<p> The purpose of this thesis was to conduct a policy analysis of Title III of the Older Americans Act of 1965 (P.L. 106-501 ). The policy was enacted to assist older adults in combating food insecurity and malnutrition. The policy specifies that federal funding be allocated to states, in order for the states to provide both congregate meal programs and home-delivered meal services to older adults. For this reason, a more in-depth analysis of Title III of the Older Americans Act was conducted in this project, in order to better understand the nutritional needs of older adults, and the need for nutritional services for the older adult population. This study utilized David Gil's policy analysis framework to analyze Title III of the Older Americans Act of 1965 and the analysis indicated that its implementation has not produced the policy's intended outcomes and has not produced its intended goals of reducing food insecurity within the U.S. older adult population. </p>

<p> The United States population of elderly persons is growing quickly, causing an increase in concern for their health care needs. Dementia is a condition that affects the elderly. With an increase in persons with dementia, there is also an increase in apprehension of care choices. National data and published literature were used to study dementia and its effects on the patient and their family caretakers. The study concluded that minority families were less likely to institutionalize elderly dementia patients into nursing care due to a variety of cultural biases. White dementia patients had the highest number of admittance into nursing homes. This was also prevailing in the specialty care unit for dementia patients. Understanding the cultural differences and needs of the minority patient can help organizations improve the disparity among dementia patients admitted into nursing homes.</p>

<p> The purpose of the study was to investigate the prevalence and effects of vision impairment co-existing with other comorbid conditions. Utilizing the 2008 National Health Interview Survey, the most recent nationally representative data including expanded vision, health conditions, and activity questions, this study examined the effect of vision impairment co-existing with selected comorbid conditions among non-institutionalized older adults age &ge; 55 years. Specifically, this study compared 4 groups: (a) older adults with neither vison impairment nor comorbid conditions, (b) older adults with vision impairment only, (c) older adults with comorbid conditions only, and (d) older adults with both vision impairment and each of the comorbid conditions to examine the prevalence and effect of vision impairment and comorbid conditions on selected mobility and vision activity limitations, and participation restrictions. Using complex sample techniques to conduct frequency analyses and logistic regression procedures, this study compared these groups of older adults to document the likelihood of experiencing mobility and vision activity limitations, and participatory restrictions. </p><p> These results suggest that older adults reporting vision impairments are a heterogeneous population, overwhelmingly use corrective lenses, and experience substantial mobility and vision activity limitations, and participatory restrictions; however, relatively few report using low vision aids or rehabilitation services. In addition, these results revealed, even when controlling for age, sex, race/ethnicity, marital status, region of residence, and health status, older adults with vision impairment and any of the selected comorbid conditions were statistically significantly more likely to report mobility and vision activity limitations, and participation restrictions. Moreover, when comparing older adults reporting vision impairment co-existing with comorbid conditions older adults reporting either vision impairment only or a comorbid condition only, the results suggest vision impairment had the largest statistically significant effect on the likelihood of mobility or vision activity limitations, or participatory restriction in 29 of the 44 logistic regression analyses. These findings are significant as vision impairment is framed as a public health concern, and can inform improvements in programs and services for older adults. Finally, these findings highlight the need for expanded research examining the effect of specific eye diseases and comorbid conditions among older adults. </p>

<p> The purpose of this thesis was to examine the factors associated with psychological distress among older Vietnamese adults. Utilizing information from secondary data called the California Health Interview Surveys (CHIS), a quantitative research method was completed for this study. The study explored levels of psychological distress with several factors including demographic characteristics, language use and proficiencies of patients, patients' understanding of rights to request for an interpreter during doctor visits, number of visits to doctors' offices, language used by doctors during consultation (English, Vietnamese, or other), and lastly, quality of interaction with doctors. </p><p> The result of this study indicated significant relationships among several factors and the level of psychological distress among older Vietnamese adults. These factors, include: demographics, patients' understanding of rights to an interpreter, number of doctor visits, language used by doctors during consultation, and doctor-patient communication.</p>

<p> Older adults are particularly vulnerable to poorly designed environments. The built environment and its perceptions can potentially support or discourage this growing cohort to engage in outdoor activities. Municipalities can uniquely promote physical activity for this targeted population through their planning and design processes. This research explored neighborhood perceptions of older adults and how differing perceptions influence their decision to walk. The results confirm that neighborhood perceptions vary across participants. Older adults from rural, suburban, and urban communities report significantly different perceptions. Perceptions also vary by socio-demographic characteristics. While walking activity does not significantly differ across neighborhood types, some environmental perceptions are associated with specific walking behaviors. These relationships also vary by neighborhood type and socio-demographic variables. Interviews with older women confirm the presence of physical, personal, social, and temporal barriers and motivators to walking. The focus on environmental perceptions in this research offers policy makers, urban planners, engineers, public works officials, and public health providers with findings and recommendations that specifically address walking in older adults, a growing population uniquely affected by the environment.</p>

<p> The purpose of this study was to investigate the value of older adult volunteers in the workplace, specifically looking at the management and service delivery impact of the Long Beach Fire Ambassador Program on existing community relations efforts and employee morale, from the Command Staff perspective of the Long Beach Fire Department. The study identified seven themes that specified the value of Ambassador Program volunteers to management: supporting community relations, supporting employee morale, appreciation, extended family, pride, purpose, and significance. Ambassador and Program contributions to life safety and quality of life&mdash;for Ambassadors, their families, and the community at large&mdash;were also recurrently expressed. Results showed that older adult volunteers uniquely have much to offer and have an increasingly vital role in the workplace.</p>

<p> Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample <i>t</i> tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a significant predictor of perceived success for all participants. The relationship between the 2 variables was positive for Hispanic women and negative for non-Hispanics women. Diet and exercise also emerged as a significant direct predictor of perceived success in handling CVD when the variable of emotional support was controlled. Key findings also showed that, while Hispanic women had higher scores for perceived success in handling CVD, non-Hispanic women had higher emotional support scores. This study supports positive social change by highlighting the unique needs of Hispanic women to healthcare providers, relative to effective recognition and positive treatment regimens, if cardiovascular disease is suspected. Positive social change will be demonstrated with the recognition of better health outcomes for Hispanic women.</p>

<p> Individuals enrolled in both the Medicare and Medicaid programs, the "dually eligible," are generally vulnerable and face a wide range of health care needs; numerous studies have found that their health care is beset with problems of cost and quality. Health policy researchers find that these problems are directly associated with the inadequate coordination of benefits and services, but studies about care coordination have largely used quantitative approaches and focused on providers&mdash;they have not explored the critical perspective of patients receiving the care. To improve the complex processes of care coordination, this hybrid case study examines the experience of a sample of dual eligible enrollees served in North Carolina's patient centered medical home, and care managers. The subjects were generally independently living, and at lower-risk that typical dual eligibles. Although some experienced some continuity of care issues within NC's PCMH, generally they described receiving the right care, at the right time, in the right care settings. However, some experienced barriers to accessing necessary care, especially in the areas of prescription drugs and navigating the health care delivery system. Some of these challenges could potentially be resolved by NC's PCMH, but many issues are outside the program's control. Care managers who were interviewed suggested modifications to the Agency for Healthcare Research and Quality's Care Coordination Ring, which represents care coordination for a more stable, middle-class population than the dual eligibles they serve.</p>

<p> The purpose of this project was to locate a potential funding source and write a grant for an HIV/AIDS education programs for older Asian and Pacific Islander (API) adults. An extensive literature review was performed to investigate the need for HIV/AIDS prevention services and to expose barriers to the utilization of such services. </p><p> The proposed program will be held at AltaMed in El Monte, California, where there is a large diverse and underserved API population. The objectives include (1) increased knowledge of services, (2) increased knowledge of HIV/AIDS and the need for safe sex, and (3) empowerment to communicate about sexual matters with health care providers. By providing multilingual education programs, it is hope that the spread of HIV/AIDS will diminish among older API adults. The submission of this grant was not a requirement for the thesis project. </p>

<p> The purpose of this project was to locate a potential funding source and write a grant to provide home-based mental health services to Latino older adults for Beach Cities Health District, in Redondo Beach, California, the host agency for this program. An extensive literature review was conducted to investigate the best way to provide non-traditional therapeutic services to older adults. The Archstone Foundation was chosen as the most appropriate funding source. </p><p> The population of Latino older adults is expected to grow significantly in the coming years. Many in this population suffer from depression but fail to access services due to language barriers and other obstacles. This program was developed to improve knowledge of depression and improve coping skills, as well as reduce symptoms of depression. </p><p> If funded, this program could provide social workers an opportunity to bridge the gap the need for and the receipt of mental health services among older Latinos. Submission of the grant was not a requirement for the thesis project.</p>