Understanding the implementation and sustainability needs of evidence-based programs for racial and ethnic minoritized older adults in under-resourced communities with limited aging services.

Aging Community health services Disease management Evidence-based practice Health equity Older adults

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
13 Apr 2024
Historique:
received: 24 07 2023
accepted: 28 03 2024
medline: 14 4 2024
pubmed: 14 4 2024
entrez: 13 4 2024
Statut: epublish

Résumé

Evidence-based programs (EBPs) for older adults effectively improve health outcomes. However, there is a limited understanding of the unique needs of service providers as they consider adopting, implementing, and maintaining programs for older minority adults in low-income communities with limited aging services. We conducted semi-structured interviews with key informants of community-based organizations (CBOs) to understand implementation and sustainability needs of CBOs within four racial and ethnically diverse Los Angeles County geographic areas. We performed thematic analysis of interview transcripts. Interviews were conducted with representatives from 25 senior-serving agencies providing aging-related EBPs. CBO representatives reported implementing EBPs in 8 domains: Falls Prevention (68%), Mental Health (64%), Caregiver Health (48%), Chronic Disease Management (48%), Diabetes Management (36%), Arthritis Management (28%), Physical Activity (24%), and Multiple Conditions Management (8%). Themes are presented using the six domains of the Bass and Judge framework for factors impacting successful and sustained EBP implementation. CBOs in low-income and diverse communities described unique challenges with tailoring interventions based on local community context (literacy, language), cultural context, and locally available resources (technology, safe community spaces, transportation) and faced resource-intensive administrative burdens through staff turnover, data collection, sustainable funding, and networking. Serving racial and ethnic communities has unique challenges that require tailored approaches and additional resources to ensure equitable access to EBPs for all communities. We describe suggestions for enhancing the effective adoption of EBPs among service agencies in under-resourced and diverse aging communities serving populations with aging-related health disparities.

Sections du résumé

BACKGROUND BACKGROUND
Evidence-based programs (EBPs) for older adults effectively improve health outcomes. However, there is a limited understanding of the unique needs of service providers as they consider adopting, implementing, and maintaining programs for older minority adults in low-income communities with limited aging services.
METHODS METHODS
We conducted semi-structured interviews with key informants of community-based organizations (CBOs) to understand implementation and sustainability needs of CBOs within four racial and ethnically diverse Los Angeles County geographic areas. We performed thematic analysis of interview transcripts.
RESULTS RESULTS
Interviews were conducted with representatives from 25 senior-serving agencies providing aging-related EBPs. CBO representatives reported implementing EBPs in 8 domains: Falls Prevention (68%), Mental Health (64%), Caregiver Health (48%), Chronic Disease Management (48%), Diabetes Management (36%), Arthritis Management (28%), Physical Activity (24%), and Multiple Conditions Management (8%). Themes are presented using the six domains of the Bass and Judge framework for factors impacting successful and sustained EBP implementation. CBOs in low-income and diverse communities described unique challenges with tailoring interventions based on local community context (literacy, language), cultural context, and locally available resources (technology, safe community spaces, transportation) and faced resource-intensive administrative burdens through staff turnover, data collection, sustainable funding, and networking.
CONCLUSIONS CONCLUSIONS
Serving racial and ethnic communities has unique challenges that require tailored approaches and additional resources to ensure equitable access to EBPs for all communities. We describe suggestions for enhancing the effective adoption of EBPs among service agencies in under-resourced and diverse aging communities serving populations with aging-related health disparities.

Identifiants

DOI: 10.1186/s12913-024-10925-0 PMID: 38614988
pubmed: 38614988
doi: 10.1186/s12913-024-10925-0
pii: 10.1186/s12913-024-10925-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

466

Subventions

Organisme : NCATS NIH HHS
ID : UL1TR001881
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1TR001881
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1TR001881
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1TR001881
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Yelba Castellon-Lopez (Y)

Department of Biomedical Sciences, Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA. yelba.castellon-lopez@cshs.org.

Savanna L Carson (SL)

Department of Medicine, Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Katherine T Ward (KT)

Department of Medicine, Section of Geriatrics, LAC/Harbor-UCLA Medical Center, Torrance, CA, USA.

Karina D Ramirez (KD)

Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Lynn Phan Vo (LP)

Department of Medicine, Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Tony Kuo (T)

Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Los Angeles County Department of Public Health, Los Angeles, CA, USA.

Teresa Seeman (T)

Department of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Stefanie D Vassar (SD)

Department of Medicine, Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Laura Trejo (L)

Los Angeles County Aging and Disabilities Department, Los Angeles, CA, USA.

Ellen Eidem (E)

Los Angeles County Department of Public Health, Los Angeles, CA, USA.

María P Aranda (MP)

USC Edward R. Roybal Institute on Aging, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA.

Arleen F Brown (AF)

Department of Medicine, Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Classifications MeSH