Background: Globally, cancer predominates in adults aged older than 60 years, and 70% of older adults have ≥1 chronic condition. Cancer self-management interventions can improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multimorbidity. Despite growing evidence of digital health tools in cancer care, there is a paucity of theoretically grounded digital self-management supports for older adults. Many apps for older adults have not been co-designed with older adults to ensure that they are tailored to their specific needs, which would increase usability and uptake. Objective: We aim to report on the user evaluations of a self- and symptom-management app to support older adults living with cancer and multimorbidity. Methods: This study used Grey’s self-management framework, a design thinking approach, and involved older adults with lived experiences of cancer to design a medium-fidelity app prototype. Older adults with cancer or caregivers were recruited through community organizations or support groups to participate in co-designing or evaluations of the app. Data from interviews were iteratively integrated into the design process and analyzed using descriptive statistics and thematic analyses. Results: In total, 15 older adults and 3 caregivers (n=18) participated in this study: 10 participated (8 older adults and 2 caregivers) in the design of the low-fidelity prototype, and 10 evaluated (9 older adults and 1 caregiver) the medium-fidelity prototype (2 older adults participated in both phases). Participants emphasized the importance of tracking functions to make sense of information across physical symptoms and psychosocial aspects; a clear display; and the organization of notes and reminders to communicate with care providers. Participants also emphasized the importance of medication initiation or cessation reminders to mitigate concerns related to polypharmacy. Conclusions: This app has the potential to support the complex health care needs of older adults with cancer, creating a “home base” for symptom management and support. The findings from this study will position the researchers to conduct feasibility testing and real-world implementation.

Health SA Gesondheid promotes communication, collaboration and teamwork between professions and disciplines within the health sciences to address problems that cross and affect disciplinary boundaries.

Background: There are ongoing workforce challenges with the delivery of long-term care (LTC), such as staffing decisions based on arbitrary standards. The Synergy tool, a resident-centered approach to staffing, provides objective, real-time acuity and dependency scores (Synergy scores) for residents. The purpose of this study was to implement and evaluate the impact of the Synergy tool on LTC delivery. Methods: A longitudinal mixed methods study took place within two publicly funded LTC homes in British Columbia, Canada. Quantitative data included weekly Synergy scores for residents (24 weeks), monthly aggregated resident falls data (18 months) and a six-month economic evaluation. Qualitative data were gathered from family caregivers and thematically analyzed. Results: Quantitative findings from Synergy scores revealed considerable variability for resident acuity/dependency needs within and across units; and falls decreased during implementation. The six-month economic evaluation demonstrated some cost savings by comparing Synergy tool training and implementation costs with savings from resident fall rate reductions. Qualitative analyses yielded three positive impact themes (improved care delivery, better communication, and improved resident-family-staff relationships), and two negative structural themes (language barrier and staff shortages). Conclusions: The Synergy tool provides useful data for enhancing a ‘fit’ between resident needs and available staff.

Context: Long-term care (LTC) staff have been burdened by heavy workloads, compromising their ability to deliver resident-centred care. Objectives: This study adapted the Synergy Model for LTC and evaluated the impact from usage of the Synergy tool, a resident-needs assessment tool, on LTC staff perspectives. The tool assesses eight resident acuity and dependency characteristics and can be used in real-time to identify residents’ priority care needs and inform staffing and workload distribution. Methods: A mixed-method study was conducted in two Canadian LTC homes where the impact of the implementation of the Synergy tool was assessed. Quantitative data included online staff surveys (2 time points) and administrative overtime data (18 months). Qualitative data were gathered through two focus groups per LTC home with staff and leadership (n = 3–5 participants per focus group, N = 14 total participants). Findings: Quantitative data indicated mental health improvement and short-term decline in staff overtime rates during implementation. Qualitative data themes were improved care planning and resident-centred staffing. However, increased workload was perceived with short-term tool use. Limitations: Adoption of the tool was implemented over a short duration with a minimal impact strategy in a limited number of care units within the natural LTC setting to reduce overall LTC workload impact and to more closely mimic what would be feasible in most LTC homes. The findings from this study should be interpreted with the implementation constraints in mind. Implications: Although tool use yielded positive outcomes, structural barriers must be addressed to ensure successful implementation and sustainability.

Background. Health resources are key determinants of healthcare coverage. Community members who utilise healthcare have significant insights into the availability of health resources in providing healthcare. Aim. This study sought to explore community (health committee) members perspectives on health resource gaps in lower-level health facilities in the municipality. Methods. The qualitative descriptive study explored the perspectives of community members who served on the health committee. Thirty-four community health committee members at community-based health planning and services (CHPS) compounds, maternity-unit CHPS, and health centres were studied. Results. The study found three high-level categories of resource gaps deemed relevant to community membersinfrastructural gaps, equipment gaps, and safety-quality gaps. Conclusion and Recommendation. There are perceived gaps in health resources from the community members perspective. It is recommended that the Lawra Municipal Health Directorate and other health directorates with similar health resource challenges take steps to fill health resource gaps to ensure universal health coverage.