Instrumental activities of daily living (IADL) limitations are known to have adverse effects on older adults’ subjective well-being (SWB). However, there is a dearth of research examining potential moderators of the relation between IADLs limitations and SWB. Drawing on the proactivity model of successful aging and the transactional model of stress, the present research aimed to investigate if different types of coping strategies would differentially moderate the relation between IADL limitations and SWB. Using a large-scale nationally representative dataset of midlife adults (N = 3,294) from the MIDUS 3 (Midlife Development in the United States) study, we found that problem-focused and emotion-focused coping differentially moderated the relations between IADL limitations, overall SWB, and the facets of SWB (i.e., life satisfaction, positive affect, and negative affect). Specifically, problem-focused coping alleviated the negative relation between IADL limitations and overall SWB, whereas emotion-focused coping aggravated this relation. Further analyses revealed that the attenuating and aggravating effects of problem-focused and emotion-focused coping, respectively, were driven by negative affect. Our findings suggest that enhancing the use of problem-focused coping strategies and reducing the use of emotion-focused coping strategies may buffer against SWB declines and increased negative affect in older adults facing IADL limitations.

Objectives: In recent years, increasing efforts have been made to apply arts- and culture-based strategies to public health concerns. Accumulating studies point to the value of these strategies for addressing social determinants of health in ways that center communities, cultures, and lived experiences. However, this work has lacked a common framework to support application and advancement. The objectives of this study were to examine knowledge, experience, and evidence related to uses of arts and culture in public health in the U.S., and to develop a pilot version of an evidence-based framework to guide cross-sector development and research.

Methods: Using a convergent mixed methods design with sequential elements, this study drew upon findings from a national field survey, seven focus groups, eight structured working-group dialogues, and a five-day structured dialogue and writing process with 12 interdisciplinary thought leaders. Data were integrated to develop a pilot evidence-based framework.

Results: The study identified six broad ways in which arts and culture can be used in public health, and 59 specific outcomes that can be addressed through arts and cultural strategies. The Framework identifies evidence supporting the effects of arts and culture on each outcome, along with mechanisms that may mediate or moderate these effects.

Conclusion: The pilot framework clearly links arts and culture practices with public health outcomes. In doing so, it provides both a resource for current practice and a model for continued development of interdisciplinary tools that support health researchers and practitioners in utilizing arts and culture resources to advance community health and health equity.

Background: Guided imagery is an evidence-based approach to tobacco cessation that can be delivered using telephone quitlines. Previous guided imagery interventions have not used scripts tailored to individuals. Reported here is a sub-study of a randomized feasibility trial that tested the impact of guided imagery compared to an evidence-based approach using a smokers quitline. The purpose of this study was to identify themes across guided imagery scripts developed by smokers in the guided imagery condition.

Methods: Fifty-six adults (Mean age = 46.6 years, 64% female) who completed up to 6 quitline sessions with a coach were part of this study. The guided imagery scripts were recorded and transcribed verbatim. Inductive and deductive analysis and the constant comparative method were used. The transcripts were independently coded by two team members and discrepancies were reconciled by a third member.

Results: Themes observed corresponded to the topic of each session. Sub-themes identified included: financial, health concerns, appearance, and relationships as reasons to quit; religion/spirituality and replacement activities as coping strategies for triggers; acceptance, being outdoors, confidence-building, and connection with others as strategies for coping with cravings and withdrawal; and appreciation of food and lifestyle changes for quit preparations and living smoke-free.

Discussion: These themes could be used to create guided imagery tobacco cessation programs and may help smokers who have difficulty creating images or scripts. They could also be used to create standardized scripts and audio files with the potential to reach large numbers of smokers.

Background/Purpose: Urban-dwelling indigenous older adults in Taiwan have poorer psychosocial well-being than their non-indigenous counterparts, resulting from factors related to their experiences of marginalization, such as migration from tribes to urban centers, social isolation, and disconnection from nature and land. Following the principles of indoor horticultural therapy, we developed a group-based intervention, aiming to promote mental well-being among indigenous older adults through reconnecting them with community and plants. The present study focuses on assessing the feasibility and acceptability of this intervention.

Methods: We first identified and contacted the organizations providing social services to indigenous communities in urban areas to collect feedback from the stakeholders and adjusted our intervention accordingly. We then recruited indigenous older adults from these organizations to participate in our one-time group intervention, which typically consisted of 10-12 older adults and lasted for 1.5-2 hours in the community center. The activities included mindfulness practice, mindful interactions with plants widely used in indigenous cuisine, creation of personal moss-ball bonsai, self-reflections on their relationships with the selected plants, as well as sharings of thoughts and emotions arising from the activities. All the group sessions were facilitated by a registered horticultural therapist, with interns providing support and documenting participants’ engagement and expressed emotions. After each session, we debriefed with local stakeholders, including service providers and opinion leaders and randomly invited participants for exit interviews. We analyzed qualitatively the information from all the sources.

Results/Outcomes: From May to July 2023, we hosted five sessions in three different communities in Taipei metropolitan area, with a total of 55 older adults participating in the intervention. First, the indoor horticultural activities were well received by the participating older adults. Even though a few participants were less engaged, most of them actively participated and showed great enjoyment during and after the group sessions. Participants also expressed that the activities made them feel connected to the nature and land which they missed substantially after moving to urban areas. Second, indoor horticultural activities appeared to be feasible for indigenous older adults. Most of them were able to fully participate in all designed activities even though a few of them had some functional limitations and intermediate level of Chinese language. However, there were some barriers for their participation and engagement, including the schedule conflicts with other personal and community activities and caregiving duties for their family members. Also, although participants felt satisfied and supported after the intervention, the single session intervention may not be enough to sustain improvements in their mental health and well-being. Finally, stakeholders also voiced their concerns over the continuity of the intervention, citing the unmet mental health needs may not be easily met by this one-time intervention.

Introduction: Acute kidney injury (AKI) is a sudden episode of kidney failure or kidney damage that happens within a few hours or days and can cause a build-up of waste products in the blood. Signs and symptoms differ depending on the cause and may include reduced urination, swelling in legs, fatigue, and shortness of breath, or the patient may be asymptomatic. If left untreated, AKI causes glomerulosclerosis - irreversible scarring of the glomeruli. Conventional management of AKI is aimed at preventing further insult, whereas integrative management focuses on improving renal function if possible. The purpose of this case report is to explore the effects that Acupuncture, Ayurveda, and Traditional Chinese Medicine can have on a patient with reduced kidney function due to AKI.

Methods: A 71-year-old male presented to his primary care physician with a rash, headache, fatigue, and excessive thirst. The diagnosis of herpes zoster was given with a treatment plan of Valtrex and blood tests were ordered to screen for diabetes. Testing revealed normal hemoglobin A1C, but elevated creatinine and a low estimated glomerular filtration rate (EGFR). A diagnostic ultrasonography of the kidneys returned with bilateral echogenicity. Referral to a nephrologist led to a diagnosis of nontraumatic acute kidney injury; management included hydration of 2-2.5l of water daily, B-vitamin formula, low salt diet, limited animal protein intake and avoidance of NSAIDs. The patient followed medical recommendations, and EGFR, creatinine, and blood urea nitrogen (BUN) began to improve, but not near normal limits. The patient continued to experience fatigue and sought treatment with a Doctor of Ayurveda. Examination revealed blood pressure 130/80mmHg; tongue pink, slightly thick white coating; pulse bilaterally overall weak but slightly slippery, weak in kidney position and Ayurveda pulse - vata was more predominant bilaterally. The patient was diagnosed with spleen Qi deficiency, kidney deficiency (Qi and yang) and mutra vikara (vrikka roga) - urinary (kidney dysfunction). Acupuncture at LI4, Liv3, S25, 36, Sp6, 9, 10 and Ren 9 was provided weekly once, with 20 minute needle retention and no stimulation. Orally, Chinese herbal medicine Ji Sheng Shen Qi Wan – 2 pills twice daily with warm water after food was administered. An Ayurvedic herbal tea made up of equal portions of punarnava and gokshura was also advised and the patient was instructed to drink barley water. At a follow-up appointment, the nephrologist recommended discontinuing herbal treatment out of concern that it might cause further renal damage, but the patient opted to continue.

Results: After twelve weeks post-diagnosis, renal function was gradually improving: creatinine was at 1.65 mg/dL (down from 2.48), EGFR was 44 mL/min/BSA (up from 27), and BUN was 21 mg/dL (down from 41). The patient reported no more fatigue.

Conclusion: An incidental finding of reduced renal function requires workup as patients with AKI may present with few to no symptoms. An integrative approach that included conventional and complementary approaches might have helped improve renal function in our patient. Second opinions are often advisable, and ample communication between conventional and integrative medicine clinicians is recommended.

This study investigated the correlation between the religiosity of Muslim healthcare providers and how often they advise on the use of a type of Complementary Alternative Medicine (CAM) called Prophetic medicine to their Muslim patients. A cross-sectional survey was administered to 191 healthcare providers in the United States that measured religiosity as the independent variable and CAM recommendations as the dependent variable. We used SPSS to conduct the analysis. The sample consists of 67.5 percent of South Asians, 67 percent males, and 28 percent working in primary health care. The result of the linear regression analysis indicates that the model fit was poor with an R-squared value of .105 and an R-value of .323. This suggests that religiosity explains only a small proportion of the dependent variable. However, simple linear regression was calculated to predict the CAM recommendations base on the religiosity of the health care providers, b=.32, t (189) =4.70, p<.001. A significant regression equation was found (F (189) = 22.090, p<.001, with R2 of .105. Additionally, religiosity scores were higher among healthcare providers who frequently advised on the use of Prophetic medicine. These findings are important for public health, as they suggest that religiosity may play a role in influencing healthcare providers’ attitudes and behaviors toward alternative medicine. However, further research is needed to understand the role of religiosity in more detail.

Healthy Washington Heights (HWH) culturally adapted the Touch, Caring, and Cancer (TCC) program to Touching Others Using Caring Hands (T.O.U.C.H) and partnered with churches and community organizations to serve the African American Community on the Southside of Chicago, IL. The program was created to follow a non-medical model that welcomed the community into the T.O.U.C.H program. In 2021, they held its first virtual T.O.U.C.H program. The virtual T.O.U.C.H program continued in 2022, with an addition of learning four Tai-Chi forms to provide a holistic care approach to improve the quality of life(QOL) and health among individuals with cancer and their caregivers. This program served to empower participants to care for themselves and others.

Methods:

Five total participants recruited from different cities included: 2 survivor-caregiver dyads and 1 cancer survivor/thriver. The program spanned over 4 consecutive days designed with two 2-hour sessions of touch techniques exploring various areas on the body and two 1-hour sessions of seated and/or stand Tai-chi. Self-reported surveys, daily feedback forms, and a virtual focus group captured an impact on QOL, fatigue, pain, and providing care.

Results:

Participants were 80% female with a diagnosis of breast or kidney cancer. Minimal to moderate impact was noted to improve nausea, fatigue, and stress among participants. However, no change was noted on the visual analog scale. Themes emerged around pre- and post-program impact. Sub-themes included communication, physical activity level, stress/anxiety, routines, and community. Participants emphasized integrating the program into their routine by stating “I had to make a schedule for us to, you know, loosely follow...and we'll have at least five to 10 minutes of sitting or standing Tai Chi in the morning”.

Conclusion:

Although participants showed no improvement in the VAS, they offered rich insight into the benefits of the touch techniques and tai-chi forms on their QOL. Overall, the T.O.U.C.H and tai-chi program positively impacted participants based on verbal feedback. Exploring T.O.U.C.H and Tai-Chi for cancer survivors/thrivers and their caregivers provided insight that quality care can be from the patient’s home, quality of life could improve through learned techniques, and participants can be empowered to be autonomous in their care or the care of their partner.

Background

Youth in the United States (U.S) are in a mental health crisis. Approximately 31.9% of school aged youth aged 5-17 suffer from mental health and anxiety disorders (Anxiety & Depression Association of America [ADAA], 2022). These mental health disorders can result in self-harm and suicide, as the 2016–2018 suicide rate among persons aged 10–24 in Louisiana alone was over 10 per 100,000 persons (Padmanathan, 2020). One factor that contributes to poor mental health outcomes among youth includes bullying, which involves unwanted physical and verbal and even online abuse and harassment, that is inflicted on any individual. (Stop Bullying, N.D.)

Methods

This intervention will include a cohort study in the form of 45-minute mindfulness elective class. The priority population will be 7th and 8 grade students at Audubon Charter elementary school. This site was chosen as the researcher has entre into the school community. The class will include a check-in where students move, connect to their breath and journal about their thoughts. Mindfulness sessions will also include ways to role-play scenarios to combat bullying in and out of the classroom.

Outcomes

The objective of the program is to decrease rates of anxiety and depression among 7^th and 8^th grade students, by providing them with coping skills that they can carry into their teenage and adult years. The outcome objective is to decrease rates of suicide among 7^th and 8^th grade students.

Conclusions

As the proposed intervention begins in September 2023 after the school year starts, there are no conclusions that can are available currently.

References

Anxiety & Depression Association of America. (2022, June 27). Anxiety Disorders- Facts &

Statistics. Facts & Statistics | Anxiety and Depression Association of America, ADAA

NAMI. (N.D.) Mental Health by the numbers. Retrieved from Mental Health By the Numbers | NAI: National Alliance on Mental Illness.

Padmanathan, P., Bould, H., Winstone, L., Moran, P., &amp; Gunnell, D. (2020). Social media use, economic recession and income inequality in relation to trends in youth suicide in high-income countries: A time trends analysis. Journal of Affective Disorders, 275, 58–65. https://doi.org/10.1016/j.jad.2020.05.057

SAMHSA. (N.D). What Is mental health? Retrieved from https://www.samhsa.gov/mental-health.

Stop Bullying. (N.D.) Laws, policies and regulations. Retrieved from What Is Bullying | StopBullying.gov

Early Childhood Education experiences a high staff turnover rate in spite of incentive programs intended to retain high quality teachers, (Caven, 2021, and U.S. Department of Education, 2016). Low job satisfaction and depressive symptoms, from financial woes working more than one minimum wage job may correlate with high staff turnover also, (Caven, 2021 and Roberts, A.M., Gallagher, Kathleen, C., Daro, Alexandra A., Iruka, Iheoma, U. Sarver, Susan L, 2019).

A set of logic models are derived after review of the Consumer Assessment of Health Providers Survey by AHRQ and New Vital Signs by Pfizer, and PEDS Quality of Life inventory, and Multicultural Assessments, informs an updated logic model for ECE provider and family navigation to where there may be opportunity for intervention to promote health literacy and parent health education for better parent child health outcomes for early education settings, mental health referrals, and utilization of health coaches.

The original model from Roy (2018) describes health literacy levels of parents of young children and their health seeking behavior as this relates to utilization of primary care, and child health outcomes for child BMI. The results then influence a trajectory that interacts with lower parental education, assessments, and referrals, to yield an unknown level of health seeking behavior. The second path depicts the possible association between lower parental health literacy and high child BMI interacting with parent education, screenings, and referrals, to yield another unknown level of health seeking behavior. The two groups are then compared, with differences in perception in quality of care as a possible mediating factor influencing frequency and utilization of pediatric primary care.” The model is then updated to reflect incorporating family navigation.

The conceptual model is updated again to reflect the level of professional development

seeking of ECE teachers by comparing the trajectory of federally funded or private pay ECE.

The conceptual model is updated again to reflect the level of professional development and cultural competence of ECE teachers by comparing the trajectory of federally funded or private pay ECE centers. ECE teacher demographics would compare with family demographics, plus assessment scores of level of ECE awareness for incentive programs/loan forgiveness programs/knowledge of how to complete child assessments and evidenced based

programs, instead of Health Literacy Score could indicate who most requires a professional

development intervention.

The intervention opportunity would be professional development training participation and human resources, career growth

options. Then ECE teacher or home visitors could complete a survey about their education and

wellbeing, and awareness levels of career options. Lower education would lead to likelihood to

utilize referrals to CDA scholarships and funding to earn higher education, resulting in

utilization of scholarships, loan forgiveness programs, and other funding streams to earn a

bachelors degree and correlated with job satisfaction and improved child health outcomes.