Human Development & Community Health
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Item Value-based healthcare payment models: a wolf in sheep’s clothing for patients and clinicians(Informa UK Limited, 2024-07) Bohler, Forrest; Garden, Allison; Brock, Callaham; Bohler, LilyValue-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients’ outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide.Item Neighborhood racial income inequality and cognitive health(Wiley, 2024-06) Zahodne, Laura B.; Sol, Ketlyne; Scambray, Kiana; Lee, Ji Hyun; Palms, Jordan D.; Morris, Emily P.; Taylor, Lauren; Ku, Vivian; Lesniak, Mary; Melendez, Robert; Elliot, Michael R.; Clarke, Phillippa J.INTRODUCTION. Neighborhood socioeconomic status (SES) has been linked to dementia, but the distribution of SES within a neighborhood may also matter. METHODS. Data from 460 (47% Black, 46% White) older adults from the Michigan Cognitive Aging Project were linked to census tract–level data from the National Neighborhood Data Archive (NaNDA). Neighborhood SES included two composites reflecting disadvantage and affluence. Neighborhood racial income inequality was the ratio of median incomes for White versus Black residents. Generalized estimating equations examined associations between neighborhood factors and cognitive domains. RESULTS. Neighborhood racial income inequality was uniquely associated with worse cognitive health, and these associations did not differ by participant race. Neighborhood disadvantage was only associated with worse cognitive health among Black participants. DISCUSSION. Both the level and racial distribution of SES within a neighborhood may be relevant for dementia risk. Racial differences in the level and impact of neighborhood SES contribute to dementia inequalities.Item Critical Science: A systematic literature review of empirical research (1979–2022)(Wiley, 2024-05) Wanago, Nicole C.; Alexander, Karen L.; Vaterlaus, J. Mitchell; Miller, Cynthia L.; Roberson, Kyle L.The Critical Science Approach (CSA) was developed in 1979 with the intent to create a consistent conceptual identity unifying the Family and Consumer Sciences (FCS) profession's philosophy, knowledge, and practice. This systematic literature review examines empirical CSA research published between 1979 and 2022 to better understand what the CSA means for the profession. A total of 71 articles met the criteria with the CSA highly integrated in 22 of those articles. Results illustrate a need for increased CSA scholarship, continuity in keyword usage within the CSA language, and collaboration among preprofessional programs and professional organizations to support and sustain a CSA paradigm shift.Item Baseline Measures of Physical Activity and Function Do Not Predict Future Fall Incidence in Sedentary Older Adults: A Prospective Cohort Study(Human Kinetics, 2023-01) Whitten, Justin; Barrett, Rod; Carty, Christopher P.; Tarabochia, Dawn; MacDonald, David; Graham, DavidPhysical activity (PA) and physical function (PF) are modifiable risk factors for falls in older adults, but their ability to predict future fall incidence is unclear. The purpose of this study was to determine the predictive ability of baseline measures of PA, PF, and lower limb strength on future falls. A total of 104 participants underwent baseline assessments of PA, PF, and lower limb strength. Falls were monitored prospectively for 12 months. Eighteen participants fell at least once during the 12-month follow-up. Participants recorded almost exclusively sedentary levels of activity. PA, PF, and lower limb strength did not differ between fallers and nonfallers. Twelve participants, who reported a minor musculoskeletal injury in the past 6 months, experienced a fall. The results of this study suggest that in a cohort of highly functioning, sedentary older adults, PA does not distinguish fallers from nonfallers and that the presence of a recent musculoskeletal injury appears to be a possible risk factor for falling.Item The Acceptability of a Community-Based Perturbation-Based Balance Training to Older Adults and Healthcare Professionals(SAGE Publications, 2024-01) Whitten, Justin; O'Leary, Bryant; Graham, David; Grocke-Dewey, Michelle U.; Riley, Julie; Harper, Danielle; Tarabochia, DawnBackground: Perturbation-based balance training (PBT) is a promising fall risk reduction method that involves inducing unexpected perturbations to balance to train participants reactive balance control. Due to the unpredictable nature of PBT, its acceptability to older adults could present a barrier to the implementation of PBT in the community. Aim/Purpose: The purpose of this study was to assess the perceived acceptability of a community-based PBT program to both older adults and healthcare professionals (HCPs). Methods: Nineteen older adults (aged 69.6 ± 6.6 years, 17 women, 2 men) and three HCPs participated in the qualitative study. Participants completed four PBT sessions facilitated in conjunction with HCPs. Interviews, based on the theoretical framework of acceptability, were conducted before and after PBT and analyzed using template analysis. Results: PBT was perceived as effective by older adults and HCPs. However, HCPs perceived the equipment cost as a substantial barrier to feasibility in the community.