Process and Structure: Service Satisfaction and Recommendation in a Community-based Elderly Meal Service in Shanghai
Lin Chen; Minzhi Ye; Eva Kahana
Journal of Aging & Social Policy, December 2019

Informed by Donabedian’s quality-of-care framework, this study aims to examine elderly clients’ service satisfaction and service recommendation for community-based meal services in Shanghai. We analyzed secondary survey data from randomly sampled elderly clients of a community-based meal service in the old Jing’an District in Shanghai (N= 690). Quality of food and caregivers’ attitudes were key to respondents’ service recommendation while tidiness of tableware and interactions with caregivers were positively related to their service satisfaction. Overlaps and differences between structure and process factors are discussed. We also provide tailored policy recommendations.


Meeting Challenges of Late Life Disability Proactively 
Eva Kahana; Jeffery S Kahana; Boaz Kahana; Polina Ermoshkina
Innovation in Aging, Volume 3, Issue 4, August 2019

Discussions of disability in the gerontological and the disability studies literatures have seldom considered unique perspectives and needs of older adults. Disability has often been stigmatized and viewed as antithetical to successful aging. We call for expansion of prevailing paradigms of disability to address the resilience and continuing human potential of older adults living with disabilities. In addition to recognizing the environmental context of disability, we propose greater attention to adaptive potential of disabled older adults. We discuss 6 types of proactive adaptations that can contribute to empowerment, meaning, enhanced quality of life and psychological well-being among persons living with late-life onset disabilities. These include: (a) helping others, (b) planning for future care, (c) marshaling intergenerational support, (d) self-advocacy for responsive health care, (e) making environmental modifications to improve safety and comfort of the home, and (f) finding strength in spiritual pursuits. Enacting proactive adaptations can contribute to resilience in facing late life impairments and functional limitations. Such efforts can complement utilization of services and obtaining accommodations. Maintaining life satisfaction among older adults living with disabilities also involves focus on transcendent personal goals and acceptance of an altered self. We note how a more integrative view of medical and social dimensions of disability, infused with concepts of human agency, contributes to rapprochement between alternative disciplinary orientations to late life disability. Without negating society’s important responsibilities for accommodating to needs of older adults living with disability, we reaffirm their potential for greater control and self-determination through proactive adaptations.


Gendered “Long Arm” of Parental Education? Life Course Influences on Later Life Functional Limitations in India 
Tirth R. Bhatta; Jeffery M. Albert; Jessica Kelley; Eva Kahana
Journal of Aging and Health, 2018

We adopt a novel approach to mediation analysis to account for interrelated life course social processes that constitute later life health disparities. We examine gender-specific direct effect of parental education on functional limitations in later life.


Whose advocacy counts in shaping elderly patients’ satisfaction with physicians’ care and communication? 
Boaz Kahana; Jiao Yu; Eva Kahana; Kaitlyn Barnes Langendoerfer
Clinical Interventions in Aging 2018; 13: 1161-1168

The purpose of this article was to examine the relative importance of patients’ self-advocacy and perceived physicians’ advocacy for impacting patients’ satisfaction in terms of physician communication and physician–patient relationship. We also examine the influence of physicians’ emotional support and patients’ demographic as well as health characteristics on patients’ satisfaction.   


Disability and Aging: Learning from Both to Empower the Lives of Older Adults
Jeffrey S. Kahana and Eva Kahana
Lynne Rienner Publishers, Inc. (May 30, 2017)

What is the lived experience of previously healthy older adults as they face disability in late life, and how is disability assimilated in their identity? How do prevailing practices facilitate―or limit―options for elders living with new disabilities? To address these questions, Jeffrey Kahana and Eva Kahana uniquely synthesize disability and gerontological perspectives to explore both the unfolding challenges of aging and the practices and policies that can enhance the lives of older adults.

 


Defining Successful Aging: A Tangible or Elusive Concept
Martin, Peter; Kelly,  Norene;  Kahana, Boaz; Kahana, Eva; Willcox, Bradley J.; Willcox, D. Craig; Poon, Leonard W.
The Gerontologist 55(1): 14-25, 2015.

Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper undertook a thorough review and evaluation of the literature and highlighted work of scholars who made significant theoretical contributions to the topic.  Historical perspectives reached back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging.

 


Health Web Science
Joanne S. Luciano; Grant P. Cumming; Eva Kahana
Now Publishers Inc, 2014

Health Web Science is a co-authored monograph in the series Foundations and Trends in Web Science, with Now Publishers. Kahana and her colleagues note that the transformative power of the World Wide Web on all aspects of daily life, including health care, has been widely recognized. Health Web Science explores the role of the Web as it drives discussions, technologies, policies and solutions related to health. It also examines the impact of the Web’s health-related uses on the design, structure and evolution of the Web itself.

 


 

Baby Boomers’ Expectations of Health and Medicine
Eva Kahana and Boaz Kahana
Virtual Mentor 16(5): 380-384, 2014

As large numbers of baby boomers cross into old age, there will be greater demands for chronic health care and for meeting the special needs posed by the “graying” of disability. Baby boomers are different from the generations that preceded them; they are more savvy, assertive, health-conscious, and engaged in their care. 

The authors’ recent research has involved interventions to encourage older adults to be more proactive in communicating with their clinicians. As part of a randomized controlled trial (RCT), they are evaluating the efficacy of a patient communication intervention—“Speak Up”—compared to a civic engagement-oriented attention control group—“Connect.” During the four-year period of this study, they have noticed a marked increase in patient preparedness and initiatives and an increasingly active group process in which study participants offer advice to one another about speaking up to their primary care physicians and requesting test results and other data about their health status and care needs.

 


 

The emergent discipline of health web science
Luciano, Joanne S.; Cumming, Grant P.; Wilkinson, Mark D.; Kahana, Eva
Journal of Medical Internet Research, 15(8): e166-173, 2013

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large.

This paper explored and interrogated the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. This paper then introduced Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0.We present Health Web Science (HWS) as a subdiscipline of Web Science that, while being interested in the Web’s impact on health and well-being, also examined the impact of the Web’s health-related uses on the design, structure, and evolution of the Web itself.

 


 

Altruism, helping, and volunteering: Pathways to well-being in late life
Kahana, E.; Bhatta, T.; Lovegreen, L.D.; Kahana, B.; Midlarsky, E.
Journal of Aging and Health, 25(1): 159-187, 2013

This study examined the influence of prosocial orientations including altruism, volunteering, and informal helping on positive and negative well-being outcomes among retirement community dwelling elders. We utilized data from 2 waves, 3 years apart, of a panel study of successful aging (N = 585). Psychosocial well-being outcomes measured included life satisfaction, positive affect, negative affect, and depressive symptomatology. 

Ordinal logistic regression results indicated that altruistic attitudes, volunteering, and informal helping behaviors make unique contributions to the maintenance of life satisfaction, positive affect and other well-being outcomes considered in this research. Predictors explained variance primarily in the positive indicators of psychological well-being, but are not significantly associated with the negative outcomes. Findings underscore the value of altruistic attitudes as important additional predictors, along with prosocial behaviors in fostering life satisfaction and positive affect in old age.

 


Self-regulatory driving behaviors: Gender and transportation support effects
Choi, M.; Adams, K. B.; Kahana, E.
Journal of Women & Aging, 25(2): 104-118, 2013

 

This study examined the relationship between transportation support and self-regulatory driving behaviors of 566 community-dwelling older adults living in retirement communities, with a focus on gender differences. The results of logistic regression analysis showed that older women were more likely to avoid driving at night or on the highway than their male counterparts.

Transportation support from peer friends was found to increase the likelihood of self-regulatory driving behaviors. The findings of this study imply that transportation policy and driving safety programs for older adults need to be developed, considering available transportation alternatives and gender differences in driving behaviors.