When studying a topic as broad as aging, there’s no doubt an interprofessional approach is the most effective way to explore aging-related questions and help identify solutions. That’s why enabling interprofessional collaboration is among the principal catalysts of Western Kentucky University’s new Center for Applied Science in Health and Aging, which opened last fall.
CASHA is the brainchild of three WKU professors: Jason Crandall, Ph.D., associate professor, School of Kinesiology, Recreation & Sport; Jean Neils-Strunjas, Ph.D., department head and professor, Communication Sciences & Disorders; and Matthew Shake, Ph.D, associate professor, Psychological Sciences. The three were no strangers to collaborating, having worked together for years on various studies centered on Bingocize®, a health promotion program developed by Crandall that combines bingo, exercise, and health education. When WKU’s College of Health and Human Services put out a call for proposals to develop a new research center, the trio seized their opportunity. (CASHA is now the second center for applied research created by WKU’s College of Health and Human Services, according to a Bowling Green Daily News article.)
“Our motivation for creating CASHA was really that WKU didn’t yet have a center geared toward what we do and what we see as fundamental to a lot of the needs that are found in our region, including a need for interprofessional perspectives and work,” Shake said.
Added Crandall, “We want to expand not only the Bingocize® research, but also go into other aging research areas. We want to make it interprofessional because we’ve found how successful we’ve been working together and we want to invite other faculty — including from other universities, both in the U.S. and around the world — to join us.”
So far, Crandall said that around a dozen WKU faculty members are regularly attending CASHA meetings to participate in discussions about projects and initiatives, including a goal to make WKU an Age-Friendly University. This designation, given by the Academy for Gerontology in Higher Education, indicates that an institute of higher education has “endorsed the 10 AFU principles and committed themselves to becoming more age-friendly in their programs and policies,” according to AGHE.
As new projects are being planned by CASHA participants, several Bingocize® research studies are already in the works. Shake and Crandall are leading a National Institutes of Health-funded clinical trial of Bingocize® at senior centers throughout Kentucky and Tennessee.
“We randomly assigned older adults at participating senior centers to one of four different conditions,” Shake said. “They still live independently but are at a high risk for losing that independence. The goal here is to get them to engage in health-promoting behavior so that they can age in place as long as possible.”
By the end of the three-year clinical trial, Shake hopes to discover whether there’s sufficient evidence to officially designate Bingocize®.
“We’ve published several papers based on smaller studies that document improvements, so we know that Bingocize® provides beneficial impacts, but that’s separate from a designation as an actual clinical trial, which is another level of demonstration of efficacy,” Shake said.
With the help of several WKU undergraduate and graduate students, Shake and Crandall are collecting data on both physical and cognitive outcomes. After initial data collection, participants complete a 12-week Bingocize® program. Once the program has concluded, the students return with Shake for another round of physical and cognitive tests and questionnaires. By simultaneously studying four different conditions, Shake hopes to produce evidence-based findings about the most effective approach to help improve aspects of physical and cognitive function, which can help older adults live independently for a longer period of time.
The simplicity of Bingocize® also makes it versatile, easily tailored for specific participants. Crandall and Neils-Strunjas are studying a different application of Bingocize® as part of a Civil Monies Penalty Grant in nursing homes across the Commonwealth of Kentucky.
“There are federal fines that are posted for nursing homes that don’t follow regulations, and then that money comes from the government back to the state for use to benefit individuals in nursing homes,” Neils-Strunjas said.
That funding source is driving their study, Bingocize®: An Evidence-Based Health Promotion Program to Improve Quality of Life of Kentucky Certified Nursing Facility Residents. Bingocize® is provided to nursing homes throughout Kentucky with the help of universities who serve as sub-contractors in their respective areas. The program is adjusted depending on a center’s specific needs or population. For example, many Bingocize® participants living in a nursing home may have less physical function and/or a higher probability of dementia, so Bingocize® can be adjusted to accommodate these and other health conditions.
“When we work in long-term care, success to us is that Bingocize® participants maintain their health,” Crandall said.
Neils-Strunjas said they’ve reached over 1,000 nursing home residents so far. Like Shake and Crandall’s research, Neils-Strunjas and Crandall’s project gives students — including those at WKU, as well as participating sub-contractor universities — an opportunity to collect and analyze data firsthand. That immersive experience has produced some surprising — and unforeseen — results.
“We published an article based on the Bingocize® project in 2018 and we were able to show that participating students showed more positive attitudes toward working with older adults,” Neils-Strunjas said. “It definitely made an improvement in how young people think about older adults.”
It’s an important skill to cultivate, especially given the continued growth in the country’s aging population.
“By 2030, one in five people will be over the age of 65,” Neils-Strunjas said. “Whether you like it or not, you’ll be working with or caring for older adults, so it’s really important to have a positive attitude toward what will be the reality.”
Neils-Strunjas saw this skill develop firsthand with one of WKU’s graduate students, Lauren Stevens, who will graduate in May.
“She developed a love of and interest in working with nursing home residents as a speech-language pathologist,” Neils-Strunjas said. “She also developed a skillset in working with older adults, which is exactly what we want to see happen with our students.”
Giving students opportunities to explore and participate in applied research is among the top priorities of CASHA. As the center grows to include more faculty and research projects, students will have more chances to work on a research team. Shake said one of CASHA’s goals is to apply for student training-focused grants, including those given by the National Institutes of Health and the National Science Foundation. Additionally, CASHA’s interprofessional approach introduces opportunities for students to learn from more faculty, creating a more enriching experience both in and out of the classroom.
“Dr. Shake was able to speak to one of my classes this year, so he offered a different perspective on changes in reading ability,” Neils-Strunjas said. “My students benefitted because he has that expertise that I don’t have. I also tapped into a professor of epidemiology who was able to assist with a master’s thesis, so we have a lot of opportunities in collaborating on student projects and teaching opportunities that benefit WKU students.”
CASHA’s three co-founders also hope that older adults — especially in Kentucky — will benefit from the center’s research and evidence-based findings.
“Our work is driven by larger societal issues having to do with the aging population nationwide,” Shake said. “Our state ranks pretty poorly in health demographics. What can we do about that?”
Added Neils-Strunjas, “We’ve brought together different disciplines at CASHA, including social work, speech-language pathology, exercise science, physical therapy and nursing. We try as much as possible to bring together people at WKU with an interest in aging and join forces to help better the lives of people in Bowling Green and throughout Kentucky.”