TY - JOUR T1 - Determinants of Hearing Aid Use Among Older Americans With Hearing Loss JF - The Gerontologist Y1 - 2019 A1 - Michael M McKee A1 - Choi, Hwajung A1 - Wilson, Shelby A1 - Melissa J DeJonckheere A1 - Zazove, Philip A1 - Helen G Levy KW - Hearing aids KW - Hearing loss KW - Social Support KW - Stigma AB - Background and Objectives Hearing loss (HL) is common among older adults and is associated with significant psychosocial, cognitive, and physical sequelae. Hearing aids (HA) can help, but not all individuals with HL use them. This study examines how social determinants may impact HA use. Research Design and Methods We conducted an explanatory sequential mixed methods study involving a secondary analysis of a nationally representative data set, the Health and Retirement Study (HRS; n = 35,572). This was followed up with 1:1 qualitative interviews (n = 21) with community participants to clarify our findings. Both samples included individuals aged 55 and older with a self-reported HL, with or without HA. The main outcome measure was the proportion of participants with a self-reported HL who use HA. Results and Discussion Analysis of HRS data indicated that younger, nonwhite, non-Hispanic, lower income, and less-educated individuals were significantly less likely to use HA than their referent groups (all p values < .001). Area of residence (e.g., urban) were not significantly associated with HA use. Qualitative findings revealed barriers to HA included cost, stigma, vanity, and a general low priority placed on addressing HL by health care providers. Facilitators to obtaining and using HA included family/friend support, knowledge, and adequate insurance coverage for HA. Implications Many socioeconomic factors hinder individuals’ ability to obtain and use HA, but these obstacles appeared to be mitigated in part when insurance plans provided adequate HA coverage, or when their family/friends provided encouragement to use HA. UR - https://academic.oup.com/gerontologist/advance-article/doi/10.1093/geront/gny051/5000029http://academic.oup.com/gerontologist/advance-article-pdf/doi/10.1093/geront/gny051/24836322/gny051.pdf ER - TY - JOUR T1 - Older Adults' Residential Proximity to Their Children: Changes After Cardiovascular Events. JF - Journals of Gerontology Series B: Psychological Sciences and Social Sciencess Y1 - 2015 A1 - Choi, Hwajung A1 - Robert F. Schoeni A1 - Kenneth M. Langa A1 - Michele M Heisler KW - Cardiovascular health KW - Heart disease KW - Older Adults KW - Proximity KW - Social Support AB -

OBJECTIVES: To assess changes in family residential proximity after a first cardiovascular (CV) event among older adults and to identify families most likely to experience such moves.

METHOD: Using a nationally representative longitudinal study of older adults in the United States, we identified respondents with no prior diagnosis of CV disease (CVD). We examined subsequent development of stroke, heart attack, and/or heart failure among these older adults and examined changes in their residential proximity to their closest child before and after the CV event. We then compared the likelihood of changes in proximity between families with and without CV events. Finally, we determined which types of families are most likely to relocate following a CV event.

RESULTS: Having a first CV event increases the 2-year predicted probability of children and adult parents moving in with and closer to each other (relative risk ratio = 1.61 and 1.55, respectively). Families are especially likely to move after a first CV event if the older person experiencing the event is spouseless or has a daughter.

DISCUSSION: CVD is a leading cause of disability, which in turn creates a significant need for personal care among older adults. Assessment of changes in family residential proximity responding to CV events is important to fully understand the consequences of older adults' CV events including the cost of caregiving.

VL - 70 IS - 6 ER - TY - JOUR T1 - The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status. JF - Patient Educ Couns Y1 - 2012 A1 - Donna M Zulman A1 - Ann Marie Rosland A1 - Choi, Hwajung A1 - Kenneth M. Langa A1 - Michele M Heisler KW - Aged KW - Blood Glucose Self-Monitoring KW - Cross-Sectional Studies KW - Diabetes Mellitus, Type 1 KW - Diabetes Mellitus, Type 2 KW - Disease Management KW - Female KW - Glycated Hemoglobin KW - Health Knowledge, Attitudes, Practice KW - Health Status KW - Humans KW - Interviews as Topic KW - Male KW - Middle Aged KW - Multivariate Analysis KW - Risk Factors KW - Self Care KW - Self Efficacy KW - Severity of Illness Index KW - Social Support KW - Stress, Psychological KW - Surveys and Questionnaires KW - Treatment Outcome AB -

OBJECTIVE: To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.

METHODS: Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.

RESULTS: In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.

CONCLUSION: Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.

PRACTICE IMPLICATIONS: Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.

PB - 87 VL - 87 UR - http://www.ncbi.nlm.nih.gov/pubmed/21840149 IS - 1 N1 - Zulman, Donna M Rosland, Ann-Marie Choi, Hwajung Langa, Kenneth M Heisler, Michele U01 AG09740/AG/NIA NIH HHS/ Ireland Patient Educ Couns. 2012 Apr;87(1):74-80. Epub 2011 Aug 15. U1 - http://www.ncbi.nlm.nih.gov/pubmed/21840149?dopt=Abstract U2 - PMC3229832 U4 - Diabetes/glycemic control/glycemic control/psycho-social/self-management ER -