The purpose of this dissertation was to understand how genetics, socioeconomic status (SES), and lifestyle factors influence the development of age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy in an adult population in Dallas County. Two hundred fifty-three older adults participated in this study as the sample. Crosstabulation and binary logistic regression were utilized to analyze the data. Results indicated a disparity among participants' test scores, visual health status, and perceptions of their visual impairment and highlighted the fact that many seniors are not educated about age-related retinal disorders. Furthermore, variables reaching statistical significance were consistent with the literature included race/ethnicity, age, having a family history of both AMD and diabetes, frequency of eye exams, and level of education. The results not consistent with the literature as affecting visual health included health insurance, access to health care, body weight, and smoking status. Recommendations for future study included applied research focusing on determining risk factors, raising awareness, educating, and providing early detection of these diseases among low to middle income Caucasian, African American, and Hispanic older adults.

This study assessed falls efficacy and confidence-related changes among participants attending the a Matters of Balance/Volunteer Lay Leader (AMOB/VLL) falls prevention program for older adults, based on their residential location. Data were examined from 431 older Texans enrolled in AMOB/VLL during a two-year period, and assessed at baseline and post-intervention. Results indicate that participants significantly increased falls efficacy, reduced activity interference due to their health, and decreased the number of days limited from usual activity. Regression models show that participants, despite entering the program with lower reported health status, reported greater rates of positive change for falls efficacy and health interference compared with their baseline pre-intervention counterparts. Overall program attendance and attendance at major sessions showed the greatest influence. Findings contribute to the understanding of cognitive restructuring and strengthening variations with falls prevention program outcomes.

HIV/AIDS can affect individuals of any age. Efforts to educate those considered to be most at-risk, based on the age at which the most individuals are infected, are ongoing and public. Less work and mainstream education outreach, however, is being directed at an older population, who can be more likely to contract HIV, is more susceptible to the effects of HIV, and more likely to develop AIDS, than younger persons. Guided by the Health Belief Model theory, research was conducted to determine what, if any, relationship existed between age of an individual and the possibility that an HIV test will be sought. Factors of gender, education, ethnicity and marital status were included in analyses. the research indicated that as age increased, likelihood for getting an HIV test decreased. Overall, most individuals had not been tested for HIV. the implications of an aged and aging population with HIV include a need for coordinated service delivery, increased education and outreach.

This study examined if domestic violence shelters in Texas are responding to the needs of older female victims of intimate partner violence. Data for this study was collected through online questionnaire surveys of 45% of Texas domestic violence shelters. Findings of this study indicated that less than 10% of Texas shelters are providing specialized programming for older victims of IPV. In Texas, the demographic growth of older adults has remained comparable to increased national trends. The state of Texas will face several policy implications and social issues related to an older population that is rapidly growing. This includes, the importance of addressing certain members of an aging population who continue to fall victim to domestic violence. Furthermore, an unchanged resource of safety for victims of IPV is domestic violence shelters. Therefore, this study challenges current domestic violence shelter policies to address this issue of a rapidly growing segment of the Texas population. This study found less than 10% of shelters in Texas, who participated in this study, were providing specialized programming and outreach for older victims. Important practical implications for domestic violence shelter programming in Texas is provided.

Understanding underlying mechanisms and pathways that lead to chronic homelessness would help develop intervention strategies that could help prevent subsequent episodes of homelessness. Quantitative data for this cross-sectional study was gathered by interviewing individuals who were homeless in the State of Arkansas, using a structured survey between 2007 and 2011. Qualitative data was gathered using semi-structured interviews between 2016 and 2018. Chi-square statistics and a multivariate logistic regression model was used to analyze the quantitative data, while phenomenological methods were used to analyze the qualitative data. Nearly half of the study participants identified themselves as being chronically homeless. Chronically homeless adults in this region were significantly more likely to be older men with no family ties, more likely to be victims of domestic violence, have higher rates of physical health problems, and have alcohol and substance abuse problems. Results from the multivariate nominal regression revealed that individuals who reported themselves as chronically homeless were more likely to be in the 50 years or older age group. In addition, study findings highlighted a dynamic interplay between three biopsychosocial risk factors for homelessness. Fostering development of inclusive sustainable communities, intergenerational relationships, and shared housing practices could help ease such social inequities and …

The purpose of this study was to investigate patient use and presentation of Internet health information and its effect on patient-health professional relationship from a sample of residents at active adult communities in Texas. Five sites were used to recruit the 260 participants between November 2012 and January 2013. The data were received using a self-administered survey. Using Cronbach’s alpha, logistic regression and regression analysis through SAS, the data revealed that older respondents are less likely to discuss web-based information with health professionals. In addition, logistic regression analysis indicated that four of the variables, IHI Sharing, educational status (bachelor degree), marital status (married), and perceived health status (excellent and very good health) predicted varied of the 20 indicators making up the patient-health professional relationship scale. Further studies are needed to enhance this research.

Access to healthcare is needed and wanted by people of all ages and especially by those of the older population. The number of people in the 65 years of age and older population is rapidly growing with their needs expected to have a significant impact on the existing healthcare system and healthcare providers. The impact will be critical given the severe shortage of healthcare providers, especially of nurses and the rate of services being more often provided in non-hospital settings. The objectives of the study were to discover the plans of graduating nursing students as they choose their first place of employment, if they have future plans to pursue a nursing advance practice degree, and if they are very happy with their decision to become a nurse. Data for the study were obtained from a questionnaire presented to senior graduating nursing students. The findings were: (a) Most students prefer a hospital setting. (b) Younger students are three times as likely to seek out the hospital, and 1/3 of the students seek out the hospital setting because they were encouraged to become a nurse. (c) About 70% of the students want to work with their friends while 1/3 will seek the …