In services, which require significant customer participation to create value, customers who lack the knowledge, skills and motivation necessary to participate effectively can negatively impact service quality and cost outcomes. This paper develops a conceptual model to investigate the effectiveness of utilizing customer training and education (CTE) to improve customer readiness to provide effective behaviors in a professional service. The model was tested using survey data from patients diagnosed with diabetes who received CTE as part of their healthcare service. We found that customers who are taught why they have to perform the tasks, have higher levels of motivation to perform these tasks effectively. Further, as proposed by the customer readiness model, when their task performance is higher, they have improved health and lower healthcare costs.

This study elicited perceptions about physical activity in 28 older rural and low-income women (27 were Caucasian) in four focus groups to identify factors that affected their physical activity levels. This population is greatly understudied and underserved. Overall, themes that surfaced across the groups were consistent with social cognitive theory. Prominent themes included outcome expectations about both physical and mental benefits; beliefs about the sources of motivation to be physically active, including both internal sources and external sources; barriers to being active; and the types of social environments important for physical activity. These findings provide useful information regarding the types of physical activity programs preferred by rural, low-income older women and ways to build self-efficacy and social support among members of this population group with regard to increasing physical activity.

Caregivers of Alzheimer's patients find respite in online communities for solutions and emotional support. This study aims to understand the characteristics of information caregivers of Alzheimer's patients are searching for and the kind of support they receive through Internet-based peer support communities. Using a Web crawler written in Python Web programming language, we retrieved publicly available 2,500 random posts and their respective solutions from April 2012 to October 2016 on the solutions category of the Caregiver's Forum on ALZConnected.org . A content analysis was conducted on these randomly selected posts and 4,219 responses to those posts based on a classification system were derived from initial analyses of 750 posts and related responses. The results showed most posts (26%) related to queries about Alzheimer's symptoms, and the highest percentage of responses (45.56%) pertained to caregiver well-being. The LIWC analyses generated an average tone rating of 27.27 for the posts, implying a negative tone and 65.17 for their responses, implying a slightly positive tone. The ALZConnected.org Web site has the potential of being an emotionally supportive tool for caregivers; however, a more user-friendly interface is required to accommodate the needs of most caregivers and their technological skills. Solutions offered on the peer support groups are often subjective opinions of other caregivers and should not be considered professional or comprehensive; further research on educating caregivers using online forums is necessary.

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Background:The purpose of the described exploratory study was to test proactive strategies for enhancing engagement and cognitive ability while diminishing dementia-related disordered behaviors of those diagnosed with Alzheimer’s disease and other dementias. Study participants resided in an Memory Care unit of an assisted living community.Method:The researchers measured the effects of exposure to music and nature images on engagement using the Individualized Dementia Engagement and Activities Scale tool, on cognitive ability using the Montreal Cognitive Assessment, and on agitation using the Cohen-Mansfield Agitation Inventory.Result:The within-subject study design revealed that use of both music and nature images hold promise for reducing undesirable behaviors and improving engagement of residents.Conclusion:The authors suggest caregivers for those with Alzheimer’s disease and other dementias can effectively use nature images and music to improve engagement and reduce disordered behaviors, thus potentially enhancing quality of life for the care recipient as well as the caregiver while possibly reducing the costs of medications used to control dementia-related undesirable behaviors.

The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition) were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19). The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

These data were used to identify strategies and messages to enhance adherence to nutrition and activity recommendations for persons with type 2 diabetes and accompanying cardiovascular risk factors.

Older adults prefer to age in place (AIP), and there are psychological, physiological, and economic benefits in doing so. However, it is especially challenging to AIP in rural communities. AIP models have been tested in urban settings and age-segregated communities, but they are not appropriate for rural communities. This paper presents rural AIP variables identified in the literature as well as those described by 39 older adults in five focus groups.Older adults prefer to stay in their familiar homes and communities (i.e., age in place). Despite their intentions, older adults move for various reasons such as diminishing health status, economic hardships, poor housing quality, and lack of support services and care giving. Rural elderly have a particularly strong ''attachment to place''