Clinical trials and cohort studies are required to meet target recruitment of study participants within stipulated timelines, especially when the priority is to include populations traditionally unrepresented in biomedical research. By the third quarter of 2019, the University of Arizona‐Banner Health Provider Organization (UA‐Banner HPO) has enrolled > 30,000 core participants into the All of Us Research Program ( AoURP ), the research cohort of the Precision Medicine Initiative. The majority of enrolled participants meet the criteria for individuals under‐represented in biomedical research. The enrollment goals were calculated based on a target of 20,000 as set by the National Institutes of Health and our health provider organization achieved enrollment numbers between 17% and 86% above the targeted daily enrollment. We evaluated enrollment methods and challenges to enrollments encountered by the UA‐Banner Health Provider Organization into the AoURP . Challenges to enrollment centered around the need for high‐touch engagement methods, time investment necessary for stakeholder inclusion, and the use of purely digital enrollment methods especially in populations under‐represented in biomedical research. These challenges occurred at the level of the individual, provider, institutions, and community, and cumulatively impacted participant enrollment. Successful strategies for engagement and enrollment leveraged provider partners as advocates for the program. For high‐volume enrollment in clinical research, it is important to engage leaders in the healthcare setting, patient providers, and tailor engagement and enrollment to potential participant needs. We emphasize the need for precision engagement and enrollment methods tailored to individual needs.
For an organization to be customer centric and service oriented requires that it use each encounter with a customer to create value, leverage advanced technologies to design digital services to fulfill the value, and assess perceived value-in-use to continue to revise the value as customer expectations evolve. The adaptation of value cycles to address the rapid changes in customer expectations requires agile digital platforms with dynamic software ecosystems interacting with multiple actors. For public health agencies focused on population health, these agile digital platforms should provide tailored care to address the distinct needs of select population groups. Using prior research on aging and dynamic software ecosystems, this paper develops a template for the design of an agile digital platform to support value cycle activities among clinical and non-clinical actors, including population groups. It illustrates the design of an agile digital platform to support clients that suffer from delirium, using digital services that leverage Internet of Things, natural language processing, and AI that uses real-time data for learning and care adaption. We conclude the paper with directions for future research.
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Prejudice, discrimination, and negative stereotypes based on age (ageism) are long-standing and strongly implicated in poor health outcomes and limited access to health care for older adults. Recent writings suggest the COVID-19 pandemic raised the specter of ageism to an entirely new level. Do these observations reflect an exaggeration of “usual” ageism or a unique manifestation of intergenerational tension rooted in resentments of younger people concerning COVID-related disruptions in their lives believed to be primarily a function of older people’s vulnerability to the disease phenomenon? To address this question, the purpose of this study was to develop and test an instrument to measure ageist tendencies associated with the COVID-19 pandemic. Scale items, written to reflect attitudes about paternalism, inconvenience, and sacrifice, were assessed for content validity. Then the 12-item scale was administered to 227 undergraduate and graduate students in the health and social sciences. Analysis showed items have strong internal consistency and concurrent and discriminant validity. Importantly the scale explained unique variance over and above other standard measures of ageism. Ageism is deeply embedded in global and U.S. culture and strongly related to negative outcomes. This scale will assist researchers investigating the ageist consequences of the current pandemic and help us to monitor what could be long-term residual ageist effects of the COVID pandemic.
Burgeoning research on the effects of COVID-19 and university experiences in the U.S. tends to focus on transmission of COVID-19 virus or student-related consequences of COVID-19. However, none to our knowledge examine the effects on older university employees. Universities employ a higher percentage of older adults with diverse job responsibilities and socioeconomic status, presenting a unique closed community for understanding the pandemic’s consequences for older adults. Our aims are to: 1) understand older university employees’ concerns related to COVID-19, 2) develop intervention strategies to mitigate the adverse impact of the COVID-19 pandemic on the health and wellbeing of older employees, and 3) test the interventions within the target population to help reduce stress and promote wellbeing. Using a community participatory approach, we sought input from employees aged 50 and older at the University of Arizona. Mixed methods were used to collect qualitative (six focus groups; N= 24) and quantitative (online survey; N=1030) data. We conducted and evaluated a set of interventions (i.e., virtual Tai Chi and Qigong, walking exercises, and meditation) using focus group feedback, process evaluation, and outcome assessment with validated questionnaires on sleep quality, mindfulness and psychological wellbeing. Findings show that a significant percentage of older employees worried about getting COVID-19 and had experienced undesirable changes in sleep quality, weight, and physical activity, and concerns about caregiving; however, we also observed psychological resilience in this population. The study highlights the importance of developing immediate and effective programs for promoting health and wellbeing for older employees during the pandemic.
Most educational programs on aging target college students in disciplines which might provide services or work with older adults, such as medicine or social work, to the exclusion of students in high school. The purpose of this study is to better understand high school students and teacher's attitudes and perceptions regarding aging. Focus groups were conducted to collect data for this study. A total of 35 teachers and 55 students participated in the study. Findings indicate that attitudes about aging are both positive and negative, however there is a consensus among both teachers and students that incorporating aging into the high school curriculum would be beneficial. Teachers are in need of strategies to incorporate aging education into the high school curriculum, as there are many barriers. Results from this study can be used to aid in the development of educational modules designed to incorporate aging content into the curriculum.
College students in disciplines that might provide services or work with older adults, such as medicine or social work, are usually the target of most educational programs on aging. High schools provide an untapped opportunity to engage students earlier. This project is the next step following a pilot study conducted in New Jersey and Kentucky to better understand high school students’ attitudes and knowledge regarding aging. That study also reviewed current high school curriculum for aging-specific content and perceived barriers among teachers to incorporating aging education into the curriculum (Davis & Sokan, 2019). Study findings indicate inter alia, a need to educate high school students about aging, increase interactions among older and younger adults, incorporate education about careers on aging, and educate teachers on how to infuse more aging content into their courses. To that end, this project’s goal was to develop both a training module and educational program on aging for high school students. Also, we propose a plan to develop, implement, and evaluate both the training module and the educational programs. We hypothesize that the training module will increase high school teachers’ confidence in their ability to teach their students about aging. The educational program’s delivery will increase students’ knowledge of aging-related issues and awareness about careers in aging. Upon completing the project, we will use feedback from students and teachers to revise the educational program, for implementation among a larger sample of high schools.
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