I was one of the first interns to be involved in this new internship program. I really didn’t begin this internship with a defined role for the program. I worked with a representative from ODA named Tiffany Dixon. Her and my professor Dr. Van Dussen served as my site supervisors for the project in the Fall 2012 semester. We worked jointly with the Area Agency on Aging 11 who governs Ashtabula, Trumbull, Mahoning, and Columbiana Counties. Our contact for AAA11 was Chief Operating Officer, Tony Cario. Tony eventually became my site supervisor for the Spring 2013 semester. I am still on the project maintaining the contacts between schools, volunteer organizations, and our project group through the summer. The other organization involved with the project was NEO HealthForce, which is part of the Mahoning County One Stop Ohio. The contact from that organization was NEO HealthForce Coordinator, Ronald Shadd.

The primary goal of this project was to work collaboratively with our group members to establish afterschool or during school tutoring and mentoring programs in our local school systems with our retired older adult population serving the roles as tutors/mentors to young students. Not only was it our primary goal to involve our large population of older adults but we wanted these programs to be sustainable and to hopefully grow into a vast network of successful older adult tutoring programs. We aimed to specifically focus on the Ohio Department of Education’s Third Grade Reading Guarantee. This program identifies students behind in reading skills from kindergarten through third grade. Schools are required to hold back those students who test below standard reading levels at the end of third grade.

My responsibilities within the group were mostly as a mediator of meetings and contacts for the project. I have helped set up meetings with local contacts to help establish community partnerships with local organizations and volunteer sources. I also did extensive research on other schools using an intervention program that has been proven successful in numerous schools across the state called Project MORE. Project MORE is a low cost and easily sustainable, 1:1 reading intervention program that has been supported by the Ohio Department of Education and the Ohio Department of Aging. It was our hope that we could use this program as a base for the reading intervention pilot programs.

Our group has met via conference calls and personal meetings to outline ideas and structure a plan to start pilot programs in local schools. The primary goal was to have a pilot program started in at least one local school district by the beginning of 2013. Unfortunately we were unable to do so, but we have made several contacts with Youngstown City Schools and Struthers school district. Struthers Elementary School is supporting our efforts to start a pilot program in their school by Fall of 2013. I helped to establish a Project MORE training session for the interested schools districts to attend so that we can begin planning for the implementation of these tutoring programs. We have also developed a relationship with our local YMCA. This branch has a large number of active older adults who have expressed interest in programs such as these. We hope plan to train volunteers this summer and prepare them for tutoring in the fall.

This internship has really opened my eyes to what I am capable of. Not only did I help develop the initial stages of a program that has the chance to impact the community in many ways, but I did this with no experience or idea of what it takes to develop a program of this caliber. By no means did I accomplish this on my own. I was surrounded by a great supporting cast of individuals from diverse backgrounds that really helped to shape and mold my ideas. This was the great opportunity that I had been waiting for all of college. Without this opportunity, I would have never met or worked with many of the people and agencies that I did.

In a sense, this internship project is a reflection of myself. When I started this internship I really had no direction or idea of what it was that I really I truly wanted to do. As I helped develop and plan this program I was also developing and planning my future self. The more communication I had with my group and outside sources the more I was able to develop my thoughts and goals into practical ideas. I really began to see a future for myself as I began to see I real future for this program. With the guidance and advice from Dr. Van Dussen and Tony Cario, I have developed a love for organizing projects like this and would love to oversee or help develop more programs. Through the research and planning I found not only that I am capable of doing more than I thought I was capable of and that my best talent was being able to communicate effectively with everyone that was a part of developing this pilot program. I enjoyed every second I spent on this project and I look forward to seeing this develop into a successful community program.

I had the good fortune to participate in the Ohio Department of Aging’s innovative internship program in collaboration with the Ohio Association for Gerontology in Education this spring.  The agency that I worked with is the HANDS Across Medina County Foundation, an organization whose mission is to improve the quality of life for older adults in Medina County.  The HANDS Foundation has its office in Brunswick, but true to its vision:  The HANDS Foundation shall be an instrument for the improvement of senior issues through education, community resources and community partnerships; the majority of what this organization does is out in the community of Medina County.  My site supervisor, Cindie Schneider, is the executive director of the organization and I have collaborated with her for the past 10 years on issues related to behavioral health and well being in the aging population in Medina County.  The project that I was involved with, Making Prevention Work for Older Adults is in its 10^th year.  This project focuses on increasing older adults and care providers’ awareness about the unique vulnerability that aging adults face regarding medication and alcohol related problems.  This project has had many avenues to carry the message that older adults are uniquely vulnerable to problems with medications and with alcohoI, from seminars for medical professionals, Brown Bag seminars where older adults could meet one on one with a pharmacist to review their medicines, to co-sponsoring drug disposal efforts, to training emergency professionals and providing Lifepouches to store medical information in a magnetized red pouch and prominently display for emergency service professionals to quickly access in a home.  For my internship, I examined how to increase the effectiveness of one of our most promising programs, Prevention BINGO, which is an educational game specific to the content of alcohol and medication related risks in aging adults.  The development and refining of this intervention has been a continued work in progress.  Many challenges come from simply getting large enough sample sizes to compare pre to post test change.  I have also wanted to gather data that would demonstrate the difference between groups receiving the intervention versus not receiving the intervention.  My focus during my internship was to work closely with Dr. Sterns and edit our pre and post test to best evaluate what we are wanting older adults to learn.  Specifically, items were edited to be more clearly stated, and item scales were changed from a dichotomous, yes/no format, to a Likert scale, which has the advantage of identifying degrees of change.  Ideally, I wanted to end up with at minimum of 30 participants for an intervention and no intervention test condition.  We have had several Prevention BINGO games scheduled and then rescheduled, due to circumstances beyond our control.  The events that we have scheduled in Senior Housing complexes have been the most successful, as residents do not need to travel to participate.  The event is held right in their own community room in their apartment building.

Intervention History and Development of Prevention BINGO intervention 

Prevention BINGO (PB) includes information about older adults and polypharmacy, and alcohol use risk associated with aging.  Research-based educational facts were organized into teaching points to create a BINGO game. An image or icon related to the fact or information content was assigned to each teaching point.  The PB program consists of BINGO playing cards. The cards have 10 randomly assigned presentations of the teaching point images/icons.  The presenter uses a master set of educational cards   that   contains   the image/icon found on each player’s BINGO play card. The master set of educational cards shows the image/icon on the front of the card and lists the educational content on the back. In this way, the presenter  may hold the card for  all  players  to  see, while reading  the  educational information  from  the  back  of  the  card.   Each test question is highlighted on the back of the educational cards, so that the presenter may clearly state that information to the players. Information printed on the back of the master set of educational cards also aids in maintaining continuity between presenters, because the information is presented consistently. Players place tokens on the image/icon on their playing card, one at a time, after each image/icon is presented from the educational master   card.   Participants play   actual BINGO   for small prizes while learning   about   the topics.  Even  though  BINGO  may  be  called  early  in the  game,  play  proceeds  until  all  educational  image cards   are   presented.    The   pre-test    administration occurred before the first card is drawn.  The post-test administration occurred   immediately   following   the game play. The program can be administered in approximately one hour.  The PB program  was first introduced  in June 2007 to  groups  of  older  adults  (60 and  older)  in  Medina County  simply  as an  effort  to  increase  awareness  of the risks related to polypharmacy and alcohol use. Attendance increased; participants enjoyed the program and awareness seemed to increase.  As requests for   the   program   grew, developers   decided   it was important to evaluate the effectiveness of the program. Older adults in Medina County were recruited to participate. Interested groups were able to contact the presenters and schedule the program.

The  process  of  playing  PB  began  with  providing information  on   the   purpose   of  the   program   and obtaining   informed   consent   for  data   collection   on program   effectiveness.  Presenters then explained the game play and provided participants with a pre-test. The PB instructor showed each of 27 icon/image cards and read the information on the back of each one to the participants. Once the post-tests were collected, the presenter reviewed the post-test with the participants, so that they could hear the correct answers. The participants were also provided with a list of test questions and correct answers to take with them. Small prizes were presented during the game play to the first five participants who showed a ‘BINGO’   on their playing cards.

Subjects

Participants were recruited through local centers for older adults.  Advertising was done through the Helping HANDS quarterly newsletter and through fliers posted at the Centers for Older Adults in Brunswick, Wadsworth, and Medina.  Only the Brunswick centers events were scheduled within the time frame of the current study.  A total of 3 events were scheduled.  The first event was established at a center that regularly played bingo and bingo was held as usual for this group, with an explanation of the voluntary participation in completion of the pre and post test for this study.  The “no intervention” group played regular BINGO and completed the pre and post test.  Of a group of 15, seven agreed to participate.  Two other events were scheduled as intervention groups to play Prevention BINGO.  The first event included 19 participants who agreed to play Prevention BINGO and complete the pre and post test, while the second event was cancelled due to a very low number of preregistrations and will be rescheduled.  A total of 26 older adults participated in this study.

Intervention

Prevention BINGO is an educational intervention designed to raise awareness about aging adults’ unique vulnerability to problems with alcohol, medications, and harmful interactions between the two through play.  This intervention has been developed over the course of eight years, through the work of Hands Across Medina Foundation and Cornerstone Wellness and funding through a Medina County Drug Abuse Commission grant.  The goals of this educational game to increase aging adults’ knowledge about their unique vulnerability to problems associated with their medications, alcohol and drug interactions and to raise awareness about the importance of sharing their lifestyle choices with their physicians. To date, the intervention has been played with over 750 participants since it was first launched in June of 2007.  The initial game included a post test only and over trial and error, a pre, post and follow up test have been developed and refined.  Previous versions of the test used dichotomous response sets with some knowledge content remaining difficult to discern for the adults participating.  The present study has revised the pre and post test to more clearly represent knowledge content and to refine ability to detect knowledge gain through the use of a 5 point likert scale.  Likert scales have the advantage of being relatively easy to construct, it takes little time to construct the scale, and it can be easily used in seeking participant responses to stimuli, and is considered more reliable.  The disadvantage of a likert scale is that the space between positions on the scale may not be equal.

Results

A total of 19 adults participated in the intervention and 7 participated in the no intervention condition.  Low turnout and one event cancellation resulted in smaller numbers of participants than is idea to evaluate the effectiveness of the intervention.  Of the total group, 61.5% had never played Prevention BINGO before while 38.5% reported playing previously.  All were included in the analysis.  The group consisted of 22.2% male and 77.8% female participants ranging in age from 60 to 84 years old.  Seventy-one percent of the no intervention group and seventy-five percent of the intervention group were between 70 and 84 years of age.   In both groups, 100% of participants indicated that their race was Caucasian.  In the no intervention group, 71.4% reported income of $24,999 and below, while in the intervention group 100% of the participants reported incomes of $ 24,999 or below.    While 42.9% of the no intervention group were married, only 20% of the intervention group reported that they were married and a larger number of the intervention group were widowed, 55%, and divorced, 20% compared to only 28.6% widowed and 28.6% divorced in the no intervention group.  Paired t-tests were performed and 7 of the 12 knowledge items showed significant increase in knowledge from the pre to post test.

I continue to learn, each time I lead a program of Prevention BINGO-last week a participant noted on one of the items that it didn’t say what kind of drinkwe were asking about (the item asks: in the past 30 days have you had 5 or more drinks on any one occasion and the preceding item asked the participant to respond to the item:  how often do you have a drink containing alcohol).  In my reading and re-reading the survey, it was clear to me that I meant how many drinks of alcohol, but the item didn’t specifically state alcohol in that item-another lesson learned!    It is my goal to submit the intervention to the National Registry of Evidence Based programs, and hopefully see it be utilized by others who seek to raise awareness amongst adults over 60 and care providers about the unique vulnerability that older adults face regarding their medications and alcohol.  I am also hoping to gather more cohort specific data this year, regarding Baby Boomers perceptions of harmfulness about marijuana to develop items in Prevention BINGO that are also cohort specific.  I am so very grateful for the opportunity to work with the HANDS Foundation and for Dr. Sterns’ wisdom and guidance throughout this project.  It has been a great privilege to get out of my office and be able to meet everyone at the Ohio Department of Aging.  I would welcome any input from everyone at the Department about this intervention and would love to have the opportunity to lead the program outside of Medina County.  I believe that older adults have been overlooked in regards their vulnerability in this area and healthcare providers also do not routinely provide the needed information, and even if they do, substance use treatment services specific to aging adults are the exception, rather than the rule.  I am invested in seeing this change and this internship experience is affording me that opportunity to carry this message further.

I would welcome inquiries about leading a Prevention BINGO event from any of the other interns from this years program, or from anyone at the Ohio Department of Aging, as it would afford me the opportunity to try the intervention with different demographic areas.

The purpose of my ODA/OAGE internship was to assist Gerontology Director and Coordinator, Dr. Daniel J. Van Dussen with the planning, implementation and coordination of the 2013 Youngstown Regional Respite Summit. This summit, which was held on March 21, 2013 at Youngstown State University, was a networking and information-gathering event that included a wide range of shareholders in respite across the lifespan. The purpose of this summit was to address key respite concerns, including the successes and challenges of respite care, as well as the major barriers of service.

Following the summit, priorities were set for future work to be done in our area of the state. Our findings were then coordinated with prior summit information gathered by the Ohio Respite Coalition as they continue to develop a lifespan respite system across the state of Ohio. Findings from the summit were also shared with the ODA and the Benjamin Rose Institute on Aging (BRIA), and suggestions were made regarding ways to coordinate care more effectively.

Through further collaboration through BRIA, we were also able to expand our project and access the raw data and findings from various other summit locations throughout the state of Ohio. By obtaining this information, we were able to pull keywords, concepts and themes to compare and integrate with our findings and develop a rubric system for the analysis of both the qualitative and quantitative respite data from each summit location. Ultimately, our aim is to not only compare our regional findings to the rest of the state, but to compare our findings from the state of Ohio to other state respite initiatives. Our findings are expected to be presented both at conferences and hope to be published in the future.

Over the course of this project, my involvement and knowledge in respite research has continued to increase, and I have been fortunate to have made several new contacts through my endeavors as an ODA/OAGE intern. I have experienced not only a behind-the-scenes glimpse of how summits and conferences are organized, but have also gained first-hand knowledge of some of the preparations and collaborations necessary to organize such an endeavor and research project involving multiple organizations and data collection sites. I have also had the privilege to oversee and manage multiple student volunteers. Some of our greatest obstacles involved encouraging stakeholders to participate in the summit and receiving necessary information and timely responses from various organizations.

The internship that I worked with and still am currently involved with took place in the German Village area in Columbus Ohio, not too far from The Ohio State Univerity which is where I go. Some people aren’t familiar with the German Village area but there are a lot of elder people that live there and the surrounding area but the community itself is not older people, or anybody who uses a stroller, biker, etc., friendly. The roads are brick allowing for the historical aspect of the area to be present but the bricks are in terrible shape making it hard for people to get around. The sidewalks are awful and hard to walk on without tripping especially if walking is hard enough for a person. So the point of this project is to help have the city realize that the streets need some help, more benches placed throughout the roads, have maybe other entrance points to places for people who can’t use stairs, etc. For the elderly living there, being able to walk around is a way of keeping their independence and really maintaining a healthy lifestyle. The project didn’t get as far as we wanted during the school year as we want to get a focus group together to see what the people who live down there think about what could potentially be made better to better suit their lifestyle. Going through the IRB took awhile to get everything approved in order to even have the focus group but right now we are working on getting people to attend the focus group. The agency was interested in having this project completed because being able to comfortably walk around to get to places is a very essential way for elders to maintain a healthy, physical and independent lifestyle. Through this internship and project I was able to go to the Ohio Department of Aging and meet tons of people for networking purposes and more importantly to see how other projects were approached and what they did in their project. I learned that improving an area for the people really takes a long time and you have to be persistent but in the end it’s completely worth it knowing you helped make someone’s life better in some way.

Being given the opportunity to participate in the Ohio Internships in Aging Program during the Spring Semester certainly provided me with an invaluable experience for networking with experts in aging as well as for building a stronger foundation for applied research in aging.  I had the privilege of completing my internship with Dr. Heather Menne at the Margaret Blenkner Research Institute of the Benjamin Rose Institute on Aging in Cleveland.  During my time with Dr. Menne, I assisted with analysis of data collected during the Ohio Replication of the Reducing Disability in Alzheimer’s disease intervention.  Reducing Disability in Alzheimer’s Disease (RDAD) is an evidenced-based intervention for individuals with dementia and their family caregivers aimed at improving physical performance of the IWD as well as reducing psychosocial strain of the caregiver.  There have been manuscripts published reporting the successful results in terms of individuals’ subjective functional improvements using caregiver-based reports.  However, no statistical analysis has been published utilizing the objective physical performance measures (walking speed, functional reach, balance) or falls.

Throughout the semester, previous literature and theoretical consideration guided several iterations of statistical analyses of these physical performance outcomes to ensure inclusion of important predictor variables as well as necessary covariates regarding efficacy of the exercise portion of RDAD on these measures.  Time was the most limiting factor during the semester as in-person meetings were most effective in discussing statistical and theoretical concerns although much of the analysis was able to be completed via teleconferencing or electronic communication.

Many opportunities have arisen from my participation in this internship.  Dr. Menne and I have collaborated on a presentation for the OAGE annual conference in the spring.  We have also submitted abstracts for 2 national conferences including the Gerontological Society of America’s annual conference and the national Physical Therapy conference.  A manuscript is also in preparation at this time which will be completed by the end of the calendar year as I have been preparing for my comprehensive examination this summer.  Additional opportunities currently being discussed are potential grant applications to further test validity of physical assessment tools in individuals with dementia as well as further collaboration on exercise interventions with older adults with dementia.

I would like to express my sincere gratitude to the leaders in the ODA and OAGE along with Drs. Heather Menne and Katherine Judge for this great opportunity.  I look forward to continuing a lifelong relationship with these organizations and researchers.

This semester, I interned for the Opening Minds through Program (OMA). OMA is an intergenerational program that brings together elders living with dementia and Miami University students. Every week, students met one on one with elders, who experienced autonomy through their ability to create beautiful art pieces. OMA is an organization that I believe deserves to be promoted as it has played a special role in the lives of all involved. Therefore, for my internship, in addition to volunteering as a student leader, I designed a line of OMA t-shirts. This project was relevant to the organization in order to spread the word about OMA, as well as act as a fundraiser for the organization. This was an opportunity for me to put my own creativity to use in the designing of the t-shirt. Also, I interacted with both OMA leaders as well as the company that printed the t-shirts. Because of this, I learned how to work with both a non-profit organization as well as a for profit company. From this experience, I learned that while the actual program is very important, it is also essential to have financial resources to sustain. My favorite aspect of interning with OMA was working one on one with my elders. However, I think I was able to leave a lasting impact through the design of these t-shirts. My internship was a very rewarding experience, and I am happy to have had the chance to be a part of a program as unique and meaningful as OMA.