Background: With the global population aging rapidly, ensuring the autonomy and well-being of older adults living at home is paramount. Public health initiatives are instrumental in addressing the unique challenges faced by aging populations, aiming to enhance their quality of life and health outcomes.

Objective: This comprehensive review aimed to assess the effectiveness of public health interventions in promoting elderly independence through community-based approaches and policies. The study sought to identify the key components contributing to successful aging in place.

Methods: A comprehensive synthesis of evidence was conducted by systematically reviewing studies retrieved from MEDLINE/PubMed, Embase, Web of Science, CINAHL, Scopus, and PsycINFO. The review focused on public health initiatives designed to support elderly autonomy within their communities. Data extraction encompassed intervention types, outcomes, and levels of community engagement, with analysis conducted using thematic synthesis methods.

Results: The results demonstrated that successful aging-in-place programs were characterized by significant interventions, including home modification services, well-established social support networks, and accessible preventive health measures. Participants in these programs demonstrated significant improvements in physical health, mental well-being, and social connectivity, emphasizing the efficacy of public health initiatives in fostering elderly independence.

Conclusions: Public health initiatives play a crucial role in nurturing the independence of older adults, thereby addressing the evolving needs of aging populations. Future research should prioritize exploring scalable models and assessing long-term impacts to ensure sustained independence and health among elderly individuals.

Background: The Program of All-Inclusive Care for the Elderly (PACE) is an innovative model supporting functionally and medically vulnerable older adults (55 and older) living in the community, rather than in institutional settings. Rural residents are older, on average, than urban residents, and have unique assets and challenges related to supporting healthy aging. While most PACE organizations serve primarily urban populations, roughly 20 serve primarily rural older adults across the United States. Some rural-serving PACE organizations are headquartered in rural areas and others have an urban base but serve large swaths of rural areas. Better understanding how PACE is working in rural areas is critical to informing aging policy and practice.

Methods: We invited 19 rural-serving PACE organizations to participate in in-depth interviews designed to illuminate specific innovations and challenges related to providing PACE services in rural areas. To date, we have conducted 12 interviews, and we will use deductive content analysis to identify themes.

Results: Interviews have focused on innovations, assets, challenges, and opportunities related to providing PACE in rural areas. Specific focus areas include housing, transportation, and health care workforce.

Conclusions: Supporting the growing population of older adults in rural areas, most of whom want to age in place, requires comprehensive and innovative models. PACE is one such model, currently operating in 32 states around the U.S. However, more information is needed on how PACE operates in rural settings, given unique rural contexts. This presentation will provide that information, which can inform rural research, policy, and aging services.

Background: One in three older adults struggle to pay for regular expenses, with over 40% of households unable to weather an income loss and expense spike. Technology-assisted social care coordination is one strategy to connect individuals to community-based resources to address needs. This study uses cross-sector platform referral data to 1) describe common financial needs among individuals ages 65+ and 2) examine the relationship between demographic factors and resolution of financial needs.

Methods: A retrospective analysis was conducted using social care referral data of U.S. adults 65+ with at least one documented financial need from 2015-2023. Logistic regression analysis assessed the association between sociodemographic characteristics and resolved financial need requests.

Results: During the study period, we observed 27,892 adults (median age: 71 years) with at least one financial need. Of the 42,407 documented financial needs, top requests included SNAP/nutrition benefits (26.11% of adults), utility bill payment assistance (24.19%), emergency/one-time financial assistance (21.52%), rent/mortgage payment assistance (19.99%), and home expense assistance/repairs (12.74%). Results also show that women were slightly more likely to have a resolved financial need compared to men (OR: 1.08, p <0.01); when adjusted for age, race, ethnicity, military affiliation, and census region.

Conclusions: Data suggests that programs bridging short-term financial needs for adults 65+ can have an outsized impact. Some demographic groups are more likely to get income support, however, further research is required to gain an understanding of barriers and facilitators across sociodemographic groups.

Background: Older adults in Alaska make up the fastest growing population and face some of the greatest provider shortages in the country, suggesting an increased need to support older Alaskans in preventative health behaviors. Persuasive Hope Theory (PHT) suggests that eliciting feelings of hope may motivate people to make positive changes. Research also suggests that older adults may respond to positive, hopeful information that aligns with their desires and future goals.

Methods: We designed and delivered a 15-week, student-led health intervention using PHT to 39 older adults to increase feelings of hope and improve overall health. Our research question was: Did self-efficacy, fruit and vegetable intake, physical activity, self-rated health, or BMI improve significantly as a result of the program?

Results: Dependent sample t-tests revealed that the number of servings of fruit and vegetables consumed increased significantly after the program compared to before the program (p<.01). BMI was also statistically significantly lower after the program compared to before the program (p<.05). Participants’ self-rated health was also significantly higher after the program compared to before the program (p<.01). Unfortunately, there was no significant difference in self-efficacy, physical activity levels, or functional fitness over time.

Conclusions: Despite the use of a convenience sample, it was sufficiently powered (80%) and results indicate that the student-led intervention may have helped to decrease BMI and increase fruit and vegetable intake and self-rated health among the sample population, which can serve as a model for other intergenerational healthy aging initiatives in our community.

Background

In rural Korea, where about 34% of counties face population extinction, older adults remain in agriculture as their children move to cities. However, upon entering long-term care, these older people face isolation due to limited resources. This study aimed to assess the multilayered care needs of older people in resource-limited rural areas and proposed recommendations for individual, community, and national efforts to mitigate the care deficit.

Methods

We conducted qualitative interviews to gather the care needs of 61 rural older adults, especially in areas known for population decline. Recruitment was done in collaboration with community partners using a purposive sampling. All the interviews were conducted face-to-face. Data were analyzed using a template analysis approach according to the WHO Integrated Care for Older People (ICOPE) Framework, guiding integrated health care for older people at clinical, service, and system levels.

Results

Utilizing a multi-layered framework, factors related to integrated care for older people were elucidated at clinical, service, and system levels, identifying 17 categories and 22 subcategories. At the clinical-level, factors related to the decline in an individual’s intrinsic capacity were included. At the service-level, caregiving personnel-related factors including paid and unpaid caregivers were involved, along with the quantitative and qualitative aspects of existing care services and coordination. At the system-level, service delivery systems, financial resources, and information systems emerged as significant factors associated with integrated care for older people.

Conclusions

Tackling unmet care needs requires coordinated engagement from individuals, communities, and government, as well as interdisciplinary collaborations from various sectors.