Browsing by Author "Roberto, Karen A."

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    Abandonment Fears in Persons with Alzheimer's at Adult Day Care Centers
    Judkins, Wayne A. (Virginia Tech, 1998-04-10)
    In my research, I examined abandonment fears in persons with Alzheimer's disease at the Salem Veterans Affairs adult day care center. I observed fifty hours at the center, and conducted open-ended interviews with two of the participants and their respective caregivers. These two participants (Ellen and Opel) at the center expressed abandonment fears much more frequently than any of the other participants. I found that most of the time, these two women would express their abandonment fears in the form of repetitive questions about going home. Staff used two different methods to deal with the problem: 'reassurance by fact' and redirection. The staff was divided as to the efficacy of their methods and whether more frequent attendance would help Ellen and Opel to adjust to the center. Some participants were bothered by the their constant questions, while others were not. Using an existing attachment questionnaire, Ellen's daughter classified her mother as having an avoidant attachment style, but Opel's daughter classified her mother as having secure attachment. Although Ellen's behavior at the center fit with the description of a person with avoidant attachment (e.g., extreme self-reliance, activity disturbance), Opel's fearful nature did not suggest that she had a secure attachment style as her daughter believed.
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    Age-Related Ankle Strength Degradation and Effects on Slip-Induced Falls
    Khuvasanont, Tanavadee (Virginia Tech, 2002-07-18)
    Each year there is an increasing incidence of slip and fall accidents, especially among the elderly population. Existing evidence has identified several aging effects related to slip and fall accidents, yet, the causes of these accidents with advancing age are still little known. The objective of this research was to investigate the factors influencing the initial phase of unexpected slips and falls in younger and older individuals. More specifically, the relationship between ankle strength, the ankle joint power to transfer the whole body center-of-mass during normal gait, and the likelihood of slip-induced falls was identified. The walking experiment and the ankle strength tests were conducted in the Locomotion Research Laboratory, Virginia Tech. Fourteen old (67-79 years old) and 14 young (19-35 years old) individuals participated in this study (7 male and 7 female for each age group).Within a subsequent 20-minute session of natural walking on a linear track, kinematic and kinetic data were collected synchronously. A slippery surface was introduced to the participant on the purpose of unexpected slip event. The ankle strength tests were performed using a dynamometer. The results indicated that ankle strength degradation in older individuals was related to the outcome of slips (i.e., higher frequency of falls). The results also indicated that older individuals' RCOF was less than their younger counterparts. However, older individuals fell more often than younger individuals. It is concluded that friction demand characteristics may not be a total deterministic factor of fall accidents. Thus, the further research should focus not only on the dynamic of slips, but also on the dynamics of falls.
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    The Age-Related Effects of Visual Input on Multi-Sensory Weighting Process During Locomotion and Unexpected Slip Perturbations
    Jongprasithporn, Manutchanok (Virginia Tech, 2011-09-09)
    Falls are the leading cause of fatal and non-fatal injuries among older adults. Age-related sensory degradation may increase instability and increase the risk of slips and falls in older adults. The integration of three sensory systems (visual, proprioceptive, and vestibular systems) and the respective weighting of each are needed to maintaining balance during unexpected slip-induced falls. The visual system is often thought of as the most important sensory system in playing a major role in stabilizing posture, guiding locomotion and controlling slip response. However, previous studies have focused on the age-related effects of visual input on static postural stability. The age-related effects of visual input associated with locomotion and unexpected slip perturbations (i.e., dynamic tasks) remains unclear. The purpose of this study is to investigate the age-related effects of visual input on multi-sensory processing during locomotion and unexpected slip perturbations. Fifteen young and fifteen old adults were recruited to participate in this study. Motion capture system, force plate, and EMG data were collected during the experiments. Various biomechanical and neuromuscular characteristics were identified to quantify the age-related effects of visual input during locomotion and unexpected slip perturbations. The results indicate that temporary loss of visual input during walking could cause individuals to adopt a more cautious gait strategy to compensate for their physical and neuronal changes as shown in increased double support time and higher co-contraction (i.e., stiffness) of the knee and ankle joints. Older adults also have higher co-contraction at the ankle joint during walking as compared with young adults. Regarding slip-induced falls, temporary loss of visual input causes increased slip distances and response times of upper and lower limbs in both younger and older groups. In terms of kinematics, the combination of age and temporary loss of visual input influenced the perturbed limb. In terms of muscle activation patterns, temporary loss of visual input may increase the proprioceptive gain as shown in early muscle activity onset, increased muscle activation duration, and increased co-contraction at the knee joint. However, stiffness may increase the difficulty to detect a slip event and reduce flexibility and increase slip-induced falls. Although the human body cannot fully compensate for the temporary loss of visual input, the results in this study suggest that the reweighting process increases proprioceptive gain while visual input is unavailable. These findings support the implication of future research in order to understand the potential hazards which could occur while walking and slipping with temporary loss of visual input. The results may also contribute to the design of effective interventions to improve motor learning by applied visual occlusion in slips/falls training to reduce fall risk and enhance safety. The visual occlusion paradigm may assist to increase learning encoded in intrinsic coordination, related to motor performance skill, providing the flexibility required to adapt to complex environments such as slip-induced falls.
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    Agency in the Midst of Illness Uncertainty: How Women and Families Live without a Diagnosis
    Potter, Emma C. (Virginia Tech, 2017-06-09)
    Those living without a diagnosis reside in an invisible margin of health and family research. The purpose of this study was to explore illness uncertainty as experienced by women and their families in the United States. I examined illness uncertainty through a feminist ecological interactionist (FEI) approach with three core constructs: interaction, agency, and context. I conducted narrative-focused, semi-structured interviews with 15 women (aged 25-46) and 11 family members (aged 22 to 62) identified by each woman and completed a constant comparative grounded theory analysis. The findings revealed women's lived experiences with symptoms and social support, interactions with the medical system, and agency in the context of such uncertainty. Findings also model a System of Illness Uncertainty that contends that women's experiences with illness uncertainty is an endless process that changes over time. In the System of Illness Uncertainty, women were Doubters, Resisters, Persisters, or Burnouts; all women experienced a paradigm shift regarding the Western health system as a result of their experiences. This research adds to the knowledge base on individuals who occupy spaces between the legitimized, diagnosable ill and the symptom-free healthy. Implications affect not only individuals and their families, but the politics of Western medical establishments.
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    Aging America: Essays on Population Aging and the Physical and Economic Landscapes in the United States
    Fisher, Mary Caperton (Virginia Tech, 2010-08-11)
    Major population shifts shape both economic and physical landscapes of nations because demographic and economic drivers are inextricably linked. This study follows a three essay approach focused on the impact of population aging on two broad categories, physical and economic development in the United States. Specifically, this dissertation investigates later life entrepreneurship, elder housing choices and the impact of aging on rural prosperity. It appears that age is a factor in later life labor force participation choices, with 61 to 70 year olds and those over 70 years of age exhibiting a greater tendency toward self-employment than their 50 to 60 year old counterparts. However, individuals over age 60 are more likely to retire than transition to self-employment. Still, economic developers should consider small business development programs that include even those ahead of the baby boomer cohort. Amongst recent mover households, age influences dwelling selection. Households headed by 50 to 69 year olds are more likely to move to single family dwellings of 1,000 to just under 3,000 square feet. Conversely, households headed by individuals aged 70 years or more, are more likely to select multi-family dwellings and in particular, smaller units (under 1,000 square feet). Thus, oldest individuals are more likely to relocate to the smallest, highest density units even after controlling for increased housing costs, shocks, income and children. These results suggest that older households are not homogenous in their housing preferences. As expected, population aging impacts rural prosperity. The effect is not significant for the proportion of the population aged 70 to 79 years. However, the greater the percentage of the population that is 50 to 59 years of old or 60 to 69 years old, the less likely a rural county is to be prosperous. Contrary to this finding, the greater the proportion of the population that is 80 years of age or older, the greater the likelihood of rural prosperity. It was originally hypothesized that rural areas may fall short of prosperity because of a mismatch between an aging labor force and the prevalence of physically demanding occupations - this is likely not the case.
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    An Assisted Living Private Dwelling Unit Based on User Needs
    Stumb, Emily Maples (Virginia Tech, 2004-05-07)
    The United States is experiencing a rapid rise in its citizens aged 85 and older, which is the fastest growing segment of the population. By the year 2050 the population of adults 65 years old and older is predicted to double in size. This trend, referred to as the graying of America, has been a catalyst for researchers eager to fill gaps in appropriate housing options for this population. For the past decades assisted living has grown as such an option for senior housing. The purpose of this study was to design an assisted living private dwelling unit based on criteria found in literature and in the findings of two research projects. Data were collected during site visits to five assisted living facilities as part of the Best Practices study. Data collected during the CAVE study, in which participants expressed preferences toward assisted living apartment designs, were also utilized. Design criteria emerging from both studies were found to be in support of current literature. A design concept employing these criteria was developed. The design was presented through graphic techniques including plans, elevations and isometric drawings.
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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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    Biomechanical analysis of effects of neuromusculoskeletal training for older adults on the likelihood of slip-induced falls
    Kim, Sukwon (Virginia Tech, 2006-02-06)
    Research Objectives The objective of this study was to evaluate if neuromusculoskeletal training (i.e., weight and balance training) for older adults could reduce the likelihood of slip-induced fall accidents. The study focused on evaluating biomechanics among the elderly at pre- and post-training stages during processes associated with slip-induced fall accidents. Motivations: Older adults are at a higher risk of falls due to deficient gait characteristics and postural control, especially when facing unexpected external perturbations such as slippery surfaces. The literature (Alexander et al., 1992; Englander 1996; Hausdorff, 2001; Rizzo 1998) indicates that falls among the elderly over 65 result in enormous economic and personal losses, therefore, the losses must be diminished. The results from this study can provide intervention strategies for researchers, health care individuals, and the elderly and their families in reducing the likelihood of slip-induced falls. Background: More than 25% of older adults fall every year (Sattin, 1992), and older adults and their family members fear their falls and fall-related injuries due to the associated high mortality rate (Jensen, 2003). The Center for Disease Control (CDC) reported in 2003 that emergency departments treated more than 1.6 million seniors due to fall-related injuries and, among them, 373,000 were admitted to the hospital. In 2002, The National Safety Council reported that 14,500 people died due to fall-related accidents, and 60 percent of them were 65 years of age and older. To minimize economic and personal losses, tribometric techniques for assessing shoe/floor interactions, the biomechanical responses in walking on slippery floor surfaces, and postural control were studied. Still, the elderly population is at a high risk of falling, severe enough that it is a major cause of hospitalization (CDC, 2003). Yet reasons for slip-induced fall accidents are not clear. Therefore, mechanisms involving fall accidents must be explored and, further, interventions to minimize fall accidents must be discovered and implemented. The occurrence of falls among the elderly are postulated to result from neuromusculoskeletal aging. The changes in neuromusculoskeletal components with advancing age are commonly accompanied with mobility problems and poor health status contributing to a decreased physical capability such as a reduction in lower extremity strength (Larsson et al., 1979; Lord et al., 1991 and 1994; Murray et al. 1985; Stalberg et al., 1989; Whipple et al. 1987) and insecure and unconfident balance (Manchester et al. 1989; Stelmach and Sirica, 1987; Teasdale et al. 1991; Thelen et al., 1998; Woolacott, 1986) leading to unstable dynamic postural control and poor gait dynamics (Alexander, 1994; Judge, 2003; Lockhart et al., 2003; Wolfson, 2001). Unstable dynamic postural control and poor gait dynamics influence the likelihood of falls among older adults (Guralnik et al.1994; Judge et al.1996; Lockhart et al., 2003; Tinetti et al. 1988). Therefore, in an effort to improve unstable dynamic postural control and poor gait dynamics, strength and balance training have been proposed and implemented. (Campbell et al., 1999; Day et al., 2002; Fiatarone et al., 1994; Neil, 1994; Shepard et al., 1993; Tinetti et al, 1994; Wolfson et al, 1993). Problem Statement: Although the significance of muscle strengthening and balance training in reducing falls for older adults has been addressed previously, most studies (Berg et al., 1992; Duncan et al., 1990; Guralnik et al.,1994; Hageman et al., 1995; Nashner, 1993; Nashner and McCollum, 1985; Nevitt et al., 1989; Overstall et al., 1977; Rikli and Jones, 1999; Tinetti, 1986) have focused on the effect of muscle strengthening and balance training on the static and dynamic postural control such as quite standing, one-leg stand, the sit-to-stand test, the test of precise movement, functional reaching, or the mobility test. Yet, research to evaluate the effectiveness of muscle strengthening and balance training on actual slip-induced fall events was lacking. This study were carried out to evaluate the likelihood of falls at pre- and post stages of training by incorporating and validating the effectiveness of training utilizing actual perturbations commonly associated with slips and falls. Method: 18 older adults participated in the study for 8 weeks: 6 individuals in balance group, 6 individuals in weight group, and 6 individuals in control group (social group). Each group met three times a week and each session lasted for 1 hour. Biomechanical dependent measures and psychosocial dependent measures were evaluated to the effects of training. Results: The results indicated that, overall, training resulted in improvements in biomechanical dependent measures. Further, regular social activities resulted in improvements in proprioception sensory sensitivity and in ankle dorsiflexion muscular strength. Conclusion: Balance training contributed to an improvement in ankle flexibility, whereas, weight training did not contribute to an improvement in ankle flexibility although either weight or balance training played a role in decreasing slip-propensity and the likelihood of slip-induced falls among older adults. An ability to integrate neuro-musculo-skeletal systems was improved by training and was a main contributor in reducing the likelihood of slip-induced falls. Proprioception sensitivity by itself did not play a role in decreasing the likelihood of slip-induced falls. In addition, the exercise training as well as social activities played a role in altering psychosocial behavior (i.e. fear of falling and independency) of older adults. The author concluded that an ability to integrate neuro-musculo-skeletal systems could be improved by either balance or weight training and could be a primary factor contributing to a reduction in the likelihood of slip-induced falls among older adults. In addition, the author concluded that the regular social activities also could contribute to an enhancement in the psychosocial characteristics of older adults.
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    Caregivers of Persons with Mild Cognitive Impairment: Information and Support Needs
    Wilcox, Karen L.; Roberto, Karen A.; Blieszner, Rosemary; Winston, Brianne L. (Virginia Tech, 2004-11)
    One of the newer concepts of age-related memory deficit is mild cognitive impairment (MCI). MCI reflects self-reported changes in cognitive function that do not necessarily interfere with work or social relations; it is viewed as a transitional phase between normal cognitive aging and dementia. Researchers and practitioners lack a comprehensive understanding of what relatives of persons with MCI are actually experiencing and what they realistically believe would be helpful to manage their situation now and in the future. In a multi-method, mini-longitudinal design that incorporated quantitative and qualitative approaches, we collected information from patient charts and semi-structured family interviews to investigate the information and support needs of 20 (out of 100 to be interviewed) family members of older adults with MCI. We found that, apart from information available about potential later diagnoses such as dementia or Alzheimer’s disease, families reported having little information available to them to assist in decision making and caregiving for early stages of memory loss. Family members were hesitant to think about and plan very far into the future and were more likely to take things a day at a time. Past experiences with family members or friends with memory difficulties or other serious health conditions enabled some family members to feel more at ease and knowledgeable with the process of seeking help for themselves and the older adult they were supporting. Findings suggest that earlier identification of memory loss has implications for clinical practice and the delivery of health care and social services to older individuals and their relatives.
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    Case Study of the Generation Connection Program: An Intergenerational Program Transfer Initiative
    Wilcox, Janel Lynn (Virginia Tech, 2001-09-25)
    The Generation Connection Program (GCP), an intergenerational program transfer initiative, was examined as the focus of this study in order to determine how an enabling agency approach can advance the implementation and sustainability of innovative intergenerational programs throughout a community. Teachers and long term care staff from three sites with active programs and staff from two sites that had disbanded programs participated in this study. Additional data included field notes from intergenerational program activities and orientations observations, journal articles, implementation package materials, newspaper articles, and the GCP s internal written documents. This study was largely exploratory, as the critical factors for the successful transfer of social programs are not clearly understood. Five themes emerged from the data: the process of program transfer as a continual process, the transfer of knowledge and skills, building collaborative relationships between long term care staff and teachers, continual innovation, and building capacity through networks. The findings suggest that a community-based managed network approach, combining central agency leadership with capacity in long term care centers and schools/child care centers, can advance the implementation and institutionalization of intergenerational programs.
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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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    Coming Out: One Family's Story
    Baptist, Joyce Alexandria (Virginia Tech, 2002-09-10)
    This case study elicits the process of coming out of a 6 member family-of-choice of an adult gay man in rural New Hampshire. 27.5 hours of face-to-face interviews were conducted with the family individually and collectively. Reflexivity, as a technique, was used extensively. Four themes were identified: Embracing gay identity, integrating as a family, building social networks, and social awakening. This study addresses the complexities of how multiple individuals negotiate rules and accommodate diverse viewpoints within a family system, provides insight into a family's journey of accepting their gay identity, utilizes personal narratives of family members, and reveals how the reflexive process contributes to a family's creation of new stories. Implications for clinical practice and future research are discussed.
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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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    Comparison of Adult Day Services in Atlantic Canada, Maine, and Vermont
    Weeks, Lori E. (Virginia Tech, 1998-09-11)
    Comparisons of aging services in Canada and the United States reveal similarities and differences in the structure and function of the two systems. In both countries, adult day services (ADS) is an integral component in the array of services available to older adults. In this study, I compared structural characteristics of programs, participant characteristics, and examined the National Adult Day Services Association classification model of ADS in demographically similar areas of Canada and the United States. Directors of 47 ADS programs in demographically similar provinces and states in Atlantic Canada, Maine, and Vermont responded to a mailed survey. Adult day services programs in each province and state exhibited some unique structural and participant characteristics. Statistically significant differences emerged between ADS programs in the two countries on the following structural variables: town population, center affiliation, center location, levels of government support, participant fees, organizational structure, hours of operation, months of attendance, hours attended per day, service frequency, and service provision. Participant characteristics that significantly varied between the two countries involved educational level and functional characteristics. A minority of programs exhibited a match between participant needs and services provided. However, very few programs belonged to the most mismatched category of providing core services to intensive level participants. The findings of this study support the importance of individual programs providing services appropriate to meet the needs of participants rather than adhering to a predetermined model of care.
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    Credibility of a Person-Centered Design Decision-making Prototype: Spaces for Older Persons with Vision Loss
    Gowda, Vidya (Virginia Tech, 2016-06-29)
    Decline in both visual acuity and visual performance is a fact of life for older people and their increasing share of the population requires that buildings be designed with their visual needs in mind. As their field of vision decreases, people find it harder to identify an objects location, distance, and orientation. Elderly people with vision impairments usually find it harder to perform daily activities such as navigation through indoor spaces. Functional vision can be improved by modifying the design of spaces, for example, with better lighting. However, architects typically do not know how to take the needs of the visually impaired into account in their design process, or simply do not think of doing so. The researcher designed and feasibility-tested a prototype person-centered tool to help architects judge how appropriate a designed space will be for visually impaired people. The study was conducted as a qualitative mixed-methodology research analysis. The researcher used knowledge from literature interpretation to rationalize the development of a person-centered prototype. The researcher immersed design PhD students and vision science experts to inform the prototyping process. Along with an expert group of design and vision science professionals, the researcher beta-tested the prototype during a mock design-process scenario. The researcher also selected a small group of industry experts to participate in open-ended interviews on post-use demonstrations to qualitatively triangulate the findings on the prototypes usability. The study summarizes the feasibility including the challenges of using the prototype for professional purposes and suggests improvement.
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    Daily Stressors and Marital Interactions Affect Diurnal Cortisol and Alpha-Amylase Rhythm in Spouses of Persons with Mild Cognitive Impairment
    Savla, Jyoti S.; Roberto, Karen A.; Blieszner, Rosemary (Virginia Tech, 2011)
    Research aims: 1. To document daily symptoms and behaviors of persons with MCI 2. To assess how MCI-related symptoms, care needs and other stressors influence psychological well-being of care partners 3. To examine effects of MCI-related symptoms, care needs and other stressors on spouse care partner’s physiological indicators of health (Diurnal Rhythm of Coritsol and Alpha-Amylase)
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    Design and Testing of an Adult Age-Independent Online Needs Assessment Tool and Development of Adult Age-Independent Design Guidelines
    Durak, Tolga (Virginia Tech, 2003-04-24)
    This thesis addressed the following research activities: (1) Developing and evaluating the usability of an adult age-independent online assessment tool that includes health care related content and is centered on the needs and capabilities of both older and younger users and, (2) Developing adult age-independent design guidelines. An online tool, which was developed for a previous study, was revised according to the results of the previous study and preliminary development activities based upon the user requirements of older adults (50 years or older). The online assessment tool was also tested with younger adults (between 18 and 35 years of age) to determine the differences between younger and older adults. Subsequent to these activities, a final tool that captured the needs of both older and younger adults was developed and evaluated for usability. According to the usability testing results, a design guideline set for an adult age-independent Online Needs Assessment Tool was developed and revisions were conducted in order to develop the final Online Needs Assessment Tool. The results of these studies, along with the tools developed, provide online survey and interface designers information on older and younger adult user requirements. They provide a knowledge resource for older and younger user healthcare information needs and information about the usability of one online assessment tool to accommodate both older and younger adult users. They also assist interface designers to proliferate and to facilitate more rapid application development