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This study assessed the effect of variables such as life satisfaction, self-rated health, social support and coping styles on subjective well-being. The level of subjective well-being was studied in a sample of Mexican elderly persons from the state of Yucatan in Merida (n = 122) with an age range of 60-93 years. The results in women show that coping styles predicts subjective well-being in negative affects. Moreover, self-perception of health, coping styles, and satisfaction with life are adequate predictors of the cognitive dimension of subjective well-being. Results in men show that satisfaction with life and coping styles predict the cognitive dimension of subjective well-being. Findings point to the importance of exploring psychosocial variables in older adults. / El presente estudio evaluó el efecto de las variables satisfacción con la vida, autopercepción de salud, apoyo social y estilos de enfrentamiento sobre el bienestar subjetivo. Se contó con una muestra de 122 adultos mayores mexicanos del Estado de Yucatán, en la ciudad de Mérida con un rango de edad de 60 a 93 años. Los resultados en mujeres muestran que los estilos de enfrentamiento son predictores del bienestar subjetivo en los afectos negativos. En cuanto a la dimensión cognitiva del bienestar subjetivo, la autopercepción de salud, los estilos de enfrentamiento y la satisfacción con la vida fueron predictores adecuados. En hombres, los resultados demuestran que la dimensión cognitiva del bienestar subjetivo fue predicha a partir de la satisfacción con la vida y los estilos de enfrentamiento. Los hallazgos muestran la importancia del profundizar y promover variables psicosociales en los adultos mayores. / Cette étude a évalué l’effet de la satisfaction de la vie, de l’auto-perception de la santé, du soutien social et des styles d’adaptation sur les variables de bien-être subjectif. Nous avons étudié le niveau de bien-être subjectif d’un échantillon de 122 Mexicains âgés de l’État du Yucatan, dans la ville de Mérida, âgés de 60 à 93 ans. Les résultats chez les femmes montrent que les styles d’adaptation sont des facteurs prédictifs du bien-être subjectif des affects négatifs, en termes de la dimension cognitive du bien-être subjectif, l’auto-perception de la santé, les styles de confrontation et de satisfaction avec la vie étaient des prédicteurs adéquats, tandis que chez les hommes, les résultats montrent que la dimension cognitive du bien-être subjectif est prévu de satisfaction de la vie et les styles d’adaptation. Les résultats montrent l’importance d’approfondir et de promouvoir les variables psychosociales chez les personnes âgées. / Este estudo avaliou o efeito de variáveis, satisfação com a vida, autopercepção de saúde, apoio social e estilos de coping no bem-estar subjetivo. o nível de bem-estar subjetivo foi estudado no estado de uma amostra de adultos mexicanos mais antiga do Yucatan em Merida (n = 122) com uma faixa etária de 60-93 anos. Os resultados em mulheres mais antiga mostram que os estilos de enfrentamento são preditores de bem-estar subjetivo em efeito negativo em termos da dimensão cognitiva do bem-estar de saúde subjetiva auto-avaliação, estilos e satisfação com a vida de enfrentamento foram preditores adequados em homens mais antiga resultados mostram que a dimensão cognitiva do bem-estar subjetivo está previsto a partir de satisfação com a vida e estilos de enfrentamento.

El proyecto nace de la problemática del adulto mayor olvidado y su necesidad de vivienda permanente, funcional y segura con espacios complementarios y adaptados a su movilidad. Este usuario, adulto mayor, es el enfoque del quehacer cotidiano dentro de la Residencia; sin embargo, el éxito de esta tipología recae en la convivencia de dos generaciones. Es por ello que el segundo usuario permanente es aquel joven independiente que busca residencia temporal. La Residencia Intergeneracional busca materializar un ambiente autónomo, pero a la vez especializado que funcione exitosamente con el usuario de apoyo, en relación al usuario dependiente. Enfermeros y jóvenes estudiantes pueden prestar su servicio para el cuidado del adulto mayor y este se convierta en un hogar temporal que los acoge mientras se encuentran estudiando o buscando un trabajo en la capital. La columna vertebral del proyecto es el puente en niveles múltiples integrados por dobles alturas y plataformas de ingreso a cada uno de los departamentos en esta residencia. Este eje articulador permite el recorrido de los usuarios, desde el bloque de bienvenida sobre la avenida Melgarejo y atraviesa la residencia en los niveles superiores hasta el segundo acceso en la calle 5. El adulto mayor como eje de diseño, requiere un programa completo y especializado dividido en salud, ocio y vivienda. La correcta organización de estos paquetes y los ejes de circulación directos permiten la convivencia libre de los peligros de la ciudad en un espacio en armonía. / The project stems from the problem of the forgotten older adult and their need for permanent, functional and safe housing with complementary spaces and adapted to their mobility. This user, older adult, is the focus of daily work within the Residence; However, the success of this typology lies in the coexistence of two generations. That is why the second permanent user is that young independent person seeking temporary residence. The Intergenerational Residence seeks to realize an autonomous environment, but at the same time specialized that works successfully with the support user, in relation to the dependent user. Nurses and young students can provide their service for the care of the elderly and this becomes a temporary home that welcomes them while they are studying or looking for a job in the capital. The backbone of the project is the multi-level bridge integrated by double heights and entrance platforms to each of the departments in this residence. This articulating axis allows users to travel, from the welcome block on Melgarejo Avenue and crosses the residence on the upper levels to the second access on 5th Street. The older adult as a design axis, requires a complete and specialized program divided into health, leisure and housing. The correct organization of these packages and the direct circulation axes allow the coexistence free of the dangers of the city in a space in harmony. / Tesis

L’éducation par les pairs est de plus en plus utilisée en promotion de la santé. Elle consiste à faire appel à des personnes pour offrir des interventions de prévention et de promotion de la santé (PPS) à leurs pairs. Une formation est généralement offerte aux pairs avant qu’ils débutent leur implication en PPS. Peu d’études ont examiné l’implantation de programmes de promotion de la santé (PPS) offerts par des pairs, ses déterminants et leurs mécanismes d’action. Cette thèse s’inscrit dans le cadre d’une étude quasi-expérimentale visant à évaluer les effets du programme Vivre en Équilibre (VEE), un PPS offert par des pairs ciblant la peur de tomber et ses conséquences sur la participation sociale des aînés. La thèse vise à développer et appliquer un modèle conceptuel des facteurs influençant l’implantation de programmes offerts par des pairs. Les objectifs spécifiques sont: 1) de développer un modèle conceptuel de l’implantation des PPS offerts par des pairs; 2) de documenter l’implantation de VEE; et 3) d’identifier les facteurs associés à son implantation. À la suite d’une recension des écrits, un modèle conceptuel de l’implantation des PPS offerts par des pairs a été élaboré en se basant sur des travaux conceptuels existants et en adoptant une conceptualisation des PPS en tant que systèmes complexes. Ce modèle postule que des facteurs liés aux individus, au programme et au contexte influencent l’implantation et suggère trois mécanismes (interactions, auto-organisation, processus d’adaptation) par lesquels ces facteurs agissent. Une étude de cas multiples a permis d’analyser l’implantation de VEE dans six résidences pour aînés du Québec. La population rejointe, la fidélité d’implantation, les adaptations, la réponse au programme et les facteurs associés à l’implantation du programme ont été documentés à l’aide de grilles d’observation, de journaux de bord, de fiches de présences, de questionnaires téléphoniques et d’entrevues réalisées auprès des pairs, des répondants de résidences et d’un sous-groupe de participants au programme. Une analyse intra- et inter-cas a permis d’identifier les facteurs associés à l’implantation et de les comparer au modèle élaboré. Au total, 71 aînés ont participé au programme. Les participants recrutés correspondaient majoritairement à la population ciblée par le programme. Les pairs ont offert toutes les activités du programme, mais ont rapporté avoir fait certaines adaptations. Le taux de participation (91%) et le niveau de satisfaction des participants, des pairs et des répondants des résidences étaient élevés. L’analyse révèle que des facteurs liés aux individus (ex. : attitudes des participants, expérience des pairs), au programme (ex. : qualité du contenu et du matériel, formation des pairs) et au contexte (ex. : climat d’implantation) ont influencé l’implantation du programme par le biais des mécanismes identifiés dans le modèle conceptuel. La thèse montre que VEE peut être implanté avec succès par des pairs aînés dans des résidences. Les résultats soutiennent aussi le modèle conceptuel élaboré dans le cadre de cette thèse. Ils apportent un éclairage sur les facteurs associés à l’implantation de VEE et guideront les chercheurs et les intervenants intéressés par l’implantation de PPS offerts par des pairs. / Peer education is increasingly being used in health promotion. In this strategy, peer leaders deliver health promotion programs (HPPs) to their peers. Peer leaders usually attend training before delivering HPPs. Few studies have examined the implementation of peer-led HPPs, along with their determinants and mechanisms of action. This thesis was undertaken as part of a quasi-experimental study aiming to evaluate the effectiveness of Vivre en Équilibre (VEE), a peer-led HPP targeting fear of falling and its consequences on older adults’ social participation. The purpose of this thesis is to develop and apply the implementation framework of peer-led HPPs. More specifically, the objectives are to: 1) develop a conceptual framework of peer-led HPPs; 2) document the implementation of VEE; and 3) identify the factors associated with its implementation. Following a literature review, a conceptual framework of peer-led HPPs was developed based on existing conceptual work and on complex systems theory concepts. This framework postulates that factors related to individuals, to the program and to the context influence implementation. It further suggests three mechanisms (interactions, self-organization, adaptation process) through which these factors may act. A multiple case study analyzed the implementation of VEE among six independent-living residences for older adults in Quebec. Program reach, fidelity of implementation, adaptations, responsiveness, and factors associated with implementation of the program were documented. Observation grids, peer leaders’ logbooks, attendance sheets, phone questionnaires and interviews (with peer leaders, activity coordinators of the residences, and a subgroup of program participants) were used to collect the data. Content analysis and case comparisons helped identify factors associated with implementation of VEE and compare them with the conceptual framework developed. Overall, 71 older adults participated in the program. Most participants corresponded to the program’s target population (i.e. older adults with fear of falling). Peers delivered all program content but adapted some elements. The participation rate (91%) and the satisfaction level of participants, peers and activity coordinators were high. The analysis revealed that some factors related to individuals (e.g., participants’ attitudes, peer leaders’ experience), to the program (e.g., materials and content quality, training) and to the organizational context (e.g., implementation climate) facilitated VEE implementation through mechanisms identified in the framework. This thesis shows that VEE can be successfully delivered by peer leaders in independent-living residences. The results also support the conceptual framework and shed light on factors associated with the implementation of VEE. These results can guide researchers and practitioners interested in implementing peer-led HPPs.

<div>Older adults aged 60+ represent the fastest growing segment of the US population, yet they are rarely seen as users of technology. Members of this age cohort often struggle with the material and conceptual requirements of computing—such as clicking small targets or remembering usernames and passwords for account logins—leading them to adopt technologies like smartphones and social media at much lower rates than their younger counterparts. Digital devices and interfaces are not typically designed with older adult users in mind, even though all users are always aging, and the “silver economy” represents a powerful, and often untapped, market for technological innovations. The little existing research in this area often conflates age with disability, framing elders according to a deficit model. While it is certainly important to consider the impacts that aging bodies have on technology use, they are not the sole factor shaping usage for older age cohorts. Moreover, if we reduce elder users to their “impairments,” we risk stereotyping them in ways that curtail design possibilities, as well as these users’ possibilities for full participation in digital life. For this reason, studies of technology users aged 60+ and their communities are necessary to shed light on the multifaceted needs of older age cohorts, and the interventions into technology design, documentation, and education that can help them reach their digital goals. </div><div><br></div><div>To build an understanding of the unique technology use of a group of the oldest Americans (aged 75+), as well as to assess their needs and desires for digital engagement, I conducted interviews and observations with computer users in a senior living community. Data collection revealed a great diversity of computing purposes and activities, ranging from social functions such as email and messaging, to managing finance and medicine, to art and design applications, and beyond. Moreover, participants’ accounts of how and where they developed their computing skills shed light on their motivations for engaging with technology, as well as their fears of technology’s intrusiveness. Analysis of participants’ performance on a series of digital tasks yielded insights into physical and cognitive factors, as well as a clear divide in forms of knowledge and mental models that older adults draw upon when attempting to engage with technology. To conclude, I provide recommendations for technology design and education, as well as future research to account for age as a factor mediating user experience.</div>

Thèse en cotutelle avec l'Université de Strasbourg. / Le vieillissement de la population nous amène à imaginer de nouvelles approches pour promouvoir la santé et le bien-être à un âge avancé. Les liens sociaux et la mobilité quotidienne jouent potentiellement un rôle important, mais ces dynamiques sont actuellement mal comprises. Cette thèse vise à explorer comment les réseaux sociaux des aînés s'intègrent dans leurs espaces d'activité, et comment les relations sociales, inscrites dans l'environnement spatial, sont associées au bien-être. La thèse explore les données de l’étude CURHA collectées au Québec au sein de la cohorte NuAge. La population d’étude comprend 183 aînés âgés de 79 ans et plus enquêtés en 2014 et 2015, habitant dans les régions de Montréal et Sherbrooke. Le premier volet de cette thèse est de nature méthodologique, et concerne le développement d’un module de questionnaire cartographique interactif permettant de recueillir à la fois des lieux d’activité réguliers et des relations sociales, ces deux niveaux d'information connectés en fonction des “personnes vues dans les lieux d’activités”. Ces données ont été représentées en réseaux bipartites, ce qui a permis de distinguer des structures en étoile formées d’un nœud central connecté à un ensemble de nœuds périphériques. Ces structures identifient d’une part un lieu où l’aîné voit plusieurs personnes, qui pour la plupart, ne sont rencontrées qu’en ce lieu, et d’autre part une personne centrale avec qui plusieurs activités sont réalisées, de manière relativement exclusive.  Le deuxième volet de la thèse porte sur les liens entre les relations sociales et le bien-être émotionnel. Les relations sociales peuvent être catégorisées en relations proches, personnelles, ou de camaraderie. Le nombre de camarades et la présence d’une relation proche sont positivement associés au niveau de bien-être émotionnel, tandis que le nombre de relations personnelles est associé négativement au bien-être émotionnel.  Le dernier volet décrit de manière plus détaillée la distribution des catégories de relations sociales au sein des structures en étoiles identifiées dans les réseaux bipartites. Les relations proches représentent la majorité des personnes qui sont rencontrées ou qui accompagnent les personnes âgées dans un grand nombre de lieux d’activités. La résidence primaire est un lieu de socialisation importante, tandis que les lieux non résidentiels semblent servir de cadre privilégié aux relations de groupes. Les relations personnelles sont plus fréquentes au domicile des participants que dans les autres lieux d'activités. Cette thèse montre que l'analyse de réseau offre un cadre utile pour étudier les relations sociales en rapport avec l'environnement géospatial. Elle met en lumière la concentration de la vie sociale des aînés dans un nombre restreint de lieux d’activités, ainsi que la distribution spatiale différentielle de catégories de relations sociales spécifiquement associée au bien-être émotionnel. Ces approches peuvent soutenir la compréhension des influences socio-environnementales et favoriser la santé et le bien-être des aînés. / The aging of the population leads us to imagine new approaches to promote health and well-being in old age. Social connections and daily mobility potentially play an important role, but these dynamics are currently poorly understood. This thesis aims to explore how older adults' social networks fit into their activity spaces, and how social relationships, embedded in the spatial environment, are associated with well-being. The thesis explores data from the Contrasted Urban settings for Healthy Aging (CURHA) study collected in Quebec within the NuAge cohort. The study population includes 183 older adults aged 79 years and older surveyed in 2014 and 2015, living in the Montréal and Sherbrooke regions. The first part of this thesis is methodological, and concerns the development of an interactive cartographic questionnaire module allowing to collect both regular activity locations and social relationships, those two layers of information connected by “people seen at activity locations”. These data were represented as bipartite networks, which allowed us to identify star-like structures formed by a central node connected to a set of peripheral nodes. These structures identify, on the one hand, a location where the older adult sees several people, most of whom he or she meets only in that place, and on the other hand, a central person with whom several activities are carried out, while being the only person seen in most of these locations. The second part of the thesis focuses on the links between social relationships and emotional well-being. Social relationships can be categorized into close relationships, personal relationships, or companionship. The number of companions and the presence of a close relationship are positively associated with emotional well-being, while the number of personal relationships is negatively associated with emotional well-being.  The final section describes in more detail the distribution of social relationship categories within the star-like structures identified within the bipartite networks. Close relations represent the majority of people who are met or accompany the elderly in a large number of activity locations. The primary residence is an important place of socialization, while non-residential places seem to serve as a privileged setting for group relations. Personal relationships are most common in participants' homes. This thesis shows that network analysis provides a useful framework for studying social relationships within the geospatial environment. It highlights the concentration of older adults' social lives in a limited number of activity locations, as well as the differential spatial distribution of social relationship categories specifically associated with emotional well-being. These approaches can help to understand the socio-environmental influences on older adults' health and well-being.

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Many older adults desire to maintain their quality of life by living and aging independently in their own homes. However, it is difficult for older adults to notice and track the subtle changes in their own abilities because these abilities can change gradually over a long period of time. Technology in the form of ubiquitous sensors embedded in objects in the home can play a role in keeping track of the functional abilities of individuals unobtrusively, objectively, and continuously over a long period of time. This work introduces a sensing technique called “task-based embedded assessment” that monitors how well specific tasks important for independence are carried out using everyday objects found in the home with which individuals regularly interact. Following formative studies on the information needs of older adults and their caregivers, a sensing system called “dwellSense” that can monitor, assess, and provide feedback about how well individuals complete tasks, such as taking medications, using the phone, and making coffee, was designed, built, and evaluated. Multiple longterm (over 10 months) field deployments of dwellSense were used to investigate how the data collected from the system could support greater self-awareness of abilities and intentions to improve in task performance. Presenting and reflecting on data from ubiquitous sensing systems such as dwellSense is challenging because it is both highly dimensional as well as large in volume, particularly if it is collected over a long period of time. Thus, this work also investigates the time dimension of reflection and has identified that real-time feedback is particularly useful for supporting behavior change, and longer-term trended feedback is useful for greater awareness of abilities. Traditional forms of assessing the functional abilities of individuals tend to be either biased, lacking ecological validity, infrequent, or expensive to conduct. An automated sensor-based approach for assessment is compared to traditional performance testing by a trained clinician and found to match well with clinician-generated ratings that are objective, frequent, and ecologically valid. The contributions from this thesis not only advance the state of the art for maintaining quality of life and care for older adults, but also provide the foundations for designing personal sensing systems that aim to assess an individual’s abilities and support behaviors through the feedback of objective, timely sensed information.

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