Resource Accessibility

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Status: Completed

St. Louis County

Print this page City population: 100056022.9% over 60Practice started in 2017

Summary

The St. Louis County Older Residents Program agreed to partner with graduate students from Washington University in St. Louis Program in Occupational Therapy (WUOT) to create a mobile information kiosk that provides hard copy material as well as electronic access to resources, and establish regular venues for display. CORP has identified that despite the high quantity and quality of community resources in existence, older adults (OA) are not utilizing these resources. The discrepancy shows that while OA may have awareness of available resources, they are not accessing or using them to their full potential. The students conducted a Needs Assessment (NA) to evaluate how OA access resources and health information, and aims to determine the preferred methods for OA to receive it (i.e. brochures, word-of-mouth, email). CORP’s request for research regarding how and where OA in the Ferguson, MO area access information drove the student NA process. To explore this topic further, a survey was created for distribution to community members. Research on the existing state of practice and implementation of current programs for OA were used as a template for potential solutions. The NA outlines findings from the investigation, and proposes two program solutions to improve accessibility of resources and health information for OA in Ferguson and strategies to modify the content for other St. Louis County communities.

In order to move forward with the project deliverable, it was pertinent to speak with the OA residents of Ferguson. The survey was designed to probe residents about perceptions of resource accessibility, and to assess how residents engage in their community. The goal of the survey was to reveal key information about how and where OA access information, and their preferred methods for doing so. Survey distribution occurred at the Ferguson Community Center.

OA face numerous barriers when attempting to interact with their communities, many of which are overcome by OA desires to stay active and healthy. One study examined how technology influences OA interactions with their communities finding 85% of OA were willing to try tech devices. Barriers to using the device included concerns about cost (42%) and unfamiliarity (32%).Facilitators to using the device were training prior to use (61 %) and tailoring the device to the functional need~ ofOA (Parker, 2013). These facilitators and barriers to technology use align with concerns of CORP staff and the mission of this project. One study deduced that providing online health resources does not guarantee OA will be successful with accessing or understanding the information. Websites that do not meet the online needs of targeted users may pose virtual barriers that prevent seekers from being successful (Becker, 2004). CORP is struggling with the current barriers OA face when attempting to access the organization’s online resources, which aligns with findings that conclude online resources are ineffective for OA. This information helped us to refine our research to find where and how OA access their health information outside of the Internet.

Regarding OA and their interactions with health professionals, many adults place more trust in a face-to-face interaction as opposed to Internet searches. One study investigated how OA perceive and access health information, ranking different sources of information on level of trustworthiness. Average scores indicated that respondents trusted health information sources in the following order: health care providers, pharmacists, friends/relatives, retirement community staff, newspapers, Internet, television, and radio. OA hold greater trust in a person with whom they are able to discuss their health face-to-face, as opposed to a non-living source, like the Internet (Chaudhuri, M., 2013). A primary goal of our NA was to target how OA access information and this provides insight on how to better distribute information to this population.

Successful aging is a major priority of CORP and found within their mission statement. A study examining successful aging found low probability of disease/ disease-related disability is closely correlated with increased cognitive and physical functional capacity and active engagement in life (Gazmararian, et. al, 2003). Researchers explored the intermediate factors that link health literacy to health status and utilization of health services. The study expected to find that individuals with higher health literacy would have better health status, and less frequent use of emergency room/hospital services due to (1) greater disease knowledge, (2) healthier behaviors, (3) greater use of preventive care, and ( 4) a higher degree of compliance with medication. These findings suggest that improving health literacy with user-friendly wording may be an effective strategy to improve health status, and reduce the use of hospital and emergency room services among OA.

These findings offer suggestions on how to target health literacy and increase overall understanding of health status. More focused and cost-efficient efforts could be made to identify ways to address those with low health literacy, and create resources that are reader-friendly. This would increase the understanding of health-based information, especially for those who lack the resources and bridge the unmet literacy demand of OA chronic health conditions (Lee et. al, 2004). Efforts highlighted in this study are reflected by current successful programs and show additional efforts must be made to reach those with low health literacy.

Proposals and Rationale for Project Plan

The graduate students proposed two programs based on our findings on access to resources. The goal of the programs are to build capacity to engage OA and provide access to resources through different methods to disperse information. Based on the NA for CORP, we propose the best fit from the following options for program development.

Option 1: Mobile Kiosk Blueprint
The first proposal is the implementation of a series of sessions to create a plan/blueprint to be utilized by CORP staff to create a modifiable kiosk. The initial mobile kiosk will be tailored to  Ferguson, but can be customized to different St. Louis County communities. These sessions will give CORP staff the tools to create and build a kiosk that holds resources relevant to each individual community within the county. The sessions will go in depth about the target audience, community needs, and specific resources that will benefit OA. Also, the importance of layout and presentation will be addressed in order to increase readability and access for OA. To build CORP’s capacity to implement the mobile kiosk, the program would include literature regarding the most critical needs of OA and our survey findings to assist in choosing appropriate resources to benefit each specific community.

Option 2: Community Partner Training
For this option, the students would design a series of training sessions for CORP staff to present to key community partners in order to best reach OA in the places they frequent most. The top identified places in the community that OA in Ferguson frequent are grocery stores and places of worship. The goal of this option would be to identify an employee at each location to educate on the mobile kiosk and train to give out resource information. This closely aligns with the Knowledgeable Neighbor Model in that we are providing OA and family members with a trusted community member to receive the information from. Resources provided would be tailored to not only meet the needs of OA in Ferguson but would also provide support and information to caregivers and children of these older residents. By sharing this program design, we would build CORP’s staff capacity to reach out to community partners and OA alike, and create open and lasting lines of communication between members of the Ferguson and greater community. Option #2 could provide a valuable link between local resources in the community and community frequenting OA in Ferguson, as well as caregivers and family members who are looking for additional support but are unsure where to turn.

Overall, both program plan options will provide a foundation to ultimately allow OA to access information more easily and effectively, and increase their overall self-efficacy. The two options support research that has been conducted regarding how to best disseminate information to OA, specifically in the Ferguson community. The implementation of either program will promote independence, safety, and community engagement within the Ferguson community.

Age-friendly practice in detail (click to expand):