Preparing for a Diverse Career in Aging

Meghan Mattos, PhD; Jaime Hughes, PhD, MPH, MSW & Heather Derry-Vick, PhD; Aging SIG Co-Chairs

The proportion of adults 65 years of age and older is projected to increase to almost 22% of the US population by 2040.¹ This continued growth signals the need for evidence-based health promotion and chronic disease management programs across diverse settings and via novel modes of delivery. Together, these trends suggest several priority areas for all behavioral medicine students, trainees, and professionals working across research, education, and practice-based settings.

Prepare. There is a striking, widening gap between the number of older adults and the number of providers specialized in caring for them, as well as researchers focused on older adults or age-related conditions. Preparing future and current workforces is essential to providing optimal services and health promotion programs to this population. All behavioral medicine professionals should be prepared to work with older adults and incorporate gerontologic considerations in their research, clinical practice, education, or policy careers.

Recommended Actions:

• Build on clinician training designed for the care of older adults to develop short courses and webinars highlighting relevant health promotion behaviors and chronic disease considerations for older adults.
• Devote specific academic courses to focusing on gerontologic principles within the curriculum. For example, address each Gerontological Nursing Competency presented by the American Association of Colleges of Nursing in the baccalaureate nursing curriculum.
• Challenge age-related bias that may affect behavioral medicine research, clinical practice, education, and policy. For example, the GSA-led Reframing Aging Initiative is “a long-term social change endeavor designed to improve the public’s understanding of aging and the ways that older people contribute to society.”² 

Engage. Developing, refining, and evaluating programs in collaboration with end users and key groups is key to building successful and sustainable programs.

Recommended Actions:

• Work with end users, including patients, caregivers, providers, healthcare leaders, and policymakers, early and often. Consider seeking informal or formal feedback via surveys and listening sessions to learn about local and regional preferences/concerns of older adults and their families.
• Develop additional education and resources in areas such as engaged design and adapting co-design methods for complex populations, including older adults with cognitive or functional limitations.

Innovate. Although there are critical considerations around access and equity, the COVID-19 pandemic also demonstrated the value of thinking creatively about program delivery using digital health. As broadband access and Internet use increase, older adults can benefit from personalized medicine and sustained healthcare services in the comfort of their own homes.

Recommended Actions:

• Consider and address ageism associated with the use of digital health by older adults.³
• Involve older adults in the design, development, and evaluation of new digital behavioral health interventions. Conduct focus groups early in the development phase to identify barriers and facilitators to digital health use and engage older adults throughout the refinement and testing process to evaluate reach, usability, and acceptability.
• Use digital health to provide accessible behavioral care and services to older adults. This approach allows for scalability and sustainability in behavioral interventions that is difficult to achieve with limited workforce resources.

Apply. The rapid growth of the older adult population demands quick translation of evidence-based programs into clinical practice and community settings. Applying novel research methods and principles of implementation science may accelerate this translation.

Recommended Actions:

• When developing and evaluating interventions, integrate principles of implementation science, including designing for dissemination, considering scalability from the start, and promoting adaptability.
• Consider pragmatic trials, which are research studies planned in collaboration with key decision-makers and conducted under real-world conditions to inform clinical practice and policies.

References:

1. The Administration for Community Living. 2020 Profile of Older Americans, 2021. https://acl.gov/sites/default/files/aging%20and%20Disability%20In%20America/2020Profileolderamericans.final_.pdf
2. The Gerontological Society of America (March 14, 2022). Reframing Aging Initiative Advocates for Inclusivity in New Educational Video. Accessed on November 10, 2022. https://www.geron.org/press-room/press-releases/2022-press-releases/1427-reframing-aging-initiative-advocates-for-inclusivity-in-new-educational-video
3. Mace, R., Mattos, M.K., & Vranceanu, A. (2022, EPub, ahead of print). Older adults can use technology: why healthcare professionals must overcome ageism in digital health. Translational Behavioral Medicine. Doi: https://doi.org/10.1093/tbm/ibac070