Giving a voice to medically vulnerable populations: A mixed-methods investigation of their unique perceptions and needs in emergency situations

Older Adults' Experiences of Institutional Eating and Dining: A Qualitative Study on Mealtimes in Adult Day Centers

Background/Objectives: As the global population ages, it is becoming increasingly important to create sustainable, health-promoting environments that support healthy aging. This study explores seniors' mealtime experiences in adult day centers (ADCs) in southern Israel, focusing on identifying health and well-being needs related to eating and dining behaviors through the lens of the healthy placemaking approach. Methods: Thematic analysis was used to analyze data from focus groups and interviews with ADC attendees and leaders across a multicultural sample of ADCs in southern Israel between April and November 2022. Results: Three main themes emerged from the study: (1) individual-level needs, which are met through meals or during mealtimes and include positive experiences, a sense of empowerment, and the cultivation of warmth and domesticity; (2) social needs, which are addressed through interactions during mealtimes and food-related behaviors, including building social connections, fostering community, and encouraging social engagement; and (3) sustainability, health, and environmental aspects, including promoting a healthy and disease-appropriate diet, alongside addressing ecological and food security concerns. Conclusions: We demonstrate the pivotal role of ADC meals in facilitating social engagement and fostering a sense of community among attendees. Additionally, we highlight the importance of centering attendees' concerns and needs in the dining experience and promoting their active participation in decision-making processes. Transforming ADC meals through the healthy placemaking approach can promote healthy eating, enhance social interactions, and support sustainable environments.

Disaster Preparedness and Housing Tenure: How Do Subsidized Renters Fare?

Homeowners are significantly more prepared for disasters than renters. However, disaster preparedness among subsidized renters is an understudied topic despite their increased vulnerability to negative disaster outcomes. Previous research shows that one in three subsidized units is at risk for exposure to disasters, relative to one in four unsubsidized rental units, and one in seven owner-occupied units. Subsidized housing residents often fall into many vulnerable statuses that would make them less prepared than renters and owners. Using 2017 American Housing Survey data, we examine differences in household disaster preparedness by housing tenure, with and without controls for such factors. Logistic regression analyses indicate that subsidized renters are significantly less prepared than unsubsidized renters, and both renter types are significantly less prepared than homeowners, controlling for demographic and neighborhood characteristics. The policy implications of this research are considered as they relate to the location and management of subsidized housing in an era of climate change.

Integrating drones in response to public health emergencies: A combined framework to explore technology acceptance

The aim of the study was to propose and test an integrated model combining the technology acceptance model (TAM), task-technology fit (TTF), social motivation, and drone-related perceived risks to explore the intention to use drones in public health emergencies (PHEs). We conducted a survey among the Israeli population, yielding a sample of 568 participants. Structural equation modeling was implemented to test the research hypotheses. The results showed that our integrated model provided a robust and comprehensive framework to perform an in-depth investigation of the factors and mechanisms affecting drone acceptance in PHEs. First, ease of use, attitudes, individual-technology fit, task-technology fit, and social influence significantly and directly influenced users' behavioral intention to utilize drone technology. Second, attitudes were significant mediators of the effects of social influence and perceived risks on the intention to use drones. Finally, significant relationships between TAM, TTF, social motivation, and perceived risks were also observed. Theoretical aspects and practical implications-which can serve as the basis for shaping a positive development in drone public acceptance in PHEs and in general-are discussed.

The effect of the Australian bushfires and the COVID-19 pandemic on health behaviours in people with multiple sclerosis

BACKGROUND

Crises and disasters disproportionally impact people with chronic health conditions such as multiple sclerosis (MS).

OBJECTIVE

To assess the impact of the COVID-19 pandemic and the Australian Black Summer Bushfires on health behaviours in people with MS.

METHODS

People with MS, carers, healthcare and advocacy professionals were recruited online between May-July 2020 for an online survey and telephone interviews.

RESULTS

Survey items relating to health behaviours were completed by 113 people with MS, and 18 people with MS, 4 MS advocates, 5 healthcare professionals, and 2 carers were interviewed. The bushfires affected 34.5% and the pandemic affected 74.3% of survey participants with MS. The pandemic and bushfires caused a decrease in physical activity in 53.8% and 55.3% of participants respectively, as well as increases in unhealthy eating (43.6% and 24.3% respectively) and alcohol consumption (35.4% and 10.5% respectively), and a decrease in typical sleeping patterns (40.5% and 39.5% respectively). Conversely, 27.5% of participants reported an increase in physical activity during the pandemic. Interview data detailed the circumstances and motivations for changes in health behaviours, as well as consequences, including reduced mobility, fitness, mood disturbances, and weight gain.

CONCLUSION

There is a need to increase support and health promotion for people with MS to maintain or initiate positive health behaviours, especially in times of adversity.

Chronically unprepared: emergency preparedness status among US medically vulnerable populations

Background

The prevalence of large-scale natural and biological disasters has increased in recent years and can have detrimental impacts on health. Some populations are more susceptible to these impacts, including medically vulnerable populations. The purpose of this study was to evaluate the association between medically vulnerable populations and perceived emergency preparedness status.

Methods

This study used 2010 and 2012 Behavioral Risk Factor Surveillance System data (n = 33,852). Participants were classified into four exposure groups related to medical vulnerability for each of three chronic diseases. The outcome was based on responses to a question that asked how prepared the individual’s household was to handle a large-scale disaster or emergency. Logistic regression was used to assess the medical vulnerability-preparedness association.

Results

In adjusted analyses, individuals who were considered medically vulnerable had approximately 40% decreased odds of feeling prepared (OR range 0.61–0.64) compared to individuals without chronic diseases and disabilities.

Conclusions

Public health professionals should direct their efforts toward medically vulnerable individuals and their preparedness statuses. This study further solidifies the need for community partnerships between medical, emergency, and public health professionals to help individuals prepare for future emergencies.

Geographically Indexed Referral Databases to Address Social Needs in the Emergency Department

Introduction

Unmet health-related social needs (HRSN) are among the drivers of disparities in morbidity and mortality during public health emergencies such as the novel coronavirus 2019 (Covid-19) pandemic. Although emergency departments (ED) see a high volume of patients with HRSN, ED providers have limited time to complete detailed assessments of patients’ HRSN and are not always able to provide up-to-date and comprehensive information to patients on available community resources. Electronic, geographically indexed resource database systems have the potential to provide an efficient way for emergency physicians to rapidly identify community resources in settings where immediate social work consultation is not accessible.

Methods

We conducted a systematic review of papers examining the use of geographically indexed resource database systems in healthcare to better understand how these services can be used in emergency care. We then conducted simulated, standardized searches using two nationally available databases (211 and Aunt Bertha), applied to a single metropolitan area (Boston).

Results

Our systematic review found that most public health and screening interventions using nationally available databases have focused on chronic care needs. A small subset of publications demonstrated that these databases were mobilized during disasters to successfully aid vulnerable populations during Hurricanes Katrina and Rita. A total of 408 standardized searches were conducted to identify community resources related to four domains of social needs (food, transportation, housing, and utilities). Although 99% of the resources identified by both databases were relevant to the search domains queried, a significant proportion of the resources identified by each database were restricted to a specific demographic (eg, veterans).

Conclusion

Our findings demonstrate that geographically indexed referral databases may be an effective tool to help ED providers connect patients to nearby community resources during public health emergencies. We recommend that EDs select a referral database based on the greatest number of resources that are not demographically restricted.