All individuals deserve an equitable opportunity to achieve a good death. Unfortunately, access end-of-life care and services is largely unequal on the basis of race, gender, class, other social identities. We need understand how with multiple marginalized identities face different in attaining death use this knowledge bring equity care. The conceptual framework for argument derives from intersectionality theory existing disparities This sheds light relationship between death, demonstrated...

Background Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of change, it is difficult measure. This study aims assess criterion validity Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other measures. Methods Using data from Ohio-based NHs ( n = 771), logistic regression techniques demonstrated relationship between PELI and two validated measures, Resident...

Champions are a highly influential, yet understudied, aspect of evidence-based implementation in the nursing home setting. This study explored role champions implementing Preferences for Activity and Leisure (PAL) Cards their community as quality improvement project. PAL communication tool designed to alert team members important individual preferences. Participants included n = 35 homes who identified create 15–20 older adults living community. A total 88 monthly qualitative interviews with...

Despite federal legislation requiring nursing home (NH) staff members to be vaccinated against coronavirus disease 2019 (COVID-19), unvaccinated pose an ongoing public health risk. The research question guiding this study is as follows: What the relationship between strategies address vaccine hesitancy and vaccination rates among staff? We used diffusion of innovation (DOI) theory a theoretical framework.The sample (N = 627) included Ohio-based NHs. Using national state NH data,...

The coronavirus disease 2019 (COVID-19) has challenged the way nursing homes deliver person-centered care (PCC). Preferences for Activity and Leisure (PAL) Cards are a tool to communicate residents' important preferences staff. Monthly interviews ( N = 32) were conducted with champions who conducting PAL Card quality improvement project in Tennessee 11) between March August 2020. Three major themes emerged: Structural Changes (e.g., halting admissions, adding an isolation unit), Resident...

ABSTRACTNursing homes receive complaints when actual care provided to residents misaligns with desired care, suggesting that person-centered (PCC) and honoring resident preferences in delivery may help prevent from arising. We explore whether nursing home implementation of a PCC tool, the Preferences for Everyday Living Inventory (PELI), is related measures complaints. Publicly available data on Ohio was used examine 1,339 home-year observations. Regression techniques were evaluate...

Abstract Background and Objectives The Individualized Positive Psychosocial Interaction (IPPI) program is an adaptable, evidence-based intervention. IPPI trains nursing home care partners to engage residents living with moderate severe dementia in preference-based, one-to-one interactions using emotion-focused communication. We sought understand provider-driven adaptations made the whether were fidelity-consistent. Research Design Methods Data collected from n = 78 interviews 23 provider...

This study assessed the readiness of The Individualized Positive Psychosocial Interaction (IPPI) program in nursing home (NH) setting from perspective NH providers implementing IPPI. evidence-based IPPI is designed to help remediate distress and improve mood for residents living with dementia. staff are trained engage brief (i.e. 10-min) one-to-one, preference-based activities alleviate emotional enhance quality life.

Abstract Understanding modification motive can help improve intervention protocols and future implementation efforts. The core components of the IPPI that should not be modified include staff approach one-to-one resident interactions with a positive intent, use good communication skills, base on preferred activity living dementia. We sought to understand what was motivations behind modifications from champions. utilized Framework for Reporting Adaptations Modifications Evidence-Based...

Person-centered care practices are essential to providing high-quality for nursing home (NH) residents. A key component of implementing person-centered is the assessment and fulfillment residents' preferences. However, few NHs consistently assess implement preferences into care. From 2015 2019, Ohio Department Medicaid added Preference Everyday Living Inventory (PELI), a scientifically validated tool preferences, as quality indicator improve person centeredness Ohio's NHs. In this study, we...

Background: The Preferences for Everyday Living Inventory (PELI) is a person-centered care (PCC) tool that uncovers/honors older adults' important preferences. PCC implementation in nursing homes (NHs) often requires additional resources, such as staff time. We explored if PELI associated with NH staffing levels. Methods: Using NH-year the unit of observation (n = 1307), 2015 and 2017 data from Ohio NHs was used to examine relationship between complete versus partial levels, measured hours...

Background: Burnout is often prevalent among healthcare workers (HCWs) given the stressful nature of their work. COVID-19 has intensified HCW burnout, and little known about burnout prevention interventions that may help alleviate during COVID-19.Methods: This study adopted a pre-experimental post-test only design. The sample (n = 53) was adult HCWs at large metropolitan-area hospital. intervention consisted memorial service included music by therapist, chaplain support,...

Siblings are often cited as a source of support throughout life, but they have not been included in studies sexual violence disclosure. Survivors delay or do disclose their violence. The current study investigated if and why survivors decided to sibling. This qualitative investigation 10 female participants, which six had disclosed abuse participants ranged age from 20 58, five identified Hispanic, one Hispanic White three White, Middle Eastern. Thematic analysis was used examine the data....

Abstract Implementation efforts of evidence-based practices focusing on the nursing home setting remain understudied. The purpose this study was to explore role Consolidated Framework for Research (CFIR) inner domain implementation PAL Cards. Monthly qualitative interviews (n=50) with project champions (n=16) were audio-recorded, transcribed, checked accuracy, and coded using “Inner Setting” from CFIR in Dedoose. Major themes emerging data included networks communication (e.g., including...

Abstract Background The CFIR Process domain can be used to evaluate practices that are associated with successful or unsuccessful implementation. purpose of this study was understand the processes led implementation PAL Card QIP during height pandemic from provider champion’s perspective. Methods Qualitative interviews n=11 champions who completed were audio recorded, transcribed verbatim, and coded using Domain. Results Major themes regarding process included engaging (e.g., staff family),...

Abstract Understanding the barriers and facilitators of an intervention can inform implementation efforts. The purpose this study was to understand characteristics associated with PAL Card that led successful in nursing home (NH) settings. Qualitative telephone interviews were conducted n=11 NH champions who completed QIP. Interviews recorded, transcribed verbatim, coded using CFIR Intervention Characteristics domain Dedoose. Three main themes regarding emerged including, relative advantage...

Abstract This was the third time replicating Preferences for Activity and Leisure (PAL) Card quality improvement project, but first conducted entirely during height of pandemic. Nursing home providers attempted n=174 PAL Cards completed n=166 (96%). Feedback from surveys with n=68 staff who came in daily contact residents (e.g., 26% CNAs, 10% housekeepers, 6% maintenance, 9% dining) were collected by project champions. Staff had worked on average 6 years, indicated that they remember being...

Abstract Champions are crucial to successful intervention implementation; however, as an area of research champions have only recently begun gain empirical focus. The purpose this study was identify the barriers and facilitators regarding champion qualities using domain “Characteristics Individual” from CFIR. Qualitative interviews were conducted with nursing home provider (n=16) who led efforts create PAL Cards for 15-20 residents participated in a total n=50 monthly that audio-recorded...

Abstract Background Nursing home staff members unvaccinated against COVID-19 pose an ongoing public health risk considering their frequent contact with older adults, a population especially vulnerable to the virus. In order address vaccine hesitancy and foster confidence effectively among nursing staff, evidence-based communication strategies are necessary. Methods Using dataset composed from three sources of Ohio data, research questions guiding this study as follows: 1) What is...

Abstract Preferences for Activity and Leisure (PAL) Cards are a communication tool designed to alert nursing home staff important resident preferences. This study explored the role of provider champions implementing in their community. Champions (n=35) created PAL 15-20 residents. A total 88 monthly interviews were audio-recorded, transcribed, checked accuracy, coded using domain “Characteristics Individual” from Consolidated Framework Implementation Research. Each construct was assigned...