Browsing by Author "Brossoie, Nancy"

Now showing 1 - 20 of 36
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    Adolescent Trauma Treatment in Integrated Primary Care: A Modified Delphi Study
    Stephen Premo, Jessica Lynee (Virginia Tech, 2019-06-21)
    Early stressors like trauma can lead to developmental changes that have life-long negative health consequences (Merikangas et al., 2010; Anda et al., 2006). Approximately 1 in 4 youth experience substantial trauma during their developmental years (Merikangas et al., 2010; Duke, Pettingell, McMorris, and Borowsky, 2010). Such findings suggest the need for early intervention and treatment for adolescents exposed to traumatic events and adversity. Ideally, adolescents could be treated within primary care settings where parents overwhelmingly seek services for their children. Primary care settings are sought out at a 94% to 97% rate of services as compared to only a 4% to 33% rate of parents seeking out mental health services (Guevara et al., 2001). Unfortunately, no adolescent trauma-informed interventions have yet been adapted for use in primary care (Glowa, Olson, and Johnson, 2016). This study aimed to fill this critical gap between adolescent mental health issues associated with trauma and adverse childhood experiences and the lack of treatment in integrated primary care settings. The need for trauma-informed treatment for adolescents who have experienced trauma and adverse experiences is especially salient as evidence-based treatment for adolescents in this setting is limited. A modified Delphi approach was employed to address this gap in the research. Two rounds of questionnaires and focus groups were utilized with a panel of experts and youth stakeholders to gain consensus on treatment recommendations. Ultimately, expert panelists and youth stakeholders identified 59 recommendations for adolescent trauma treatment to be delivered in integrated primary care settings.
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    Appalachian Church Leaders: An IPA Study to Understand Their Experiences with Substance Misuse
    Thomas, Michael Evan (Virginia Tech, 2020-03-06)
    The region of Appalachia in the United States is a diverse region that is full of beauty, mountains, art, and culture. Due to a history of abuse from large corporations, the impact of the decline in coal mining and generational poverty, the region is currently on a road toward recovery. Substance misuse rates are disproportionality high, and there are limited resources available to address the issue. Literature suggests that church leaders may be a potential resource. The goal of the study was to provide a better understanding of the substance misuse epidemic through the eyes of church leaders. Interpretative Phenomenological Analysis guided this qualitative study. Church leaders (n = 10) were interviewed and four significant themes emerged: narratives used to describe their experiences with substance misuse, the stigma associated with substance misuse, the community impact that substance misuse has on Appalachia, and the lack of understanding and need for training on substance misuse for church leaders and healthcare practitioners. The results of the study are discussed and connected to discussions of the implications for clinical practice, recommendations for further research, and limitations of the study.
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    Assuring Quality Care: Exploring Strategies of Medicaid E&D Waiver Providers
    Brossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne (Virginia Tech, 2004)
    Implementing quality assurance (QA) programs in unregulated noninstitutional settings remains a challenge for home and community-based service providers. A sample of 65 Elderly & Disabled (E&D) Waiver providers in Virginia were presented with eight problem scenarios commonly found in home-care services. Each of the respondents was able to identify strategies they would use to recognize and address each problem. Findings suggest providers currently use multiple mechanisms as part of their overall QA program. Discussion focuses on the strengths of using multiple approaches and on increasing provider awareness of complementary QA strategies and reducing the reliance on staff report as a major QA strategy.
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    The Characteristics and Functions of Weak Ties
    Brossoie, Nancy (Virginia Tech, 2007-12-12)
    The primary purpose of this study was to identify dimensions of weak tie relationships including characteristics (e.g., distinctive qualities, traits, or properties), functions (e.g., outcomes, purposes, or meanings derived from the interaction) and determinants of engagement to gain insight into the weak tie exchange process and develop frameworks that can be used to operationalize the concept. Data were collected through stories provided by participants during face-to-face interviews. Respondents recounted a situation when someone they did not know well and to whom they did not feel particularly close provided them with assistance. Over 70 stories were collected from 50 adults aged 65 and older who were active in their community. Stories collected were analyzed using an inductive approach that was supported by the concepts of interpersonal tie strength, loose connections, social exchange theory, and social support. Findings suggest that weak tie relationships occur in a variety of community settings and in response to a variety of daily challenges. The exchanges occur more frequently with acquaintances than strangers and the initiator of the exchange is generally the person offering support. The types of support offered are broad-based and include instrumental, emotional, and informational support. Weak tie exchanges range from one-time brief interactions to intermittent exchanges over extended periods, depending on the circumstances. Findings also suggest that weak ties have a specific task or purpose, encourage awareness about the value and purpose of social interactions, and influence participants' future social interactions. Six factors were identified as determinants of engagement in weak ties: situational factors, personal characteristics, judgments of responsibility, attitudes about helping behaviors, personal network type, and exchange history. The findings from this study provide a foundation for further conceptualization of weak ties and a framework on which to develop instruments to measure tie strength and the potential for engaging in weak tie exchanges.
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    Choosing Community-Based Services for Older Adults and Their Families
    Brossoie, Nancy; Teaster, Pamela B.; Roberto, Karen A. (Virginia Cooperative Extension, 2009-05-01)
    This publication lists many services available for older adults and where to find further information if necessary.
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    Community Connections and Sense of Community among Older Adults
    Brossoie, Nancy (Virginia Tech, 2003-05-05)
    Many older adults are electing to age in place within their communities. Even though they may be frequent consumers of community programs and services, their role as contributors to community well-being should not be overlooked. Sense of community is a core dimension of well-being because the connections associated with sense of community are important for everyday life. The model in this study was developed to explore the effects of community connections (community capacity, ease of making connections, active participation in the community, and informal supports) and demographic variables on sense of community. A probability sample of 1,499 adults 65 years and older that resided in rural areas responded to questions concerning their sense of community and community connections. Using multiple regression analysis, results indicate that community capacity, ease of connecting with others in the community, and having an informal support network are significant in predicting sense of community. Nonsignificant associations were found with regard to participation in community activities, age, sex, health status, and length of time living in the county. These findings suggest that key dimensions of aging (age, sex, health status) are less relevant when addressing sense of community when compared to associations and connections. Factors that predict sense of community may be amenable to community-level interventions, thus allowing for the development of sense of community among community members, which could ultimately lead to their participation as community resources.
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    Community Connections and Sense of Community among Older Adults
    Brossoie, Nancy; Mancini, Jay A.; Roberto, Karen A.; Blieszner, Rosemary (Virginia Tech, 2003)
    The goal of this exploratory study is to identify what factors predict sense of community in older adult community members.
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    Community-based Services for Older Adults and Their Families
    Brossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B. (Virginia Cooperative Extension, 2019-03-01)
    Discusses community services for senior citizens including geriatric care management, adult day care facilities, emergency systems, meal services, home health care, and more.
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    Elderly & Disabled Waiver Services: Development of the Client Satisfaction Survey-Short Forms
    Brossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne (Virginia Department of Medical Assisstance Services, 2005-04)
    This report is an addendum to an earlier report, Elderly & Disabled Waiver Services: Results of a Statewide Client Survey. Since the study’s distribution, further development and analysis of the Client Satisfaction Survey was conducted, with the purpose of creating a short form version to be administered by providers and utilization review analysts of Elderly and Disabled (E & D) Waiver services. Also, a second version of the short survey is presented for use during home visits as a supplement to questions asked of nursing supervisors and utilization review analysts.
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    Elderly & Disabled Waiver Services: Provider Survey, Executive Summary
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department for Medical Assistance Services, 2003-03)
  • Elderly & Disabled Waiver Services: Results of a Statewide Client Satisfaction Survey
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department of Medical Assisstance Services, 2004-10)
    As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a statewide survey of clients receiving personal care services under the Medicaid Elderly and Disabled (E & D) Waiver. The goal was to learn about clients’ experiences with personal care, using performance, satisfaction, and outcome measures. Demographic data about clients and aides were also collected. A comparison of the study sample with the larger E & D Waiver population on the available indicators of age, gender, and location showed the sample was representative of the full E & D Waiver population. All planning districts were represented, and the regional distribution reflected that of the larger population. Therefore, findings and observations are likely to be applicable to the full population of E & D Waiver clients in Virginia.
  • Elderly & Disabled Waiver Services: Utilization Review Summary Report
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department of Medical Assisstance Services, 2004-03)
    : As part of Virginia’s Real Choice Systems Change Grant (July 20, 2001), the Center for Gerontology at Virginia Tech is responsible for Goal 4: “Address gaps in quality assurance and client satisfaction for community-based waiver service programs through the development of performance, outcomes, and satisfaction measures for continuous quality improvement and use.” To meet this goal, the Center has conducted extensive research in client satisfaction with E&D Waiver services (reported elsewhere, e.g., Glass, Roberto, Teaster & Brossoie, 2003a). In addition, the Center reviewed the existing Utilization Review (UR) process, as it is currently the primary means of quality assessment (QA) for the E&D Waiver program in Virginia. Our evaluation, based on the following activities, indicates that mechanisms are now in place to address and monitor the quality of services delivered by provider agencies. Continual development and refinement of the UR process will help ensure clients receive quality services and are satisfied with the assistance they receive.
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    Elderly & Disabled Waiver Services: What Do We Know About Providers?
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Tech, 2003)
    Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a survey of agencies providing HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. A written survey was sent to 160 providers across the state, based on a sampling plan designed to ensure representation of all planning districts and services mixes. Seventy surveys were returned for a response rate of 44%.
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    Elderly and Disabled Waiver Services: Important Dimensions From the Client's Perspective
    Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Department for Medical Assistance Services, 2003-06)
    Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted an exploratory survey of clients receiving HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. The goal of the survey was to learn about clients’ experiences with HCBS and to identify the most important dimensions of service provision from their perspectives. An initial focus group with 11 caregivers was first held in Big Stone Gap. Twenty-five telephone interviews were then completed (18 clients and 7 caregivers) in five areas of the Commonwealth. Fifteen were in urban areas (Northern Virginia, Richmond, and Chesapeake) and ten in rural or non-metropolitan areas (New River Valley and Planning Districts 13 and 14).
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    Final Report Abstract: Caregivers of Persons with Mild Cognitive Impairment: Information and Support Needs
    Roberto, Karen A.; Blieszner, Rosemary; Brossoie, Nancy; Winston, Brianne L. (Alzheimer's Association, Medical and Scientific Affairs, 2007)
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    The Impacts of the Neighborhood Built Environment on Social Capital for Middle-Aged and Elderly Koreans
    Hwang, Eunju; Brossoie, Nancy; Jeong, Jin Wook; Song, Kimin (MDPI, 2021-01-14)
    The purpose of this study was to investigate the relationship between the neighborhood built environment (NBE) aspects of age-friendly cities and communities (AFCCs) and social capital in the Korean context. We described and compared age differences when analyzing misfits of AFCC NBE and impacts on social capital. We collected the data (N = 1246) from two Korean communities; our multiple and binary logistic regression outcomes show that AFCC NBE aspects such as outdoor spaces, transportation, and housing are significant predictors of different subcategories of social capital. For the older group, the outdoor spaces misfit was significant for all three subcategories of social capital, but transportation and housing misfits were significant for the social trust and reciprocity index scores. For the middle-aged group, the outdoor spaces misfit was significant for social networking and participation, and a transportation misfit was significant for participation and social trust and reciprocity. Fewer misfits or better fits of outdoor spaces and transportation encouraged more networking, participation, social trust, and reciprocity. Dwelling type was important to predict social capital, especially for the older group. The present study confirmed the importance of AFCC NBE in predicting social capital and unique factors in the Korean context.
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    Intersections: Cross-Disciplinary Conversations about Social Justice and the Built Environment
    Brossoie, Nancy; Dorsa, Ed; Tural, Elif; Jacobson, Wendy R. (Virginia Tech. University Libraries, 2019-10-16)
    Focus: Aging and Place Moderated by Wendy Jacobson, Associate Professor, Landscape Architecture
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    Intimate Partner Violence Among Older Adults: Bridging the Disciplinary Divide
    McPherson, Marya C.; Brossoie, Nancy; Roberto, Karen A. (Center for Gerontology and Dept. of Human Development Virginia Polytechnic Institute and State University and the Women's Resource Center of the New River Valley, 2009-11)
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    Intimate Partner Violence in Rural Aging Women: Promoting Community Knowledge
    Roberto, Karen A.; Brossoie, Nancy; McPherson, Marya C. (Center for Gerontology and Dept. of Human Development Virginia Polytechnic Institute and State University and the Women's Resource Center of the New River Valley, 2009-10)
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    Living Options For Adults Needing Assistance
    Brossoie, Nancy; Teaster, Pamela B.; Roberto, Karen A. (Virginia Cooperative Extension, 2009-05-01)
    This publication describes some possibilities for living options where older adults may receive assistance: continuing-care retirement communities, assisted housing, nursing homes, ECHO housing, board-and-care homes, congregate housing, and foster care.