Specify the Populations Most at Risk for the Identified Problem

A third consideration that must occur in the discovery prephase is identifying the specific populations most at risk for the identified problem and for whom intervention development is most warranted. For example, depression in late life is common, and there are various effective depression treatments. However, older minority populations are differentially affected; depression tends to be underdetected and undertreated with most proven interventions not typically including these populations in their evaluations (Arean, & Unutzer, 2003). Furthermore, there are numerous interventions for older Caucasians that have been tested in primary care settings. As depression in minority groups is underrecognized and undertreated in this setting, developing an intervention that specifically targets underserviced groups and is delivered in settings other than primary care to overcome persistent health disparities in access and treatment has become a recognized public health imperative (Gitlin, 2014).

For the ABLE Program, the groups identified as those most at risk for functional challenges at home were minority and low-income populations, representing the fastest growing segment of the aging population. Other subgroups affected included the oldest old, older adults living in poor housing stock, and those living alone and lacking resources to address their functional limitations. These groups all became targets for the ABLE Program (Gitlin, Winter, Dennis, & Hauck, 2008).

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