Capital Region, the process is now beginning its implementation period with foci on the following: linking health, social service and faith communities; developing accessible health education and wellness programs; creating and implementing a regional system of information and assistance; and mounting a media campaign.

Although previous studies have established a strong association between diabetes and disability, little is known regarding the impact of disability on access to diabetes care among older adults with diabetes. The purpose of this study is to examine the impact of disability on accessing diabetes care among older adults who are living with diabetes. This study used survey data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS). The sample included adults age 50 and over who have diabetes. Multivariate logistic regression analysis was conducted to examine the impact of disability on accessing diabetes care among older adults with diabetes. Two dependent variables were identified to measure diabetes care access: (1) receipt of a course or class on managing diabetes and (2) visit to a health professional in the past year for diabetes. 47.30% of the sample reported not having received diabetes education and 10.86% did not visit health professionals for diabetes in the past year. Older adults with diabetes who had disabilities were more likely to have received diabetes management education (OR=1.17, p

Exploring the Impact of Culture and Acculturation on Older Families Caregiving for Persons With Developmental Disabilities* Philip McCallion,** Matthew Janicki, and Lucinda Grant-Griffin A series of focus group meetings were held with African American, Chinese American, Haitian American, Hispanic/Latino American, Korean American, and select Native American communities. Cultural issues in caring for persons with a developmental disability were discussed. Differences were found in the following themes: (I) how disability is perceived, (2) who are the family, (3) who provides care, (4) how the family makes decisions, (5) what family members expect of each other, (6) what support families receive from friends and community, (7) why the family moved, (8) cultural values important to family members, (9) family willingness to accept services from outside the family, (10) the family's first language, and (11 ) families' concerns about service providers. A range of adherence was observed as most prevalent among each of the cultures and across generations and age groups. Implications for the development and delivery of services are discussed. Key Words: developmental disabilities, diversity, family caregiving, focus groups, service use. Increasing attention has been paid to the needs of older families caring at home for family members with a developmental disability. Concerns have been raised that many families are not connected to services and have not planned for the future (Smith, Fullmer, & Tobin, 1994; Wood, 1993). Indeed, agency workers in both the aging and developmental disabilities service systems have reported that families are often resistant to their efforts, or that they themselves are unprepared for the issues that these families present (McCallion & Tobin, 1995; Sutton, Sterns, Schwartz, & Roberts, 1992). More limited attention has been paid to families from diverse cultures caring for family members with developmental disabilities. It is not known if their caregiving experiences are similar or different from other families, or whether prevalent emphases in the service system on permanency and future planning are appropriate or effective for families from diverse cultures. To address these questions, findings will be reported on a series of focus groups held with African American, Chinese American, Haitian American, Hispanic/Latino American, Korean American, and select Native American communities. The focus groups were held to gain an understanding of the uniqueness of the caregiving experiences of specific cultural groups, reasons for lower service use and the extent of cross-cutting concerns around aging, disability, caregiving and future planning. They were also a means to build trust, and to provide a context for future research. Background Informal caregiving is the primary mode of care in the U.S. for people who are aging, including those persons with a developmental disability (Doty, 1986; Seltzer, & Krauss, 1994). Although positive and rewarding aspects of providing care to a family member have been identified, stressful and burdensome aspects of caregiving have also been documented (AnthonyBergstone, Zarit, & Gatz, 1988; Biegel, Sales, & Schulz, 1991; Seltzer & Krauss, 1994). Key Concerns for Caregiving Families Converging demographic trends are raising concerns both about the continued viability of relying on informal caregivers to meet long-term care needs and about the best ways to support families who are continuing to care for dependent adult family members (Doty, 1986). Those demographic trends include the growing numbers of persons who are aging, including persons with a developmental disability (Jacobson, Sutton, & Janicki, 1985; U.S. Senate, 1987-88). Also, increasing rates of divorce, geographic dispersal, and lower birth rates are reducing the number of potential family caregivers (Crystal, 1982). Furthermore, growing workforce participation and later child birth among the largest group of family caregivers, women, are increasing tensions between work, child care, and adult care responsibilities (Horowitz, 1985; Kiecolt-Glaser, Dura, Speicher, Trast, & Glaser, 1991; Lang & Brody, 1983). …