title: Participant-Direction in a Culturally Diverse, Rural Population: The Hawaìi Community Living Program.
abstract: The Hawaii Community Living Program was a participant-direction pilot project aimed at rural, multicultural, and community-dwelling older adults at risk of institutionalization. This evaluation examined participant outcomes, and explored the role of culture, health literacy, and rural settings in participant-direction programs. The program enrolled 91 participants and, of these enrollees, helped 84 (92.3%) participants avoid institutionalization and spend down to Medicaid. Findings indicated that Program Coaches needed to be culturally appropriate and creative in arranging for services and the delivery of goods and supplies. Results suggested that participants need to be health literate to direct their care, but further research is needed.
authors.affiliation: 1 University of Hawaii, Honolulu, USA.
authors.forename: Christy
authors.initials: C
authors.lastname: Nishita
authors.affiliation: 1 University of Hawaii, Honolulu, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Trockman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D018864:Cultural Diversity; D005260:Female; D006254:Hawaii; D057220:Health Literacy; D006801:Humans; D057187:Independent Living; D007326:Institutionalization; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D008484:Medicaid / Q000458:organization & administration; D008875:Middle Aged; D010865:Pilot Projects; D015397:Program Evaluation; D012424:Rural Population; D014481:United States
keywords: aging; aging in place; consumer direction; culture; health literacy; participant-direction; rural; service delivery