Iowa State Plan on Aging: Balancing Long-Term Community Support Services for Aging Iowans, FY 2014–2015

This plan outlines the activities and strategies that the IDA will purse to achieve its goals, objectives, and expected outcomes in modernizing Iowa’s aging network. The goals that will move Iowa’s state plan.

The State of Iowa Consolidated Plan for Housing and Community Development: Annual Action Plan, 2016

The state of Iowa must submit to HUD a Consolidated Plan and an Annual Action Plan. The Consolidated Plan is a 5-year plan to address housing and community development needs. The 2015-2019 Consolidated Plan was submitted to HUD in 2015 and outlines the state of Iowa’s goals for the 5-year period. The state’s Consolidated Plan includes goals and proposed activities under the Community Development Block Grant (CDBG), HOME Investment Partnerships (HOME), Emergency Solutions Grant (ESG), and Housing Opportunities for Persons with AIDS (HOPWA) programs.

Medicaid Home and Community Based Services Elderly Waiver Program

The Medicaid Home and Community Based Services (HCBS) Elderly Waiver program provides assistance to qualified individuals who are 65 or older and prefer to stay in their own home or another community setting when needing long-term health care services. The Elderly Waiver program provides services and support to older Iowans who are medically qualified for the level of care provided at a nursing facility but do not wish to live in a nursing home. The program allows older Iowans to age in environments that are familiar and comfortable, while saving money from expensive nursing home costs.

Evolution of Gait Performance and Fear of Falling after a 10-Week Program of Exercise Training in Community Dwelling Older People

A pilot study was conducted to determine the effect of a 10-week, low intensity, exercise training program on fear of falling and gait in fifty (mean age 78.1 years, 79% women) community-dwelling volunteers. Fear of falling (measured by falls self-efficacy) and gait performance were assessed at baseline and one week after program completion. At follow-up, participants modestly improved their falls self-efficacy and gait speed. To investigate whether this effect differed according to participants' fear of falling, secondary analyses stratified by subject's baseline falls efficacy were performed. Subjects with lower than average falls efficacy improved significantly their falls efficacy and gait performance, while no significant change occurred in the others. Small but significant improvements occurred after this pilot training program, particularly in subjects with low baseline falls efficacy. These results suggest that measures of falls efficacy might be useful for better targeting individuals most likely to benefit from similar training programs.

Community Care Access Centre accountability reforms: executive director perceptions /

The purpose of this study was to explore how four purposefully selected executive directors of Community Care Access Centres (CCACs) understood the idea of accountability, and how they viewed the accountability reforms that had been imposed on their sector of health care over the previous three years. Data were collected through personal interviews and a reflective journal. An analysis of key documents and the reflective journal informed the data analysis. The findings suggest that executive directors perceive that accountability relationships have shifted since reforms have been implemented. They noted that CCACs have become more accountable to the provincial government at the expense of accountability to the local community. From their perspective, the demand for greater standardization and bureaucratization has left fewer opportunities to adapt programs to meet particular community needs and has slowed the ability to respond quickly to community inquiries and concerns.

Attitudes of second year diploma nurses in three community colleges toward the use of computers in the nursing role /

The effectiveness of various kinds of computer programs is of concern to nurse-educators. Using a 3x3 experimental design, ninety second year diploma student nurses were randomly selected from a total population at three community colleges in Ontario. Data were collected via a 20-item valid and reliable Likert-type questionnaire developed by the nursing profession to measure perceptions of nurses about computers in the nursing role. The groups were pretested and posttested at the beginning and end of one semester. Subjects attending College A group received a computer literacy course which comprised word processing with technology awareness. College B students were exposed to computer-aided instruction primarily in nursing simulations intermittently throughout the semester. College C subjects maintained their regular curriculum with no computer involvement. The student's t-test (two-tailed) was employed to assess the attitude scores data and a one-way analysis of variance was performed on the attitude scores. Posttest analysis revealed that there was a significant difference (p<.05) between attitude scores on the use of computers in the nursing role between College A and C. No significant differences (p>.05) were seen between College B and A in posttesting. Suggestions for continued computer education of diploma student nurses are provided.

Linking community variables to parenting behaviours and youth risk behaviours

The puq)ose of this thesis is to test a model Hnking community disadvantage and urbanicity factors to parenting variables (i.e., monitoring, warmth, and knowledge) and to youth risk behavior (i.e., substance use and delinquency), measured both concurrently and one year after the assessment of parenting variables. The model builds on the work of Fletcher, Steinberg, and Williams-Wheeler (2004) but a) includes a more comprehensive measure of SES than that conceptualized by Fletcher et al.; b) considers whether the role of community disadvantage is indirectly as well as directly linked to youth risk behavior, by way of its association with parenting variables; c) considers whether level of community urbanicity plays a direct role in predicting both parenting variables and risk behaviors, or whether its influence on risk behaviours is primarily indirect through parenting variables. Both community disadvantage and urbanicity had virtually no relation to parenting and risk behaviour variables. Results found for relations of parenting variables and risk behaviour were similar to Fletcher et al. Although urban youth are typically perceived as being more at risk for substance use and delinquency, no evidence was found for a distinction between urban and rural youth within this sample. Targeting risk behaviour prevention/reduction programs toward only urban youth, therefore, is not supported by these findings.

Self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey

The purpose of this cross sectional survey design was to examine self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey. Using a mail-out survey, entitled the Fort Erie Survey of Health (FESH), a probability cluster sampling technique was used to measure self-reported health status (present health, health conditions, health challenges, functional health limitations) and lifestyle behaviour (smoking, alcohol use, drug use, physical activity, fruit and vegetable consumption, body weight, and gaming). Each variable was described and analyzed in relation to socio-economic variables, age and gender. The findings from this study were compared to the Canadian Community Health Survey 2000/2001. Overall, 640 surveys were completed. The majority of Fort Erie residents rated their present health as good and were satisfied with their overall health and quality of life. The main chronic conditions reported were arthritis, back pain and heart disease. Other main health problems reported were vision, sleeping and chronic pain. Overall, 14.6% smoke; 58.8% engaged in physical activity either occasionally or never as opposed to regularly engaging in physical activity; 52.1% did not eat the required daily fruits and vegetables; and 40.0% were in the overweight category. Persons who practiced one healthy lifestyle behaviour were more likely to practice other healthy promoting behaviours. Therefore, health promotion programs are best designed to address multiple risk factors simultaneously. The ffiSH was generally consistent with the Canadian Community Health Survey in the overall findings. A small number of inconsistencies were identified that require further exploration to determine if they are unique to this community.

Understanding space, place and leisure of women over 85 living in the community

There is an increase in the number of older adults 85 and over, who are choosing to live alone within the community. Moreover, older adults who live alone are reportedly spending an extensive amount of time alone within the home environment. In an effort to provide additional support and resources to older adults living in the community, a compliment of services are being offered through public and private organizations. These in-home supports focus on the instrumental or functional tasks of daily living, such as personal and rehabilitative care, nourishment, maintenance and upkeep of the home, as well as volunteer social visitation. However leisure resources and programs are not included among these services. Consequently, this creates a gap in leisure provision among this segment of the population. Throughout the life course, an individual's identity, role and purpose are developed and sustained through instrumental work roles in the formal and informal sector, as well as through personally meaningful leisure pastimes and experiences. Although roles shift post retirement, participation in instrumental and expressive activities can provide opportunities through which older adults are able to fulfill their need for agency (individuality and autonomy) and affiliation (social relatedness). Therefore barriers that inhibit instrumental or leisure experiences can negatively impact older adults' quality of life. This study explored the leisure lifestyles of four older adults, all of whom were over 85, lived alone within the community and were oriented to person, time and place. It became apparent that participants ordered their lives around a routine that consisted of instrumental, expressive and socially integrated tasks and activities. Moreover participants purposely chose to remain at home because their home environment facilitated freedom, choice and independence. As a result all four participants viewed their independence within the home as a critical determinant to their overall quality of life. Challenges associated with the home environment, participants' personal capacities and relationships were negotiated on a daily basis. Failure to positively adapt to these challenges inhibited meaningful engagement and personal fulfillment. Traditionally, leisure service delivery has been offered within institutions and through various community based venues. As a result leisure provision has been focused on the needs of the frail elderly who reside in institutions or the well elderly who are able to access leisure amenities within the community. However the growing number of older adults electing to live alone is on the rise. As individuals age the home becomes the preferred context for leisure experiences. If older adults are choosing to live alone, then both their instrumental and leisure needs must be addressed. As a result, it is imperative that leisure professionals extend the scope of service delivery to include home centered older adults.

The journey towards comprehensive school health within an aboriginal community

The purpose of this research is to describe the journey towards Comprehensive School Health at two Aboriginal elementary schools. An advocate and a healthy schools committee were identified at both schools and were responsible for developing initiatives to create a healthy school community. A case study was used to gather an in-depth understanding of Comprehensive School Health for the two schools involved. As a researcher, I functioned within the role of a participantobserver, as I was actively involved in the programs and initiatives completed in both schools. The research process included: the pilot study, ethics clearance and distribution of letters of invitation and consent forms. Data collection included 16 semi-structured, guided interviews with principals, teachers, and stupents. Participant observations included sites of the gymnasium, classroom, playgrounds, school environments, bulletin boards as well as artifact analysis of decuments such as school newsletters, physical education schedules and school handbooks. The interviews were transcribed and coded using an inductive approach which involves finding patterns, themes and categories from the data (patton, 2002). Research questions guided the findings as physical activity, physical education, nutrition and transportation were discussed. Themes developed t~rough coding were teacherstudent interactions, cultural traditions, time constraints and professional development and were discussed using a Comprehensive School Health framework.

A case study investigation of the learning needs of the Niagara grape and wine community

The Niagara Grape and Wine Community (NGWC) is an industry that has undergone rapid change and expansion as a result of changes in governmental regulations and consumer preferences. As a result of these changes, the demands of the wine industry workforce have changed to reflect the need to implement new strategies and practices to remain viable and competitive. The influx of people into the community with little or no prior practical experience in grape growing (viticulture) or winemaking (oenology) has created a need for additional training and learning opportunities to meet workforce needs. This case study investigated the learning needs of the members of this community and how these needs are currently being met. The barriers to, and the opportunities for, members acquiring new knowledge and developing skills were also explored. Participants were those involved in all levels of the industry and sectors (viticulture, processing, and retail), and their views on needs and suggestions for programs of study were collected. Through cross analyses of sectors, areas of common and unique interest were identified as well as formats for delivery. A common fundamental component was identified by all sectors - any program must have a significant applied component or demonstration of proficiency and should utilize members as peer instructors, mentors, and collaborators to generate a larger shared collective of knowledge. Through the review of learning organizations, learning communities, communities of practices, and learning networks, the principles for the development of a Grape and Wine Learning Network to meet the learning needs of the NGWC outside of formal institutional or academic programs were developed. The roles and actions of members to make such a network successful are suggested.

Exploring Reciprocity in International Service Learning Programs

Using aspects of grounded theory methodology, this study explored the perceptions and practical implementation of reciprocity in International Service Learning (ISL) Programs. Data were collected through interviews with nine ISL practitioners representing a variety of organizations offering international service learning programs. Findings suggest that multiple conceptualizations of ISL programs exist. ISL programs are interdisciplinary in nature and that using reciprocity as a guiding framework is problematic. Further attention is needed in relation to shifting the guiding framework of ISL programs from reciprocity to interdependence.

An Exploration Into Doctoral Students' Sense of Community and its Influence on the Formation of Informal Mentoring Relationships

This exploratory mixed method research project was designed to investigate an area of doctoral education that has received little attention in the past. This research focused specifically on the non-intellectual, hoped-for by-products of doctoral education; the dynamic processes of developing and maintaining both a sense of community and informal mentoring relationships. The design of the study captured the experiences of doctoral students and alumni at various time periods in the doctoral program. Participants represented a diverse group of students with differences in professional and academic backgrounds and life stages. A pilot study for this research suggested that the presence of a sense of community and informal mentoring may provide the necessary relationships to support this diversity. The primary question at the forefront of this study was: Do doctoral students feel connected to one another? Five subquestions were developed to address this research topic: Does a sense of community already exist and flourish in doctoral education? Are the programs and resources of the doctoral program organized to nurture the creation and maintenance of a sense of community? Is a sense of community a foundational element in the formation of naturally occurring relationships among doctoral students? What educational and socio-emotional benefits are associated with informal mentoring relationships during the doctoral experience? and Do doctoral students perceive a change in their development as stewards of their discipline over time? The principal methods used to investigate these research questions combined both quantitative and qualitative techniques in a concurrent time sequence. The quantitative portion of the study involved a questionnaire, while the qualitative portion involved two approaches; face-to-face interviews and an open-ended question at the end of the questionnaire. Findings from the study indicated that the presence of both sense of community and informal mentoring enhance the overall quality of doctoral education. Program elements that enhanced or hindered connection between students were identified. Both the dynamics and the emotional, social, and academic benefits of informal mentoring were elucidated. Over time participants perceived changes in their development of the qualities assqciated with stewardship. This study brought the "hoped-for by-products" associated with doctoral education from the background shadows to an illuminated position at the forefront of inquiry.

The Essence of Feeling a Sense of Community: A Hermeneutic Phenomenological Inquiry With Middle School Students and Teachers

In contemporary times, there is a compelling need to understand the nature of positive community relationships that value diverse others. This dissertation is a hermeneutic phenomenological inquiry into the essence of what it means to feel a sense of community. Specifically, I explored this phenomenon from the perspective of middle school teachers and students through the following questions: What meanings do students and teachers ascribe to feeling, experiencing, and developing a sense of community in their classes? To what extent do students’ and teachers’ ideas about feeling a sense of community include the acceptance of individual differences? Together these questions contributed to the overarching question, what is the essence of feeling a sense of community? As the data pool for the research, I used 192 essays and 218 posters from students who had been asked to write or draw about their visions of a positive classroom community where they felt a sense of community. I conducted 9 teacher interviews on the topic as well. My findings revealed one overarching ontology, Being-in-Relation, which outlined a full integration between individuality and community as a “way of being.” I also found five attributes that are present when individuals feel a sense of community: Supporting Others, Dialogue, An Ethic of Respect and Care, Safety, and Healthy Conflict. Contributions from this research include extensions to the literature about community; clarity for those who wish to establish a strong foundation of community relationships within formal and non-formal educational programs; insight that may assist educators, leaders, and policy makers within formal educational systems; and an opportunity to consider the extent to which the findings may point toward broader implications.

Using Network Analysis to Understand and Advance Falls Prevention Services and Programs

The purpose of this study was to understand referral linkages that exist among falls prevention agencies in a southern Ontario region using network analysis theory. This was a single case study which included fifteen individual interviews. The data was analyzed through the constant comparative approach. Ten themes emerged and are classified into internal and external factors. Themes associated with internal factors are: 1) health professionals initiating services; 2) communication strategies; 3) formal partnerships; 4) trust; 5) program awareness; and 6) referral policies. Themes associated with external factors are: 1) client characteristics; 2) primary and community care collaboration; 3) networking; and 4) funding. Recommendations to improve the referral pathway are: 1) electronic database; 2) electronic referral forms; 3) educating office staff; and 4) education days. This study outlined the benefit of using network analysis to understand referral pathways and the importance of implementing strategies that will improve falls prevention referral pathways.