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Background and Objectives Community Aging in Place, Advancing Better Living for Elders (CAPABLE) is an evidence-based intervention to promote aging in place. Although CAPABLE has been implemented in more than 40 community sites, wide variation in implementation exists. Guided by the Consolidated Framework for Implementation Research (CFIR), this study sought to determine key barriers and facilitators that may influence CAPABLE implementation with older adult and care partner dyads through an area agency on aging (AAA). Research Design and Methods A formative evaluation was completed using qualitative data from the pilot of a Hybrid Trial Type 1 study implementing CAPABLE in an AAA. Multiple sources of data were collected, including 2 focus groups, field notes, a tracking log, and meetings with CAPABLE interventionists. Data were analyzed using a framework method and validated through a negative case analysis approach in NVivo 12 Pro. Results Fourteen dyads enrolled in the pilot and 6 completed the CAPABLE intervention. Key themes aligned with 10 constructs from 5 domains of the CFIR. Facilitators included adaptability of the intervention, cost, networks and communication, and knowledge and belief of individuals. Barriers included intervention complexity, client needs and resources, and executing the planned process. Discussion and Implications Results enhance understanding of contextual factors that can influence the implementation of CAPABLE with care partners. Strategies to overcome barriers include simplifying recruitment materials and targeting older adults with recent onset of disability. The CFIR is a valuable resource for planning and evaluation of the implementation of evidence-based interventions to promote aging in place.

With the increased life expectancy, people aging with spinal cord injury (SCI) are more likely to experience chronic conditions, including diabetes mellitus (DM). The results of previous literature related to the prevalence of DM are mixed and risk factors associated with diagnosis of DM after SCI are not well defined. This study aims to investigate the prevalence of DM and explore associated risk factors for diagnosis of DM among adults aging with long-standing spinal cord injury in the United States. This is a secondary data analysis using the National Spinal Cord Injury Model Systems Database. Participants included 516 people age 45 and older who have been living with SCI for more than 10 years. The prevalence of DM in this sample was 13.2%. Multivariate logistic regression, controlling for confounding variables, was conducted to identify risk factors associated with DM diagnosis in this sample. The multivariate logistic regression model found that the participants who responded with less severe SCI measured by the ASIA impairment scale were less likely to be diagnosed with DM (OR=0.332, p=.017). Also, DM was found to be significantly associated with BMI (OR=1.043, p=.010) and age (OR=1.038, p= .010) respectively. Duration of disability was not significantly associated with DM. Future research is needed to validate these findings and identify other common risk factors for DM such as diet/nutrition. Further, exploration of the effect size of risk factors is also warranted. Such findings will inform interventions to aid prevention and early detection of DM.

People with long-standing physical disabilities are living longer than at any time in history, owing to advancements in medical science, rehabilitation, and social systems. Approximately 12–15 million people in the U.S. are aging with long-standing disabilities that were acquired before age 40 years. This population is forecast to grow, resulting in a subset within the aging community. More research is needed to increase understanding of successful aging with disabilities, the pathways of aging with disability, and unique characteristics of the aging process. The purpose was to define and clarify the conceptual meaning of aging with disability, identify its attributes, antecedents, and consequences, and explore the significance and implications of the concept in nursing. Rodgers’ evolutionary method of concept analysis was used. Three databases, CINAHL, PubMed, and PsycINFO were used to retrieve literature. Inclusion criteria were publication year from 2001 to 2019, peer-reviewed academic journals, and English-language. Exclusion criteria included other than physical disability such as developmental, learning, or intellectual disability, focus on the aging process of people without disability, the main topic on the perspectives of caregivers or health care providers. Thirty-five articles met inclusion criteria. The analysis identified three antecedents (e.g., contributing barriers), three attributes (e.g., premature aging), and three consequences (e.g., accommodation needs). An understanding of the antecedents, attributes, and consequences of aging with disabilities will enhance quality of care including effective prevention and communication. Findings will guide researchers in developing a framework or theory to increase understanding of aging in individuals who acquired disability early in life.