bluuebunny/crossref_metadata_2025 huggingface dataset:
EDUCATIONAL PREPAREDNESS IN MEETING THE NEEDS OF AN AGING POPULATION
Authors: Narine Donnette , Helsinger Abigail , Cummins Phyllis , Karam Rita , Punksungka Wonmai , Kramer Jenna , Yamashita Takashi
Published: December 2022

Community colleges play an important role in training adults in healthcare-related occupations, such as nurses and medical technicians, to meet the needs of an aging population in the U.S. In addition, community colleges with open access policies, have a long-standing record of serving a diverse population, including students of all ages. However, the relatively low program completion rates (e.g., about 30% in Ohio) are of concern in general, and among older students in particular. One of the reasons for the low completion rate is the lack of postsecondary education readiness or basic skills, such as literacy, numeracy, and digital skills. The COVID-19 pandemic has created additional challenges, including faculty shortages, lack of internet access, poor digital skills, and transitions to online classes. This study examined characteristics of health-related occupational programs at community colleges located in Washington, Indiana, and Ohio, focusing on adult student characteristics, and their administrators' and faculty’s views on basic skills and program completion. In addition, potential employers were interviewed regarding the skill expectations of community college hires. Using the semi-structured qualitative interview, community college administrators, faculty, and potential employers reported that numeracy skills, excellent grammar, and critical thinking skills are important to succeed both in the classroom and in the workplace. Creating a supportive atmosphere in the classroom and providing tutoring, either by the instructor or at a tutoring center, are also important for student success. More detailed results as well as other policy implications are discussed in this study.
DIFFERENCES IN COMMUNITY AND PROVIDER STAKEHOLDERS' PERCEPTIONS ON BRAIN HEALTH SERVICE GAPS AND SCREENING NEEDS
Authors: Rhodes Annie , Sargent Lana , Zanjani Faika
Published: December 2022

Introduction

Alzheimer's Disease and Related Dementias (ADRD) management and prevention is a priority for providers and community members. Aligning perceptions regarding resources and screening supports person-centered care while addressing the increased dementia burden attributed to systemic inequity and health disparities. This project aimed to identify needs in lower-income diverse populations.Research Question: What are the differences in perceived service gaps and screening preferences for brain health and ADRD?

Methods

A convenience sample of 15 providers and 20 community stakeholders (55+) completed a 2021 survey about Richmond's service gaps and screening needs for brain health and ADRD.

Results

40% of providers were ADRD focused, 65% of community members reported a memory concern. Overall, providers reported fewer service gaps: Administration on Aging Service Gaps 46.7%/75%, Caregiving gaps 80%/85%, Specialty Health gaps: 53.3%/80%. Clinical ADRD gaps 73.3%/80%, Memory Case Management gaps 86.7%/90%, Memory Social Services gaps 33.3%/90%, Memory Screening gaps 53.3%/85%. Provider and Community stakeholders were more aligned regarding screenings that should be included in a brain health/ADRD management program: Advance Care Planning screening: 80%/80%, Caregiving Status screening: 93.3%/90%, Memory Loss screening: Lifestyle Risk screening: 100%/95%, Cognitive-Comorbidity Risks screening: 100%/75%, Psychosocial Risks screening:100%/100%, Depression screening 100%/100%, Clinical Health screening 73.3%/90%, Substance Use Disorder screening 86%/75%, Sleep Problem screening 93%/75%

Conclusion

Although there were areas in which both providers and community members aligned, results show that providers underestimate brain health/ADRD service gaps experienced by the community. Both groups are amenable to comprehensive screening for services. However, providers are interested in more expansive ADRD screeners.
PLACE-BASED HEALTH DISPARITIES: FUNCTIONAL DISABILITY IN APPALACHIAN WEST VIRGINIA
Authors: Pullen Carly , Ibrahim-Bacha Kareem , Patrick Julie Hicks
Published: December 2022

Place-based health disparities contribute to disability across the lifespan. Additional examinations of contributors to morbidity and disability at mid-and late-life are needed to inform policies and programs. Using data from the 2020 Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS), we examine some of the social determinants of health (e.g., age, gender, education, income) as predictors of access to health care and predictors of functional ability. The study included 5,880 adults living in West Virginia all between the ages of 18 to 65+ years. Access to healthcare was indexed by three variables, including whether one had medical insurance, saw personal physicians, and avoided medical treatment due to cost. Functional ability was indexed by reports of difficulty in three ADLs and the number of chronic health conditions. Although most paths were significant, our initial model fit the data poorly, X2 (DF = 39, N =5880) = 2503.6, p < .001, CFI = .70, RMSEA = 1.0. We re-ran the model, using age as a moderator. In this set of analyses, the model fit well for middle-aged and older adults, but a different set of predictors characterized the relations for younger adults. Our results suggest that policies and programs that increase medical access for current middle-aged and older adults might decrease functional disability. Moreover, as younger adults age into midlife, they enter with lower economic and educational resources, further exacerbating their lack of access to health care and increasing disability.
NORMALIZING COGNITIVE EVALUATIONS IN ADULTS: GETTING PEOPLE IN THE SCREENING PIPELINE EARLY
Authors: Mehegan Laura , Raineville Chuck
Published: December 2022

To understand how adults and healthcare providers perceive a dementia diagnosis and cognitive evaluations, AARP fielded a nationally representative survey of adults aged 40 and older (N=3,022) along with a companion survey of healthcare providers in a position to diagnose dementia (N=500). Like healthcare providers, Americans aged 40 and older understand the benefits of diagnosing dementia at an early stage, 81% agree that early detection would motivate them to engage in healthier behaviors to slow the progression of the disease. Adults look to healthcare providers as authorities to determine when a cognitive evaluation should be triggered with 63% saying they would get an evaluation if their doctor recommended it and 49% of healthcare providers saying evaluations should be done if the doctor feels it is necessary and 39% saying it should be done yearly beginning at age 65. The research also showed that most adults (76%) want to know if they have dementia. Additionally, majorities of adults would engage in healthy behaviors if they knew it’s good for their brain health. Given the desire to prevent and improve outcomes, routine screening for cognitive function should be as commonplace as getting a screening colonoscopy. Unlike a colonoscopy, routine screening for cognitive function is not a normalized process yet. Data from both populations suggest an opportunity for routine evaluation due to a shared understanding of the long and short-term benefits of screening.
NONVERBAL STRATEGIES TO ENHANCE PERSON-CENTERED COMMUNICATION WITH PEOPLE LIVING WITH DEMENTIA
Authors: Bender Emma , Savundranayagam Marie , Murray Laura , Orange Joseph
Published: December 2022

Many people living with dementia experience difficulties comprehending language, and benefit from nonverbal communication (NVC). Yet, little published empirical evidence exists for care partners regarding NVC strategies that support person-centered communication with perons living with dementia. This study aimed to determine whether NVC strategies used by personal support workers accompany verbal communication demonstrating person-centered communication indicators (facilitation, negotiation, recognition, validation). Secondary data analysis of video-recorded interactions (n=40) between personal support workers and simulated persons living with dementia was conducted. The recordings were transcribed according to communication-units, which were coded for person-centered communication and NVC, using a novel coding system consisting of ten NVC strategies. The overlap between NVC strategies and verbal person-centered communication was examined. Findings revealed that personal support workers frequently accompany verbal person-centered communication with NVC strategies. Out of 1848 communication-units in which person-centered verbal communication was used, 69% overlapped with NVC strategies. Gaze overlapped with all person-centered communication indicators frequently, both individually (40% – 49% of overlapping communication-units) and when combined with touch (13-24%). Gestures using objects (with and without gaze) frequently accompanied facilitation (17%) and negotiation (21%), while positive facial expressions (with and without gaze) were commonly found in recognition (16%) and validation (16%). The use of NVC strategies which support person-centered communication may lead to communication enhancement, in turn improving interactions and relationships between persons living with dementia and their care partners.
FEASIBILITY OF THE ACTPLAN PROGRAM FOR AFRICAN-AMERICAN DEMENTIA CAREGIVERS: A SELF-DIRECTED MULTIMEDIA DELIVERY
Authors: Watkins Yashika , Tharpe Rita , Aggarwal Neelum , Bonner Gloria
Published: December 2022

African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.
COMMUNITY MOBILITY PATTERNS OF OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Stinchcombe Arne , Mullen Nadia , Timinski John , Marshall Shawn , Naglie Gary , Rapoport Mark , Bédard Michel
Published: December 2022

The COVID-19 pandemic has had appreciative impacts on the lives of older adults. At various times during the pandemic, Canadian provinces put in place public health measures to prevent the spread of the virus, including closures of non-essential businesses and services. The Candrive Driving Cessation sub-study is a 12-year, mixed methods, longitudinal study. During the COVID-19 pandemic, participants from four sites (n=124, mean age=85.5 years) were asked to report how their community mobility patterns during the pandemic compared with before the pandemic. They also completed the COVID-19 Anxiety Syndrome Scale and the Assessment of Readiness for Mobility Transition (ARMT) tool. The results indicated that during the pandemic, participants were less likely to drive (χ2=7.11, p=.004) or ride a public bus (χ2=20.05, p<.001) when leaving their home. During the pandemic, they reported fewer trips to the supermarket (χ2=99.00, p<.001) and fewer visits with family (χ2=68.00, p=.001). We observed a statistically significant relationship between COVID-19 Anxiety Syndrome Scale scores and ARMT (Anticipatory Anxiety subscale; r= .810, p<.001), such that higher COVID-19-related anxiety was associated with greater anxiety related to anticipating changes in mobility. These results emphasize the impacts of the COVID-19 pandemic on the mobility patterns of older adults. Promoting community mobility for older adults alongside preventative public health measures is essential.
SUICIDAL IDEATION AMONG OLDER ADULTS LIVING WITH CHRONIC ILLNESS
Authors: Poe Abigail , Puga Frank
Published: December 2022

Older adults living with chronic illnesses, such as diabetes, cancer and heart disease, have an increased risk of poor mental health outcomes. While a link between living with chronic illness and depression have been examined in previous studies, relatively little is known about factors that increase and decrease the risk of suicidal ideation among older adults living with chronic illness. Using data from the third wave of the Midlife in the United States (MIDUS) database, we examined the relationship between living with a chronic illness were more likely to endorse thinking about death in the previous two weeks ( OR=3.17, CI: 1.16 – 8.65, p=0.24). The analysis also revealed that the likelihood of suicidal ideation in the previous two weeks increased with the number of chronic conditions reported by participants (OR=1.128, CI: 1.04 – 1.23, p=0.005). The results of this study are consistent with previous studies suggesting a relationship between older adults living with a chronic condition are at a higher risk of suicidal ideation. Findings from this study can help inform intervention development to support mental health of older adults living with chronic illness. Future studies are needed to examine additional psychosocial factors that may mediate the relationship between living with a chronic illness and suicidal ideation among older adults.
THE IMPACT OF SLEEP ON MINDFULNESS, WELL-BEING, AND DEPRESSIVE SYMPTOMATOLOGY IN MIDDLE TO OLDER AFRICAN AMERICANS
Authors: Ilori Folasade , Dabiri Sanaz , Ramirez-Ruiz Mara , Daniel George , Head Robert , Wright Regina , Mwendwa Denee
Published: December 2022

The decline in physical and mental well-being is common with age. The negative impact of poor quality of sleep and depressive symptomatology contributes to the decline in well-being among middle to older adults. African Americans are more likely to report a decrease in well-being as they age. They are also disproportionately affected by poorer sleep quality and may be at greater risk for depressive symptomatology. Dispositional mindfulness is linked to improved well-being. Research has shown dispositional mindfulness is related to adaptive health behaviors, improved sleep quality, and reduced negative affect. Mindfulness allows engagement of early regulation of intense emotional responses because of nonjudgmental acceptance of thoughts and emotions. Therefore, this study aims to examine the impact of mindfulness on physical/mental well-being and depressive symptomatology through sleep. 131 African American participants were recruited for the study, with an average age of 58 years. The results showed a significant effect of mindfulness on well-being and depressive symptoms. Additionally, the impact of mindfulness on mental and physical well-being was mediated by sleep quality (B = .7920, CI [.1482, 1.6702]) and sleep disturbance (B = 2.874, CI [.1582, 6.335]). The results also showed an indirect effect of mindfulness on depressive symptoms through sleep quality (B = –6.139 CI [-12.871, -.5298]). This study demonstrates the positive impact of mindfulness on well-being and depressive symptomatology. Sleep quality also plays an important role in the relationship between dispositional mindfulness and physical/mental well-being and depressive symptomatology in middle to older African Americans.
CHANGE IN SOCIAL INTERACTION AND MENTAL HEALTH AMONG OLDER AMERICANS DURING COVID-19 PANDEMIC
Authors: Keller Krystyna , Lin Jielu , Zajdel Melissa , Macfoy Fiona Gilpin , Shaw Philip , Curtis Brenda , Ungar Lyle , Koehly Laura
Published: December 2022

Recent research has shown the mental health consequence of social distancing during the COVID-19 pandemic, but longitudinal data are relatively scarce. It is unclear whether the pattern of isolation and elevated stress seen at the beginning of the pandemic persists over time. This study evaluates change in social interaction over six months and its mental health impact among older adults. We drew data from a panel study with six repeated assessments of social interaction and mental health conducted monthly May through October 2020. The sample included a total of 380 White, Black and Hispanic participants aged 50 and over, of whom 33% had low income, who residing in fourteen U.S. states with active stay-at-home orders in May 2020. The analysis examined how change in living arrangement, in-person interaction outside the household, quality of relationship with family and friends, and perceived social support affected trajectories of isolation stress, COVID worry and sadness. While their living arrangements and relationship quality remained stable, older adults experienced fluctuations in perceived social support and increases in in-person conversations outside the household. Living with a spouse/partner stabilized isolation stress and COVID worry over time. Individuals with better relationship quality with friends became happier over time. Changes in social support were associated with greater fluctuations in isolation stress and COVID worry. During the pandemic, social interactions are protective and lack of stability in feeling supported makes older adults vulnerable to stress. Efforts should focus on (re)building and maintaining companionship and support to mitigate the pandemic’s negative impact.
EXPLORING THE PHYSICAL FUNCTION PROFILES OF OLDER ADULTS WITH SERIOUS MENTAL HEALTH CONDITIONS
Authors: Browne Julia , Morey Miriam , Elbogen Eric , Mueser Kim , Hall Katherine
Published: December 2022

Older adults with serious mental health conditions experience high rates of comorbid chronic medical diseases, which affect the physical function and long-term aging trajectory of this population. Existing physical function research in this population has focused almost exclusively on endurance with little to no attention paid to other important domains such as balance, mobility, and strength, which are critical to promoting independence and improved quality of life. The primary aim of this study was to explore the multiple dimensions of function that are important to maintaining independence and health in older adults with serious mental health conditions. This study examined publicly available data from the 2014 and 2016 waves of the Health and Retirement Study, a national longitudinal panel study of older adults. Analyses were limited to participants that self-reported lifetime diagnoses of serious mental health conditions (schizophrenia, bipolar disorder, depression, posttraumatic stress disorder). The sample comprised 428 older adults over age 50 (M=67.1, SD=10.1; 68% female) who completed standardized assessments of grip strength, single-leg standing balance, and usual walking speed. Scores on these three measures were compared to established age- and/or gender-based norms for each assessment to characterize performance. Overall, 65% of the sample demonstrated deficits in strength and 31% of the sample performed below established norms for both balance and walking speed. These findings highlight that physical function in this population is compromised across multiple domains and suggest a need for multicomponent interventions.
GENERATIVITY AND OLDER ADULTS’ COVID-19 ADJUSTMENT AND MENTAL HEALTH
Authors: So Christine , Fiori Katherine , Rauer Amy , Marini Christina
Published: December 2022

Generativity, the capacity to be productive, caring, and concerned with the well-being of the next generation, has been linked to positive mental health outcomes and posttraumatic growth (Bellizzi, 2004). Generativity may be particularly important nowadays as older adults adjust to the pandemic and its aftermath. For example, after months of social distancing, the availability of vaccines has enabled many older adults to begin resuming social activities. Considering the meaning-making function of generativity, generativity may be associated with more positive outcomes, including better mental health and views on quality of life and family relationships during this post-pandemic adjustment period. The current study used a community sample of 136 older adults (M age = 67.77, range 50-91; 69.3% females; 93% White) to explore whether generativity predicted older adults’ anxiety and depressive symptoms, and attitudes about how the pandemic affected their quality of life and family relationships. Using hierarchical linear regressions controlling for age and gender, we found that generativity was negatively linked to anxiety and depressive symptoms. Furthermore, those with greater generativity were more likely to report that their family relationships improved because of the pandemic. In contrast, generativity was not associated with positive growth in the personal domain or with perceptions that the pandemic had harmed either personal or family domains. Our findings are consistent with Erikson’s theory on the important role that generativity plays in shaping well-being and psychological health in older adults, and our findings suggest these effects may be especially pronounced during this post-pandemic adjustment period.
THE ASSOCIATION OF INCREASING RESILIENCE WITH POSITIVE HEALTH OUTCOMES AND QUALITY OF LIFE AMONG OLDER ADULTS
Authors: Musich Shirley , Wang Shaohung , Schaeffer James , Kraemer Sandra , Wicker Ellen , Yeh Charlotte
Published: December 2022

Background

Resilience has been recognized as a concept central to successful aging. Higher resilience has been associated with positive mental health while a direct impact on physical health outcomes has been less consistent. Objective: To investigate three levels of resilience (low, medium, and high), identify characteristics associated with medium and high resilience and measure the impact of increasing resilience on selected health outcomes: quality-of-life (QOL), and healthcare utilization and expenditures.

Methods

The study sample was identified from adults age ≥65, covered by an AARP® Medicare Supplement Insurance Plan from UnitedHealthcare, who had completed a health survey during May-June 2019 (N=3,573). Resilience was categorized to three levels: low, medium, and high. Other positive resources, including purpose-in-life, locus of control, social connections, and optimism, were dichotomized as high/low and counted with equal weighting as a continuous variable. Quality of life was measured from the health survey; healthcare utilization and expenditures from administrative databases.

Results

Among weighted survey respondents, the prevalence of low, medium, and high resilience levels were 27%, 29%, and 43%, respectively. The strongest predictors of medium and high resilience included increasing number of other positive resources, lower stress, and no depression. Individuals with medium and high resilience had significantly higher QOL, lower healthcare utilization and reduced healthcare expenditures.

Conclusions

Interventions promoting the maintenance and/or increase of resilience should include a focus on other positive resources and stress/depression management. Resilience strategies integrated into healthy aging programming could be associated with improved health outcomes.
ADJUSTMENT TO AGING AMONG LBGT+ OLDER ADULTS
Authors: von Humboldt Sofia , Carneiro Francis , Leal Isabel
Published: December 2022

Intervention programs that highlight predictors of adjustment to aging (AtA)(1) for minority older lesbian, gay and bisexual (LGB) populations are scarce(2).The aim of this preliminary study is to build a structural model to explore whether socio-demographic, health and lifestyle-related variables, are correlates of AtA in a group of LGB older adults(3).The sample comprised 287 LGB older adults aged 75 years old and older.Convenience sampling was used to gather questionnaire data.Measures encompassed the Adjustment to Aging Scale, the Satisfaction with Life Scale, demographics and lifestyle and health-related characteristics.Structural equation modeling was used to explore a structural model of the self-reported AtA, comprising all the above variables.The structural model indicated the following significant correlates: perceived health(β=0.456; p< 0.001), leisure(β=0.378; p< 0.001), income(β=0.302; p< 0.001), education(β=0.299; p=0.009), spirituality(β=0.189; p< 0.001), sex(β=0.156; p< 0.001), physical activity(β=0.142; p< 0 .001), satisfaction with life(β=0.126; p< 0.001), and marital status(β=0.114; p=0.008).The variables explain respectively 76.4% of the variability of AtA. These outcomes suggest that policy making and community interventions with LGB older adults may benefit of including variables, such as, perceived health, leisure and income, as these were pointed out as significant for this group of older adults for promoting adjustment to aging in late adulthood. 1.von Humboldt S et al. How do older adults experience intergenerational relationships? Different cultures, ambivalent feelings. Educ.Gerontol.2018;44(8):501-513. 2.von Humboldt S et al. Analyzing adjustment to aging and subjective age from Angolan and Portuguese community-dwelling older adults' perspectives. Int.J.Gerontol.2013;7(4):209-215. 3.von Humboldt S et al. What influences the subjective wellbeing of older adults?: A systematic review of the literature. Rev.Argent.Clín.Psicol.2014;23(3):219-230.
ACCULTURATION ON PSYCHOLOGICAL DISTRESS AMONG OLDER KOREAN AMERICANS: DOES ETHNIC COMMUNITY SOCIAL CAPITAL MATTER?
Authors: Park Juyoung , Aranda Maria , Choi Yeon Jin , Jang Yuri
Published: December 2022

Responding to the rapid growth of the older immigrant population and building upon the literature on the critical role of acculturation in older immigrants’ health and well-being, we focused on the role of ethnic community social capital (social cohesion, social engagement, safety, and negative interactions in ethnic communities) in older Korean Americans. Guided by social capital and stress-buffering theories, we examined the direct effect of acculturation and ethnic community social capital on psychological distress, as well as their interactions. We hypothesized that the negative impact of low acculturation on mental health would be lowered by positive perceptions of and experiences in ethnic communities. Using data from 2,150 participants in the Study of Older Korean Americans (Age range = 60-99, M [SD] = 73.4 [7.97]), the direct and interactive effect models were examined. Results showed that low acculturation posed a significant risk to mental health and all four types of ethnic community social capital had a significant direct effect. Furthermore, significance was observed in the interaction of acculturation with social cohesion (B [SE] = .01 [.01]. p < .05) and with negative interaction (B [SE] = -.01 [.01]. p < .01). The negative impact of low acculturation was attenuated among those with a high sense of ethnic community social cohesion but intensified among those with frequent experiences of negative interactions with ethnic community members. Our findings highlight the importance of social capital that forms within ethnic communities and provide implications for programs and services to promote older immigrants’ mental well-being.
RACIAL DIFFERENCES IN COPING STRATEGIES AND MENTAL HEALTH OUTCOMES
Authors: McWilliams Jordan , Custis Meghan , Peterson Natasha , Lee Jeong Eun
Published: December 2022

Previous literature has examined the consequences of loneliness coping methods; however, scarce research has examined racial/ethnic disparities and the differential association between coping activities and psychological outcomes. This study aimed to fill this gap in the literature by examining racial/ethnic differences in loneliness coping strategies and their impact on anxiety and depression among middle-aged and older adults. Data were from the 2018 Loneliness and Social Connections survey (N=3,233) conducted by AARP. Findings revealed minorities reported higher levels of loneliness and coped with loneliness by socializing with friends in person, socializing with friends using technology, and individualized activity significantly more compared to white counterparts. Logistic regressions revealed that minorities who engage in risky behaviors are 1.66 times more likely to be depressed (95% CI [1.07, 2.58]) and 1.98 times more likely to be anxious (95% CI [1.51, 2.59]). Moreover, the odds of being anxious increased by 58% if minorities coped with loneliness by socializing with friends via technology (95% CI [1.12, 2.21]). However, minorities who socialize with friends in person are 48% less likely to be anxious (95% CI [.35,.79]). In general, socializing methods have more implications for mental health among minorities. Findings suggest that differential coping strategies may have differential outcomes for minorities. The results of this study point to the need for further longitudinal research examining factors contributing to coping strategies and the direction of causality between coping strategies and psychological outcomes.
PREPARING THE GROUND: DEVELOPING COMMUNITY-BASED STRATEGIES TO ENGAGE OLDER BLACK MEN IN HEALTH RESEARCH
Authors: Mitchell Jamie , Key Kent , Flores Elena , Knurek Sean , Perry Tam , Rorai Vanessa , Ilardo Joan , Sass Alexandra
Published: December 2022

Black men across the lifespan are overburdened by poor health and underrepresented as participants in health research. The Flint Healthier Black Elders program seeks to engage more older Black men in research that could contribute to health discoveries by developing and testing strategies to recruit Black men into a community participant research pool (PRP). The PRP recruitment strategies account for the influence of gender role norms, mistrust derived from current and historical research and medical abuses, and other factors that affect older Black men’s willingness to participate in safe and ethical research. This initiative also focuses on building trust in research engagement by foregrounding the voices of local older men as community stakeholders and research gatekeepers, and tailoring multimedia recruitment materials to represent older Black men more fully and positively. Videos and print materials developed as recruitment tools specifically tailored to older Black men were pilot tested for messaging and impact, and the results of this community-driven process can serve as an innovative model for equitable and trustworthy research recruitment in Black communities. We would like to acknowledge the contributions of the Flint Healthier Black Elders Community Advisory Board: Yaushica Aubert, Rev. Dr. Sarah Bailey, E. Hill DeLoney, Luther Evans, Ella Greene-Moton, Cynthia Howell, Bishop Bernadel Jefferson, Beverly Lewis, Geraldine Redmond, Sharon Saddler, Arlene Sparks, Erica Thrash-Sall.
LIMITED ENGLISH PROFICIENCY AND HEALTH LITERACY IN KOREAN OLDER ADULTS: MEDIATING EFFECT OF ACCULTURATION
Authors: Sagong Hae , Tsai Pao-Feng
Published: December 2022

Language proficiency and comprehension in the culture and health systems of the host country are imperative factors enabling appropriate health literacy (HL) for non-English speaking immigrants. Older immigrants with limited English proficiency have fewer opportunities and limited abilities to improve their English skills. Increasing individuals’ acculturation levels can be an effective strategy for older immigrants than solely educating English language skills. The purpose of this study is to investigate the mediating effect of acculturation between English proficiency and HL in older Korean immigrants. From June to October of 2020, a total of 244 older Korean immigrants aged 50 years or older residing in the Southern US were recruited. English proficiency was categorized into limited (very limited to fair) and fluent (fluent to very fluent). HL and acculturation were measured using the Health Literacy Survey-12 Questionnaires (HLS-Q12), and the East Asian Acculturation Measure (EAAM), respectively. Covariates were gender, age, monthly income, education, and length of residency in the U.S. The statistically significant differences were shown in age, gender, education, perceived health, and length of residency in the US by the level of English proficiency The limited English proficiency was negatively associated with HL (β= -.192, p=.002) and acculturation had a mediating effect between English proficiency and HL (β= -.133, p=.001). To alleviate the language barrier that causes low HL in older Korean immigrants, enhancing their understanding of the host country’s culture as well as improving organizational HL should be considered.
CORRELATES OF HEALTH LITERACY IN THE BLACK BELT AREAS OF ALABAMA: IMPORTANCE OF INTERNET ACCESS
Authors: Shah Avani , Luo Yan , Roberts LeAnna , Lee Hee
Published: December 2022

Health literacy, which is defined as being able to understand and utilize information related to one’s health, is an essential part of the health care process as it is related to health outcomes. However, little is known about health literacy in Black Belt communities in Alabama although this rural area has shown very high rates of health concerns such as diabetes, cardiovascular disease, stroke, and cancer (CDC Interactive Atlas, 2022). Study participants were recruited from the Black Belt areas of Alabama. A total of 180 African-American participants with a mean age of 57.5 completed a survey. A regression analysis was conducted to understand if sociodemographic and other relevant factors would predict health literacy. Lower education, gender, age, perceived racism, and perception that race impacts health care quality predicted health literacy. Interestingly, those with less internet access had significantly lower health literacy. Access to internet and smart phones was a reported concern for over a third of the participants. Only a quarter of participants reported use of the internet to assist with lifestyle modifications while almost half reported internet use to obtain health information; suggesting this as a potential means to improve health literacy and even potential lifestyle modification in health behaviors. Recommendations are made for interventions to improve health literacy in minority populations of this underserved region.
HETERONORMATIVE DEFINITIONS OF SEX: IMPLICATIONS FOR LGBT+ WOMEN’S PREVENTIVE HEALTHCARE
Authors: Noblitt Jessica , Barrett Anne
Published: December 2022

The dominant cultural definitions of sex, which is heteronormative, has implications for preventive health screening among LGB+ women. Medical recommendations for women’s screening exclude some same-sex behaviors from this definition, and they center on reproduction – both of which can discourage LGB+ women’s preventive health screening. Qualitative studies have found that sexual minority women, as well as their doctors, are less likely to see sexual health exams as important for sexual minority women’s healthcare because many are not engaging in penile-vaginal intercourse. However, we are aware of no study that has used a large, nationally representative dataset to examine potential differences in health screening by sexual identity. We used data from the National Health Interview Survey (2018; n=1394) to examine differences by sexual identity in having Pap tests and mammograms. We found that sexual minority women were about 40% less likely than heterosexual women to have ever had a Pap test. Moreover, among sexual minority women, lesbian women were about 50% less likely than bisexual women to have ever had one. Sexual minority women also were 22% less likely than heterosexual women to have had a Pap test in the last 12 months. Differences by sexual identity in receiving mammograms were less striking. We found, however, that bisexuals were 25% less likely than lesbians to have ever had a mammogram. In addition, these differences in health screening were more pronounced in younger than older women.
IS THE HEALTH OF OLDER AMERICANS WITH A GED EQUIVALENT TO THEIR PEERS WITH A HIGH SCHOOL DIPLOMA?
Authors: Fuller-Thomson Esme , Grossman Robin , MacNeil Andie
Published: December 2022

Previous research has found higher levels of educational attainment to be strongly associated with better health outcomes in later life, such as better cognitive functioning and fewer functional and sensory impairments. However, most studies have grouped General Educational Development (GED) recipients with high school graduates, neglecting potential differences in socioeconomic status, health behaviours, and health outcomes among these two groups. The aim of the current study is to identify differences in the age-sex-race-poverty adjusted prevalence and odds of cognitive impairment, hearing impairment, vision impairment, limitations in activities of daily living (ADLs), and ambulation limitations among three groups of older American adults: high school dropouts, GED recipients, and high school graduates with no post-secondary education. The present study uses secondary analysis of the 2017 American Community Survey, a nationally representative survey of community-dwelling and institutionalized older adults aged 65 years and older, of whom 20,489 were GED recipients, 154,892 had a high school diploma and 49,912 had finished grade 8 but had not completed high school. Our findings indicate that there is a gradient in health outcomes among Americans aged 65-84, with the highest prevalence and odds of cognitive impairment, hearing impairment, vision impairment, ADL limitations, and ambulation limitations occurring among high school dropouts, followed by GED recipients, and the lowest prevalence among high school graduates. These findings suggestion that although GED recipients have better health outcomes than high school dropouts, there is still a significant disparity in health status between GED recipients and high school graduates.
SYMPTOM BURDEN AND QUALITY OF LIFE FOR NURSING HOME RESIDENTS WITH DEMENTIA: UPLIFT TRIAL EARLY DATA
Authors: Cagle John , Orth Jessica , Becker Todd , Zhang Peiyuan , Ersek Mary , Tu Wanzhu , Floyd Alex , Unroe Kathleen
Published: December 2022

Communication difficulties in nursing home (NH) residents with dementia make valid assessment of symptoms and quality-of-life (QOL) challenging. Thus, researchers and clinicians frequently rely on proxy-based measures. The End-of-life Dementia-Comfort Assessment in Dying (EOLD-CAD) and two single-item QOL measures (7-point item; 5-point item) have been used in several studies, though evaluation of their psychometric properties is limited. We used baseline data from an ongoing multi-site randomized trial (UPLIFT) to describe symptoms and QOL and examine the measures’ validity and reliability in 138 residents with moderate to severe dementia living at 16 facilities. Descriptive data and assessments of convergent validity and inter-rater reliability are provided. Based on assessments by 134 staff and 45 family, physical symptoms, physical distress, and emotional distress were reported as infrequent by staff and family; indications of well-being were more frequently observed. Median QOL was the same for staff and family observers (4=“Life is so-so” [7-point item]; 3=“Fair” [5-point item]). Inter-observer assessments of resident QOL (staff vs. family) were correlated (7-point item: r=0.47, ICC=.643; 5-point item: r=0.48, ICC=.645, p<.05 for all). Seven of 18 EOLD-CAD symptoms were significantly positively correlated. ICC values varied between high or moderately high: shortness-of-breath (ICC=.74), choking (ICC=.65), gurgling (ICC=.81), agitation (ICC=.51), fear (ICC=.46), crying (ICC=.65), peace (ICC=.57), and care resistance (ICC=.68) (p<.05 for all). Choking and gurgling were the most prominently reported symptoms by both groups.Early findings provide a contemporary assessment of QOL and symptoms among NH residents with dementia. Measurement properties affirm general reliability and validity of study instruments.
HEALTHCARE ACCESSIBILITY AND UTILIZATION AMONG LGBTQ+ OLDER ADULTS
Authors: Dayrit Jessika , Pasatiempo Ana Maria , Salom-Bail Shirley , Islaya Cesz
Published: December 2022

Background

Studies show disparities in healthcare have exacerbated during the COVID-19 pandemic, especially among Lesbian, Gay, Bisexual, Transgender, and Queer + (LGBTQ+) older adults. The aim of this paper is to understand health care utilization and accessibility among LGBTQ+ older adults and to examine if social assets, such as income, education, and employment are associated with health care utilization and accessibility.

Methods

Data from BRFSS 2020 was used. Study focused on LGBTQ+ and non-LGBTQ+, age 65 and older, comparing health care utilization and accessibility. Data was weighted for complex sampling design. Logistic regression was used to examine the odds of health care accessibility and health care utilization while controlling for socioeconomic status.

Results

Total sample size of study was 14,453. 6.14% of participants identified as LGBTQ+, which 11% of them were unemployed (CI=0.08-0.17), 21% earned less than $15,000 annually (CI=0.15-0.28), and 35% did not graduate from high school (CI=0.27-0.44). Our analyses indicated LGBTQ+ are less likely to have primary health care provider than non-LGBTQ+ (OR=0.64; CI=0.48-0.84); they are less likely to have health care insurance than non-LGBTQ+ (OR=0.60; CI=0.39-0.93). We did not find association if LGBTQ+ are less likely to seek medical help, when needed, due to cost (OR=0.72; CI=0.53-1.02). Our findings suggest disparities in socioeconomic status, such as income, employment, and education have significant association with health care accessibility and health care utilization. Limitation of study includes recall bias due to self-report. Longitudinal and qualitative research regarding healthcare utilization and accessibility among older LGBTQ+ population need to be explored.
HOW COVID-19 NEWS AFFECTS OLDER ADULTS' MENTAL HEALTH
Authors: Li Grace , Ng Zoe Ziyi , Yow W Quin
Published: December 2022

Media affects the trajectory of many individuals’ mental health. With the rise of COVID-19 cases, the media not only provides informative updates on the pandemic, it also fuels the hysteria and paranoia of citizens across the world. Studies show that older adults (OA) who consume media frequently were at a higher risk for declining mental health (Negarestani et al., 2021) and that individuals experience negative bias more than positive bias (Vaish et al., 2013). However, no studies have directly investigated how much positive and negative COVID-19 news affect OA’s mental health and emotions. Sixty-nine OA (aged 55-95) answered questions about their weekly media consumption, how closely they followed COVID-19 news, and the General Health Questionnaire. They were then randomly assigned to read either positive or negative COVID-19 news (n=35 and 34 respectively), and asked if the news made them feel happy/fearful and if they wanted to read more about/ignore the news. Analysis revealed that the more OA consumed media and closely followed COVID-19 news, the more they felt unhappy and depressed, rs>.25, ps<.05. There was a significant condition effect, where OA who read positive news reported more positive emotions than those who read negative news, t(67)=5.21, p<.001. Chance analyses revealed that positive news evoked positive emotions significantly above chance, t(34)=8.99, p<.001, but negative news evoked negative emotions only marginally above chance, t(33)=1.92, p=.064. These findings suggest that media consumption of COVID-19 news does negatively impact OA’s mental wellbeing, and OA appear to have a strong positivity bias for COVID-19 news.
AGING AGENCIES’ AND PROVIDERS’ REASONS FOR HOSTING OR NOT HOSTING GERONTOLOGY INTERNS
Authors: Karasik Rona , Greenberg Phyllis , Kroeber Maria , VanderWerf Jessica , Zuniga Claudia Burgos
Published: December 2022

Hands-on experience is essential to gerontological education and associated with numerous student benefits. Much less is known about the community agency perspective, including why they do/don’t host gerontology interns. In this national study (n=281), non-profit, for-profit, and government aging-service providers (e.g., Social Services, Health Care, Housing) were surveyed regarding their perceptions of internship benefits, challenges, and areas to improve. Unique to this study is the inclusion of both hosting (n=129) and non-hosting (n=142) agencies. Hosts’ reasons for accepting interns included: share experience/knowledge (n=81, 87%); future university relationships (n=71, 76%); intergenerational interaction for students (n=69, 74%) and clients (n=60, 65%); attract future employees (n=68, 73%); and fills unmet need at agency (n=47, 50%). Non-host reasons for abstaining included: lack of applicants (n=58, 41%); never considered it (n=40, 28%); insufficient staffing (n= 37, 26%); unsure where to start (n=34, 24%) or find/attract interns (n=34, 24%), and too time-consuming (n=25,18%). Additional reasons for nonparticipation included: lack of space; insufficient intern-suitable work; risk/liability; and agency policy. Both hosting and non-hosting agencies anticipated/realized student-related challenges (e.g., limited motivation, inconsistent availability, inadequate preparation) and agency-based factors (e.g., insufficient time, staffing). Given the ongoing need for suitable gerontology internship sites and the finding that almost half of the non-hosting agencies indicated possible future interest in accepting gerontology interns (n=80, 49%), attention to agency recommendations (e.g., increased faculty communication/feedback, stronger student commitment/preparation, recognition of agency contributions) is warranted. Strategies for addressing identified challenges and implementing requested changes to enhance the community agency experience with gerontology interns are discussed.
OPTIMIZING OLDER ADULT BLOOD PRESSURE SCREENING IN A COMMUNITY SETTING BY INTERPROFESSIONAL STUDENTS
Authors: Miller Erin , Charara Rima , Turfah Ali , Mendez Jennifer
Published: December 2022

A novel program was implemented in an effort to optimize the blood pressure taking skills of medical and pharmacy students, in collaboration with older individuals in Detroit. Under the supervision of Interprofessional faculty, pharmacy and medical students provided blood pressure screenings at the popular Riverwalkers program, a community exercise program designed for older Detroiters. Prior to volunteering at the program, students were required to complete the AMA blood pressure modules to develop proficiency in blood measurement best practices. Over the course of two months, 72 students provided blood pressure screenings for 79 older individuals during 266 distinct encounters. We believe this program can serve as a model for other professional schools, as it efficiently accomplishes several distinct