bluuebunny/crossref_metadata_2025 huggingface dataset:
INADEQUATE PHYSICAL ACTIVITY ON HEALTHCARE EXPENDITURES AMONG MIDDLE AGE AND OLDER WORKING ADULTS IN THAILAND
Authors: Akksilp Katika , Isaranuwatchai Wanrudee , Teerawattananon Yot , Chen Cynthia
Published: December 2022

Physical inactivity is a significant risk factor for developing non-communicable diseases. This study estimates the additional health costs due to physical inactivity in Thai middle age and older working adults. We included participants aged 40 years and above from the Physical Activity at Work study, who had valid physical activity data from ActiGraph. Health costs were collected using the Health and Welfare Survey and the Work Productivity and Activity Impairment Questionnaire in Thailand. Direct and indirect costs (absenteeism and presenteeism) of the most recent illness in the previous month were collected. Active participants were defined as having at least 150 minutes of moderate-intensity equivalent activity per week. Two-part models were used to compare health costs between active and non-active participants. Data from 105 participants aged 40 to 63 were included in the analysis, where 42% of participants were active. Inadequate physical activity was significantly associated with increased direct health costs of 160.5THB (95%CI: 31.3 to 289.7THB) (~7.8 times higher in inactive). Further adjustment for sex, age, education, obesity, and cardiovascular condition yielded similar findings. After incorporating these indirect costs, the societal cost of having inadequate physical activity was 791.22THB (95%CI: 115.6 to 1466.8THB) (~1.3 times higher in inactive), even after adjusting for the covariates. Obesity and the female were also associated with higher societal costs (551.9THB and 342.9THB, respectively), although these results were not significant. Increasing physical activity in middle age and older working adults to meet the current guidelines may reduce Thailand’s health costs.
A MODEL FOR STUDENT PARTICIPATION IN COMMUNITY-ENGAGED RESEARCH FOR OLDER ADULTS: THE ENROLL PROGRAM
Authors: Peterson Matthew , Newsham Tina , Sellon Alicia , Norris Madison , Sidey Leanza , Barnes Christian , Holland William , Rich Jodi
Published: December 2022

The current academic climate has left naturally occurring faculty-led student research experiences and mentoring a challenge. This is coupled with an already existing dearth of future scientists interested in aging-related research. The overarching goal of the Enhancing Research for OnLine Learners (EnROLL) Program is to facilitate research collaboration among undergraduate minoritized students, graduate distance learners, health sciences faculty, and academic partners. The program includes a variety of strategic initiatives, one of which includes building five inter-institutional research cores: epidemiology, preclinical, allied health, applied learning, and community engagement. Here, we present a community-based participatory project led by students and researchers in the EnROLL community engagement core in partnership with local government. Researchers at UNCW were contacted by New Hanover County Parks & Gardens staff to assist in wellness planning for area older adults. Two surveys were developed: Nf103 community members and Nf8 staff members completed separate surveys. Community respondents were 60.8 +/- 13.7 years old, 72% female, and 80% Caucasian. Approximately 58% of community respondents were at least somewhat likely to participate in wellness programming at County locations. Based on preferred days, times, and types of classes of the respondents, a comprehensive weekly schedule of wellness classes was developed and provided to County staff for implementation under the guidance of a UNCW masters student. This community engagement project, and the EnROLL program, can serve as a model for student-engaged, aging-related research in the health sciences, particularly as gerontologists work to diversify the demographics of researchers who focus on aging.
WORKING TOWARD AN AGE-FRIENDLY UINDY: EXAMINING THE PROCESS AS IT UNFOLDS
Authors: Borrero Lisa , Ewen Heidi
Published: December 2022

Universities must adapt by expanding their understanding of inclusivity in higher education, acknowledging new aging-related career opportunities for students and their role as destinations for lifelong learning and community engagement for older adults. Accordingly, nearly 100 institutions have committed to age-inclusivity on their campuses by achieving Age-Friendly University (AFU) designation. For those interested in pursuing this designation at their institutions, an important part of the process is learning from one another about strategies used at other campuses that could be tailored to their own needs. With this in mind, this poster presentation will outline the initial strategies and resulting outcomes of the path to AFU designation at the University of Indianapolis (UIndy) via a preliminary “discovery” phase. Using GSA’s Tools for Advancing Age Inclusivity in Higher Education as a guide, AGHE members at the University of Indianapolis are in the beginning stages of their own process, characterized by discussions with various campus stakeholders during the recent spring semester. This “listening tour” has revealed strong support of the AFU principles and an eagerness to be part of an age-inclusive vision. These conversations have identified existing infrastructure and other strengths that support age-inclusivity, as well as current challenges to be managed and new opportunities to pursue. The authors will also describe the next phase of the process, including interviews with older UIndy alumni and retired faculty and staff about engagement with retired community members, as well as subsequent steps, such as working with colleagues to design viable age-friendly initiatives.
GAUGING INTEREST AND NEEDS IN PROFESSIONAL DEVELOPMENT AND CONTINUING EDUCATION IN AGING IN MANITOBA, CANADA
Authors: Porter Michelle , Kops William , Dunn Nicole
Published: December 2022

The Centre on Aging at the University of Manitoba in Canada conducted a needs assessment on continuing education (CE) and professional development (PD) in aging with people who work and connect with older adults. During winter and spring 2022, an online survey of 35 questions asked respondents about their own or their staff and volunteer topics of interest, as well as logistics of CE/PD workshop training. A total of 146 participants responded. Respondents were from different regions of Manitoba, with the highest proportion (42%) located in the Winnipeg region. About 86% were female and 12% male, ranging in age from 18 to 75: with most falling in the 35 to 64 age range. Respondents were asked to indicate their level of interest for topics on a five-point scale from Not Interested to Very Interested. The topics Aging Through the Lifespan and Wellness received the highest number of responses, while Indigenous Aging received the least. Across the 1,712 individual ratings of suggested topics, the highest proportion were rated as interested (35%) and very interested (31%); while 19% rated level of interest as moderate, 11% minimal, and 4% not interested. When asked about potential workshop formats, the majority (63%) preferred a mix of both in-person and online delivery formats with preference for 1–2-hour workshops and a certificate as proof of completion. About two-thirds indicated a requirement to complete CE/PD credits to maintain related credentials. These findings provide considerations for higher education institutions on CE/PD for those working and connecting with older adults.
ADVANCING DIVERSITY IN ADRD/AGING RESEARCH AND CLINICAL CARE: EDUCATIONAL AND CAREER TRAJECTORIES OF MSTEM MENTEES
Authors: Thompson Sheri
Published: December 2022

As an NIA-funded mentorship program, MADURA addresses the lack of diversity among Aging and Alzheimer’s Disease & Related Dementia (ADRD) researchers and clinicians. Aims include improving retention and academic success of URM MSTEM undergraduates, and increasing rates of graduate/medical school applications and entry into Aging/ADRD clinical careers. MADURA offers paid research lab experience, weekly whole-cohort research skills training, guest seminars and presentations, and weekly faculty-facilitated small group supervision, advising and support. It served 23–29 undergraduates/quarter, in its initial five quarters. The Program accepts students at varying undergraduate educational levels, particularly because students from target populations often enter as Junior-level transfers from community colleges. Thus, although the Program just completed its second year, 17 MADURA trainees have already graduated. While ongoing data collection on Program, Mentor and Student Mentee performance is beneficial, outcomes data are of utmost importance to ensuring achievement of aims. This poster will present descriptive data on MADURA graduates’ immediate employment and educational activities. Notable findings include a significant proportion of trainees who take a gap year before applying to graduate or medical school (for financial and personal reasons), and others taking internships, post-baccalaureate training or research jobs, to strengthen future medical and graduate school applications. Understanding the multiple pathways of recent graduates will enable mentorship programs to help current trainees critique and optimize preparations for their selected educational and career trajectories. These findings also suggest additional mentorship program outcomes of interest (beyond a sole focus on graduate program acceptance), and the need for longer-term alumni follow-up.
THE IHSS+ ADRD TRAINING PROJECT: BOLSTERING THE DEMENTIA CARE WORKFORCE IN CALIFORNIA
Authors: Yeh Jarmin , Pond Brittney , Beld Matthew , Eldridge Corinne , Ross Leslie
Published: December 2022

California’s In-Home Supportive Services (IHSS) program provides vital home care to low-income consumers, some of whom live with Alzheimer’s disease or related dementias (ADRD). Yet, most IHSS caregivers receive little or no training in dementia care. With the prevalence of ADRD among Californians age 55+ projected to increase 127% by 2040, reaching over 1.5 million people, the IHSS consumer population living with ADRD will likely increase at a similar rate, exacerbating the need for dementia-trained home care workers. This poster describes preliminary outcomes of the IHSS+ ADRD Training Project, a 10-week, competency-based training program, aiming to reach 600 IHSS caregivers in Alameda County, California, by 2024. All planned in-person activities switched to virtual strategies due to the COVID-19 pandemic. To date, 348 IHSS caregivers have been trained through 16 classes, with 9 classes offered in English, 3 classes in Spanish, and 4 classes in Cantonese. A quasi-experimental, longitudinal design was used to evaluate the project’s impact through pre, post, and 3-month follow-up surveys. Caregiver outcome measures included the: 1) Dementia Knowledge Assessment Tool 2, 2) Fortinsky self-efficacy scale, 3) Caregiver Self-Assessment Questionnaire, and 4) Patient Health Questionnaire-2. Preliminary outcomes trend toward significant increases in caregivers’ knowledge about ADRD and self-efficacy to maximize care they provide to consumers. While caregivers also reported slight increases in stress and depression, they expressed high levels of satisfaction with the training. Future analysis will include comparing IHSS caregiver outcomes to healthcare utilization patterns of IHSS consumers before and after their caregiver’s participation in the training.
TIPS FOR TIMELY (AND POSITIVE) REVIEWS: THE INTERNATIONAL JOURNAL OF AGING & HUMAN DEVELOPMENT
Authors: Patrick Julie Hicks , Nehrkorn-Bailey Abigail , Nadorff Danielle
Published: December 2022

For more than 40 years, under the leadership of four editors and two publishers, The International Journal of Aging and Human Development (IJAHD) has featured multidisciplinary scholarship related to aging processes and older adults. With the publication of eight issues a year, with over 800 pages of scientific content, the IJAHD places emphasis upon psychological and social studies of aging and the aged. However, the Journal also publishes research that integrates observations from other disciplines that illuminate the "human" side of gerontology. A more recent focus includes midlife development, as well. About half (47%) of the publications in the IJAHD are from international colleagues. This presentation will discuss tips for both international and US-based scholars for ensuring timely reviews and positive decisions for manuscript submissions, including such areas as key words, suggesting unbiased reviewers, formatting, writing mechanics, clearly-articulated methods, and a sound theoretical basis.
REVISITING THE TEACHING NURSING HOME: QUALITATIVE ANALYSIS OF NURSING STUDENTS’ CLINICAL EXPERIENCE
Authors: Morgan Brianna , Foley Kierra , Hodgson Nancy , Kolanowski Ann , Strauch Kim , Zionts Nancy , Dickson Chelsea , Degenholtz Howard
Published: December 2022

Revisiting the Teaching Nursing Home is a two-year pilot project to address the long-term care workforce shortage by introducing nursing students to geriatric nursing while also improving quality of care within nursing homes. The initiative has multiple components: enhanced clinical rotations for nursing students with partner schools of nursing, implementation of the Institute for Healthcare Improvement Age-Friendly Health System “4M” quality improvement model, and an online learning network. Undergraduate and graduate nursing students at three Schools of Nursing participated in clinical experiences at regional nursing homes. Students completed an “activity feedback” form after each clinical rotation at the nursing home or related activity, such as a session about the 4Ms or quality improvement/assessment. The activity feedback form asked students to share their most important takeaway and suggestions for improvement. Data from 340 feedback forms was coded qualitatively using conventional and directed content analysis using the American Association of Colleges of Nursing (AACN) Essentials for Professional Nursing Education. Multiple coders and audit trials were used to establish rigor. Students’ takeaways encompassed 7 of 8 key concepts in the AACN Essentials; Knowledge for Nursing Practice, Person-Centered Care, and Interprofessional Partnerships were most frequently mentioned. Students provided numerous suggestions for improving their clinical experiences including facilitated learning from instructors and supported engagement with nursing home staff. In conclusion, the program addressed many of the core competencies designated by AACN. One recommendation that flows from these findings is to enhance the role of clinical preceptors in the nursing home setting to facilitate mentored training.
REVISITING THE TEACHING NURSING HOME: IMPACT ON NURSING STUDENTS’ PERCEPTIONS OF WORKING IN LONG-TERM CARE
Authors: Degenholtz Howard , Boltz Marie , Fick Donna , Hodgson Nancy , Strauch Kim , Kariuki Jacob , Cai Yurun , Pajerski Dawn
Published: December 2022

Revisiting the Teaching Nursing Home is a two-year pilot project to address the long-term care workforce shortage by introducing nursing students to geriatric nursing while improving quality of care within nursing homes. The initiative has multiple components: enhanced clinical rotations for nursing students with partner schools of nursing, implementation of the Institute for Healthcare Improvement Age-Friendly Health System “4M” quality improvement model, and an online learning network. Nursing students at three schools of nursing participated in the clinical rotations at regional nursing homes. The experience was limited to students in one specific course at each school of nursing. At the beginning and end of the spring 2022 semester, students rated their competence in: patient assessment, collaborating with the care team, gathering clinical information, medication review, eliciting resident values, and health promotion. Students also rated their preferences for working in long-term care and with older adults. Data from 85 responses at the start of semester and 64 responses to the end of semester survey were analyzed. Analysis of student responses found that students self-rated competencies improved in all areas except eliciting resident values. Prior to their clinical experience, students ranked working in long-term care and with older adults lower than other settings or populations. The rankings were unchanged after their clinical experiences. These initial findings suggest that although the Teaching Nursing Home Program is meeting the pedagogical goals, attitudinal shifts may require different strategies.
PRACTICE CHANGE OUTCOMES OF POST-GRADUATE TRAINING IN ADVANCED CLINICAL DEMENTIA PRACTICES
Authors: Kaplan Daniel , Chan Keith
Published: December 2022

Neurocognitive disorder is common among older adults with often progressive symptoms impacting multiple domains of life and with major implications and challenges for family involved in care. Clinical providers including doctors, nurses, and social workers play instrumental roles in addressing health and mental health vulnerabilities associated with neurocognitive disorder as skillful interventions can effectively improve wellness and quality of life for patients and care partners. Yet, providers report needing expanded knowledge to deliver appropriate clinical dementia care. An advanced clinical dementia practice certificate program at a major university in the U.S. offers a 45-hour training that covers 35 clinical practices identified by an interprofessional advisory group. This study aims to test the learning impacts of the educational program. Since 2017, 74 participants have completed this training. Their self-reported frequency of use of each clinical practice was measured before and after the training using a 5-item rating scale ranging from “Never” to “Several times per day”. Comparisons across two time periods demonstrate significant increases in overall use of clinical practices (mean difference: 0.45), with a large mean effect size (Cohen’s d = 0.8). These increases were statistically significant in 30 of 35 practices (p < 0.05). The largest effects were observed for clinical practices emphasizing the teaching of practical care strategies and the application of person-centered interventions. Implications of this educational method for enhancing clinician practice behaviors and recommendations for quantitative evaluation of training outcomes will be presented.
CHANGING AGING MYTHS AND READINESS FOR INTERPROFESSIONAL EDUCATION IN FAMILY NURSE PRACTITIONER STUDENTS
Authors: Picella David , Woods Diana Lynn
Published: December 2022

The preparation of Family Nurse Practitioner (FNP) students caring for the older adult population is inadequate. The design was a quasi-experimental pilot study (N = 30) to assess change in myths about aging and readiness for interprofessional education (IPE) in FNP students near graduation. The Woolf Aging Quiz (WAQ) containing 24 true-false myths about older adults, and the Readiness for Interprofessional Learning Scale (RIPLS) containing 19 items rated on a 5-point Likert scale (high score indicates more readiness), were completed at baseline and post-intervention. The intervention consisted of 4-weeks of education on normal aging, agism, age friendly healthcare, and IPE using online weekly brief video presentations and peer discussion. Thirty FNP students, mean age 43.5 years, 80.6% (N = 25) female, 19.4% (N = 6) male. A paired t-test showed no significant pre-post difference in the WAQ (t = -1.388, p < .05). McNemar crosstab analysis of the WAQ items indicated 14 aging myths where students chose the wrong answer pre and post intervention. In addition, the RIPLS showed no significant change (t = .793, p < .05) from pre-intervention (mean = 35.87) to post-intervention (mean = 34.42). FNP students near graduation held strong ageist beliefs, reflected in the WAQ, and were unprepared for IPE. Both of these results were resistant to change. The data suggests that FNP programs need to address aging and IPE content earlier and provide students with exposure to older adults that addresses myths about aging affords both theoretical and practical opportunities for interprofessional learning.
HOW DOES THE INTERSECTION OF RACE AND GENDER AFFECT HOSPICE CARE AT THE END OF LIFE?
Authors: Suntai Zainab
Published: December 2022

Research in the palliative and end-of-life-care field has shown that hospice care in the final months of life can improve outcomes such as pain, emotional well-being, and physical comfort. Yet, researchers often find significant disparities in the ability to access hospice care, with Black individuals being less likely to have hospice care at the end of life. The theory of intersectionality suggests that the combination of multiple vulnerable identities may add to the number of hardships and stressors that an individual experiences across the lifespan. To test the theory, this study aimed to access whether gender moderated the relationship between race and the receipt of hospice care at the end of life. Data were derived from Round 3 to Round 10 of the National Health and Aging Trends Study, and two multivariate regression models were used to assess the relationship between the race/gender interaction and hospice care at the end of life (Model 1: main effects, Model 2: interaction term). Results showed that the effect of race on hospice care was indeed dependent on gender, with Black women being the least likely to have hospice care at the end of life. This points to the combined disadvantages resulting from membership in two vulnerable groups (i.e., being a woman and being Black), including fewer hospice facilities in Black-populated areas, race and gender discrimination in hospice referrals, and other factors that combine to reduce hospice access for Black women. Implications for research, practice, and policy are provided.
AN EXAMINATION OF ADVANCED CARE PLANNING IN BLACK AMERICANS: DIRECTION TO IMPROVE ENGAGEMENT
Authors: Bassett Rachel , Paulson Daniel , McClure Nicole Valdes
Published: December 2022

Past studies have found that older Black Americans are less likely to establish advance care directives (ACDs) than their White age peers, and medical distrust has been identified as one possible cause. Others have suggested the formulaic approach of ACD documentation which may conflict with the spiritual and cultural nature of these decisions. The Five Wishes ACD was developed partially to address this need. This study seeks to 1) replicate past findings regarding race and ACD adoption, and test the hypotheses that 2) Race will differentially predict Advanced Care Planning (ACP) engagement scores between conditions (Five Wishes vs State Directive), and 3) level of trust in physicians will relate to ACP engagement. The sample (N = 186) was recruited from Amazon Mechanical Turk and Prolific. Participants ranged from 50 to 77 years, were predominantly female (56.8%), White (51.61%), married (52.6%), and college-educated (70 .6%). ANCOVA results were a nonsignificant main effect of ACP engagement by race (F(1, 185) = 1.93, p = .166) and nonsignificant interaction of race by condition (F(1, 185) = 0.16, p < .69). Trust in physician scale scores predicted ACP engagement (F(1, 185) = 16.15, p < .001). The lack of an effect of race on ACP utilization may be explained by educational and SES characteristics of the sample by contrast to prior studies. The Five Wishes and State Directive ACD documents resulted in similar ACD engagement. These results suggest that trust in physicians is a primary barrier to ACP utilization.
THE ASSOCIATION BETWEEN FRAILTY AND PERCEIVED FATIGABILITY IN THE LONG LIFE FAMILY STUDY
Authors: Schumacher Benjamin , Kehler Dustin , Kulminski Alexander , Andersen Stacy , Gmelin Theresa , Christensen Kaare , Wojczynski Mary , Glynn Nancy
Published: December 2022

Higher levels of frailty, quantified by a frailty index (FI), may be linked to fatigue severity as tasks become more physically and mentally demanding. However, the association between frailty and fatigability—quantification of vulnerability to fatigue in relation to specific intensity and duration of activities—has not been assessed. Using cross-sectional data from the Long Life Family Study Visit 2 (2014–2017; n=2,524; mean age +/- standard deviation 71.4+/-11.2 years; 55% women; 99% White), we examined the association between a 79-item FI (ratio of number of health problems reported (numerator) out of the 79 (denominator); higher percentage=greater frailty) and perceived physical and mental fatigability using the Pittsburgh Fatigability Scale (PFS) (range 0–50; higher scores=greater fatigability). Mean+/-SD FI scores were 0.08+/-0.06 and mean+/-SD PFS Physical and Mental scores were 13.7+/-9.6 (39.5% more severe, >=15) and 7.9+/-8.9 (22.8% more severe, >=13), respectively. Both PFS subscale scores were higher for each 0.10 increment in FI. Mean PFS scores were 10.7 and 34.2 (Physical) and 5.7 and 28.8 (Mental) for FI scores of < 0.10 (non-frail) and ≥0.30 (moderate-severely frail), respectively. In mixed effects models, a 0.03 higher FI score (accepted clinically meaningful increase in FI) was associated with 1.9-point higher PFS Physical (95% confidence interval (CI) 1.7–2.1) and 1.7-point higher PFS Mental (95% CI 1.5–1.9) scores after accounting for family structure and adjusting for age, sex, field center, body mass index, smoking status, education, and marital status. Individuals with higher FI scores may benefit from targeted interventions to mitigate further poor health outcomes.
DOES MOTIVATION PROMOTE PHYSICAL ACTIVITY IN OLDER ADULTS WITH CHRONIC MUSCULOSKELETAL PAIN?
Authors: Witonsky Kailyn , Zhu Xiaonan , Rosso Andrea , Rosano Caterina
Published: December 2022

Chronic musculoskeletal pain is common and limits physical activity in older adults. Understanding why some older adults remain physically active despite chronic musculoskeletal pain, “pain resiliency”, may offer insights to promote physical activity. We investigated the cross-sectional association of three indicators of motivation or mood with physical activity in adults over the age of 65 with chronic musculoskeletal pain from the Cardiovascular Health and Cognition Study. Of 2,703 participants with brain scans, 919 (34%) reported at least one month of either foot, knee, hip, or back pain and 47% of those with pain had moderate to high levels of self-reported physical activity, defined as “pain resilient”. Indicators of motivation included: (1) self-reported motivation: a composite score of perceived effort, difficulty getting going in the morning, and difficulty concentrating, (2) social network score from the Lubben Social Network scale, and (3) a composite depression scale. Separate multivariable linear models estimated the association between physical activity and each indicator, controlling for gender, race, BMI, age, gait speed, number of medications, number of pain sites, cognitive function, as measured by the digit substitution symbol test, and brain integrity, as measured by level of white matter hyperintensities. Higher self-reported motivation (β=-0.11, p=0.02) and larger social networks (β=0.03, p=0.01) were associated with higher levels of physical activity. Better mood was not associated with higher levels of physical activity (β=-0.017, p=0.34). Albeit based on cross-sectional self-reported measures, our research suggests the need for further research investigating psychosocial contributions to pain resilience.
A COMPARATIVE STUDY OF FALL RISK ASSESSMENT IN COMMUNITY DWELLING OLDER ADULTS IN INDIA
Authors: Kulkarni Snehal
Published: December 2022

Falls in older adults can be prevented with early identification. Recent research investigates the use of wearable sensors to provide quantitative data on mobility parameters to assess risk of fall. However, the efficiency of these new methods in comparison to conventional fall risk assessment tools is unknown. Therefore, the current study compares the sensor-based fall risk assessment with conventional fall risk measures. The study included 659 community-dwelling older adults (>60 years) who were followed for 12 months after baseline. The American Geriatric Society Fall Risk Assessment tool was used to assess risk of fall conventionally and Kinesis QTUG was used to assess the fall risk using sensors. Receiver operating characteristics curve (ROC) was used to compare the sensor-based method and the conventional method of assessing fall risk. Out of the 659 community-dwelling older adults, 24% (163) of older adults reported a fall in 12 months. According to the sensor-based assessment, 23% of older adults had low risk, 50% had medium risk and 27% had high risk of fall and according to the conventional method 66.1% were in low risk, 27.1% were in medium risk and 6.8% were in high risk. The ROC analysis showed that the sensor-based methods (AUC-78%; sensitivity- 93.8% specificity – 56.3%) outperformed the conventional method (AUC – 61.2%; sensitivity – 82.8% and specificity - 67.2%) of identifying older adults at risk of fall. Therefore, use of simple wearable sensors can determine the risk of future falls.
BURDEN OF FALL-RISK INCREASING DRUGS IN OLDER ADULTS PRESENTING WITH FALLS TO THE EMERGENCY ROOM
Authors: Casey Martin , Niznik Joshua , Anton Greta , Meyer Michelle , Kelley Casey , Busby-Whitehead Jan , Davenport Kathleen , Roberts Ellen
Published: December 2022

Prescribing of fall-risk increasing drugs (FRIDs) may be an important driver of falls in older adults. Understanding the types and frequencies of FRIDs prescribed to older adults presenting with falls to an emergency department (ED) may help identify opportunities for deprescribing. We performed a cross sectional analysis of data collected from a pharmacist-led fall-prevention program focused on older adults presenting with a fall to an academic ED in the southeastern United States between August 2020 – December 2021. ED pharmacists identified older adults (≥65 years old) presenting with a chief complaint of ‘fall’ and then performed a medication reconciliations to verify and obtain data on outpatient prescription drug use. FRIDs were identified in accord with the 2019 American Geriatrics Society Beers Criteria and the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths, & Injuries (STEADI-Rx) list. The ED pharmacists performed medication reconciliations on 424 unique older adults presenting with a fall. The cohort had a mean age of 81.3 years and were mostly female (63.3%) and white (84.9%). Prescription use of FRIDs were identified in 45.8% (194/424) of older adults presenting with a fall. An estimated 25.5% (108/424) of the subjects were prescribed 2 or more FRIDs. The most common FRIDs identified were antidepressants (25.9%), anticonvulsants (18.6%), opioids (12.7%), benzodiazepines (8.5%), and antipyschotics (3.1%). . Prescription use of FRIDs, including use of 2 or more FRIDs, was common in older adults presenting with a fall to the ED.
ACCEPTABILITY DATA OF A TECHNOLOGY-ENABLED CARE COACHING SERVICE FOR CAREGIVERS OF INDIVIDUALS WITH DEMENTIA
Authors: Judge Katherine , Thomley Amelia , Stratton Lauren , Silver Emily , Finegan Kerry , Moreno Monica , Fazio Sam , Chung Joe
Published: December 2022

This poster presents acceptability data from the Kinto Care Coaching Intervention, an innovative technology-enabled care coaching service for caregivers of individuals with dementia. The 30-day program provides caregiver support and financial information through: 1) an initial one-on-one care coaching meeting; 2) interactive and on-going support and educational resources through an app; 3) access to support groups; and 4) if needed, additional meetings with their care coach. The solution is funded through the NIH’s Small Business Innovation and Research (SBIR) program, with the specific goals of developing mobile technology that is: 1) acceptable and usable for caregivers of all ages and 2) supports cost-effective deployment of the coaching intervention at scale. To assess program acceptability, participants completed a survey after their one-on-one care coaching meeting and after the 30-day program. On average, participants (n=32) were M=51.94 (SD=12.07) years old; 68.8% female; 71.9% White; 75% married; and 56.3% worked full-time. Using a 5-point Likert scale, nearly all participants (96.6%) indicated they ‘agreed’ or ‘strongly agreed’ that their care coach was: helpful in explaining the program; provided useful information; assisted with developing goals; and were supportive. Participants rated the program resources and technology as very helpful with mean ratings ranging from 4.41 to 4.69. When asked about the overall program acceptability, participants indicated they were extremely satisfied with the program (M=4.81; SD=.40), with 100% of participants ‘agreed’ or ‘strongly agreed’ that they were satisfied. Discussion will highlight key program components along with next steps in testing program efficacy.
THAT'S WHAT FRIENDS ARE FOR: SOCIAL CAPITAL, DEVELOPMENTAL DISABILITY, AND THE LIFE COURSE
Authors: Hoyle Jessica , Warren-Findlow Jan , Wallace Lauren , Laditka James , Laditka Sarah
Published: December 2022

Social capital, resources from reciprocal relationships, helps us get by as we age. People with developmental disability have service needs that persist across the life course, which social capital can help address. However, social structures, communication problems and smaller social networks limit social capital for some people with developmental disability. We studied how researchers conceptualize, measure, and apply social capital to developmental disability research throughout the life course, reviewing peer-reviewed articles across 5 disciplines, from 2000 through February 2022. Of 673 studies, 71 met criteria. Studies used a common definition of social capital but no common measures. Fourteen studies focused on parents or other caregivers. Few included older adults with developmental disability as research participants. Results indicate a need to better understand social capital in the lives of people with developmental disability and how social capital resources can support and improve lives of people with developmental disability as they age.
IDENTIFYING FACTORS ASSOCIATED WITH CAREGIVER NEGLECT IN OLDER PERSONS WITH DEMENTIA
Authors: Chang E-Shien , Czaja Sara , Rosen Tony , Moxley Jerad
Published: December 2022

Caregiver neglect is common among older persons with dementia and is associated with significant morbidity and mortality. Despite this, little empirical research exists examining factors that contribute or prevent neglect. Our goal was to identify caregiving factors that may be associated with caregiver neglect. Data were drawn from the baseline information of 240 caregivers enrolled in the Caring for the Caregiver Network study who provided care to a family member with dementia. Caregiver depression, burden, social support, perceived mutuality with care-recipients, positive aspects of caregiving, and self-perceived caregiving preparedness, were measured using validated scales. To maximize sensitivity in our measure of caregiver neglect, we operationalized caregiver neglect as consisting of: 1) caregivers’ failure to meet care-recipients’ needs, using 8-item instrumental activities of daily living (IADL) and 6-item ADL scales, and 2) caregivers not receiving additional formal services (e.g., visiting nurses; home care aides) to address care-recipients’ unmet needs. Selection of independent variables into multivariate regression models examining predictors of neglect was based on significance in bivariate analysis (p < .10). Caregiver neglect was found in 29.2% of caregivers. The caregiver being male was significantly associated with greater risk of neglect. In the final adjusted model, only caregiver preparedness was found to be a significant risk factor for neglect (β = -.16 SE=.10, p < .05). This analysis provides the first evidence of the association between caregiver preparedness and risk of caregiver neglect. Future research should examine possible psycho-social mechanism linking preparedness and neglect to inform neglect prevention and intervention programming.
CAREGIVING BURDENS OF TASK TIME AND TASK DIFFICULTY AMONG PAID AND UNPAID CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Smith Matthew , Kew Chung Lin , Han Gang , Wilson Lucas , Lee Shinduk , Fitch John , Ory Marcia
Published: December 2022

Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Cross-sectional baseline survey data were analyzed from 110 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling for contextual items related to the caregiver, care recipient, and caregiving logistics. Caregivers whose care recipients were female (B=-0.29, P=0.006), had more chronic conditions (B=0.31, P=0.011), and had lower Mini-Mental State Exam scores (B=-0.20, P=0.015) reported higher task time burdens. Caregivers whose care recipients had other paid caregivers (B=0.30, P=0.031) and spent more months/years caring for their care recipients (B=0.28, P=0.004) reported higher task time burdens. Caregivers’ task time burden was positively associated with their emotional stress level (B=0.30, P=0.020). Caregivers’ task difficulty burden was positively associated with their emotional stress (B=0.30, P=0.029) and depressive symptomatology (B=0.32, P=0.002). Results reinforce the relationship between caregiver burden and mental health. While the care recipient’s disease profile and needs were drivers of task time burden, which may also require coordination with other paid caregivers, task difficulty was emotionally driven. Findings highlight the importance of caregiver support services and programming for mental health.
THE ROLE OF PAID CAREGIVERS IN HOME-BASED DEMENTIA CARE: FAMILY, PAID CAREGIVER, AND GERIATRICIAN PERSPECTIVES
Authors: Watman Deborah , Reckrey Jennifer
Published: December 2022

Paid caregivers (e.g., personal care aides, home health aides, other direct care workers) provide essential care that allows people with dementia to remain living at home, yet little is known about the lived experience of this care. This project uses multiple perspective, qualitative longitudinal interviews to explore paid caregiver role in home-based dementia care. We conducted one-on-one interviews via telephone or zoom with the family caregiver, paid caregiver, and geriatrician of an individual person with moderate or severe dementia (n=9) living at home in New York City. After an initial interview, up to 2 additional interviews (at 3 and 6 month intervals) were also conducted for a total of 75 interviews with 29 unique respondents. Interviews were audio-recorded, transcribed, and analyzed using the framework method of analysis. Interviews revealed nuanced care arrangements, but paid caregiver role in care remained largely stable over time. Key findings include: (1) Family caregivers played a primary role in determining overall paid caregiver role in care, (2) Paid caregivers describe the emotional components of caregiving (e.g. being “like family”, having patience) more frequently than families or doctors, and (3) Doctors rarely engage with paid caregivers unless family involvement is limited. The unique structure of each triad emphasizes the importance of person-centered dementia home care. Formal care plans may not reflect the nuances of care arrangements and responsibilities. Rather than prescriptive standards for home care, improved communication and clear expectation setting may help meet the complex needs of people with dementia and their families.
GLOBAL CLINICIAN PERSPECTIVES ON NON-OPERATIVE HIP FRACTURE MANAGEMENT DURING COVID-19
Authors: Xiang Lucille , Singh Mriganka , McNicoll Lynn , Moppett Iain
Published: December 2022

There are currently no guidelines regarding clinician decision making in the type of hip fracture management among older adults. Cultural, social, structural and economic differences between global healthcare systems may result in differing approaches. This study’s objectives were to identify possible factors influencing clinicians’ decision to undertake a non-operative hip fracture management approach among older adults, and to determine whether there is global heterogeneity regarding these factors between high income countries (HIC), and low- and middle-income countries (LMIC) clinicians. A SurveyMonkey questionnaire was distributed to clinicians through the Fragility Fracture Network’s Perioperative Special Interest Group and clinicians’ personal networks between May 24 and July 25, 2021. 406 respondents from 51 countries returned the questionnaire, of which 225 respondents came from HIC and 180 from LMIC. Clinicians from HIC reported a greater median [IQR] estimated proportion of admitted patients with hip fracture undergoing surgery (96% [95–99]) than those from LMIC (85% [75–95]) of mean (SD) at 94% (8) compared to 81% (16) among LMIC clinicians (p=2.94e-23). Several factors seemed to influence the clinician hip fracture management decision making process. Global heterogeneity seems to exist between HIC and LMIC clinicians regarding factors such as anticipated life expectancy, ability to pay, treatment costs, insufficient resources, and perception of risk in hip fracture management decision-making. This is the first international sampling of clinician perspectives regarding hip fracture management. Further research is necessary for the development of best practice guidelines to improve hip fracture management decision-making and quality of hip fracture care among older adults.
BARRIERS AND STRATEGIES TO ENGAGE AND RETAIN DIVERSE RURAL DYADS IN PSYCHOSOCIAL INTERVENTIONS
Authors: McCarthy Michael , Garcia Y Evie , Cassady Mara , Mall Neshay , Bosch Pamela , Barger Steven
Published: December 2022

It is often challenging to engage and retain rural Latinx and Native Americans in psychosocial interventions after stroke, despite the fact that these populations tend to experience poorer health outcomes. Although strategies for effective patient-provider communication exist, few studies focus on the cultural aspects of engagement and retention of diverse dyads in a rural context. The aim of this study is to describe barriers to engagement and retention of diverse rural dyads in post-stroke psychosocial interventions, as well as to elucidate specific strategies to address these barriers. Semi-structured interviews were conducted with Nf14 clinical providers with extensive experience serving diverse rural couples and families. Qualitative data were analyzed using interpretive description methods. Seven key barriers were identified, grouped broadly into: 1. Those presented by providers (1a. Lack of time and attention given to dyads “telling their story”; 1b. Lack of culturally appropriate interpersonal skills; 1c. Incongruence between provider-patient values) and 2. Those existing within dyads themselves (2a. Low priority given to interpersonal and emotional issues; 2b. Concern about confidentiality in small communities and mistrust of those in power due to current or historical experiences with dominant cultures; 2c. Perception of stigma surrounding interpersonal and emotional issues; 2d. Tendency to be polite, accommodating, or feign investment). Providers offered specific culturally-informed strategies to overcome barriers which in turn may increase engagement and minimize attrition. Providers and researchers may benefit from these insights as they work to communicate with, build trust, and meet the unique needs of these populations.
EDUCATION AND PERCEIVED FUTURE NEED FOR ADL HELP
Authors: Finan Julia
Published: December 2022

Extant literature suggests that adults with higher education are more likely to avoid poor health outcomes and to rate their health as better than individuals with less education. The current study builds on prior research by analyzing the association between educational attainment and the perceived need for future help with activities of daily living (ADLs), often measuring disability in the literature. 2011-2014 National Health Interview Survey (NHIS) data for adults in the United States age 40 to 65 (N=55,166) were analyzed using multivariate regression analysis. Among non-Hispanic Whites, increased years of education predicted stronger anticipation of the need for future ADL assistance. For non-Hispanic Blacks, this relationship was reversed at the some-college level. Education was not predictive of perceived future ADL assistance need for all other racial-ethnic groups. Results of this study suggest education has a unique impact on anticipation of future need for ADL assistance among non-Hispanic Whites.
USING STORYTELLING TO ASSESS NURSE’S KNOWLEDGE IN CARING FOR OLDER ADULTS
Authors: Murphy-Boucher Michele , Woods Diana Lynn
Published: December 2022

Continuing education, knowledge acquisition, and competence is required of all professional Registered Nurses. Remaining current in care delivery trends based on evidence practice is the responsibility of nurses supported by professional development specialists and educators. This project was conducted as a quality improvement project, using the evidence-based teaching modality of storytelling to educate practitioners in caring for older adults. This project addresses the question: For leaders of professional development and education focused on acute care and ambulatory practice, who have not had specialty geriatric training, how does using case-based/story-telling education for the care of patients 65 years and older affect confidence levels of the 4 M’s (mentation, mobility, what matters and medication) of elder care? A convenience sample of 12 Directors of Professional Development participated, and a validated comparison of responses to the Gerontological Nursing Competence Questionnaire (GNCQ) and the Facts on Aging (2015 version) (FAQ) were used for collecting data of pre intervention and post intervention. An eight-minute video was the educational intervention. GNCQ responses for confidence in knowledge and confidence in teaching were statistically significant. Although an increase in the mean score for interest in additional training, it was not statistically significant. The FAQ showed no statistical significance for the pre and post results. Findings indicate that storytelling is a viable teaching modality for increasing nurse’s knowledge of caring for older adults based on the concepts of the 4 Ms of age-friendly care. Keywords: storytelling, case studies, nurse education, professional development, narratives, and adult learning.