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Module 2: Aging and Literacy Mira Elraheb; 110147233, Robert Springer; 110155582 KINE-8310: Healthy Aging University of Windsor, Department of Human Kinetics Dr. Paula van Wyk March 13th, 2024 Faculty of Human Kinetics Department of Kinesiology ___________________________________________________________________ KINE 8310 Healthy Aging WINTER 2024 Academic Integrity – Academic Honesty Form Drawing on the language of ByLaw 31: As a member of the University of Windsor community, I am committed to uphold the University’s primary purposes and objectives: • • The advancement of learning and the dissemination of knowledge; and The intellectual, spiritual, moral, social and physical development of its members and students and the betterment of society To further these ends, I agree to promote a safe and mutually respectful environment and act responsibly and with honesty, trust, respect and fairness at all times. As a member of the University of Windsor community of scholars, I understand that academic integrity is a core value supporting quality research and constructive dissemination of knowledge in the community. I recognize that plagiarism, claiming credit for work not my own, or other forms of cheating, will undermine any contribution that I may make, and by extension the value of the degree program that I am pursuing. Accordingly, I will uphold my rights and responsibilities as outlined in the Student Code of Conduct and adhere to academic integrity principles and rules outlined in Senate-ByLaw 31. Student Name Student ID 110147233 Student Signature Date 03/13/2024 Mira Elraheb Robert Springer 110155582 Table of Contents 03/13/2024 Introduction 4 Assignment #1: 5 Assignment #2: Assignment #3: Conclusion Appendices Introduction References Successful Aging Defined Since its emergence, the term “Successful Aging” has been very subjective. In a systemic review conducted by Cosco et al., (2013) across 84 studies, there was a total of 105 different definitions [1]. Of the 105 definitions, 97 consisted of physiological constructs, 52 included engagement with the community, while 51 comprised of constructs related to well-being. Other constructs included personal satisfaction and extrinsic characteristics, such as wealth. Moreover, 70 out of the 105 definitions encompassed more than one construct. This heterogeneity is precisely what was observed throughout the 3 conducted interviews. These findings, along with the results of the interviews, suggest that aging successfully is an individual process; a process in which success is measured by the person and what they deem important. The 1st interviewee’s ideas are taking the individual’s psychosocial approach to successful aging (refer to Assignment 1, Appendix 1). They point out the usefulness of being socially active, engaged, and in touch with other people because these are constituents of the psychosocial models. Also, their definition of aging is updated with the passing years; it is a lived experience that is continuously being shaped over time. With respect to the 2nd interviewee, their responses suggest that the history and development of personality are the two main factors that developed their character. They highlight factors such as completeness, pleasure, and desirable societal ties, which are akin to the psychosocial paradigms (Trang, 2024). Furthermore, their themes about personal development, as well as presence throughout the entire life story pathways, complement the biographical view, in which more weight is given to individual experiences and their life stories. The 3rd interviewee takes a slightly different approach, which is one of culture. As can be seen from their responses, their responses define successful aging from an Egyptian perspective (refer to Assignment 1, Appendix 2). In Middle Eastern culture, generally, personal values and satisfaction are more tied to family and being surrounded by one’s social circle. This contrasts with Western culture, where fitness and wealth are of more value. Although the interviewee states that they wish they could have placed more importance on being physically active, their contentment and gratification comes from having raised a family and being surrounded by many grandchildren. Overall, it can be said that this interviewee’s point of view is more aligned with the biographical perspective of successful aging, since their success largely depends on sociocultural perspectives. Given this information, there are various interventions that can be put into place to help each of these individuals. With respect to the 1st and 2nd interviewees, the intervention’s goal may be to encourage physically active lifestyles of older adults, thus providing information about different classes or clubs in that area. Moreover, issues like transposition or movement constraints come up, which can make their life much better. Concerning the 3rd interviewee, although physical activity interventions are needed, there is a deeper situation that first must be addressed. As children and young adults, Middle Easterns place importance on education. Although physical education is a part of school, there remains the general stigma that physical activity will not benefit an individual career-wise. Moreover, if one does wish to participate in physical activity during their leisure time, expenses are ridiculously high. After university, the focus shifts to marriage and having a family. It is for this reason that longevity in Arabic countries is often associated with illness and disability [3]. For this reason, it is not only interventions to increase physical activity at the educational and economical levels that are required, but also a change in cultural perspective. Once destigmatization has been made, interventions can be put in place. Conclusively, these interviews have provided various perspectives on successful aging. The 1st and 3rd interviewees’ views aligned with strictly the psychosocial and biographical perspectives; respectively. The 2nd interviewee experienced a mix of both psychosocial and biographical views. This supports the notion that Successful Aging is a fluid concept that differs between individuals. References Trang, P. T. (2024). Concept of personality and factors affecting the formation’s personality. International Journal of Social Science and Human Research, 07(01). https://doi.org/10.47191/ijsshr/v7-i01-49 Health Literacy: S-TOFHLA Assessment Health Literacy is a crucial aspect of any adult’s life. According to Liu et al., [1], the concept is defined as an individual’s capability to improve health by acquiring and translating knowledge and/or information in a method that is appropriate to the specific individual, and their context. While there are many existing definitions of the term, it was thought that this one might be the most appropriate, as it places responsibility on not only the patient to understand instruction pertaining to their health, but also their healthcare providers and systems to facilitate that understanding. It is for this reason that while training, healthcare providers are asked to deliver news and results to patients in layman’s terms, as opposed to “medical jargon”. Unfortunately, as is the case with professionals in any field, a bias in which the meaning of words is thought to be well-known is formed. For example, a doctor delivering results may choose to say “your tumor is benign” (as opposed to “non-cancerous”), thinking that the average adult knows the meaning of the word “benign”. It is for this reason that assessments such as the S-TOFHLA are conducted. Briefly defined, the TOFHLA measures the ability of a patient to read and comprehend healthcare information [2]. The first participant (aged 57) experienced no identifiable problems with comprehension (refer to Appendix 1 of Assignment 2). However, this could be because the participant has a background in healthcare. While it was known beforehand that this may bias results, it is important to mention that options for potential participants were limited. Although this participant did not experience difficulties with the assessment, it was found that the STOFHLA does not agree with the previously mentioned definition of Health Literacy. While the test’s objective is to assess Health Literacy at the individual level, certain patients may feel embarrassed or incompetent while completing it. The nature of the assessment may mislead patients to believe that it is solely their responsibility to be health literate, when their physicians must play a role as well. Furthermore, it is believed that the assessment is not entirely functional in determining an individual’s level of health literacy. Primarily, the oral questions associated with numeracy items provide an unrealistic scenario. For example, the patient will not always be given background information of normal blood sugar level being between 60-150, or perhaps they had a late breakfast and are now wondering at what time they should take their medication. Overall, this assessment could benefit from some improvements. First, the patient should not feel blamed for their lack of knowledge. This can be accomplished by asking them if their physician has spoken to them about Health Literacy before and by defining the term for them. Second, the oral questions should be more reflective of a day-to-day situation. Lastly, passages should include a section that assesses understanding of phrases in colloquial English versus in the context of healthcare. In a study conducted by Gotleib et al., [3]., it was commonly found that phrases commonly used in medical jargon were understood in the opposite way in which they were intended. For example, few participants understood the phrase “your tumor is progressing” as bad news, since colloquially, the phrase “making progress” is often used as a positive. S-TOFHLA Assessment Observations During the administration of the S-TOFHLA assessment, it was noticeable that participants varied in their ability to comprehend and respond to the numeracy items and prose passages. The participants younger than 40 generally demonstrated higher comfort with the numerical tasks, quickly solving the numeracy items with accuracy. However, when presented with the prose passages, they encountered some challenges in extracting key information and understanding the context. Conversely, the participant older than 60 years of age displayed proficient comprehension of the prose passages, drawing upon their life experiences and contextual knowledge to interpret the scenarios. Nevertheless, they encountered difficulties with the numeracy items, particularly those involving complex calculations or medical terminology. Recommendations One of the recommendations is providing additional support and guidance for participants struggling with numeracy items by offering explanations or examples to enhance understanding. Moreover, tailoring the prose passages to be more inclusive of diverse age groups and backgrounds can ensure the content remains relevant and understandable to all participants. Offering chances for practice and strengthening health literacy outside of the evaluation setting, such as seminars or training resources aimed at enhancing understanding of medical language and numerical concepts, can be another suggestion (Charoghchian et al., 2020). It is also possible to create a helpful and educational atmosphere by promoting constant communication and cooperation between patients and healthcare professionals to resolve any doubts or inquiries about health-related information. Impact on Practice/Procedures The S-TOFHLA exam gives healthcare providers important information about a patient’s health literacy level, enabling them to adjust their educational and interpersonal strategies. Practitioners can increase patient knowledge and involvement in their medical treatment by implementing focused interventions to identify health literacy strengths and weaknesses (Kaper et al., 2021). Furthermore, treating insufficient health literacy may help to lower the likelihood of medication mistakes, misinterpretations of medical instructions, and improper use of healthcare resources, all of which may improve the patient experience and health results. By encouraging a more cooperative approach to medical decision-making and enabling clearer interaction among patients and physicians, integrating health literacy tests into everyday practice can also improve the quality of treatment given. References Charoghchian Khorasani, E., Tavakoly Sany, S. B., Tehrani, H., Doosti, H., & Peyman, N. (2020). Review of organizational health literacy practice at health care centers: outcomes, barriers and facilitators. International journal of environmental research and public health, 17(20), 7544. Kaper, M. S., Sixsmith, J., Reijneveld, S. A., & de Winter, A. F. (2021). Outcomes and critical factors for successful implementation of organizational health literacy interventions: a scoping review. International Journal of Environmental Research and Public Health, 18(22), 11906. Report on Physical Literacy Assessment for Older Adults Introduction Physical literacy is a holistic concept that focuses on the lifelong holistic individual’s ability to maintain physical activity and movement skills. That is considered; since there are quite a few assessments at the disposal of the physical literacy specialist, it may be touchy to find one of such that is of genuine assistance to older adults, especially Canadians. For this work, I tried to adapt the Canadian Assessment of Physical Literacy (CAPL) for use with older adults. The developed Comprehensive Approach to Physical Literacy Framework was designed for youths whose assessment reports are easy to implement and can easily be applied for use or adjustment for older people. Participants The two players in this assessment are a 68-year-old older adult and a 35-year-old middle-aged adult for comparison. The older adult, Mr. Smith, is actively pensioned and was left with recreational sports interests. At the same time, the middle-aged lady, Ms. Jones, works in an office with moderate physical activity. Assessment Procedure The CAPL assessment has integrated the demands of an older adult’s life and situation: this is in terms of capability in either mobility or strength, giving statistics based on a critical evaluation. The four essential components of tests involve physical competence, daily behavior, knowledge and understanding, motivation, and confidence. Findings Physical Competence The two participants were briefed to perform tasks like walking, balancing, and essential strength exercises. Mr. Smith could perform well in balance, which shows that he was experienced with such tasks, needing good coordination and balance, suitable for people who had previously been active in recreational sports. Ms. Jones was okay with balancing but failed in aerobic exercises, which outweighed the physical differences in age groups. Daily Behavior Both patients reported being equally well and reasonably active, including random walking and other everyday activities around the household. However, regarding the type of physical activity, Mr. Smith is participating in more versatile activities; he gardens and has a gym workout, while with Ms. Jones, it was just her gym workout. Knowledge and Understanding Both participants were well aware of some of the general benefits related to exercise. Engaging in some exercise might help improve mood and keep energy levels up. In this case, Mr. Smith better understood some exercises and modifications that can be made for older adults, marking back to his background in fitness. Motivation and Confidence Both expressed high motivation to stay active but for different reasons. Critical issues for Mr. Smith included independence, the need for a social outlet, weight maintenance, and stress relief for Ms. Jones. Recommendations Added to that age assessment will be some considerations like flexibility, joint mobility, and even cognition tests may be added. Giving these options of low-impact or seated exercise for people with mobility issues or chronic illnesses. Adding open questions about people’s personal preferences and barriers to physical activity makes a general sense of motivation more precise. Conclusion There is an even stronger way in which physical literacy might be operationalized across a person’s lifespan by adapting existing tools, such as the CAPL, for older adults. Although these may involve modifications to in-time programs with more senior life-related changes in physical functioning, the core components of physical competence, daily behavior, knowledge, and motivation remain relevant. The core components are very paramount to the extent of realizing active aging and well-being. As already postulated, recognizing the extra needs and abilities of the demographic groups will better guide us towards literacy in lifelong physical activities in older people. References Meier, C., Wieczorek, M., & Maurer, J. (2023). Does physical activity mediate the association of health literacy with cognition in older adults?European Journal of Public Health, 33(Supplement_2).https://doi.org/10.1093/eurpub/ckad160.531 Salman, D. (2023). Moving on up! Physical literacy and activity of older adults using a digital rehabilitation tool. http://isrctn.com/. https://doi.org/10.1186/isrctn66167887 Conclusion Appendices Assignment 1: Appendix 1 Interview Guide 1. Can you share with me your thoughts on what it means to age successfully? 2. How do you envision your ideal later years? 3. What aspects of your life do you believe contribute to successful aging? 4. Have your perceptions of aging and successful aging changed over time? If so, how? 5. Can you describe any challenges you face in maintaining your well-being as you age? 6. What activities or strategies do you currently engage in to promote your physical, mental, and emotional health? 7. How important is social interaction and support to you as you age? 8. How do you find meaning and purpose in your life as you grow older? Interview Transcript Interviewer: Thanks for your interest; this has been an excellent opportunity to contact you. First of all, would you please express your beliefs concerning more or less older age empowerment? Interviewee 1: I consider the success of later life in preserving independence and staying active. I want to avoid this balance and keep doing what I love and spending time with my loved ones. Interviewer: That is interesting. What would you choose when planning your preferred old age? Interviewee 1: I wish to achieve that by keeping myself fit and active to continue my career plan and travel to places of my choice. I want to be something other than the sort of person who is stationary and stale, so I try to be most efficient in stimulating my brain. Interviewer: Have my previous notions about aging and successful aging been changed? Interviewee 1: Definitely. I only thought a little bit about growing old once I got older. However, for many years, I saw myself more as taking care of others while being less mindful of myself and cultivating connections. Interviewer: I have faced these challenges since I was a young adult. My greatest struggle has been to stay mentally and physically healthy as I age. Interviewee 1: Sometimes, sticking to an exercise regime becomes challenging, mainly if someone develops a medical condition. For some, the loneliness can also be a trial, as friends or family members get old and wear away. Interviewer: As you embark on the next phase of life, how would you describe this role that you currently have as form-giving to your life? Interviewee 1: Doing community work or volunteering is a perfect way for me to feel like I am profiting other members of society besides myself. I also get the chance to interact with others, thus keeping my social life active. Interviewer: I appreciate you for being so kind. Moreover, now please state what prosperous aging is for you. Interviewee 2: For me, successful aging means achieving satisfaction and happiness in life after retirement. It is about being healthy and having relationships that make me feel good. It is about having a sense of purpose, which is doing things that give me a feeling of fulfilment. Interviewer: That is insightful. What has been the way you have been working thus far in an attempt to get a prosperous old age? Interviewee 2: Whatever it takes to stay physically active, either by jogging or doing some yoga, I try to do so. Then, I focus on my family and friends, often having good times together. I generally try to be everywhere and to know everyone, meaning that the social bond, an essential part of my life, can also be found through me. Interviewer: Have your perceptions of aging and successful aging changed over time? Interviewee 2: Definitely. As I’ve gotten older, I’ve realized the importance of taking care of my mental and emotional health, not just my physical health. Interviewer: How do you envision your ideal later years? Interviewee 2: Ideally, I want to be surrounded by loved ones and still be able to pursue my interests and hobbies. I want to feel fulfilled and content with where I am in life. Interviewer: Thank you for sharing your perspective. Assignment 2, Appendix 1 Assignment 2, Appendix 2 a. Numeracy Item 1 (Label on a prescription bottle) Take one tablet by mouth every 6 hours as needed. ORAL QUESTION: If you take your first tablet at 7:00am, when should you take the next one? Correct Answer: “1:00pm” Participant Response_______1:00pm_______ Numeracy Item 2 (Prompt Card) Normal blood sugar is 60-150. Your blood sugar today is 160. ORAL QUESTION: If this was your score, would your blood sugar be normal today? Correct Answer: “No” Participant Response______No________ b. Numeracy Item 3 (Prompt Card) ORAL QUESTION: When is your next appointment? Participant Response_______April 2nd_______Correct Answer: “April 2nd” or “Thursday, April 2nd” c. Numeracy Item 4 (Label on a prescription bottle) Take medication on empty stomach one hour before or two to three hours after a meal unless otherwise directed by your doctor. ORAL QUESTION: If you eat lunch at 12:00 noon, and you want to take this medicine before lunch, what time should you take it? Participant Response_____11:00_________ Correct Answer: “11:00” or “before 11:00” Passage A Your doctor has sent you to have _stomach______________ X-ray. a. b. c. d. stomach diabetes stitches germs You must have an __empty _____________ stomach when you come for ______it_________. a. b. c. d. asthma a. is empty b. am incest c. if anemia d. it The X-ray will ______take_________ from 1 to 3 ___Hours____________ to do. a. b. c. d. take view talk look a. beds b. brains c. hours d. diet THE DAY BEFORE THE X-RAY For support have only a _______little________ snack of fruit, _______toast________ and jelly, a. b. c. d. little broth attack nausea a. toes b. throat c. toast d. thigh with coffee or tea. After __midnight_____________, you must not _____eat__________ or drink a. b. c. d. minute a. easy midnight b. ate during c. drank before d. eat anything at ____all___________ until after you have ___had____________ the X-ray. a. b. c. d. ill all each any a. are b. has c. had d. was THE DAY OF THE X-RAY. Do not eat _____breakfast__________. a. b. c. d. appointment walk-in breakfast clinic Do not _____drink__________, even ___water____________. a. b. c. d. drive drink dress dose a. heart b. breath c. water d. cancer If you have any _____questions__________, call the X-ray _Department______________ at 519-3000. a. b. c. d. answers exercises tracts questions a. Department b. Sprain c. Pharmacy d. Toothache Passage B It has been explained to ___me____________ that during the course of the a. b. c. d. my me he she _______operation________ or procedure, unforeseen conditions may be __revealed_____________ a. b. c. d. syphilis a. revealed hepatitis b. depressed colitis c. directed operation d. notified that necessitate an extension of the _____original__________ procedure(s) or a. b. c. d. appendix another original addict different procedure(s) than those _____set__________ forth in paragraph 2. a. b. c. d. get set see go I, therefore, ___authorize____________ and request that the above named a. b. c. d. exercise authorize energize pressurize _______physician________, his assistants or attending physicians _____perform__________ such a. b. c. d. infection a. perform pregnant b. smear insurance c. onset physician d. stress procedures as are necessary and ___desirable____________ in the exercise of professional judgement. a. undesirable b. emergency c. desirable d. diagnosis The authority ____granted___________ under this Paragraph 3 shall _____extend__________ a. granted b. treated c. tested a. pretend b. extend c. recede d. X-rayed d. proceed to treating all conditions that __require_____________ treatment and are not known d. e. f. g. reason refer require relate ____At___________ the time the operation or __Procedure_____________ is commended. e. f. g. h. us be or at a. cholesterol b. menopause c. gonorrhea d. procedure Assignment 3, Appendix 1 Assessment Results of the Canadian Assessment of Physical Literacy (CAPL) Participants: ✓ Mr. Smith (68-year-old older adult) ✓ Ms. Jones (35-year-old middle-aged adult) Physical Competence: Mr. Smith: ✓ Proficient in balancing tasks. ✓ Demonstrated good coordination and balance, likely due to prior experience in recreational sports. Ms. Jones: ✓ Adequate in balancing tasks. ✓ Struggled with aerobic exercises despite being younger. Daily Behavior: ✓ ✓ ✓ ✓ ✓ Both participants reported reasonable activity levels. Mr. Smith: Engages in a wider variety of activities including gardening and gym workouts. Ms. Jones: Mainly relies on gym workouts for physical activity. Knowledge and Understanding: ✓ Both participants are aware of the benefits of exercise. ✓ Mr. Smith: ✓ Better understanding of exercises suitable for older adults, likely due to his background in fitness. Motivation and Confidence: ✓ ✓ ✓ ✓ ✓ Both participants expressed high motivation to stay active, driven by different factors. Mr. Smith: Motivated by independence, social outlet, weight maintenance, and stress relief. Ms. Jones: Motivated primarily by stress relief.

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