Ideally, policy development, program planning, and program implementation will be based on data, with each step of the implementation process being "defined, structured, informed, evaluated, and driven by high-quality, objective, and timely research."8 Substantial resources, energy, and effort are devoted to research on topics of direct relevance to aging and public health policy and program development. The findings of this research hold the potential "to enhance our understanding of health and disease in old age, enrich programs for older persons, and improve the quality of life for the elderly."8
Data obtained from research may help health promotion and aging program planners to avoid previously failed approaches, to adopt strategies that have been proven successful, and to more effectively target programs to identified needs. Similarly, as a program becomes well established, data are often needed to document the program's outcomes and provide additional information that may be shared with other communities and programs. By disseminating information obtained through the evaluation of a specific program or intervention, programs may be more efficiently developed elsewhere, thus broadening the impact of the original project or intervention.8
This topic area focuses on a number of federally funded studies that can be used to better understand the factors necessary for healthy aging, including self care. We provide an overview of some publicly funded large national data sets on older adults that have been collected over the past 10 years. Several of these large data sets include questions on the self-care practices of older persons, use of health and social services, performance of health behaviors, and attitudes toward different forms of care.
The remainder of this section describes the major studies and presents their key findings. In addition, it examines gaps in existing knowledge, as identified by the key investigators of these large-scale efforts, and identifies opportunities to address these gaps in future research. The information in this section is presented by the major agency or institute that sponsors the data collection and research. Table D provides a listing of these programs or activities and their principal sponsors. See Appendix D for specific information on each program.
|TABLE D. DHHS Funded Data Collection Activities Related to Health Behaviors of Older Americans|
|Evidence-Based Practice Centers||Agency for Healthcare Research and Quality (AHRQ)|
|Broadening the Evidence Base for Evidence-Based Guidelines||AHRQ|
|Aging Trends||CDC and NIA|
|Trends in Health and Aging||CDC and NIA|
|Longitudinal Studies of Aging (LSOA)||CDC and NIA|
|Demography and Aging Centers||NIA|
|National Long-Term Care Survey||NIA and ASPE|
|The Health and Retirement Study||NIA|
|Study of Assets and Health Dynamics among the Oldest Old||NIA|
|The Wisconsin Longitudinal Study (WLS)||NIA|
|Baltimore Longitudinal Study on Aging (BLSA)||NIA|
|National Survey of Self Care and Aging (NSSCA)||NIA|
|SAMHSA Data Collection Activities||SAMHSA|
A review of these studies raises a number of questions for discussion at the TAG meeting, including the following:
How can existing data help us to determine whether older individuals who have been recently diagnosed with certain health conditions (such as diabetes, heart disease, and stroke) are more likely to engage in, and/or maintain, health-promoting behaviors, relative to those not diagnosed with specific chronic conditions?
What research is needed to determine whether older persons are more likely to engage in self-care and other health-enhancing activities if they have a regular source of care?
How can existing data be used to determine whether certain healthy behaviors (such as not smoking, regularly exercising, and obtaining routine medical exams) that have been routinely practiced by adults in their young and middle years are more likely to be retained in old age?
What are some of the most significant gaps in health promotion/disease prevention research and program evaluation, and what opportunities exist using DHHS' large national data sets?
How can DHHS best support health promotion/disease prevention research, and what areas are most in need of further study?