Developing Occupation-Based Preventive Programs for Late-Middle-Aged Latino Patients in Safety-Net Health Systems

Abstract

Latino adults between ages 50 and 60 yr are at high risk for developing chronic conditions that can lead to early disability. We conducted a qualitative pilot study with 11 Latinos in this demographic group to develop a foundational schema for the design of health promotion programs that could be implemented by occupational therapy practitioners in primary care settings for this population. One-on-one interviews addressing routines and activities, health management, and health care utilization were conducted, audiotaped, and transcribed. Results of a content analysis of the qualitative data revealed the following six domains of most concern: Weight Management; Disease Management; Mental Health and Well-Being; Personal Finances; Family, Friends, and Community; and Stress Management. A typology of perceived health-actualizing strategies was derived for each domain. This schema can be used by occupational therapy practitioners to inform the development of health-promotion lifestyle interventions designed specifically for late-middle-aged Latinos.

Evaluation of ¡Vivir Mi Vida! to improve health and wellness of rural-dwelling, late middle-aged Latino adults: results of a feasibility and pilot study of a lifestyle intervention

“…Finally, including patients and all ranks of stakeholders in the development and implementation process of ¡VMV! (Schepens Niemiec et al ., 2015) provides a more realistic view of program roll-out in a real-life context.…”

“…In addition, participants were required to have visited AVCC during the past year, with self-reported capacity to complete a 16-week intervention and no plans to move outside of Antelope Valley within six months. The decision to target late middle-aged adults was based on: (a) recent theory, which emphasizes healthy aging as a continuous process throughout the lifespan (Hansen-Kyle, 2005); (b) the desirability of instilling sound health habits during a temporal window that precedes major health declines experienced in older age (Sudano and Baker, 2006); and (c) indications that Latino adults in this age group are willing to undertake health-promoting lifestyle changes (Osuna et al ., 2011; Schepens Niemiec et al ., 2015).…”

“…A preliminary qualitative needs assessment resulted in identification of a set of patient-valued health domains and health promotion strategies that informed ¡VMV! module construction (Schepens Niemiec et al ., 2015). ¡VMV!…”

A Pilot Study of the ¡Vivir Mi Vida! Lifestyle Intervention for Rural-Dwelling, Late-Midlife Latinos: Study Design and Protocol

“…Correspondingly, patients and all ranks of stakeholders have provided their input into the design of ¡VMV! (Schepens Niemiec et al, 2015), identified meaningful health outcomes, and assisted in the successful implementation of the pilot program. Conducting research in this manner is advantageous, as it approximates realistic implementation of the program in a community-based primary care setting.…”

“…To expand the reach and pragmatic sustainability of the program, health care administrators recommended that CHWs serve as front-line interveners, with OT adopting a supervisory role. We conducted a formal needs assessment with the target population (Schepens Niemiec et al, 2015). Consistent with the community-engaged research approach that we adopted (C.…”