Journal of the American Geriatrics Society最新文献

{"title":"Implementation of delirium screening in the emergency department: A qualitative study with early adopters","authors":"Anita N. Chary, Annika R. Bhananker, Elise Brickhouse, Beatrice Torres, Ilianna Santangelo, Kyler M. Godwin, Aanand D. Naik, Christopher R. Carpenter, Shan W. Liu, Maura Kennedy","doi":"10.1111/jgs.19188","DOIUrl":"https://doi.org/10.1111/jgs.19188","url":null,"abstract":"IntroductionDelirium affects 15% of older adults presenting to emergency departments (EDs) but is detected in only one‐third of cases. Evidence‐based guidelines for ED delirium screening exist, but are underutilized. Frontline staff perceptions about delirium and time and resource constraints are known barriers to ED delirium screening uptake. Early adopters of ED delirium screening can offer valuable lessons about successful implementation.MethodsWe conducted semi‐structured interviews with clinician‐administrators leading ED delirium screening initiatives from 20 EDs in the United States and Canada. Interviews focused on experiences of planning and implementing ED delirium screening. Interviews lasted 15 to 50 minutes and were digitally recorded and transcribed. To identify factors that commonly impacted implementation of ED delirium screening, we used constructs from the Consolidated Framework for Implementation Research (CFIR), an Implementation Science framework widely used to evaluate healthcare improvement initiatives.ResultsOverall, notable facilitators of successful implementation were having institutional and ED leadership support and designated clinical champions to longitudinally engage and educate frontline staff. We found specific examples of factors affecting implementation drawn from the following seven CFIR constructs: (1) intervention complexity, (2) intervention adaptability, (3) external policies and incentives, (4) peer pressure from other institutions, (5) the implementation climate of the ED, (6) staff knowledge and beliefs, and (7) engaging deliverers of intervention, that is, frontline ED staff.ConclusionImplementing ED delirium screening is complex and requires institutional resources as well as clinical champions to engage frontline staff in a sustained fashion.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in opioid prescriptions by race among U.S. older adults with a hip fracture transitioning to community care","authors":"Kaleen N. Hayes, Meghan A. Cupp, Richa Joshi, Melissa R. Riester, Francesca L. Beaudoin, Andrew R. Zullo","doi":"10.1111/jgs.19160","DOIUrl":"https://doi.org/10.1111/jgs.19160","url":null,"abstract":"BackgroundAppropriate pain management can facilitate rehabilitation after a hip fracture as patients transition back to the community setting. Differences in opioid prescribing by race may exist during this critical transition period.MethodsWe conducted a retrospective cohort study of older adult U.S. Medicare beneficiaries with a hip fracture to examine whether the receipt and dose of opioids differs between Black and White patients as they transitioned back to the community setting. We stratified beneficiaries by whether they received institutional post‐acute care (PAC). Outcomes were (1) receipt of an opioid and (2) opioid doses in the first 90 days in the community in milligram morphine equivalents (MMEs; also presented in mg oxycodone). We estimated relative rates and risk differences of opioid receipt and dose differences using Poisson and linear regression models, respectively, using the parametric g‐formula to standardize for age and sex.ResultsWe identified 164,170 older adults with hip fracture (mean age = 82.7 years; 75% female; 72% with PAC; 46% with opioid use after fracture). Overall use of opioids in the community was similar between Black and white beneficiaries. Black beneficiaries had lower average doses in their first 90 days in both total cumulative doses (PAC group: 165 [95% CI −264 to −69] fewer MMEs [−248 mg oxycodone]; no PAC: 167 [95% CI −274 to −62] fewer MMEs [−251 mg oxycodone]) and average MME per days' supply of medication (PAC: −3.0 [−4.6 to −1.4] fewer MMEs per day [−4.5 mg oxycodone]; no PAC: −4.7 [−4.6 to −1.4] fewer MMEs per day [−7.1 mg oxycodone]). In secondary analyses, Asian beneficiaries experienced the greatest differences (e.g., 617–653 fewer cumulative mg oxycodone).ConclusionRacial differences exist in pain management for Medicare beneficiaries after a hip fracture. Future work should examine whether these differences result in disparities in short‐ and long‐term health outcomes.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover","authors":"Kathleen T. Unroe MD, MHA, MS,&nbsp;Debra Saliba MD, MPH, AGSF,&nbsp;Susan E. Hickman PhD,&nbsp;Sheryl Zimmerman PhD,&nbsp;Cari Levy MD, PhD,&nbsp;Jerry Gurwitz MD","doi":"10.1111/jgs.17869","DOIUrl":"https://doi.org/10.1111/jgs.17869","url":null,"abstract":"<p><b>Cover caption</b>: Key elements for successful nursing home clinical trials. See the related article by Unroe et al., pages 2951–2956.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142123134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Thank You to JAGS Reviewers","authors":"","doi":"10.1111/jgs.19137","DOIUrl":"https://doi.org/10.1111/jgs.19137","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141980309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover","authors":"Connie S. Cole PhD, DNP, RN-GERO, NP-C, ACHPN,&nbsp;C. Robert Bennett PhD, CPNP-AC,&nbsp;Joan G. Carpenter PhD, CRNP, ACHPN, FPCN,&nbsp;Regina M. Fink PhD, APRN, CHPN, AOCN, FAAN,&nbsp;Amy Jackson BSN,&nbsp;Kathleen T. Unroe MD, MHA, MS,&nbsp;Cari R. Levy MD, PhD","doi":"10.1111/jgs.17866","DOIUrl":"https://doi.org/10.1111/jgs.17866","url":null,"abstract":"<p><b>Cover caption</b>: Domains of screening for unmet palliative care needs in nursing home residents. See the related article by Cole et al., pages 2590–2594.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141980408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alzheimer's disease and related dementia diagnoses among American Indian and Alaska Native adults aged ≥45 years, Indian Health Service System, 2016–2020","authors":"Andria Apostolou PhD, MPH,&nbsp;Jordan L. Kennedy MSPH,&nbsp;Marissa K. Person MSPH,&nbsp;Eva M. J. Jackson MPH,&nbsp;Bruce Finke MD,&nbsp;Lisa C. McGuire PhD,&nbsp;Kevin A. Matthews PhD","doi":"10.1111/jgs.19058","DOIUrl":"10.1111/jgs.19058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alzheimer's disease is the most common type of dementia and is responsible for up to 80% of dementia diagnoses and is the sixth leading cause of death in the United States. An estimated 38,000 American Indian/Alaska Native (AI/AN) people aged ≥65 years were living with Alzheimer's disease and related dementias (ADRD) in 2020, a number expected to double by 2030 and quadruple by 2050. Administrative healthcare data from the Indian Health Service (IHS) were used to estimate ADRD among AI/AN populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Administrative IHS healthcare data from federal fiscal years 2016 to 2020 from the IHS National Data Warehouse were used to calculate the count and rate per 100,000 AI/AN adults aged ≥45 years with at least one ADRD diagnosis code on their medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study identified 12,877 AI/AN adults aged ≥45 years with an ADRD diagnosis code, with an overall rate of 514 per 100,000. Of those, 1856 people were aged 45–64. Females were 1.2 times (95% confidence interval: 1.1–1.2) more likely than males to have a medical visit with an ADRD diagnosis code.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many AI/AN people with ADRD rely on IHS, tribal, and urban Indian health programs. The high burden of ADRD in AI/AN populations aged 45–64 utilizing IHS health services highlights the need for implementation of ADRD risk reduction strategies and assessment and diagnosis of ADRD in younger AI/AN populations. This study provides a baseline to assess future progress for efforts addressing ADRD in AI/AN communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responding to a nursing mandate in long-term care: A multi-modal pilot curriculum for bachelor of science in nursing students","authors":"Glenda R. Westmoreland MD,&nbsp;Kathryn I. Frank RN, PhD,&nbsp;Emilie L. Garrison BA,&nbsp;Qing Tang MS,&nbsp;Julia Loubeau MSN, AGPCNP-C,&nbsp;Julie Krieger MSN, AGPCNP-BC,&nbsp;Sarah Hartman NP,&nbsp;Sarah Roth MHA, MPH, PMP, CCRP,&nbsp;Debra K. Litzelman MA, MD, MACP","doi":"10.1111/jgs.19089","DOIUrl":"10.1111/jgs.19089","url":null,"abstract":"<p>On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) released new guidelines for staffing long-term care (LTC) in the U.S. responding to the Executive order from President Biden. The order requires improvement in the quality of care for 1.2 million residents of LTC facilities, most of whom are older adults.<span>¹</span> These guidelines mandate in-facility presence of registered nurses round-the-clock, seven-days-a-week and enhanced presence of nurse's aides who have training to meet the complex care needs of LTC residents.<span>¹</span> Expanding the currently inadequate nursing workforce in LTC is critical. Comprehensive review of the literature found that including geriatrics and LTC content in undergraduate nursing students' curriculum through clinical placements effectively enhanced their competence in these content areas.<span>²</span></p><p>We developed a new geriatrics curriculum for Bachelor of Nursing Students (BSN) that included content as the 4Ms of Age Friendly Care coupled with LTC content.<span>³</span> Learners completed the multi-modal curriculum, which included an online component, at their own pace. In the absence of real patients through clinical placements, interacting with standardized patients (SPs) is another actionable teaching model. Research by the National Council for the State Boards of Nursing found that replacing traditional clinical hours with high-fidelity simulated experiences are effective in nursing curriculum.<span>⁴</span> After completing our multi-modal curriculum, learners applied the content using virtual SPs. Our program is the first of its kind where use of “virtual SPs” means the SPs were live, but students were interacting with them through a virtual platform. After the interaction students received feedback from the SP and a faculty member who was also observing the interaction through Zoom.</p><p>Our new curriculum used multiple modalities including locally and nationally developed web modules on geriatrics topics, myths of aging, advanced care planning, and LTC and videos on dementia and the 4Ms. Students completed the roughly 10-h curriculum at their own pace. Our objectives focused on students defining the 4Ms, applying them to a LTC population, and having exposure to LTC as a potential new career option.</p><p>Student evaluation included: (1) pre- and post-knowledge assessment (using the Alzheimer's Disease Knowledge Scale and web-based module questions); (2) attitude assessment (using the Kogan's Attitude Toward Older People Scale and the Four-Domain Sense of Competence in Dementia Care Staff); and (3) skills using four virtual standardized patient scenarios developed by the investigators. Investigators trained SPs on the scenarios. Training was repeated until 80% agreement on checklist completion between the SP and the investigator was achieved. Students were given 20 min to interact with the SPs per scenario, fol","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing the 4Ms framework to create a structure and process to support voluntary health assessments in affordable housing","authors":"Elyse Perweiler MA, MPP, RN,&nbsp;Jennifer DeGennaro MA,&nbsp;Sherry Pomerantz PhD,&nbsp;Marilyn Mock MSW,&nbsp;Margaret Avallone DNP, RN,&nbsp;Aaron Truchil MS,&nbsp;Stephen Singer MCP","doi":"10.1111/jgs.19092","DOIUrl":"10.1111/jgs.19092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A growing number of older adults live in senior affordable housing, many with limited support systems and representing underserved or disadvantaged populations. Staff in these buildings are in a unique position to identify and address the healthcare and biopsychosocial needs of their residents and link them to services and supports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Staff in four affordable housing sites received training on the 4Ms approach to caring for older adults and conducting resident health assessments. They learned to collect comprehensive health information using a 4Ms Resident Health Risk Assessment (4Ms-RHRA) and results are entered into a customized electronic database. Embedded flags identify potential risk factors and initiate a follow-up process for documenting interventions and tracking referrals to healthcare and supportive services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-one percent of the 221 4Ms-RHRAs completed with residents (63% female, mean age 71.1 years, 73% live alone) were flagged for at least one concern (Mean = 2.2 flags). Items addressing What Matters were most frequently flagged: resident's “most important health issue” (55%) and Advance Care Planning (ACP: 48%). In response, staff provided Advance Directive forms and Five Wishes pamphlets to interested residents and reminded residents to review ACP documents annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Training affordable housing staff, precepting faculty, and students to conduct health assessments based on the 4Ms framework and longitudinally track interventions related to resident-centered needs and manage long-term service and supports is a first step in creating an interprofessional workforce capable of addressing the complex needs of older individuals in affordable housing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing drug evaluation in diverse populations and older adults: National Academies of Sciences, Engineering, and Medicine considerations","authors":"Jonathan H. Watanabe PharmD, MS, PhD","doi":"10.1111/jgs.19075","DOIUrl":"10.1111/jgs.19075","url":null,"abstract":"&lt;p&gt;The total value to society of eliminating all life expectancy disparities attributable to the underrepresentation of minorities for the three common conditions of diabetes, heart disease, and hypertension was approximately $11 trillion based on a commissioned analysis that applied the Future Elderly Model for the National Academies of Sciences, Engineering, and Medicine (NASEM) Committee on Improving the Representation of Women and Underrepresented Minorities in Clinical Trials and Research.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; While older adults experience higher rates of these comorbidities&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and polypharmacy&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; than the general population and are the major utilizers of medications,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; they are considerably underrepresented in clinical trials and clinical research overall.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The prioritization of COVID-19 vaccines for older adults as part of phase 1 by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices was a prominent example of the importance of studying older adults and, particularly, older adults with chronic disease in clinical trials.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;To address the societally pressing challenge of the lack of older adults, women, and minorities in clinical trials and medical research in general, NASEM hosted a virtual workshop titled “Drug Research and Development for Adults Across the Older Age Span” in 2020. The following year through 2022, NASEM performed a Congressionally mandated consensus study with culminating report titled “Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups.” The goal of these NASEM activities was to examine and shed light on the challenges and opportunities in drug research and development for older adults, women, and underrepresented groups and explore hurdles that impair clinical studies in these populations. The NASEM events described the array of consequences due to the underrepresentation of women and minoritized populations as well as the salient conclusions based on the evidence (Table 1).&lt;/p&gt;&lt;p&gt;Barriers to the necessary representation of underrepresented and excluded populations in clinical research in the current research system have reduced participation by a diverse population in clinical trials and clinical research at multiple levels. Individual research studies, the institutions that conduct research, funders of studies, institutional review boards (IRBs), medical journals, and the broader landscape of national policies and practices that govern research all contribute to barriers of populations historically excluded from clinical research.&lt;/p&gt;&lt;p&gt;At the level of an individual research study, the factors and problems that lead to the underrepresentation and exclusion of certain populations in clinical trials and research begin with and follow the life cycle of a project. Understanding and res","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community health worker training on older adults: A qualitative needs assessment","authors":"Nora Spadoni BA,&nbsp;Aliza Baron AM,&nbsp;Elizabeth Zavala MD,&nbsp;Maureen Burns BA,&nbsp;Kandis Draw BA,&nbsp;Wandy Hernandez BA,&nbsp;Jenil Bennett BECE,&nbsp;Lauren J. Gleason MD, MPH, AGSF,&nbsp;Stacie Levine MD","doi":"10.1111/jgs.19077","DOIUrl":"10.1111/jgs.19077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Community health workers (CHWs) are frontline public health personnel who serve as liaisons between vulnerable patient populations and the healthcare system. They are instrumental in health promotion and education for urban-dwelling older adults. However, no research exists on training that CHWs receive on age-friendly health care. This article explores CHW education on the 4Ms of an Age-Friendly Health System and identifies areas where additional training may be necessary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>As part of a two-pronged qualitative needs assessment, four focus groups were held with a total of 17 CHWs and semistructured interviews were conducted with 10 clinicians, including both healthcare providers and social workers. Focus group and interview transcripts were then analyzed for major themes in Dedoose, a qualitative coding software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinicians most often identified Mentation and Mobility as areas where CHWs can have the greatest impact. Correspondingly, CHWs felt under-equipped to assist patients in these areas and expressed strong interest in additional training. In general, CHWs and clinicians agreed that Medications and What Matters do not fall under CHW scope of practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings confirm the critical role that CHWs can play in promoting the health and well-being of urban-dwelling older adults. However, we also demonstrate that many CHWs lack adequate training in age-friendly care. To meet the social and medical needs of a rapidly aging US population, there is a pertinent need to develop a novel community health worker training curriculum on Mentation and Mobility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}