S1082: Aging in Place: Home and Community in Rural America

(Multistate Research Project)

Status: Active

S1082: Aging in Place: Home and Community in Rural America

Duration: 10/01/2023 to 09/30/2028

Administrative Advisor(s):


NIFA Reps:


Non-Technical Summary

Statement of Issues and Justification

A. The need as indicated by stakeholders. That is, how the proposed activity addresses national and/or regional priorities. Authors are requested to identify the appropriate SAAESD Priority Areas to which this activity contributes.
The likelihood of experiencing a minor to a chronic disability increases significantly as one ages. Preventing health problems can allow one to age in place for a longer duration. The environment in which one lives facilitates accessibility; social networks and services can ensure that older adults stay engaged with the community; and, financial resources can be used to make changes or hire help when necessary. Needs of older adults can vary, but by examining the resources in the community in conjunction with the elder’s home environment, older adults can achieve aging in place. Older adults can benefit from individual support based on indicators of wellness that facilitate aging in place, such as the ability to perform activities of daily living. Providing adequate and affordable housing to meet the needs of an aging population is one of today’s major challenges facing rural communities, where the median age is six years higher than in urban areas (U.S. Census Bureau, 2016).


This proposal addresses Goal 5. Enhanced Economic Opportunity and Quality of Life for Americans.


B. The importance of the work, and what the consequences are if the work were not done.
By 2030, one in five people in the United States (U.S.) will be 60 years of age or older (U.S. Census Bureau, 2014), and by 2060, 98 million will be over 65 (Mather, Jacobsen, & Pollard, 2015; United Nations, 2015). In rural communities, the increasing population of older adults is a critical challenge. Older adults tend to suffer from chronic conditions and have more functional limitations and require an array of medical and health-related goods and services, thereby increasing competition for limited resources at the community and individual level. This project will address the policies and programs that have been, or need to be, developed to accommodate aging in place in rural communities. And, through completion of this project, the concept, aging in place, will be holistically addressed and will advance the body of knowledge related to the phenomena.


C. The technical feasibility of the research.
We seek to answer two basic research questions: (1) What is the opportunity to maintain, remodel, or design high-quality sustainable housing for aging in place in rural communities and (2) What policies and programs provide best practices to promote the creation and implementation of successful aging in place design and initiatives?” We will use extant and primary data to answer these questions.


D. The advantages for doing the work as a multistate effort.
This multistate effort is dedicated to addressing the needs of rural older adults who prefer to age in place. The cross disciplinary team consists of social sciences academics skilled in both qualitative and quantitative methodologies, resulting in peer-reviewed journal articles, presentations, outreach programs, and successful grant proposals. The multistate approach allows use of diverse skills of team members and their affiliated institutions. Extension team members provide an understanding of stakeholder concerns and state and local governmental interventions addressing aging-in-place. Current researchers include those from Georgia, Florida, Massachusetts, North Carolina, North Daokta, Ohio, Oklahoma, Texas, Virginia, and Wyoming. We welcome researchers from other universities and states.


Multi-state is a means of “grouping like things together.” The complementary expertise and experience of the members allows the group to work collaboratively. This is noted in the previously published articles and will continue to be noted as the research efforts continue.  This approach allows for high quality scholarship and translational research. This approach is needed to ensure high quality scholarship and translational research. Each report will document progress towards goals (with both quantitative and qualitative measures).


The members of S-Temp 1082 have added new members on an ongoing basis, and will continue to pursue collaborators, adding value to the project. A plan will be developed to ensure consistency in recruiting/expectations across members/partners.


E. What the likely impacts will be from successfully completing the work.
The project will advance knowledge of state responses that allow older adults the ability to age in place in rural areas and lay the groundwork for new policies toward accommodating environmental, social and financial factors to age in place. We anticipate that identifying specific programs, policies, and practices will provide information for policy makers to improve the efficiency, effectiveness, and significance of public funding supporting aging in place initiatives in rural places. In addition to policy impacts, the project will provide a foundation for future development of Extension programs to facilitate education at the local level of aging in place.


The members of S-Temp 1082 will work diligently to ensure that all deadlines are met and quality reports are submitted, per multistate requirements. We are confused about the comment regarding the Issue and Justification section, as language has been entered (sections a-e).

Related, Current and Previous Work

Objectives from the previous project:


1. Identify and analyze secondary data sources to identify the environmental, social, and financial factors that impact (positive/negative) successful aging in place in rural communities using secondary data.


Objective met. Secondary data have been used to create peer-reviewed scholarship, including the following manuscripts.



  • Peek, G., Green, L. E., Emerson, K. G., & Carswell, A. (2021). The influence of length of residence and home modifications on housing unit satisfaction: Implications for the aging population. Housing and Society, DOI: 10.1080/08882746.2021.1996201.

  • Green, L. E., Betz-Hamilton, A., Albright*, B., Lee, S., Vasquez*, K., Cantrell, R., Peek, G., & Carswell, A. (accepted). Home Modification for Older Adults Aging in Place: Evidence from the American Housing Survey. Journal of Aging and Environment. https://doi.org/10.1080/26892618.2022.2140466


 


2. Collect primary data from key informants to identify and analyze environmental, social, and financial factors that impact (positive/negative) successful aging in place in rural communities using primary data.


Objective not met. The group has been able to utilize primary data. The group will meet Fall 2023 to discuss this objective and make progress towards measurables.


 


3. Examine and draft policies and programs that promote successful aging in place in rural communities and encourage inclusive civic participation.


Objective not met. The group is still building a body of work that may be able to inform policy. The group will meet Fall 2023 to discuss this objective and make progress towards measurables, including developing a framework to idenitify relevant policy.

Objectives

  1. Identify and analyze secondary data sources to identify the environmental, social, and financial factors that impact (positive/negative) successful aging in place in rural communities using secondary data.
    Comments: Group is actively working on this objective.
  2. Collect primary data from key informants to identify and analyze environmental, social, and financial factors that impact (positive/negative) successful aging in place in rural communities using primary data.
    Comments: Group may begin working towards this goal.
  3. Examine and draft policies and programs that promote successful aging in place in rural communities.
    Comments: Group may begin working towards this goal.

Methods

The project will employ both quantitative and qualitative research methods using secondary and primary data sources. Below, the data sources and methods of analysis are described.

Secondary data sources to be used include U.S. Census data, the American Housing Survey (AHS) including the special module associated with housing modifications, and other secondary data sources as needed, such as state level data. The years will include 2019 and 2021, which is the latest year. Addtional years will be used as they become available.

The AHS dataset contains demographic, housing unit, and neighborhood quality indicators that may address aging in place. The set also provides variables related to housing modifications, and whether respondents experienced difficulties with activities of daily living. Individual state level efforts related to aging in place will be analyzed to understand states’ factors that relate to aging in place. The states examined will be those represented by the research team members’ place of work. The research may first examine states to determine whether some policy exists. Is a policy being implemented? This is important in of itself. Second, if a policy is implemented, what are some key features? Are there commonalities across the states examined? The research may reveal other insights about policy not explored in this proposal.

Primary data will be collected from key informants in each state, including but not limited to Extension educators and relevant community connections. They will be approached through a self-completed questionnaire, one-on-one interviews, or focus groups. The questions will be framed to assess factors in their states that impact successful aging in place in rural communities. The research instrument (whether the questionnaire or interview/focus group plan) will include both closed-ended and open-ended questions. Closed-ended question responses will be analyzed descriptively and using statistical analyses such as tests of association and tests of variance. Open-ended question responses will be analyzed using content analysis to identify themes. Secondary county level data will be used (ie. housing stock) will be used in analysis, as well. These data, coupled with the secondary data will be analyzed for opportunities for policies and programs that can improve the well-being of older adults.

Measurement of Progress and Results

Outputs

  • Scholarship Comments: Outputs include conducting workshops to gather primary data to inform aging in place curriculum. This curriculum that would consist a overall presentation, a 15-minute truncated lesson, a fact sheet, and an evaluation. The primary recipient of this effort is the public. Blind peer-reviewed scholarship will include at least one referred journal article and one conference presentation per year. It is expected that the articles would have national, if not international interest, adding to the body of literature about the aging population. The primary recipient of this is academics, that is, increasing the body of knowledge and policy makers and legislators.

Outcomes or Projected Impacts

  • Identify solutions that avoid institutionalization and improve the quality of life of older adults in rural communities. The goal of the project “Aging in Place: Home and Community in Rural America” is to address the opportunities and challenges of creating and sustaining livable rural communities for older residents, operationalized as 65 years of age and over. In our study, we use the term “aging in place” to include home and community-based services to prevent relocation to an institutional setting or to a different community. Features that enable occupants to approach and use their homes independently or with minimal assistance can improve their quality of life. Inaccessible environments in rural settings can negatively impact self-esteem, increase the onset of depression due to isolation and the risks of falls, and increase the involvement of informal and formal caregivers (Pynoos & Nishita, 2003; Satariano, 2006; Stineman, Ross, Maislin, & Gray, 2007). Inaccessible environments can also impede the delivery of home health services, lessen mental and physical health, and intensify utilization of health services (Pynoos, Steinman, & Nguyen, 2010; Stineman et al., 2007). By conducting this research, we aim to identify solutions that avoid institutionalization and improve the quality of life of older adults in rural communities.

Milestones

(2023):Continue to use primary data to develop scholarship. The research team will submit at least one conference presentation and one manuscript per year.

(2024):Focus on Objective 2. Collecting primary data from key informants in the states. instruments for collecting data will be developed. Research will be at the state level in the context of rural places.

(2025):Submit one conference presentation and one manuscript based on secondary data collection and analysis.

(2026):Conduct workshops with stakeholders (n=5) to identify and implement practical ways to implement the findings and recommendations from the research.

(0):The members of S-Temp 1082 understand that documented progress on all listed objectives must be made or the project will be terminated. The team will have regular planning and work sessions that will ensure progress towards meeting objectives. The S-Temp 1082 currently meets every month in some capacity through a Zoom meeting setting. The members of S-Temp 1082 will adhere to the reporting and review schedule, including quarterly, annual, and midterm intervals. We will work closely with the OSU Experiment Station Director to ensure compliance with deadlines. To ensure quality, reports will provide additional detail, as requested.

Projected Participation

View Appendix E: Participation

Outreach Plan

Outreach plan will consist of taking the peer-reviewed scholarship to the public. Some members of the S1082 team have Extension appointments. Outreach will consist of public presentations, factsheet, and podcasts. Importantly, each opportunity will provide practical information and takeaways for participants. We will also reach out to at least one other multi state project for examples of successful outreach activities. Outreach activities will be documented in reports.

Organization/Governance

All research team officers are elected for at least two-year terms to provide continuity for the project. A USDA assigned Administrative Advisor will provide administrative guidance for the project. The research team members represent states in the south central, southeast, eastern, and north central regions.


Co-chairs (2)


Secretary (1)

Literature Cited

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Cavanaugh, J. C., Blanchard-Fields, F. (2015). Adult development and aging (7th ed.). Boston: Cengage Learning.


Demiris, G., Rantz, M. J., Aud, M. A., Marek, K. D., Tyrers, H. W., Skubic, M., & Hussam, A. A. (2004). Older adults’ attitudes towards and perceptions of ‘smart home’ technologies: A pilot study. Medical Informatics and the Internet in Medicine, 29(2), 87-94.


Golant, S. (2008). Commentary: Irrational exuberance for the aging in place of vulnerable low-income older homeowners. Journal of Aging and Public Policy, 20(4), 379-397.


Golant, S. M. (2003a). Conceptualizing time and behavior in environmental gerontology: A pair of old issues deserving new thought. The Gerontologist, 43(5), 638–648.


Golant, S. M. (2003b). The urban-rural distinction in gerontology: An update on research. In H. W. Wahl, R. J. Scheidt, & P. G. Windley (Eds.), Annual review of gerontology and geriatrics (Vol. 23, pp. 280–312). New York: Springer.


Greiman, L., & Ravesloot, C. (2016). Housing characteristics of households with wheeled mobility device users from the American Housing Survey: Do people live in homes that facilitate community participation? Community Development, 47(1), 63-74.


Hwang, E., & Ziebarth, A. (2015). Walkability features for seniors in two livable communities: A case study. Housing and Society, 42(3), 207-221.


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Iwarsson, S., & Wilson, G. (2006). Environmental barriers, functional limitations, and housing satisfaction among older people in Sweden: A longitudinal perspective on housing accessibility. Technology and Disability, 18, 57-66.


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Lies, M. M., Kang, M., & Sample, R. K. (2017). Place attachment and design features in a rural senior cohousing community. Housing and Society, 44(1-2), 41-63.


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Oswald, F., Jopp, D., Rott, C., & Wahl, H. W. (2011). Is aging in place a resource for or risk to life satisfaction? The Gerontologist, 51(2), 238-250.


Pynoos, J., Nishita, C., Cicero, C., & Caraviello, R. (2008). Aging in place, housing and the law. The Elder Law Journal, 16, 77-105.


Pynoos, J., & Nishita, C. M. (2003). The cost and financing of modifications in the United States. Journal of Disability Policy Studies, 14(2), 68–73.


Pynoos, J., Steinman, B. A., & Nguyen, A. Q. (2010). Environmental assessment and modification as fall prevention strategies for older adults. Clinics in Geriatric Medicine, 26(4), 633–644.


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Satariano, W. (2006). Epidemiology of aging: An ecological approach. Burlington, MA: Jones & Bartlett Learning.


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Stanford Center on Longevity. (2013). Livable community indicators for sustainable aging in Place. Retrieved from https://www.metlife.com/assets/cao/mmi/publications/studies/2013/mmi-livable-communities-study.pdf


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Stineman, M. G., Ross, R. N., Maislin, G., & Gray, D. (2007). Population-based study of accessibility features and the activities of daily living: Clinical and policy implications. Disability & Rehabilitation, 29(15), 1165–1175.


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  1. S. Department of Agriculture. (2015). Retrieved from https://www.usda.gov/wps/portal/usda/usdahome?contentid=2015/07/0202.xml


U.S. Census Bureau. (2014). An aging nation: The older population in the United States. Retrieved from https://www.census.gov/prod/2014pubs/p25-1140.pdf


U.S. Census Bureau. (2016). New Census data show differences between urban and rural populations. Retrieved from https://www.census.gov/newsroom/press-releases/2016/cb16-210.html


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World Health Organization. (2007). Global age-friendly cities: A Guide. Retrieved from http://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf


 

Attachments

Land Grant Participating States/Institutions

FL, GA, NC, NY, OH, SD, WY

Non Land Grant Participating States/Institutions

Texas - Texas State University, University of Massachusetts/Boston
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