2012 Professional Practice Gaps: Rural Health Care Providers

Oklahoma State University (OSU) is a consortium partner of the Oklahoma Geriatric Education Center (OKGEC). Today, we are submitting the OSU/OKGEC 2012 Professional Practice Gaps Assessment (PPGA) to gather information needed to develop evidence-based programs related to Gerontology, Aging, and Geriatrics. We need your input to develop educational programs that supports the enhancement of best practices. Only selective OSU staff will see responses. Only summary findings will be reported; names will not be used. Thank you for participating. If you have questions, please contact Dr. Tammy Henderson at or (405) 744-8350.
For conference information visit
To register for the conference:
DIRECTIONS: Please mark the appropriate box or insert your response.
For statistical and annual report purposes, please complete all pages of this form

* 1. Title (Mr., Mrs., Ms,)

* 2. Full name (First, MI, Last, Suffix)

* 3. Credential

* 4. Position

* 5. Organization

* 6. Address

* 7. City, State, ZIP

* 8. Daytime phone

* 9. Cellular Phone

* 10. Email (Please print clearly)

* 11. Age Group

* 12. Gender

* 13. Ethnicity

* 14. Retired

* 15. National Health Service Corps Member

* 16. Your most advanced degree

* 17. Certificate in Geriatrics

* 18. Please indicate the clinical sites in which you work. (Check all that apply.)

* 20. What is your profession?

* 21. DIRECT CARE PROVIDERS: Do you spend at least 50% of your time in any of the following sites that serve underserved populations? (Check all that apply)

* 22. Primary Role: (Check one)

* 23. 1. What is your preferred delivery format?

  First Second Third Forth Fifth
Face-to-Face Sessions
Live Webinar
Online Webinar

* 24. How interested would you be to receive an evidence-based presentation to enhance professional practices related to the following acute health conditions of older adults?

  Extremely Very Moderate Mild None
Bladder Control
Falls, Preventing
Hearing Aids
Hip Fracture
Hip Replacement
Knee Replacement
Sleep problems
Human Sexuality
Cardiovascular Disease
Chronic Respiratory Diseases
Dental Care
Dental Health and Cognitive Status
Mixing Medications with Dental Care
Oral Cancer
Nutrition and Oral Health
Personal Traits and Bruxism*
Tooth Loss
Aging Workplace
Working Retirement Part-Time
Financial & Retirement Planning
Transmission of Family Values
Transmission of Culture
*NOTE: Bruxism refers to the clenching or grinding of teeth, especially at night.

* 25. How interested would you be to receive an evidence-based presentation to enhance professional practices related to the following issues of economics of aging?

  Extremely Very Moderate Mild None
Reverse Mortgage
Working Retirement Full-Time
Phased Retirement
Aging In Place
Nursing Homes
Assistant Living
Retirement Communities
Spiritual Activities
Church Activities
Senior Day Services
Aging Workforce
Cultural Competence
Transmission of Cultural

* 26. Please give additional presentation topics and other suggestions that would support your promotion of the health and well-being of older adults in Oklahoma:

Hit the submit button in this survey or Send comments to:
Dr. Tammy L. Henderson
Oklahoma State University
233 Human Sciences, Stillwater, OK 74078-6122.
OFFICE PHONE: 405-744-8350