{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:37:58Z","timestamp":1792737478516,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ohio Long-term Care Research Project and the Ohio Department of Aging via LeadingAge Ohio"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult day services (ADS) are essential home- and community-based supports, yet providers continue to face significant post-COVID operational and engagement challenges. Limited state-level evidence constrains efforts to strengthen ADS capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify barriers experienced by ADS providers in Ohio and provider-driven solutions to sustain and strengthen services in the post-COVID environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A sequential mixed-methods design integrated pre-survey focus groups (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), a statewide provider survey (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 28), and post-survey focus groups (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11). Descriptive statistics and thematic analysis were used to synthesize findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two themes emerged: (1) Participants, Family, and Community Engagement, characterized by limited public awareness, caregiver hesitation, and unstable referral pathways; and (2) Operational Challenges and Limited Resources, including financial strain, staffing shortages, transportation barriers, administrative burden, and facility limitations. Providers identified solutions such as statewide education, workforce development, shared transportation models, and regulatory streamlining.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07334648261497993","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:10:32Z","timestamp":1792487432000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Providers\u2019 Perspective on Barriers and Solutions to Adult Day Services Provision in Ohio"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4299-9952","authenticated-orcid":false,"given":"Kingsley C.","family":"Udeh","sequence":"first","affiliation":[{"name":"Miami University"},{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Noble","sequence":"additional","affiliation":[{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Menne","sequence":"additional","affiliation":[{"name":"Miami University"},{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara. J","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Miami University"},{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1084822311424595"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1352\/1934-9556-57.6.499"},{"key":"e_1_3_7_4_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_7_5_1","unstructured":"Campbell S. Drake A. D. R. Espinoza R. Scales K. (2021). Caring for the future: The power and potential of America's direct care workforce. [Report]. Retrieved July 31 2026 from. https:\/\/www.phinational.org\/wp-content\/uploads\/2021\/01\/Caring-for-the-Future-2021-PHI.pdf"},{"key":"e_1_3_7_6_1","volume-title":"Designing and conducting mixed methods research","author":"Creswell J. W.","year":"2018","unstructured":"Creswell J. W., Plano Clark V. L. (2018). Designing and conducting mixed methods research (3rd ed.) Sage Publications.","edition":"3"},{"key":"e_1_3_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464807307338"},{"key":"e_1_3_7_8_1","first-page":"181","volume-title":"Long-term care in an aging society: Theory and practice","author":"Dabelko-Schoeny H.","year":"2016","unstructured":"Dabelko-Schoeny H., Anderson K. A., Park J. H. (2016). Adult day services. In Rowles G. D., Teaster P. B. (Eds.), Long-term care in an aging society: Theory and practice (pp. 181\u2013201). Springer Publishing Company."},{"key":"e_1_3_7_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare6020043"},{"key":"e_1_3_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464812443308"},{"key":"e_1_3_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/puar.13131"},{"key":"e_1_3_7_12_1","unstructured":"Gattine JD E. Griffin JD E. Snow M. H. S. A. Kimberly I. (2022). Adult day services in Maine: Benefits challenges and opportunities. https:\/\/digitalcommons.usm.maine.edu\/aging\/133\/"},{"key":"e_1_3_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.04.025"},{"key":"e_1_3_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648251315261"},{"issue":"1","key":"e_1_3_7_15_1","first-page":"71","article-title":"Online training: Can it prepare an eldercare workforce?","volume":"40","author":"Gitlin L. N.","year":"2016","unstructured":"Gitlin L. N., Hodgson N. (2016). Online training: Can it prepare an eldercare workforce? Generations, 40(1), 71\u201381.","journal-title":"Generations"},{"key":"e_1_3_7_16_1","first-page":"147130122614688","article-title":"Understanding the experiences of family caregivers of persons living with dementia participating in an \u2018overnight\u2019adult day program","volume":"8","author":"Gurung S.","year":"2026","unstructured":"Gurung S., Baumbusch J., Wu S. A., Ashe M. C., Cooke H. A., Phinney A., Sorensen J. (2026). Understanding the experiences of family caregivers of persons living with dementia participating in an \u2018overnight\u2019adult day program. Dementia, 8, 14713012261468807. https:\/\/doi.org\/10.1177\/14713012261468807","journal-title":"Dementia"},{"key":"e_1_3_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12629"},{"key":"e_1_3_7_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/08959420.2020.1740638"},{"key":"e_1_3_7_19_1","volume-title":"Toolkit: State strategies to support older adults aging in place in rural areas","author":"Kaye N.","year":"2019","unstructured":"Kaye N., Long K. (2019). Toolkit: State strategies to support older adults aging in place in rural areas. The National Academy for State Health Policy. https:\/\/nashp.org\/toolkit-state-strategies-to-support-older-adults-aging-in-place-in-rural-areas\/"},{"key":"e_1_3_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464814521319"},{"key":"e_1_3_7_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610216002532"},{"key":"e_1_3_7_22_1","unstructured":"National Center for Health Statistics. (2026). Data from The National Post-Acute and Long-Term Care Study. https:\/\/www.cdc.gov\/nchs\/npals\/webtables\/overview.htm"},{"key":"e_1_3_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"e_1_3_7_24_1","article-title":"Adult day services: A key community service for older adults","author":"O'Keefe J.","year":"2006","unstructured":"O'Keefe J., Siebenaler K. (2006). Adult day services: A key community service for older adults. United States: Department of Health and Human Services. [Online]. Available. https:\/\/aspe.hhs.gov\/_\/office_specific\/daltcp.cfmorcontacttheASPEProjectOfficers","journal-title":"United States: Department of Health and Human Services"},{"key":"e_1_3_7_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X18000843"},{"key":"e_1_3_7_26_1","volume-title":"Qualitative research & evaluation methods: Integrating theory and practice","author":"Patton M. Q.","year":"2015","unstructured":"Patton M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.) Sage Publications.","edition":"4"},{"key":"e_1_3_7_27_1","volume-title":"Differences in characteristics of adult day services centers, by level of medical service provision (vital and health statistics, series 3, no. 45)","author":"Rome V.","year":"2020","unstructured":"Rome V., Lendon J. P., Harris-Kojetin L. (2020). Differences in characteristics of adult day services centers, by level of medical service provision (vital and health statistics, series 3, no. 45). National Center for Health Statistics. https:\/\/www.cdc.gov\/nchs\/data\/series\/sr_03\/sr03-45-508.pdf"},{"key":"e_1_3_7_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1427425"},{"key":"e_1_3_7_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705420903118393"},{"key":"e_1_3_7_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaa116"},{"key":"e_1_3_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.12.005"},{"key":"e_1_3_7_32_1","doi-asserted-by":"crossref","unstructured":"Singh P. Lu Z. Sengupta M. (2022). Variation in adult day services center participant characteristics by center ownership: United States 2020. (NCHS Data Brief No. 453). National Center for Health Statistics. https:\/\/stacks.cdc.gov\/view\/cdc\/122046","DOI":"10.15620\/cdc:122046"},{"key":"e_1_3_7_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2022.2120375"},{"key":"e_1_3_7_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/14713012251334676"},{"key":"e_1_3_7_35_1","volume-title":"Regulatory review of adult day services: Final report","author":"U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation","year":"2014","unstructured":"U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. (2014). Regulatory review of adult day services: Final report (2014 edition). https:\/\/aspe.hhs.gov\/reports\/regulatory-review-adult-day-services-final-report-2014-edition-0","edition":"2014"},{"key":"e_1_3_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/FCH.0000000000000406"},{"key":"e_1_3_7_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaa178"}],"container-title":["Journal of Applied Gerontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/07334648261497993","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/07334648261497993","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/07334648261497993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:46:11Z","timestamp":1792734371000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/07334648261497993"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":36,"alternative-id":["10.1177\/07334648261497993"],"URL":"https:\/\/doi.org\/10.1177\/07334648261497993","relation":{},"ISSN":["0733-4648","1552-4523"],"issn-type":[{"value":"0733-4648","type":"print"},{"value":"1552-4523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"article-number":"07334648261497993"}}