Mobility safety, especially fall prevention, plays a significant role in successful aging for older adults. Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. Using the International Classification of Functioning, Disability, and Health (ICF) model, this dissertation aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas. They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Regression analyses indicated that fear of falls was the most predictive factor of CSMoF among older persons. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Fear of falls served as a mediator through which demographic predictors influence CSMoF. The joint effects of perception of falls and fear of falls likely explain CSMoF …

Human life is to be universally cherished and valued. Policies about how to value lives are often developed following gross human rights violations. Some of the most horrific violations have occurred under the guise of biomedical and behavioral research. As a result, policies have been developed to protect participants. Presumably, the primary responsibility of the researcher is their protection. There are, however, potential tensions between protections and research agendas, which set the occasion for over selection of participants with vulnerabilities. This dynamic may establish competing contingencies that devalue, and potentially harm, participants. Power imbalances inherent in the researcher-participant relationship establish the researcher as the dominant knowledge seeking authority and the participant as the subservient subject. Ideally, research in applied behavior analysis is driven by a steadfast orientation toward the enhancement of human life and the amelioration of suffering. The purpose of this paper is to present an analysis of human rights trends in the Journal of Applied Behavior Analysis. The dependent measures are based on ethical principles established for the protection of participants and recommendations concerning participatory research practices in applied behavior analysis. The results indicate that in some cases, protections have been minimally reported. Furthermore, power imbalances are highly …

Mental health is an intrinsic capability that constitute an essential component of healthy aging. Mental health is constituted by positive constructs such as happiness and negative constructs (mental disorders) such as depression. As people grow older, they become more prone to developing mental disorders which are linked to poorer quality of life, increased disability, increased utilization and cost of health services, and higher rates of suicide. This dissertation involved three studies that focused on factors that predict change in mental disorders and happiness of older Americans over a period of five years. Two waves of publicly available national representative data from the National Social Life Health and Aging Project (NSHAP) collected in 2010 and 2015 were used. A total of 2210 older adults within the ages 62-90 years were used in the analyses. Mental health measures were CES-Depression scale, HADS anxiety scale, and self-rated happiness. Essay 1 aimed to identify the important aspects of older adults' interaction with their neighborhood that predict the presence of mental disorder and happiness. Essay 2 evaluated the psychosocial factors that predict change in mental disorder and happiness of older adults, whereas essay 3 investigated the multifactorial determinants of change in mental disorder and happiness …

In the context of health care delivery for senior citizens, this research utilizes three studies that examine the development and implementation of health policy and the factors that can directly or indirectly impact the effective delivery of health services to senior citizens. It utilizes three essays employing mixed methods (qualitative and quantitative) methods including semi structured interviews, multiple regression and partial least squares structural equation modelling to examine the extent to which the implementation of health services delivered attributes of primary and integrated care to seniors. The two essays identified methods, approaches and strategies of integrated care relevant to the development of policy that can be successfully implemented when the contextual issues that older people consider to be important in maintaining their functional capabilities and their motivation to improve health as perceived by them are addressed. Consequent upon the results from these studies, the third essay examines the methodological issues on integrated geriatric care implementation when guidelines for effective policy development identified were not followed. By highlighting the relationship between effective policy and patient satisfaction, these three essays' recommended approach enhances the theory of health design that confirms that theoretical models of primary care must incorporate the system, process and …

This dissertation contributes to research on social isolation in older adults aged 65 years and above through three essays that expand our understanding of the social determinants of health and identify the social and interpersonal factors that contribute to elderly wellbeing. This dissertation examines the significant factors contributing to the problem of social isolation, and how the availability of interest-based, low-cost engagement resources in the community can alleviate social isolation and foster healthy aging. Essay 1 is a systematic literature review with implications for future research that explores how technological skills and training based on user intention and availability of resources can alleviate social isolation. Essay 2 is a qualitative study that evaluates the effectiveness of a unique community-based senior exercise program in fostering social integration and in reducing social isolation. Essay 3 is a quantitative study that examines the magnitude and direction of the correlated relationships among the determinants of social inclusion and the impact of social and interpersonal processes on senior wellbeing. These three essays provide insight into the social isolation phenomenon that negatively impacts senior wellbeing and recommends solutions derived from a data driven examination of the problem that is especially applicable to economically disadvantaged senior communities. …