The paper underscores the relevance of preventive and well health practices for older adults, given the current potential for extended life spans. One model for health promotion interventions consists of self-care skills, emotional and spiritual integration, and social integration. It was based on research in which older adults identified dimensions of everyday well-being.
Health promotion outcomes with older adults are characterized increasingly in terms of several effects. The outcomes of a health-promotion intervention with a group consisting of a majority of African-American older women were evaluated after six months. The study employed a quasi-experimental design with intervention and control groups all living in the area of a midwestern city with the highest proportion of low-income and non-Caucasian elders. Women in the intervention group participated in weekly group meetings over 26 weeks. The intervention was derived from the ecologic well being model and incorporated content related to three areas of outcome evaluation: health practices, psychologic and spiritual well-being, and social integration. Interviews conducted prior to and on conclusion of the intervention incorporated four single-item qualitative measures and the following three instruments as outcome measures: the senior lifestyle inventory, the integration inventory, and the social integration subscale. Although no significant increases in outcomes were demonstrated over time for the intervention group, statistical analysis before and after the intervention did reveal significant contrasts among controls in relation to well-being, health practices, and life satisfaction, suggesting a preventive-maintenance effect for the participants.
Mary Breckinridge, founder of The Frontier Nursing Service, employed ethnographic methodologies--participant observation, interviewing and fieldwork--as foundation efforts toward construction of highly responsive health-service systems, developed under circumstances of duress, e.g. after World War I and pre-industrial Appalachia. In culturally representing the Appalachian, she drew upon two vast resources, her first-hand field experience as well as her considerable rhetorical skill. She narrated and described an enormity of selected 'realities' of Appalachian life with immediacy of detail and nonpatronizing sensitivity for 'insider' perspectives. In an era of transition with few indigenous cultural writers, Breckinridge capitalized on her family heritage in Appalachia, which further underscored the intimacy and authenticity of her accounts. As portrayed in her autobiography, crosscultural encounters of one kind and time or another supplied an infrastructure of longstanding meaning throughout her life. The final and lasting impression is that, in both skills and orientation, Breckinridge's were essentially those of the ethnographer.
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