The moderating role of trust in pandemic-relevant institutions on the relation between pandemic fatigue and vaccination intentions

Journal of Health Psychology, Ahead of Print.
This research helps to clarify the relation between pandemic fatigue (PF) and vaccination intentions (VI). Theoretically, two patterns seem plausible. First, as with any other health protective measure, PF might reduce the motivation to get vaccinated. Second, PF might increase the motivation to get vaccinated because vaccination reduces the number of (other) health protective measure needed. We tested these two opposing predictions and further explored the moderating role of trust in pandemic-relevant institutions on the link between PF and VI in two large-scale survey studies from Denmark and Germany (collected between 2020 and 2021; total N > 22,000). Data was analyzed using multiple regression models. Analyses reveal a negative link between PF and VI that is less pronounced for people high in trust. Results remain stable when accounting for covariates and quadratic trends. Thus, trust might buffer the negative relation between PF and VI.

Resistance in Supervision: A Qualitative Study of Training Experiences Among Multiethnic Women

The Counseling Psychologist, Ahead of Print.
Psychology trainees operate in high stress environments and supervisees with multiple marginalized identities, such as multiethnic women, must also navigate and/or resist discrimination. Resistance as a tool against oppression (positive resistance) is an emerging concept in psychology. Consensual qualitative research method was used to explore the ways multiethnic women engage in resistance during the supervision process. The central research question was, “How do multiethnic women engage in resistance to gender- and ethnicity-based inequities during supervision?” Participants (N = 12) identified as multiethnic women who were in, or had recently graduated from, clinical or counseling psychology programs. Participants sat for a 60–90 minute interview. Analyses of the interview transcripts yielded the primary domain, Resistance, and three subdomains: Motivation for Resistance, Capability for Engagement, and Forms of Resistance. Implications for supervision with women are discussed, including ways that supervisors may encourage and respond to positive resistance in the training of diverse future psychologists.

Validating the Negative Context of Reception Scale for Mainland Puerto Ricans

The Counseling Psychologist, Ahead of Print.
This study examined the extent to which the Negative Context of Reception Scale generates valid and reliable scores with Puerto Rican Hurricane Maria survivors. A sample of 319 adult Hurricane Maria survivors completed measures of the negative context of reception, discrimination, language stress, depressive and anxiety symptoms, optimism, and life satisfaction. Confirmatory factor analyses (CFAs) indicated that the previously validated one-factor solution fit the data adequately, and multigroup invariance tests indicated that this solution fit largely equivalently across gender, age groups, year of arrival in the United States, and self-reported English proficiency. Negative context of reception was correlated positively with discrimination and language stress, positively with symptoms of depression and anxiety, and negatively with optimism and life satisfaction. It may be important to adjust item order to reduce intercorrelations among some item responses. This study offers an instrument that counselors can use with Hurricane Maria survivor clients.

Beyond Dichotomy and Stability: ICT Use Among Asian American Older Adults During the COVID-19 Pandemic

Journal of Applied Gerontology, Ahead of Print.
This study examined the effect of the COVID-19 pandemic on information and communications technology (ICT) use and the typology of ICT users among older Chinese and Korean Americans. Survey data were collected from 513 Chinese and Korean older adults in New York City. We measured ICT use for social contact, grocery shopping, health care, and COVID-19 information seeking. In the study sample, ICT use for online shopping with others, contact with doctors, and telehealth significantly increased during the pandemic. Three groups of ICT users were identified: limited, users, expanding users, and active users. Older Chinese Americans and those with better English proficiency were more likely to be expanding and active ICT users. The patterns and heterogeneity of ICT use among older Asian Americans are multifaceted and dynamic beyond dichotomy and stability. The findings of this study offer helpful guidance for future development of ICT-based interventions for older Asian Americans.

Internet Use in Very Old Age: The Role of the Social Context and Individual Characteristics

Journal of Applied Gerontology, Ahead of Print.
The social context plays an important role in very old age. However, little is known about its relationship with internet use, whereas individual characteristics (e.g., sociodemographic variables, and health status) are better studied. Still, representative studies for the oldest old are missing. Therefore, this study analyzes the relationship between social context variables and individual characteristics with internet use in a representative sample of oldest old from North Rhine-Westphalia, Germany (N = 1,862; Mage = 85.43, SDage = 4.15). Descriptive statistics reveal differences between oldest old onliners and offliners regarding their social context and individual characteristics. Logistic regression analyses show that the significant role of the social context (family and living situation, social contacts and activities) diminishes after adding individual characteristics to the model, which appear to be significantly related to internet use. The results indicate an association of social context variables and individual characteristics with internet use in very old age.

Impacts of COVID-19 on Health and Healthcare for Rural Veterans in Home-Based Primary Care

Journal of Applied Gerontology, Ahead of Print.
This qualitative study explored the impact of COVID-19 on older rural-dwelling veterans and their caregivers enrolled in home-based primary care (HBPC) through the Birmingham VA Health Care System (BVAHCS). Phone interviews were conducted with 16 veterans and/or their caregivers and rapid qualitative analysis of interview notes was performed. Average age of veterans was 77 (range = 69–97) and 93.7% were white males. Despite a significant number of co-morbidities, 68.8% reported minimal adverse impacts of COVID-19 on overall physical and mental health. Like many healthcare teams, the inter-disciplinary VA HBPC team incorporated Telehealth during COVID-19. Telehealth utilization varied among the 16 participants, with 50% using telehealth independently, 37.5% needing assistance, and 12% lacking access. Our findings are consistent with prior research that identifies resilient characteristics as potentially protective in this high-risk older veteran population during the COVID-19 pandemic.

Exploring Differences in Home Modification Strategies According to Household Location and Occupant Disability Status: 2019 American Housing Survey Analysis

Journal of Applied Gerontology, Ahead of Print.
Home modification is essential in helping older adults age in place safely and independently. The purpose of this study was to examine the impact of housing location and disability status on home modification projects among older adults using the 2019 American Housing Survey Data. The study found that recent home modification strategies were significantly different according to older adults’ housing locations and health status. Older adults in non-metropolitan areas and with disability were less likely to make home modifications, and when they did so, they spent less money on the modifications. The findings highlight the importance of providing adequate home modification programs and resources for home modifications, as well as support and education from community organizations, particularly for older adults in non-metropolitan areas. The results of this study can assist in developing housing policies and guidelines to address these current and future challenges in home modification implementation for the aging population.

Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey

Journal of Applied Gerontology, Ahead of Print.
This study explored differences among older adults in mental health by sexual minority status. Data came from the 2021 U.S. National Health Interview Survey. The study sample included older adults (or those aged ≥50 years, N = 15,559), and of those, two percent (n = 380) self-identified as lesbian, gay, or bisexual (LGB). Older LGB adults had significantly higher odds of reporting a diagnosis of depression and anxiety and experiencing serious psychological distress than older non-LGB adults. Additionally, older LGB adults reported higher odds of experiencing depression and anxiety more frequently than older non-LGB adults. Significant covariates included age, sex, housing, food security, and social support. Increased risk for mental illness may be long-term consequences of stigma and discrimination that this population has experienced over the life course. The combination of structural interventions and affirming mental healthcare that recognizes the cumulative negative experience among older LGB adults is necessary to achieve mental health equity.

Improving Older Adults’ Functional Health Using the Progressive Stay Strong, Stay Healthy Program

Journal of Applied Gerontology, Ahead of Print.
This study assessed the Stay Strong, Stay Healthy (SSSH) level two resistance training program in 406 older adults (69.3 ± 8.1 years). SSSH included 10 exercises completed during 60 minute sessions, which were offered twice weekly for eight weeks. 30-second sit-to-stand (30STS), timed-up-and-go (TUG), flexibility, and balance poses were completed pre/post-SSSH. Paired t-tests with Bonferroni corrections showed the whole group improved 30STS, TUG, flexibility, and total balance scores over time (p < .001). Repeated measures analyses of variance showed both geography and age groups improved 30STS, TUG, flexibility, and total balance scores over time (all time effects p ≤ .039). Independent t-tests showed rural participants improved to a similar or greater absolute extent than their urban neighbors for nearly all measures and all age groups improved to a similar absolute magnitude over time. This study demonstrates SSSH level two improves physical function in older adults and these benefits are similar across geography and age groups.

Person-Centered Home Care: Exploring Worker-Client Relationships Using an Intersectional and Critical Disability Framework

Journal of Applied Gerontology, Ahead of Print.
More research is needed into how “person-centered care” (PCC) manifests in home care (HC) worker-client relationships. Qualitative data were collected at three time points from twelve HC workers and others to better understand how approaches to care shape the pathways of older adult HC clients with chronic conditions in two Canadian health jurisdictions. This paper uses critical disability and intersectionality frameworks to highlight ways in which PCC enables social and instrumental benefits for workers’ and clients. It also exposes difficulties in being flexible and developing interpersonal relationships because of HC policies. Workers also acknowledged risks when trying to prioritize client preferences, sometimes drawing distinctions between reasonable and unreasonable demands. Implications for enhanced training and support for workers around navigating flexibility and boundaries and using a relational approach to PCC are discussed, as are implications for policy-making that protect all parties.