bluuebunny/crossref_metadata_2025 huggingface dataset:
ENGAGING OLDER ADULTS VIA SOCIAL MEDIA DURING A PANDEMIC: SUCCESSFUL LEARNING EXPERIENCES FOR STUDENTS AND ADULTS
Authors: Cox Krista , Zeiner Tracey , Moore Jennifer , Traywick LaVona , McAtee Robin
Published: December 2023

The Arkansas Colleges of Health Education and the Arkansas Geriatric Education Collaborative collaborated on a project to educate senior adults about the use of assistive technologies (AT) for self-care, home management, community engagement, and leisure participation to help them live safely and independently. Occupational and physical therapy students collaborated with 10 community dwelling senior adults to research, develop, and disseminate 27 video vignettes shared via Facebook. These vignettes were developed and shown during a time when senior adults were encouraged to isolate during the pandemic. As of January 2023, the outcomes of sharing the 27 video vignettes on Facebook included: a total of 17,204 views, the most viewed was “Lighting and Magnification” at 1,000+ views, followed by “Sewing” at 992 views, the least viewed was “Fishing” at 147 views. Older adult viewers feedback included: contact with ACHE to ask how to purchase the assistive devices; sharing the information gained with their family members and others; purchase of devices; providing a resource for AT assistance for OA. Additionally, the senior adults that participated in the project reported a better understanding of the AT after presenting in the videos. In conclusion, these results indicate that creating the video vignettes and sharing them on Facebook had an extensive reach beyond the 27 individual sessions. This also demonstrated that the viewers were actively engaged as noted by their questions and comments.
FEASIBILITY OF CONTINUOUS PASSIVE MONITORING OF DAILY FUNCTION AND SYMPTOMS IN OLDER ADULTS WITH MULTIPLE MYELOMA
Authors: Tibbitts Deanne , Silbermann Rebecca , Roeland Eric , Webb Jason , Meyers Gabrielle , Shannon Jackilen , Kaye Jeffrey , Winters-Stone Kerri
Published: December 2023

The impact of cancer and cancer treatment on older adults’ day-to-day health and functioning remains poorly characterized. Therefore, we evaluated the feasibility of using home-based, continuous passive monitoring of daily life functioning plus symptom surveys in older adults with multiple myeloma (MM). We assessed accrual, uptake of passive monitoring, retention, survey completion, and data completeness. Passive monitoring included infrared motion sensors (activity), door contact sensors (time out-of-home), watch (activity/sleep), bed mat (sleep), biometric scale (weight), electronic pillbox (medication-taking habits), and computer-use software (computer habits). A weekly online survey assessed health events (i.e., falls, hospitalization/ED visits, pain) and treatment-related symptoms (PRO-CTCAE). We enrolled 20 patients with MM of 55 referred (36% accrual) with a median age of 71 years (35% female); 8 patients enrolled with a care partner. Half of patients agreed to passive monitoring and weekly surveys; half completed surveys only. Refusal of passive monitoring was primarily due to concerns about privacy/intrusiveness. Retention over 17 months was 85% (3 dropouts from the survey-only group). Survey completion was 82% (missing reasons included “poor health” and “too busy”) with a median completion time of 4.6 minutes. Data completeness for passive monitoring ranged from 66% for watch-based sleep (n=9 patients) to 93% for home-based activity (n=14 homes). In sum, passive monitoring of daily life functioning plus symptom surveys is feasible among older adults with MM. Future research will integrate daily functioning with symptom data to examine longitudinal variations in health and develop digital biomarkers to inform optimal timing of future interventional studies.
SMOOTHING SPLINE ANOVA MONITORING PHYSICAL ACTIVITY AND FALL RISK IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Xie Rui , Chen Lulu , Park Joon-Hyuk , Stout Jeffrey , Thiamwong Ladda
Published: December 2023

Emerging sensing techniques, which are easily transportable, user-friendly, and cost-effective, may reveal new possibilities in monitoring daily objectively measured physical activity (PA) and fall risk appraisal (FRA) identification. We used a Smoothing Spline Analysis of Variance (SS-ANOVA) to profile the daily PA using accelerometer-based device across FRA groups. Using the BTrackS system (static balance assessment) and a short Fall-Efficacy Scale-International, 124 participants (mean age 75, range 60-96, 77% female, 72% no history of falls) were categorized into four different FRA groups: rational (46.8%, low fear of falling (FOF) and normal balance), irrational (17.7%, high FOF and normal balance), incongruent (19.4%, low FOF and poor balance), and congruent (16.1%, high FOF and poor balance). The vector magnitude (VM) and the number of steps were extracted per second from an average 10 (SD=4.89) consecutive days of PA recording. Daily (0-24h) temporal trend was analyzed from 1.7 million records. Groupwise, PA of the congruent group was significantly lower than other three groups, while the rational group had the highest PA based on 95% Bayesian C.I. It is evident that there is a periodic trend in PA; in particular, inactive during night (12-5am), increasing trend in the morning (5am-noon) and peak at noon, moderately decrease in the afternoon (noon-6pm), and significantly decline in the evening. No significant gender differences in PA were found. These results indicate that FOF associated with poor balance contributes to low PA, highlighting the necessity of balance enhancing intervention and cognitive reframing to promote PA in older populations.
SOCIAL ISOLATION IN OLDER ADULTS POST HIP SURGERY IS CORRELATED WITH MOBILITY AND PHYSIOLOGICAL INDICATORS
Authors: Dayyani Faranak , Chu Charlene , Abedi Ali , Khan Shehroz
Published: December 2023

Hip fracture affect approximately 30,000 people in Canada and more than 300,000 people in U.S., annually. Older adults post hip-fracture surgery experience social isolation along with reduced physical mobility, changes in sleeping patterns, reduced indoor and outdoor activities, and other physiological changes once they are discharged form inpatient rehabilitation. Our team has developed MAISON (Multimodal AI-based Sensor platform for Older iNdividuals), a cloud-based multimodal sensor system that supports the collection of physiological, ambient and contextual data from various smart devices. Currently, MAISON consists of a smart watch, a smart phone, a motion sensor and a sleep mattress. Using MAISON, we have collected 24 weeks of raw acceleration data, heartrate, step count, frequency of indoor motion, GPS and sleep metrics from three older adults post-hip surgery living in the community. Statistical and domain-specific features were extracted from the collected data with a time window of one day, including average heartrate, maximum acceleration, total sleep time, total steps taken, and average number of exits. Additionally, clinical data is collected from the participants on a biweekly basis consisting of three questionnaires (i.e., Social Isolation Scale (SIS)) and two physical tests. The correlation between features from sensor data and clinical data was performed using Spearman coefficient, which showed a strong positive correlation (>0.5) between the SIS and number of exits, variance of acceleration, total sleep time, and heartrate variance. Various correlation values were found between features from all the sensors and SIS, indicating the usefulness of multimodal sensors for this application.
THEORETICAL FRAMEWORK FOR AN ARTIFICIAL INTELLIGENCE–BASED COMPREHENSIVE GERIATRIC ASSESSMENT
Authors: Golden Adam
Published: December 2023

Comprehensive Geriatric Assessment (CGA) is a process where healthcare professionals evaluate and develop a management strategy for older adults who may have multiple multifactorial illnesses and geriatric syndromes. CGA has traditionally been a labor-intensive process that assesses many factors at a specific point in time. Its availability and feasibility in busy clinical settings is remains limited. Artificial Intelligence (AI) can potentially expand the accessibility and effectiveness of this currently limited resource. By integrating large numbers of longitudinal data sets, AI can evaluate in real time a broad array of ever-changing factors that include medical assessments, diagnostic testing/imaging, laboratory analysis, nursing evaluations, behavioral health interventions, social determinants, electronic monitoring, wearables, community resources, and caregiver support. A geriatric AI framework will need develop computational models that integrate changing biologic, sociodemographic, and mental health factors. The framework could also account for the changing availability of local resources and plan eligibility. The integration of large longitudinal datasets would allow for prediction modeling related to diagnosis, management strategies, and outcomes. Treatment protocols can be automated too. Machine learning will allow for the adjustment of medical alert thresholds to minimize alert fatigue that plaques current electronic health record systems. Just-in-time information can identify appropriate home technology equipment and referrals for community services. An AI framework potentially offers a more comprehensive and longitudinal geriatric evaluation that avoids delays in care while waiting for a single physician to “get to see the patient.”
UNDERSTANDING THE COMPLEXITY AND USE CHALLENGES OF MEDICARE PLAN FINDER FOR OLDER ADULTS
Authors: Lee Hye Soo , Harris Maurita , Rogers Wendy
Published: December 2023

It is critical for older adults to find an affordable health plan that meets their needs. The Medicare.gov site provides a Medicare plan finder (MPF), which is an online tool designed to assist individuals to find a Medicare plan that is most suitable for them. The MPF was updated in 2021 but remains complex and may be especially difficult for older adults to use, given age-related changes in cognitive abilities. To identify potential use challenges for MFP, we documented the complexity of the steps required for accomplishing the goal of finding a plan. We completed a task analysis using two use-case scenarios to illustrate potential paths one could take in using MPF. Both use cases were set to enroll in the same plan to explore how and why their paths could differ, focusing on whether they have prior information and experience with Medicare and MPF. The number of steps taken by these two use cases ranged from 10 steps (experienced user) to 32 steps (novice user), due to the different needs they had for using MPF. The results imply that the one-for-all design of MPF may not be optimal for meeting the different needs of users. We propose two solutions to reduce the number of steps for using MPF. First, users need to be able to access the functions they want from the start (e.g., using quick links from the initial page). Second, users would benefit from learning what they need to know and prepare before they start using MPF.
WHAT DO OLDER ADULTS THINK ABOUT ELECTRONIC PAIN APPS? USING A HEALTH LITERACY FRAMEWORK TO MEASURE QUALITY
Authors: Milidonis Mary , Rupp Hayley , McGinty Patrick , Kopiera-Frye Karen
Published: December 2023

Mobile pain applications (apps) may improve health communication. Mobile health apps do not always consider the needs of older adults. This project examines perceptions of pain apps on smartphones among older adults. The sample consisted of 23 older adults (M age = 64 years), with majority female (83%), predominantly Caucasian (91%), and majority some college education (65%). Respondents answered questions about 5 free pain apps using the Mobile Application Rating Scale (MARS). The MARS assesses descriptive and technical aspects of an eHealth apps using five categories including four quality scales: engagement, functionality, aesthetics, and information and one subjective quality scale. Participants currently had pain with range of 3 months to 12 years. The Single Item Health Literacy Screener identified 17 people have never asked for help reading health information; all participants scored 100% on the Rapid Estimate of Adult Literacy in Medicine Short Form. Participants self-reported an average of 2.6 comorbidities on the Functional Comorbidity Scale. The participants overall MARS rating ranged from 1-5; 11 participants rated pain apps very high (4-5). Important app characteristics identified by the older adults as critical for useable app included: Clear instructions, good navigation, and easy functionality. The elders reported that difficulty with loading the app and slow times would deter their use of the app. In terms of frequency of use, participants felt using the app was important weekly only if they experienced pain. These are important considerations in designing age-friendly technology for use with the frequent condition of pain among older adults.
A SYSTEMATIC REVIEW OF EFFECTIVE STRATEGIES OR INTERVENTIONS TO SUPPORT DRIVING CESSATION AMONG OLDER ADULTS
Authors: Dickerson Anne , Stapleton Tadhg , Margot-Cattin Isabel , Harries Priscilla , Gélinas Isabelle , Choi Moon , Swanepoel Lizette , Unsworth Carolyn
Published: December 2023

Driving remains the primary mode of transportation and often the only mode for rural and suburban areas. However, research is clear we all outlive our ability to drive. Nevertheless, as community mobility is essential to health and quality of life, we need to study and invest in understanding how to use and learn alternative means of transportation, especially for the vulnerable aging. A systematic review was designed to examine the literature for evidence-based strategies or interventions to support driving cessation among older adults while maintaining community mobility. The team of 13 international researchers from seven countries used the Covidence software with support of an expert health sciences librarian. Using multiple search terms (e.g., driving retirement; driving cessation; driving transition; interventions; strategies; older adults), 7317 studies were imported for screening with 7059 eliminated; 205 full texts were assessed for eligibility by 2-3 members. With 187 excluded, 19 studies were included and examined by the two primary authors. Results demonstrate low evidence of effectiveness of programmatic interventions, although multiple strategies have been identified. Overwhelmingly, the evidence supports starting very early with discussions about the process of transitioning from driving to being a passenger; particularly true with progressive diagnoses such as dementia. This presentation will highlight the programs currently available, strategies that appear to be successful, and review current toolkits for supporting driving cessation as well as emerging interventions and strategies.
CAREGIVING PUBLIC HEALTH SURVEILLANCE: EXPERT-GUIDED COLLABORATION FOR BRFSS MODULE REVISION
Authors: Shean John , Olivari Benjamin
Published: December 2023

The Behavioral Risk Factor Surveillance System (BRFSS) Caregiver Optional Module collects population-level data on caregiving prevalence, burdens faced by caregivers, and demographic information about care recipients. Developed in 2009, periodic reviews ensure the module remains current, data collected remain actionable, and encourage uptake of the module by state health agencies. In 2022, the Alzheimer’s Association and the Centers for Disease Control and Prevention’s Alzheimer’s Disease Program formed an expert workgroup to examine the ongoing value and relevance of the module and to propose improvements. The thirteen-member workgroup included academic researchers, caregiving experts, health promotion directors, epidemiologists, survey methodologists, policy analysts, and BRFSS coordinators. Over four months, the workgroup used a consensus-building process to identify areas of agreement and disagreement which informed discussion. Among many factors, the workgroup assessed the existing module for accuracy and utility. Discussion centered on utilizing plain language in the module’s questions, streamlining response options, and ensuring collection of a full scope of burden faced by caregivers, including caregivers of persons with dementia. Persons living with cognitive impairment and their caregivers were consulted during the process to ensure phrasing reflected their lived experience. The result was consensus on suggested revisions to the Caregiver Module, which was submitted to CDC for review and approval in April 2023. The revised module will be featured in this session. The robust process, involving a variety of stakeholders and perspectives, can serve as an efficient and effective model for ensuring sustainability and data-informed action using population health surveillance.
PERCEPTIONS AND EXPERIENCES OF FAMILY CAREGIVERS OF OLDER FIRST-GENERATION CHINESE AMERICANS WITH DEMENTIA
Authors: Hsu Erh-Chi , Tsai Jenny Hsin-Chun , Spigner Clarence , Chim Kannie
Published: December 2023

Family caregivers of individuals with dementia are precious assets whose health is related to the health of their care recipients. First-generation Chinese American older adults are a growing population; the research about their family caregivers’ experience is scarce. Guided by the Health Belief Model (HBM) and the National Institute on Minority Health and Health Disparities (NIMHD) framework, this study examined how the Chinese sociocultural background shapes family caregivers’ perception of dementia, caring behaviors, and caring experiences during the COVID-19 pandemic. Data were collected from 16 family caregivers through one-on-one interviews in three languages with the thematic analysis applied. Findings indicated most caregivers could not differentiate dementia from natural cognitive degeneration. Despite the unclarity, the cultural value of filial respect essentially obligated caregivers to unconditionally devote their time and efforts to provide care. Individual coping skills toward care burden were associated with their knowledge, attitude, access to supportive families/friends and reliable community-based organizations (CBOs), and access to government social services. The care recipients’ motivation and functional status affected the difficulty of providing care. The pandemic disturbed families’ care plans and limited community activities. In addition, the heightened Asian xenophobia atmosphere raised concerns for caregivers to be outdoors. Implications for practice include providing culturally appropriate educational resources on dementia care and incorporating CBOs to promote governmental service referral. Larger studies for Chinese American older adults born outside the US and studies of dementia care burden on their family caregivers’ health are needed to address social and health inequities for historically marginalized cohorts.
THE RELATIONSHIPS AMONG VOLUNTEERING, EVERYDAY DISCRIMINATION, AND LIFE SATISFACTION IN TWO AGE GROUPS
Authors: Shen Huei-wern , Wang Yi
Published: December 2023

Experiencing discrimination is known to bring life dissatisfaction across different life stages. While volunteering benefits older adults in many aspects, including life satisfaction, the interplay among discrimination, volunteering, and life satisfaction in different age groups is unknown. To explore such relationships, the present study included a subsample of 5791 respondents who were 51+ from the 2016 Health and Retirement Study; among them, 3191 were 65 years (older group) and older and 2600 were between 51 and 64 years old (younger group). Volunteering referred to doing unpaid work for religious, educational, health-related, or other charitable organizations. Discrimination was measured by the six-item Everyday Discrimination Scale (e.g. In your day-to-day life, how often are you treated with less courtesy or respect than other people) and was dummy-coded due to skewness (never experienced vs. ever experienced). Controlling for health-related variables (e.g., ADLs/IADLs), SES (e.g., income), contextual features (e.g., urban/rural), and sociodemographics (e.g., gender, race), findings from multiple multivariate linear regression models showed that in the overall sample, discrimination was negatively associated with life satisfaction whereas volunteering promotes it. When considering the role volunteering played in the relationships between discrimination and life satisfaction, volunteering in the younger group did not mediate the negative relationship between discrimination and life satisfaction. Volunteering in the older group, however, significantly mitigated the negative impacts of discrimination on life satisfaction. Results highlight the possible extended benefits of volunteering in old age. Future research considering the health impacts of different types and levels of volunteering will be discussed.
DON’T SAY GAY: LGBTQIA+ INCLUSION ON LONG-TERM CARE AND ASSISTED LIVING FACILITIES’ WEBPAGES
Authors: Maier Julie , Pickett Andrew
Published: December 2023

Many LGBTQIA+ older adults experience a variety of health disparities resulting from a lifetime of minority stress. Due to experiences of discrimination, isolation, and stigmatization, LGBTQIA+ populations have higher rates of depressive symptomology and anxiety, as well as substance abuse when compared to heterosexual, cis-gender peers. They are also more likely to experience social isolation and have a lower average socioeconomic status. For older LGBTQIA+ adults who depend on long-term care, relative levels of facility inclusiveness have the potential to mitigate or exacerbate poor health outcomes. This study examines public signals of LGBTQIA+ inclusion by assisted living and long-term care facilities in the state of Indiana. Data was collected from a stratified-random sample of 100 long term care facilities, located in rural (n = 14), mixed (n = 24), and urban (n = 62) counties in Indiana. Each facility’s website was reviewed for the presence of LGBTQIA+ inclusion, operationalized as inclusive images, symbols, messages, anti-discrimination policies, and equal opportunity employment statements or logos. The most observed signals were statements or logos indicating non-discrimination, including fair housing policies (59%) and equal opportunity employment messages (32%). These policies were most common among facilities that were part of a larger ownership group. Non-policy LGBTQIA+ inclusion symbols were rare (1%) and included a blog post with tips on finding an LGBTQIA+ inclusive care community. Findings suggest an overall dearth of LGBTQIA+ inclusive signals among older adult care facilities in Indiana.
SCIENCE AND CARE PARTNERSHIPS: THE ROLE OF THE SCIENTIFIC LINKING PIN RESEARCHER
Authors: Devi Reena , Everink Irma , Urlings Judith , Griffiths Alys , Verbeek Hilde , Haunch Kirsty , Spilsbury Karen , Hamers Jan
Published: December 2023

Background

Science and care partnerships work on promoting quality of life, care and work in long-term-care (LTC) settings. The Scientific Linking Pin (SLP) is an academic employed by a university and works one day per week in a LTC organisation. The SLP role is pivotal to the success of partnerships; the nature of this role has not yet been captured.

Methods

Fifteen SLPs took part in semi-structured interviews. Data were thematically analysed.

Results

Data are presented over two themes. The first theme, the SLP experience, outlines that SLPs have rich insights into what matters to, and the challenges experienced in LTC organisations. SLPs are well positioned to impact practice, and develop their professional careers. SLPs do experience doubts and insecurities and require mentorship/supervision. The second theme, navigating in a SLP role, outlines the multifaceted tasks involved: relationship building, raising awareness, identifying priorities, generating research questions, building committees, brokering knowledge, developing research studies, generating academic output, building links and connections, and assisting with internal projects. The challenges SLPs face in their work include mistrust and poor engagement from care staff, working with staff from different professional backgrounds, research not being a priority, multiple and rapidly changing priorities, and differences in expectations. Relationship building, creating a ‘safe’ space for care staff, building engagement, and expectation management helped to address these challenges.

Conclusion

Partnership working in the care sector is gaining international recognition and adoption. This study described one key role that contributes to the success of the partnership model: the SLP.
EFFICACY OF A HOME-BASED EXERCISE PROGRAM “SENIOR FIT” FOR OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Hyun Kate , Lee Kathy , Lervisit Vina , Vanhoose Kimberly , Gu Xiangli , Saha Troyee , Jobaidul Boni , Liegey-Dougall Angela
Published: December 2023

With elevated awareness and concerns of infectious diseases such as COVID-19, the importance of overall health and wellbeing has been highlighted. More than 25% of older adults, including individuals with underlying health conditions, did not maintain the same intensity of physical activity during the pandemic. The purpose of this study was to examine the efficacy of a home-based exercise program, Senior Fit, for older adults during the COVID-19 pandemic. Senior Fit employs conventional behavior boosting approaches to promote physical activities and reduce sedentary behaviors. Older adults (N = 58) participated in the program and completed a weekly set of exercises for eight weeks. We conducted in-depth, individual interviews with 53 participants and identified four themes related to the program: (1) positive perceptions on the structure, (2) individual variances in their overall experience, (3) perceived benefits, and (4) feedback on human interactions. The participants appreciated the structure, especially following schedules provided and using paper forms to track their activities. However, some complained the program was too easy while others thought the program was too challenging. Overall, the participants discussed physical benefits (e.g., weight loss, established exercise habits) and emotional benefits (e.g., better mood, motivations). They suggested the importance of creating an inclusive and interactive environment. Many discussed the importance of the interactions with the research team as well as other participants to stay motivated in the program during the pandemic. These findings highlighted the need to involve participant stakeholders in the development of programs to increase physical activity in older adults.
LEARNING FROM THE IMPLEMENTATION OF INTEGRATED COMMUNITY-BASED PROGRAMS FOR OLDER ADULTS WITH HIGHER NEEDS
Authors: Symes Bobbi , Lalji Kahir
Published: December 2023

Three demonstration projects of integrated community-based programs for older adults with higher needs were implemented in British Columbia over 2020 to 2023: 1) Social Prescribing (SP, n=19 programs), 2) Therapeutic Activation Programs for Seniors (TAPS, n=15 programs), and 3) Family and Friend Caregiver Groups (FFCG, n=16 programs). This presentation reports on findings on the programs’ design and implementation based on data collected via interviews and surveys of program staff. Since inception, the total number of unique participants programs have served is 1,078 for TAPS, 1,900 for FFCG, and 1,397 for SP. The majority of clients have been long-term clients receiving services for 3 or more months. Due to the COVID-19 pandemic, 80% of programs reported they had shifted their focus during their first year of operations in response to emergent pandemic needs, thus impacting their start-up and initial intake of clients. The flexibility provided to programs to pivot to offering needed supports during the height of the pandemic was considered an important success. Across all types of programs, client who were socially isolated or lacked social supports were perceived as one of the groups who benefited the most from the programs. Programs reported that their relationships with community-based organizations, primary care networks, and home and community care were strengthened and over three-quarters had formed at least three new partnerships. A variety of facilitating (e.g., leveraging pre-existing relationships) and limiting factors (e.g., awareness of programs and obtaining referrals) were identified that have affected the success of program implementation.
WHEN POLICY INTENTIONS GO ASTRAY: THE DEPLOYMENT OF HOME CARE AND HOME SUPPORT MARKET TOOLS IN FRANCE AND QUEBEC
Authors: Marier Patrik , Trabut Loïc
Published: December 2023

Using Gingrich’s (2011) typology of welfare markets, this contribution studies the selection and enactment of market tools in two different jurisdictions (France and Quebec). Quebec represents a classic example of a managed market with regional health authorities (CISSS/CIUSSS) seeking the lower the cost of long-term care by contracting services to community groups and the private sector. These contractual agents have gradually replaced health and social care professionals within the public system. France has opted to enact a consumer driven market with the introduction of the allocation personnalisée d’autonomie (APA) which provides cash benefits to eligible older adults who can then select the provider of their choice. Both of these market reforms are compared and analyzed across three types of territories : rural (Finistère and Bas-St-Laurent), urban (Paris and Montreal), and in industrial decline (Somme and Mauricie). Despite operating within highly differentiated long-term care policy frameworks and market tools, both jurisdictions face similar difficulties in the enactment of market mechanisms. For instance, rural territories fail to generate sufficient providers to develop a market where a regional health authority (Quebec) or older adults (France) can actually select a provider and negotiate terms of service. Public authorities must then intervene to generate market-like conditions. Regardless of the jurisdiction, the conceptualization of market mechanism has clearly an urban setting in mind making them ill-suited for other environment and there is gradual movement towards the development of austerity market where individuals are forced to seek alternatives beyond the market tools deployed by governments.
DESIGN NEEDS AND PERCEPTIONS OF OLDER ADULTS REGARDING SHARED-USE AUTOMATED VEHICLES
Authors: Lam Justin , O’Rourke Tarryn , Bowman Caitlin , D’Souza Clive
Published: December 2023

Many communities struggle to provide safe, accessible, and reliable transportation services for older adults due to high demand, rising costs, driver shortages, and other evolving challenges. Innovative transportation solutions are needed to support the current and future populations of older adults. Low-speed, shared-use, driverless shuttles present an exciting development in automated vehicle (AV) technology with potential to meet mobility needs of older adults in their community. Understanding older adults’ perceptions about and willingness to consider using these emerging modes of transportation is vital to realizing the full potential of these technologies. This presentation summarizes an in-person study conducted with 12 older (average: 66 +/- 4 years of age, range: 60 to 80 years) and 10 younger (average: 44 +/- 11 years) adults that evaluated a stationary, proof-of-concept shared-use AV retrofitted with accessibility features. We will present findings on perceptions regarding accessibility, safety, and willingness to use driverless AVs along with human factors design recommendations. While questionnaire-based studies have been the dominant approach to understanding older adults’ perceptions about shared-use AVs, in-person evaluations even with prototype AVs as described here, provide opportunities to identify goals, needs and preferences of older adults concerning usability and safety in early design stages, and through hands-on exploration help older adults develop good mental models, i.e., understand AV capabilities and limitations, towards building trust and acceptance for these emerging modes of transportation. Research and policy implications will be discussed towards enabling emerging driverless shared-use AV technologies that support safe and independent community mobility for older adults.
INFLUENCE OF NEGATIVE ATTITUDES TOWARD VOLUNTEER ACTIVITIES ON MENTAL HEALTH STATUS: THE REPRINTS STUDY
Authors: Fujiwara Yoshinori , Takahashi Tomoya , Murayama Hiroshi , Fujihira Kyoko , Fujita Koji , Yamashita Mariko , Matsunaga Hiroko , Suzuki Hiroyuki
Published: December 2023

Although social engagement activities can help older adults maintain mental health status, whether negative attitudes toward volunteering influence poor mental health status due to psychological burdens has not been clarified. This study examined negative influence of intergenerational picture-book reading program “REPRINTS” on older volunteers’ attitudes to volunteering activities to clarify its impact on their mental health status. A questionnaire mail survey was conducted for 481 volunteers, ≥55 years, in 12 municipalities across Japan in 2020. Of the 423 respondents (87.9%), 266 responded to the follow-up survey, conducted from November 2021 to February 2022. Mental health status was assessed by WHO-5J; a score of less than 13 was regarded as poor mental health status. Multiple logistic regression analysis was performed on the responses of 220 women, aged 65–84 years, with WHO-5J (good ≥13 points; poor < 13 points) at follow-up as the dependent variable. Participants were asked about their positive and negative attitudes toward volunteer activities using a four-point scale (disagree to agree), and the scores were operationally summed up after converting them into a negative attitude score. Subjective health (healthy/unhealthy), age, WHO-5J score, and continuous years of activity at baseline were entered as adjustment variables. Sixty-four (29.1%) participants had a WHO-5J score of < 13 at baseline. Logistic regression analysis with WHO-5J as the dependent variable showed that the adjusted odds ratio for negative awareness scores was 1.06 (95% CI: 1.00-1.12). In conclusion, negative attitudes toward volunteer activities were suggested to have a significant influence on mental health status.
LONG-TERM EFFECTS OF EDUCATION ON LATE-LIFE DEPRESSION OF RURAL WOMEN IN CHINA
Authors: Hu Lynn
Published: December 2023

Despite the noted association between educational attainment and mental health, there is considerable debate on whether this relationship is causal. Up to now, there are only a few studies using credible estimation strategies to examine the causal impact of education on mental health, and almost no evidence exists for low and middle-income developing countries from regions like Asia. This is concerning given that mental health problems and late-life depression are growing in the Asian population, especially for women and rural residents. In this paper, I aim to fill the gap by examining the long-term causal effect of additional educational attainment on the depressive symptoms of rural women in China. Using Harmonized CHARLS data, I leveraged the sudden end of the Chinese Cultural Revolution in 1976 as an exogenous shock to education, and employed both event study and regression discontinuity designs to estimate its causal effect on late-life depressive symptoms. Results show a protective effect of education for the rural women who stayed in rural areas, and a negative impact of education on the urbanized rural women. The impacts are likely to be mediated by childhood adversities (being poor and unhealthy), marriage status (being widowed), and disability status (difficulty in performing activities necessary for independent living). The proposed research will be the first study to examine the causal effect of education on the mental health of the Chinese population. It will add to the existing literature by providing evidence from underdeveloped regions in Asian countries and offering insights for future policymaking.
PERSON-CENTERED CARE WHEN OLDER ADULTS WITH DEMENTIA AND THEIR FAMILY CAREGIVERS HOLD DIFFERENT CARE PRIORITIES
Authors: Quach Emma , Azar Martina , Kennedy Katherine , Dawson Catherine , Hawley Chelsea
Published: December 2023

In person-centered care, clinicians develop care plans that incorporate “what matters most” to patients (i.e., their priorities, concerns, and preferences), a process complicated when patients’ family caregivers have their unique priorities. To investigate care planning with patients with dementia and their family caregivers, we audio-recorded, transcribed, and thematically analyzed 4 medical visits dually attended in 2022 by older patients with dementia and their spousal/adult child caregiver(s). In these visits clinicians asked both about their priorities/concerns, which mostly complemented but sometimes conflicted with each other. Older adults’ priorities related mostly to social activities and minimally to health care, emphasizing continuity. Older adults strived to resume past social activities (farmer’s market), continue enjoyable life-long activities (sports), maintain non-problematic medication regimens, and retain the same home health nurse. Caregivers’ priorities focused on emergent physical problems (patient’s worsening memory and leg pain), service access, and care coordination. When older adult and caregiver priorities did not conflict, clinicians incorporated priorities from both sources into care plans (initiated referrals for farmer’s market). When older adults and caregivers’ priorities conflicted (exercise), clinicians simultaneously acknowledged family caregiver’s concerns, expressed their (clinician) views, honored older adults’ preferences, and invited them to re-assess such preferences in future medical visits. By asking “what matters most” to both patients and their family caregivers, clinicians gain rich insights about both parties to guide care planning. Future research should examine care planning with more dementia dyads to identify care planning practices that promote both patient and caregiver outcomes and ultimately enable aging in place.
PILOTING COMMUNICATION TOOLS TO ENHANCE RESIDENT/FAMILY ENGAGEMENT IN NURSING HOMES CARE CONFERENCES
Authors: Li Jingxi , Roscizewski Alexa , Warthen Terra , Cox Elizabeth , Roberts Tonya
Published: December 2023

Nursing home (NH) regulations mandate resident and family engagement in care planning. Additionally, our previous research indicated residents/families want to be involved in care decisions. Care conferences are an important opportunity for residents/families to engage in decision-making. However, there is a lack of guidance or tools to support their engagement and a dearth of research on the most effective approaches to doing so. This study aimed to pilot test a family engagement intervention using resident, family, and staff communication tools that refocus the agenda of care conferences to topics identified as important by residents/families. The feasibility of the intervention was evaluated using a pre/post-implementation design and a preliminary analysis of effects was performed. A total of 16 (n=8 pre; n=8 post-implementation) care conferences (average length ~22min) were observed, audio-recorded, and coded using the Roter Interaction Analysis System and our prior engagement coding schemas. Frequencies of engagement outcomes were compared pre- and post-implementation using Mann-Whitney U and Fisher’s exact tests. Results suggest participants found the intervention valuable for care planning. The agenda and focus of care conferences also shifted to topics residents/families deemed important. Levels of engagement in relationship building and information exchange generally trended in a positive direction. Resident/family agenda setting was significantly higher after implementation (p=0.001). This study provides important insights into enhancing resident/family engagement in decision-making and suggests incorporating communication tools into care conferences may promote resident/family engagement. Future studies using randomized controlled trial designs and larger samples should be conducted to further evaluate effects.
A MODEL ACCESSORY-DWELLING UNIT BYLAW: INCLUSIVE ZONING FOR ALL
Authors: Gagen Travis
Published: December 2023

Adapting the built-environment to include an accessory-dwelling unit (ADU) is one alternative housing solution for older adults to remain in their home and community, avoid institutionalization, and create age-friendly environments. ADUs are one form of the built-environment in which the field of public health law can intervene to improve population aging. A legal mapping analysis was conducted using the ADU Friendliness Score to assess ADU accessibility across the target population (n = 351 Massachusetts municipalities). Municipalities were stratified into four ordinal classifications according to their ranking on the 0-100 ADU Friendliness Score and served as the dependent variable: 0-24 POOR (89 municipalities, 25%); 25-49 FAIR (30 municipalities, 8.5%); 50-74 GOOD (185 municipalities, 53%); and 75-100 EXCELLENT (47 municipalities, 13.5%). Community demographics and social capital proxy measures were used as independent variables to test for the association between aggregate social capital and the dependent variable. A regression analysis demonstrated housing density and educational attainment as statistically significant predictors of ADU score. Findings informed the first model age-friendly ADU bylaw inclusive for older adults, persons with disability, and their caregivers. Reform of zoning laws can help create age-friendly environments. The model bylaw is available for municipals to adopt and can be modified in response to municipal needs.
US HOSPITAL INFRASTRUCTURE: ARE ALZHEIMER’S CENTERS PREPARED TO ADDRESS DEMENTIA NATIONWIDE?
Authors: Gutierrez Angela , Cronin Cory , Franz Berkeley , Muniz-Terrera Graciela
Published: December 2023

Evidence on the U.S. hospital infrastructure to address dementia is scant, obscuring health improvement efforts. This study investigates the availability of Alzheimer’s Centers (ACs) in U.S. hospitals. Data come from the: (1) 2010 – 2021 American Hospital Association Annual Survey; (2) 2020 Area Health Resource File; and (3) 2020 U.S. Census. Utilizing data from U.S. general hospitals (n = 3,251), we employed multivariable logistic regression to examine hospital (size, ownership, teaching status), county (metropolitan, poverty, racial/ethnic county composition), and regional (U.S. region) predictors of AC availability (Yes/No). ACs in U.S. hospitals increased from 4.5% in 2010 to 5.9% in 2020. Large hospitals (>399 beds) had approximately 14 times higher odds of having an AC than small hospitals (< 50 beds; OR = 14.0; 95% CI = 6.44 – 30.46). Counties with a higher proportion of Latinx residents, relative to non-Latinx Whites, had lower odds of having an AC (OR = 0.05; 95% CI = 0.01 – 0.41). Northeastern (OR = 1.92; 95% CI = 1.15 – 3.22) and Midwestern (OR = 2.12; 95% CI = 1.34 – 3.37) hospitals had higher odds of having an AC than Southern hospitals. Findings extend our understanding of U.S. hospital capacity to address dementia. Although ACs have increased over time, hospitals in non-metropolitan and Southern counties, and those in counties with a high proportion of Latinx adults are less likely to have an AC. To address dementia needs fully, investment in a national infrastructure is critical.
I WISH I WAS DEAD: HEALTH CONSEQUENCES OF PHYSICALLY TRAUMATIZED OLDER ADULTS: A QUALITATIVE STUDY IN SOUTHERN GHANA
Authors: Appiah Abigail , Apiribu Felix , Dzomeku Veronica , Diji Abigail , Kolbila Lilian , Osei Elizabeth , Poku Thomas Agyarko , Donkor Peter
Published: December 2023

The transformation from a physically healthy to a physically impaired older adults due to the effects of ageing, disability or injury can be a difficult transition to navigate. Comparatively, research on trauma in the older adult population is less as opposed to the younger adults. Ghana do not have appropriate policies and programs to support the growing numbers of the older adults. This indicates that the prevalence of the hidden problem of abuse will continue to increase, and create major public health problems. For this reason the study seek to explore the physical health consequences of the physically traumatized older adults. The study employed a descriptive phenomenological design and was guided by the Social-Ecological model. A purposive sampling technique was used to recruit participants for the study. A semi-structured interview guide was used to conduct individual in-depth face-to-face interviews. All interviews were audio-taped and transcribed verbatim. Data collection and analysis were done concurrently and data saturation was achieved after interviewing the eighth participant. Data were analyzed manually using thematic analysis and five (5) themes were generated: Lack of self-support ( inability to perform simple tasks) , Lack of family and friends support (neglect) , Lack of community and government support (no policies and programs to empower them. Physically traumatized older adults experienced extreme physical, emotional, mental and psychological discomfort as a result of their inability to do the things they wish to do, the neglect by immediate family, friends and the community as a whole and poor unfriendly transportation system.
A SCOPING REVIEW: EXPLORING COLLABORATIVE GOAL SETTING AMONG AGING ADULTS AND CARE PARTNERS
Authors: Perepezko Kate , Alchin Tucker , Karibian Bianca , Still Catherine , Valente Kayla , Toto Pamela , Fields Beth
Published: December 2023

Evidence suggests that goal setting and care partner support help aging adults improve their health. Less is known about how aging adults and care partners collaboratively participate in goal setting. The purpose of the current review was to describe the scope of the literature on this topic. A search was conducted in PubMed, CINAHL, SocINDEX, and PscyINFO. Reviewers screened 1,231 articles for the following inclusion criteria: 1) Participants included aging adults (50+ years) and care partners, 2) Goal setting was conducted, and 3) Articles were in English. Of the twenty-nine articles that were included, most (n=21) assessed goal setting for care partners and aging adults separately. Goal setting was primarily directed toward patient care, with only a few studies prompting care partner specific goals (n=4). Common goals reported by aging adults were independence, improving or maintaining functioning, addressing symptoms, and remaining socially active. Care partners listed similar goals but also identified accessing services and supports as important. This review is the first to describe goal setting with aging adults and their care partners, revealing concordant and discordant prioritization of goals within dyads. These findings illustrate the importance and potential complexity of including care partners in the goal setting process. We also found that collaborative goal setting and care partner directed goals are scarce, indicating the need for additional work in this area. Collaborative goal setting aligns with patient and family-centered care approaches and can contribute to better care plans that meet the needs of aging adults and their care partners.