Progress 09/01/15 to 08/31/19
Outputs
Target Audience:The research team focussed on dissemnitation of the project module information during this reporting periods and in 2019, 6factsheets have been developed for this reporting period for the Oklahoma Cooperative Extension Service. Caregiving 101 Healthy Caregiving Developing the Caregiving Team Safe Environments for Caregiving Finances for Caregiving Elder Abuse Prevention Caregiving 101, Healthy Caregiving and Developing the Caregiing Team have been published and are available online athttp://factsheets.okstate.edu/ Safe Environments for Caregiving, Finances for Caregiving,andElder Abuse Preventionare awaiting publication on the factsheet website.In addition a publication based on interviews with county extension workers was resubmitted to the Journal of Extension and was accepted and is awaiting publication In 2019 a series of nine webinarswere provided for county extension educators to build interest in the caregiving education program. The webinar topics and number of attenddees for each are as follows: Normal Aging Part 1 - Biological Changes - 15 Normal Aging Part 2 - Psychological Changes - 21 Normal Aging Part 3 - Social Changes - 9 Planning a care team - 2 Communicating with Healthcare Professionals & Family Members - 3 Navigating Medicare, Medicaid, & Social Security - 8 Types of Housing for Older Adults - 6 Caring for yourself - 11 Record Keeping 101 - 5 Total number of extension worker 2019 webinar attendes =80 Changes/Problems:Other than Dr. Emily Roberts taking over the role of Lead Project Director from Dr. Whitney Bailey, there are no major changes to report over the course of the grant. Under the guidance of Dr. Roberts, the in-serivces where video taped and posted to the extension website along with the other module content to allow the FCS Educators access all of the resources in one place. Despite the work of the research team in developing the course content and dissemination of the the Caregiver Education Program to the FCS Educators, several factors impacted the levels of dissemination of the program to the larger caregiver community in the state. When discussing the barriers faced in implementing the new caregiver education program, several themeswere identified in interviews with state extension workers that took place in 2018 and which were used to inform the publication for the Journal of Extension. These identified themes included staff shortages, program prioritization, communication with program team, and developing a public audience. Staff Shortages Educators expressed a shortage in staff as an important barrier to engaging in new programs. One participant made this point, "I am the only educator in my county and I am trying to keep the Ag going, 4-H going, and FCS going, trying to keep my office running". Educators consistently stated that staff shortages created issues for implementing new programs, as job assignments often had to be altered to cover needed programming areas. Another participant described how her workload has been impacted by budget cuts, "...when I first did the training, I was full-time FCS educator in my county. Now because of budget cuts, I am 60% FCS and 40% 4-H, so I have added duties now." Because of staff shortages, some participants indicated that they were unable to attend trainings due to their other responsibilities related to their Extension positions. One participant explained the complexity of her circumstances, "...I am 50% FCS, 50% 4-H, and I am also county director and I also take care of rural development stuff too. There is a limit to what I can do." Overall, respondants were clearly having adjust to being overworked and under staffed in their offices, often having to perform the duties of one to three other staff member who may no longer be in the office due to state financial restraints. For some respondents, just having to keep up with their current responsibilities may have made it impossible to take the time to learn about a new caregiving education program. Program Prioritization Despite educators agreeing that caregiver education was an important need in their county, several educators did not attend trainings due to their Program Advising Committees' (PAC) lack of prioritization or perception of community need for caregiving education. One educator explained, "Advisory teams advise needs...I'm not doing caregiving because it wasn't picked by my advisory team."Along with low PAC prioritization, one educator reported that other organizations were already providing education to caregivers. As the participant explained: "It is not a high priority on the needs in this community. Also we have so many other organizations that are doing similar things...so based on our advisory council and based on the needs, caregiving is not the one that has floated at the top as a need."Other educators consistently reported trouble prioritizing their time to either participate in the training or deliver the content to the public. Without the green light to begin the caregiving education program and prioritization from their community PAC, many of the educators felt that their hands were tied with respect to taking on the caregiving education program. While they understood the importance of the content, there were just too many other pressing issues and tasks in their job to take on the program material on their own. Communication with Caregiving EducationProgram Team Educators expressed confusion regarding the structure of the program. Several educators had questions regarding how the lessons should be delivered, whether as standalone programs or as a complete series. There were discrepancies regarding how program information, such as in-service opportunities should be delivered to educators. While the initial program notification was delivered to the educators through email, several educators felt that just the fact that they had received the email that they were not necessarlily required to participate. One educator shared, "we get flooded with emails all the time. I'm not under the impression it's required." Developing a Public Audience Several of the educators identified locating family caregivers as a barrier to program delivery. One educator shared, "it's just finding the people...sometimes they call you with the audience, that would be nice to be called, "hey I have a group of caregivers." But this one doesn't work that way." .In many case caregivers do not either (1) see themselves as deserving extra help; (2) have the time to seek and receive extra help and (3) do not self-identify as family caregivers, they are just doing what is needed and expected in their family unit. This inability to be able to engage or identify caregivers left educators unsure how to keep the audience engaged in the program once they attended the first session. As one educator explained, "I haven't figured out how I am going to deliver it (programming). If I do once a week for so many weeks, or if I can get more of an audience I would take a Saturday and do it all in one time. (With multiple sessions), I am just not sure how I can get the audience to come back every time." Final Thoughts In the light of budget cuts, Extension educators are facing downsizing and consolidation of county offices while at the same timeincreased public demand for services from theExtension networkfor both the land-grant institutions and counties.These factors have led Educators to prioritize their programming based on the reflection of community needs that have been developed specificallyby the PACs.Several Educators articulated their belief that the program was needed statewide to support family caregivers and hoped that other Educators saw the potential of the program to help aging families. However, others who may not have previous or current caregiving experiences perceived the programming as unimportant in their counties dueto a lack of clarity in their community about what it means to be a "family caregiver". In essence, the caregivers that need the most support are too busy to reach out for help. Therefore, despite being informed of the needs present in Oklahoma communities, Educators did not perceive the program as a high priority because their constituents did not perceive the program as a priority. This Catch-22 is an important hurdle for program developers to address, because research, policy initiatives and practitioners within the communities continue to clearly state the level of need for ongoing support for caregivers within their communities. Further analysis of the program will continue and will help to inform other teams preparing to develop programs and services to support caregiving families in their communities. What opportunities for training and professional development has the project provided?The 6 module lessons are self-contained and can be delivered independent of each other. Caregiving 101 and Healthy Caregiving were mandatory trainings as they were added to the agents' core competency requirements. Trainings for the other four lessons were optional. Five training in-services were offered during June 2017. These trainings were held at five different locations across the state to accommodate travel, with at least one training in each district. Each in-service was an all-day event to allow for maximum time to train agents on Caregiving 101 and Healthy Caregiving. Ten additional online in-services were offered during July 2017 to train agents on the remaining lessons. Six additional in-services were held from January 2018 through March 2018 to train agents on all six lessons. Agents were given the option to either attend the in-services in person or telecommute. These in-services were recorded to allow agents access to trainings when necessary. All of the module in-services are posted in Oklahoma Extension's Program Activity Reporting System (PARS) to allow agents to enroll. CEP staff and district FCS program specialists also notified agents of all in-services via email. Despite required program attendance, only 50% of Oklahoma's Family and Consumer Science (FCS) Educators participated in the initial trainings. The numbers of FCS Educators trained on the program are as follows: Caregiving 101 - 26 Healthy Caregiving - 26 Home Safety - 6 Nutrition - 6 Finances - 5 Elder Abuse - 5 In addition to these program modules, in 2019 a series of caregiver associated webinars were provided to extension educators throug the College of Human Sciences. How have the results been disseminated to communities of interest?- Six fact sheets based on the module content have been developed, three have been published through the state extension office and three are awaiting publication. -Eight Video Vignettes produced by the research team are available in conjuntion with the module powerpoints along with other information materials -As stated in previous sections, multi[le in-service trainings have been provided to FCS Educators and OHCE volunteers(community of interest is rural FCS Educators and citizens they serve). The research team presented resources and materials at health fairs, county groups, webinars, and education sessions. -Multiple presentations of the modules have been taken into rural Oklahoma communities bythe FCS Educators. The number of actual partipants who filled out the pre-test survey is 52, but there are many uncounted attendees who did not take the survey --Multiple conference presentations by the grant team to rural health providers and aging services professionals at the state and national levels. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Goal 1- A tool kit for a sustainable rural caregiving education network was developed through the grant witha training program that reflects knowledge and skills needed among caregivers. Each domain reflects the scientific literature, applications of the socio-logical approach (i.e., examining both micro and macro influences on the care family), and proposed solutions and the tool kit includes module PowerPoints, video vignettes, fact sheets and other informational topic content.. Caregiving 101: introduction to caregiving and the aging network Healthy Caregiving: strategies to maintain healthy relationships with the care recipient and self-care Nutrition: nutritional needs of older adults Home safety: discussion of strategies to ensure the older adult's home remains safe to inhabit Elder abuse and exploitation: types of abuse and common symptoms Finances: discussion of various federal and state programs to help fund caregiving expenses Plans for continued support in the caregiving education network include the development of the Human Environmental Factors Lab (HEFL) at Oklahoma State University for research and education in caregiving issues, application for further fudning sources through the Clark Gerontology Fund and Benjamin Rose Institute and a propoed Master Caregiver Program to be developed in alignment with this projects module content. Goal 2- With the scope of the work that has been done on this project, health literacy has been the goal throughout. The research team has provided the course materials and tool kit fo the FCS Educators to take to family caregivers. Some contact was made with hospital discharge planners, but due to state budget cuts in the rural health care system, that level of training was not completed between the FCS Educators and hospital discharge planners at the levels that had been anticipated. Goal 3-Within each of the program modules there is information about access to health and social services for rural elders and family caregivers. At each of the events held by or that the research team participated in, flyers, information packets and other tools for community understanding of services available have been presented. Ongoing program building has resulted in a phone in or online opportunity to connect with a team member which can help connect a community member with the necessary information and next steps for short term and long term caregiving issues. Goal 4- While the grant has not been successful atgathering extensive pre/post metrics on empowerment and well-being among family caregivers, the data that has been gathered points to the absolute needs of family caregiviers for support. By allowing the caregivers to take the time to become educated on the support services that are available to them, they then are empowered to make decisions and take steps to no only provide the best care for their loved one, but to also take the steps to care for themselves. This outcome has been a core goal for this grant and with the data that has been gathered, the team hopes strengthen the sustainability of this and future programs moving forward. Develop webinars and educational programs for online delivery to allow public to access the program when it is convenient for them.This will help alleviate some of the time management issues reported by the extension workers, allowing the general public to make their own schedule with regards to the best time to take part in the educational program and content. Develop clear communication among partners and public.This addresses the issues of user-centered development of the course materials. Contacting potential stakeholders prior to the development for their input on current community needs and dissemination strategies will allow for personal ownership of the education program by both educators and the general public. Use established network to engage stakeholders (e.g., hospitals, home health agencies, etc.).Using existing social media and list serv networks can provide time savings in participant recruitment as the lines of communication are already open to potential participants. Development of recruitment materials that are relatable and have flexibility to address the concerns of each of the stakeholder groups will allow for direct and understandable communications in the recruitment process. Clearer prioritization processes for Educators regarding identified needed programs.Contact and buy-in from the PAC team at the inception of the development of the program will help save time and effort at all stages of the education program. Staying flexible with the proposed content will allow for current and future input from stakeholders which will lead to the desired outcomes expected from an educational program with this level of societal importance.
Publications
- Type:
Journal Articles
Status:
Awaiting Publication
Year Published:
2019
Citation:
Struckmeyer, K., Roberts, E., Gordon, S., Raczkoski, B. & Singh, C. (2019). Barriers and strategies for engaging extension educators in family caregiver education. Journal of Extension
- Type:
Other
Status:
Published
Year Published:
2019
Citation:
Roberts, E, Struckmeyer, K. Bailey, W., Gordon, S., Mejia, L.(2019). Caregiving 101. Oklahoma Cooperative Extension Service Fact Sheet.
- Type:
Other
Status:
Published
Year Published:
2019
Citation:
Roberts, E, Struckmeyer, K. Bailey, W., Gordon, S., Mejia, L.(2019). Healthy Caregiving. Oklahoma Cooperative Extension Service Fact Sheet.
- Type:
Other
Status:
Published
Year Published:
2019
Citation:
Lodor, H., Struckmeyer, K. Bailey, W., Roberts, E., (2019). Family Caregiving, Creating a Care Team Oklahoma Cooperative Extension Service Fact Sheet.
- Type:
Other
Status:
Awaiting Publication
Year Published:
2019
Citation:
Roberts, E, Struckmeyer, K. Bailey, W., Gordon, S., Pulig, L. (2019). Exploitation and Abuse Prevention for Caregiving. Oklahoma Cooperative Extension Service Fact Sheet
- Type:
Other
Status:
Awaiting Publication
Year Published:
2019
Citation:
Roberts, E, Struckmeyer, K. Bailey, W., Gordon, S., Pulig, L. (2019). Finances and Caregiving. Oklahoma Cooperative Extension Service Fact Sheet
- Type:
Other
Status:
Awaiting Publication
Year Published:
2019
Citation:
Roberts, E, Struckmeyer, K. Bailey, W., Gordon, S., Pulig, L. (2019). Safe Home Environments for Careigiving. Oklahoma Cooperative Extension Service Fact Sheet. (under review)
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Progress 09/01/17 to 08/31/18
Outputs
Target Audience:During this reporting period, our project team: -directly trained 25 FCS Educators who cover 37 Rural Oklahoma Counties. -presented resources and materials to more than 250 care families through health fairs, county groups, webinars, and education sessions. -directly oriented more than 75 home health and other health professionals with the Care Education program from this project. -attended and disseminated project information at the Southern Gerontological Society and Environmental Design Research Association conferences with contact with more than 200 professionals. Changes/Problems:Other than Dr. Emily Roberts taking over the role of Lead Project Director from Dr. Whitney Bailey, there are no major changes or problems to report. The ability to continue with the project with the no cost extension will allow the grant team to finish with data collection and analysis and for finalization of articles for publication. What opportunities for training and professional development has the project provided?Training Activities: --The team presented and video-recorded each of the one hour in services forthe 6 modules for current and future use by FCS educator --Previously created 8 videos 'family vignettes"that are used as teaching tools for all target audiences Professional Development: --Team members attended national conferences, and a rural Oklahoma caregiver symposium How have the results been disseminated to communities of interest?Team presented resources and materials at county groups, webinars, and education sessions. Disseminated project information at the Southern Gerontolgocial Society annual conference in Lake Lanier, Georgia in April, 2018 and the Environmental Design Research Association annual meeting in Oklahoma City, Oklahoma in June, 2018. What do you plan to do during the next reporting period to accomplish the goals?Activities during the final year (through 8-31-19) will be Complete collection of all assessment data, which includes pre-post assessements with all target audiences and module specific assessments of learning outcomes. Present project activities and results at national meetings. Submit manuscripts in professional outlets
Impacts
What was accomplished under these goals?
Mobilize and unify a multi-institution, multi-agency team of experts on rural health and aging to develop a sustainable rural caregiving education network. Multiple events have been pre-planned and led by FCS Educators Improve health literacy amoung key rual care members (FCS Educator, hospital discharge planners, and family caregivers). The full series of module in-services were presented to FCS Educators either live or through zoom meeting technology. The zoom meeting in-services were also video recorded and can be found on the FCS Educator grant site and used at any time for a refresher or to gain more understanding of the content. A principle outcome of the FCS Educator interviews speaks to the number and breadth of other programs that these educators must familiarize themselves with. For many, this is the first time that they have been introduced to the concepts in our modules, and several interviewees expressed difficulty in remembering/understanding all of the concepts. The video-taped in-services will play a large role in mitigating these issues and many educators expressed their gratitude for these posted sessions. Improve understanding of and access to health and social services for rural elders and family caregivers.The Caregiving 101 module and associated in-service training is required for all Educators. A key objective of this training is understanding, supporting and helping others access health and social services. Interview data collected in 2018 clearly shows a gap in training and educational opportunities for FCS educators to take into their communities that this Caregiver Education project fills. Increase sense of empowerment and well-being among family caregivers. A principle outcome of the FCS educator interviews speaks to the difficulty in caregivers self-identifying as such. FCS educators expressed that many family members who are principle caregivers see themselves only as family members doing their duty. With this duty may come guilt and stress of not being able to live up to the demands that are part of this role. This is a key factor in the current project's slow growth in the community, FCS educators have attempted on many occasions to pre-plan events, which in the end were either sparsely attended or not attended at all. The other piece of this described by the FCS educators is for those who may label themselves a caregiver, there is an inability to make time for events such as those put on by the FCS educators. Where will the care recipient stay or with whom while the caregiver is at educational sessions? This is a key factor that the project team sees as a barrier for caregivers in receiving important support and education outside of the home and the research team is re-thinking dissemination techniques such as "Dementia Café" meetings that may better serve to allow caregivers opportunities to gain important support and information. These Dementia Cafes may be held in homes, churches or other meeting areas and can include caregivers and care recipients. Care recipients may be involved in other supervised activities while the caregivers are attending the educational session, but both parties are in the same location which can alleviate caregiver concerns/guilt about leaving the house to go to meetings or sessions while the care recipient is home alone or with an outside caregiver.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2018
Citation:
Roberts, E., Gordon, S., Struckmeyer, K.M. & Raczkoski, B. (June, 2018). Approaching care education through empowering rural communities to engage in exceptional care of rural elders. Presentation and conference proceedings for the Environmental Design Research Association annual meeting, Oklahoma City, Oklahoma.
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Progress 09/01/16 to 08/31/17
Outputs
Target Audience:During this reporting period, our project team: -directly trained 31 FCS Educators who cover 37 Rural Oklahoma Counties. -presented resources and materials to more than 250 care families through health fairs, county groups, webinars, and education sessions. -directly oriented more than 75 home health and other health professionals with the Care Education program from this project. -attended and disseminated projejct information at IAGG/GSA conference/expo in July of 2017 - contact with more than 100 professionals. Changes/Problems:There are no major changes or problems to report. The no cost extension was a tremendous help as this allows us to continue our training and data collection into the 2018 planning/work period for FCS Educators. What opportunities for training and professional development has the project provided?Training Activities: --provided 8 in-service trainings for 31 FCS Educators --created 8 videos that are used as teaching tools for all target audiences Professional Development: --team members attended rural health conferences, national conferences, specific training on elder exploitation and abuse, participated in webinars related to nutrition and elders. How have the results been disseminated to communities of interest?Team presented resources and materials at health fairs, county groups, webinars, and education sessions. Disseminated projejct information at IAGG/GSA conference/expo in July of 201. What do you plan to do during the next reporting period to accomplish the goals?Activities during the final year (through 8-31-18) will be: complete all FCS in-service trainings, including in-person and online trainings to be utilized in the future (for new hires, refreshers, etc) complete collection of all assessment data, which includes pre-post assessments with all target audiences and module specific assessments of learning outcomes. present project activities and results at national meetings. submit manuscripts in professional outlets
Impacts
What was accomplished under these goals?
1 - Mobilize and unify a multi-institution, multi-agency team of experts on rural health and aging to develop a sustainable rural caregiving education network. --This macro goal is ongoing. However, this ongoing project is resulting in concrete connections. For example, our FCS Educators are holding meetings with their elected officials about caregiving. FCS Educators are hosting health fairs for care families, while strengthening partnerships with home health agencies and other rural health providers. Several of our FCS Educators are being asked to serve on hospital health boards and being recognized as knowledgable in caregiving education. We are also seeing more events (6 this past year) co-hosted by our FCS Educators and our grant partners (AARP, Office or Rural Health, local health departments, and rural hospitals). Our team remains dedicated to training the FCS Educators on Care Education while also educating the health network about the critical role FCS plays in Care Education. 2 - Improve health literacy among key rural care members (FCS Educators, hospital discharge planners, and family caregivers). The 31 FCS Educators who have completed the initial training on Care Education report a greater understanding of the federal and state aging network, caregiving resources, and the role of discharge planning in care. As we wrote in our initial proposal for funding, this is critical to health literacy. As we enter the final year of this project, that training of FCS Educators will be completed and their training of health professionals and care families will be far reaching. 3 - Improve understanding of and access to health and social services for rural elders and family caregivers. The Caregiving 101 module and associated in-service training is required for all Educators. A key objective of this training is understanding, supporting and helping others access health and social services. Initial data collected from our FCS Educators prior to their first Caregiving 101 in-service shows that their familiarilty and comfort with such information is low. This supports the need for our efforts to specifically improve training on this front. In our final year, we will have two more data points to demonstrate how their knowledge and understanding improves. 4 - Increase sense of empowerment and well-being among family caregivers. Data to support this goal are measured through our pre and post data from caregivers who attend Care Education progamming. These data are beginning to be collected as each of our 31 trained educators is hosting sessions in their respective counties.
Publications
- Type:
Book Chapters
Status:
Accepted
Year Published:
2017
Citation:
One member of our team served as co-editor for a book volume on Caregiving Resilience. Two members of our team wrote the preface for that volume, in which there was a strong focus on both care education and mobilizing the FCS Extension network to respond to rural, care families. Because this volume was related to this grant but not supported by this project, NIFA support was not explicitly acknowledged.
- Type:
Conference Papers and Presentations
Status:
Submitted
Year Published:
2017
Citation:
Struckmeyer, K. M., & Bailey, W. A. (March, 2017). Strategies for engaging caregivers in care education through the Cooperative Extension Network. Proposal submitted to the American Society on Aging annual meeting, San Francisco, CA.
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2017
Citation:
Struckmeyer, K. M., Raczkoski, B. M., Bailey, W. A., Gordon, S. R., Roberts, E., & Clancy, N. (October, 2017). Filling the gap between policy and need: Development of a caregiving education program for FCS educators. Seminar presented at the National Extension Association of Family & Consumer Sciences annual session, Omaha, NE.
- Type:
Conference Papers and Presentations
Status:
Submitted
Year Published:
2017
Citation:
Raczkoski, B. M., Struckmeyer, K. M., Bailey, W. A., Gordon, S. R., Roberts, E., & Clancy, N. (October, 2017). FCS Educators perceptions of a blended approach to in-service trainings. Seminar proposal submitted to the National Extension Association of Family & Consumer Sciences annual session, Omaha, NE.
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