Su-I Hou

Background: The World Health Organization published the 2019 Integrated Care for Older People (ICOPE) framework to guide, assess, and promote the intrinsic capacity (IC) of older adults, referring to their physical and mental health. This study aims to investigate the relationship between IC and frailty among older adults. Methods: This cross-sectional study was conducted in a medical center in Taiwan in 2021. Two hundred ten patients over 65 admitted to the geriatric ward were invited to participate. The questionnaire included an IC measure, Fried Frailty Scale, and demographic items. The IC measure was ascertained using the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms). The Fried Frailty Scale was used to categorize participants as robust (Fried Frailty Scale=0), prefrail (Fried Frailty Scale=1-2), or frail (Fried Frailty Scale ≥3). Multinomial logistic regression was used to analyze the association between individual ICOPE domains and frailty stages, while adjusting for confounders. Results: Among the participants, 39.0% were prefrail, and 28.6% were frail. Limited mobility and depressive symptoms were significantly associated with prefrail (adjusted odds ratio [aOR]=4.44, 95% confidence interval [CI] 1.82–10.82; aOR=8.41, 95% CI 1.75–40.37) and frail (aOR=11.57, 95% CI 3.63–36.93; aOR=13.77, 95% CI 2.62–72.49) individuals, respectively. Malnutrition (aOR=4.01, 95% CI 1.18–13.62) and hearing loss (aOR=4.37, 95% CI 1.09–19.66) were significantly associated with frail older adults.Conclusion: Limited mobility and depressive symptoms occurring at the prefrail stage could be used as assessment items for early detection of prefrail.

Background: Since the COVID-19 pandemic, telehealth has become a core component of modern health care, encompassing both synchronous services (real-time video or phone) and patient portals, which offer a wide range of online features to streamline care delivery, including asynchronous communication and access to medical records. Older adults often face greater barriers to these technologies, potentially widening health care access gaps. Objective: This study examines factors influencing the adoption of patient portals and synchronous telehealth in the postpandemic era. It compares the 2 modalities and identifies distinct usage patterns across age groups to inform targeted strategies. Methods: We analyzed data from the Health Information National Trends Survey (HINTS) Cycles 6 and 7. Outcomes over the past 12 months included (1) frequency of patient portal use (continuous), (2) use of synchronous telehealth (binary), and (3) no engagement with any telehealth services (binary). Key variables included demographics, socioeconomic status, technology familiarity, and health care behaviors. Age groups were categorized as young (18–49 years), middle-aged (50–64 years), and older adults (≥65 years). Interaction terms between age groups and other variables were included to uncover age-specific patterns. To mitigate multicollinearity arising from the interaction terms, we used penalized linear and logistic regression models using the least absolute shrinkage and selection operator (LASSO) penalty without survey weights, supplemented by bootstrapping to evaluate the stability. Using the selected variables, we then fitted survey-weighted generalized linear models to account for the complex design of the HINTS survey and more accurately represent the US population. Results: Among 12,865 respondents, 36.1% (n=4638) were 65 years or older. Overall, 65.2% used patient portals and 38.4% used synchronous telehealth. Age alone was not a significant factor, but older adults exhibited distinct patterns. Older adults with higher care frequency were less likely to use patient portals (coefficient −0.07, 95% CI −0.10 to −0.04; P <.001). Those who completed the survey online in this age group were more likely to use patient portals (coefficient 0.32, 95% CI 0.18-0.47; P <.001) than to use a paper form. Older Black or African American patients were less likely to use patient portals (coefficient −0.30, 95% CI −0.45 to −0.16; P <.001). These age-specific patterns were identified only in patient portal use, not in synchronous telehealth use. Conclusions: Telehealth usage among older adults differs in subtle ways from other age groups, and the factors driving adoption vary between patient portals and synchronous care. These findings underscore the need for age- and context-specific strategies to enhance the uptake of both types of services.

Introduction: Nursing educators and clinical leaders face persistent challenges in engaging the next generation of nurses, often characterized by short attention spans, frequent phone use, and underdeveloped communication skills. This article describes the design and delivery of a full-day interactive teaching workshop for nursing faculty, senior clinical nurses, and nurse leaders, developed using a design-thinking approach supported by generative AI. Methods: The workshop comprised four thematic sessions: (1) Learning styles across generations, (2) Interactive teaching methods, (3) Application of interactive teaching strategies, and (4) Lesson planning and transfer. Generative AI was used during planning to create icebreakers, discussion prompts, clinical teaching scenarios, and application templates. Design decisions emphasized low-tech, low-prep strategies suitable for spontaneous clinical teaching, thereby reducing barriers to adoption. Activities included emoji-card introductions, quick generational polls, colored-paper reflections, portable whiteboard brainstorming, role plays, fishbowl discussions, gallery walks, and movement-based group exercises. Participants (N = 37) were predominantly female (95%) and represented multiple generations of X, Y, and Z. Mid- and end-of-workshop reflection prompts were embedded within Sessions 2 and 4, with participants recording their responses on colored papers, which were then compiled into a single Word document for thematic analysis. Results: Thematic analysis of 59 mid- and end-workshop reflections revealed six interconnected themes, grouped into three categories: (1) engagement and experiential learning, (2) practical applicability and generational awareness, and (3) facilitation, environment, and motivation. Participants emphasized the workshop’s lively pace and hands-on design. Experiencing strategies firsthand built confidence for application, while generational awareness encouraged reflection on adapting methods for younger learners. The facilitator’s passion, personable approach, and structured use of peer learning created a psychologically safe and motivating climate, leaving participants recharged and inspired to integrate interactive methods. Discussion: The workshop illustrates how AI-assisted, design-thinking-driven professional development can model effective strategies for next-generation learners. When paired with skilled facilitation, AI-supported planning enhances engagement, fosters reflective practice, and promotes immediate transfer of interactive strategies into diverse teaching settings.

Introduction: Nursing educators and clinical leaders face persistent challenges in engaging the next generation of nurses, often characterized by short attention spans, frequent phone use, and underdeveloped communication skills. This article describes the design and delivery of a full-day interactive teaching workshop for nursing faculty, senior clinical nurses, and nurse leaders, developed using a design-thinking approach supported by generative AI. Methods: The workshop comprised three thematic sessions: (1) Learning styles across generations, (2) Interactive teaching methods, and (3) Application of interactive teaching strategies. Generative AI was used during planning to create icebreakers, discussion prompts, clinical teaching scenarios, and application templates. Design decisions emphasized low-tech, low-prep strategies suitable for spontaneous clinical teaching, thereby reducing barriers to adoption. Activities included emoji-card introductions, quick generational polls, color-paper reflections, portable whiteboard brainstorming, role plays, fishbowl discussions, gallery walks, and movement-based group exercises. Results: Analysis of 59 participant reflections revealed six interconnected themes, grouped into three categories: engagement and experiential learning, practical applicability and generational awareness, and facilitation, environment, and motivation. Participants emphasized the workshop’s lively pace and hands-on design, noting “It was impossible to fall asleep; we were always talking, sharing, writing, or moving.” Experiencing strategies firsthand built confidence for application, while generational awareness encouraged reflection on adapting methods for younger learners. The facilitator’s passion, personable approach, and structured use of peer learning created a psychologically safe and motivating climate, leaving participants recharged and inspired to integrate interactive methods. Discussion: The workshop illustrates how AI-assisted, design-thinking-driven professional development can model effective strategies for next-generation learners. When paired with skilled facilitation, AI-supported planning enhances engagement, fosters reflective practice, and promotes immediate transfer of interactive strategies into diverse teaching settings.

BACKGROUND Since the COVID-19 pandemic, telehealth has become a core component of modern healthcare, encompassing both synchronous (real-time video/phone) and asynchronous (patient portal) services. However, older adults often face more barriers to using these technologies compared to younger populations, potentially widening gaps in healthcare access. OBJECTIVE This study comprehensively examines factors influencing the adoption of asynchronous and synchronous telehealth in the post-pandemic era. It compares the two modalities and highlights distinct usage patterns across age groups, offering insights to inform more targeted telehealth strategies. METHODS We analyzed data from the 2022 and 2024 Health Information National Trends Survey (HINTS) 6 and 7, focusing on three outcomes over the past 12 months: 1) frequency of asynchronous telehealth use (continuous), 2) use of synchronous telehealth (binary), and 3) no engagement with any telehealth services (binary). Key variables included demographics, socio-economic status, technology familiarity, and healthcare behaviors. Age groups were categorized as young (18–49), middle-aged (50–64), and older adults (65+). Interaction terms between age and other variables were included to uncover age-specific patterns. We employed penalized linear and logistic regression models using the least absolute shrinkage and selection operator (LASSO) to address multicollinearity and bootstrapping to assess the variability of the estimated coefficients. RESULTS Of the 12,865 respondents, 36.1% (4,638) were aged 65 or older. Asynchronous and synchronous telehealth were used by 65.2% and 61.6% of participants, respectively. While age group alone was not a significant predictor, older adults exhibited distinct patterns. For example, older patients who used one telehealth modality were less likely to use the other (Odds Ratio [OR]=0.91, 95% Confidence Interval [CI]=[0.85,0.98], P=.008 for asynchronous predicting synchronous use; coefficient [coef]=-0.12, 95% CI=[-0.23, -0.02], P=.019 for the reverse), despite strongly positive associations in the general population. Older adults who frequently received care were less likely to use asynchronous telehealth (coef=-0.07, 95% CI=[-0.10, -0.04], P<.001), which is contrary to trends in other age groups. Additionally, the following associations stood out relative to the overall population: tech-savvy older adults were more likely to use asynchronous telehealth (coef=0.28, 95% CI=[0.17, 0.39], P<.001), while those in non-metropolitan areas were less likely to use synchronous telehealth (OR=0.74, 95% CI=[0.56, 1.00], P=.048). Finally, older Black or African American patients were less likely to use asynchronous telehealth (coef=-0.21, 95% CI=[-0.35, -0.07], P=.004), which is not observed in the broader population. CONCLUSIONS This study reveals nuanced differences in telehealth usage among older adults, emphasizing the need for age-specific strategies. These insights can guide more effective implementation of both asynchronous and synchronous telehealth services, particularly for older populations.

Purpose: This study explores aging attitudes among older adults participating in two distinct community programs: neighborhood lunch (NLP) and lifelong learning (LLP) programs. Methods: Participants were recruited from NLP and LLP programs within the same county in Florida, and an aging attitudes scale originally developed by German researchers was administered.

This study examined physical activity (FITNESS) and social relationships (FRIENDS) on social engagement among community older adults. Members from two Florida aging-in-village programs participated.