bluuebunny/crossref_metadata_2025_split huggingface dataset:
EDUCATION, LITERACY, NUMERACY AND HEALTH INFORMATION SEEKING IN LATER LIFE
Authors: Yamashita Takashi , Bardo Anthony R , Millar Roberto J , Sahoo Shalini , Cummins Phyllis , Liu Darren 
Published: November 2019

Abstract
Health information plays a critical role for health promotion and maintenance in later life. While health information seeking is primarily driven by need (e.g., health), significantly less is known about the roles of education and health-literacy. Thus, we examine complex pathways that link health information seeking behaviors with education and health literacy (decomposed into general literacy and numeracy), and how these pathways differ by health status among a nationally representative sample of Americans age 50 and older (n = 2,750). Data come from the 2012/2014 Program for International Assessment of Adult Competencies. Multi-group structural equation models were used to examine the use of eight health information sources (newspapers, magazines, internet, radio, TV, books, friends/family, and health professionals) by health status (good vs. poor). Findings showed that literacy and numeracy are significant mediators of the relationship between education and health professional as an information source. Additionally, the mediation effects on health professionals by literacy status [indirect-effect (good vs. poor health) = 0.48 vs. 2.13, p &lt; 0.05] and numeracy [indirect-effect (good vs. poor health) = -0.47 vs. -1.81, p &lt; 0.05] were significantly moderated by health. At the same time, no moderated mediation effect was observed in the use of any other information sources. This study provides some of the first nationally representative evidence regarding how education functions through health literacy components to shape health information seeking behaviors by health status. Explanations and implications for differing effects of education, literacy, and numeracy on health information seeking in later life were evaluated.
THE EDUCATION-HEALTH GRADIENT AND PATHWAYS TO MORTALITY
Authors: Kiel Justin J , Soh Yenee , Guo Muqi , Canning David 
Published: November 2019

Abstract
Large and widening educational gaps in life expectancy exist in the United States, but the mechanisms behind the education-health gradient are not well understood. We aim to study the different pathways of mortality by education group and decompose the life expectancy gap at age 50 into three components: differences in initial health at age 50, differences in transition rates to poor health states, and differences in mortality rates, given the health state. We use 11 waves of the Health and Retirement Survey and model the evolution of mortality, and health states (measured by self-rated health, limitation on any activity of daily living, and ever diagnosed with a range of health conditions). We estimate Markov models of transitions between health states and mortality over two year periods and use these transition matrices to simulate how a cohort’s health changes as they age. We find a 6-year gap in life expectancy between the highest and lowest education groups. Initial health states account for one-third of the gap in life expectancy, primarily from differences in objective health measures. The gap has widened over time, explained by comparatively better health status changes for the higher educated group, compared to the other education groups. The lower education groups have high rates of transition to poor health states, but not differential mortality rates conditional on their health state. These results suggest that educational gaps in life expectancy are due to the onset of ill health at earlier ages, and not different mortality outcomes after disease diagnoses.
SOCIAL AND BEHAVIORAL FACTORS IN COGNITIVE AGING: APPLYING THE CAUSAL INFERENCE FRAMEWORK IN OBSERVATIONAL STUDIES
Authors: Leist Anja K 
Published: November 2019

Abstract
Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with social and behavioral interventions, given that there is currently no medical cure available to prevent, halt or reverse the progression of cognitive decline and dementia. However, in current models, it is still not well established which factors (e.g. education, BMI, physical activity, sleep, depression) matter most at which ages, and which behavioral profiles are most protective against cognitive decline. In the last years, advances in the fields of causal inference and machine learning have equipped epidemiology and social sciences with methods and models to approach causal questions in observational studies. Method: The presentation will give an overview of the causal inference framework and different machine learning approaches to investigate cognitive aging. First, we will present relevant research questions on the role of social and behavioral factors in cognitive aging in observational studies. Second, we will introduce the causal inference framework and recent methods to visualize and compute the strength of causal paths. Third, promising machine learning approaches to arrive at robust predictions are presented. The 13-year follow-up from the European SHARE survey that employs well-established cognitive performance tests is used to demonstrate the usefulness of the approach. Discussion: The causal inference framework, combined with recent machine learning approaches and applied in observational studies, provides a robust alternative to intervention research. Advantages for investigations under the new framework, e.g., fewer ethical considerations compared to intervention research, as well as limitations are discussed.
SUBJECTIVE APPRAISALS OF PHYSICAL AND EMOTIONAL HEALTH: EXAMINING AGE DIFFERENCES ACROSS RURAL URBAN COMMUNITIES
Authors: Dorman Hillary , Allen Rebecca S , Parmelee Patricia A , McGuire Lisa C 
Published: November 2019

Abstract
Using the Meikirch model as a theoretical underpinning, the present study aimed to examine population health disparities by discerning age variations within and across rural urban areas. Secondary data analysis was conducted using the CDC’s 2017 Behavioral Risk Factor Surveillance System. The study’s outcome variables included physical health and mental health burden (zero days, 1-13 days, 14+ days). A total sample of 96,568 adults were included with a mean age of 66.05 years (SD = 9.91). Individuals were classified in the following age groups: 43% middle-aged (45-64 years), 33% young-old (65-74 years), and 25% old-old adults (75+ years). The sample was largely female (61%), Non-Hispanic White (86%), and urban (67%). A series of chi-square tests of independence – post hoc tests when applicable – were completed. Overall, rural residents reported a higher prevalence of severe physical and mental health symptom burden. Regarding physical health burden, a significant difference was found within urban settings (X2(4) = 50.74, p &lt; .001), where, unexpectedly, young-old adults reported the best physical health. Regarding mental health burden, a significant difference was found for both urban (X2(4) = 1661.72, p &lt; .001)) and rural settings (X2(4) = 820.65, p &lt; .001), with middle-aged adults reporting greater mental illness and the old-old adults reporting greater mental health resiliency. Findings suggest that a multidimensional framework of health usefully informs public health and clinical service interventions, identifying populations and locations in need (i.e., targeting rural physical health across age groups and mental health among the middle-age, regardless of location).
OCCUPATIONAL MOBILITY AND CHRONIC ILLNESS IN LATE LIFE: A SYSTEMATIC REVIEW
Authors: Fu Rong , Abrahamson Kathleen , Campbell Tara 
Published: November 2019

Abstract
Objectives: Occupational mobility at various stages in the life course may have a cumulative influence on health outcomes in later life. This study aims to (1) systematically review the association between occupational mobility and chronic illness in late life; and (2) identify potential mechanisms underlying this relationship. Methods: A systematic review of literature was carried out by searching two databases (PubMed and SocIndex) and reference lists. Eligible studies examined associations between occupational mobility and at least one measure of chronic illness among adults aged 50 years or above. Occupational disruptions (e.g., job loss) were reviewed as special cases of occupational mobility. Results: Downward occupational mobility and mid-life occupational disruptions have been consistently shown to predict higher risk of chronic illness in older adults. Several potential mechanisms were identified from the literature: (1) health behaviors, including dietary practices and alcohol consumption; (2) psychosocial factors, including stress, stigma, job control, job demands, and job satisfaction; (3) economic factors, including financial incentives or constraints; and (4) other individual characteristics, including personality traits and coping skills. There is also evidence that the timing of job mobility and the duration of (each) occupation modify the association between occupational mobility and health in late life. Discussion: These findings suggest that experiencing involuntary occupational mobility at various stages in the life course can increase the risk of chronic illness in late life. Health professionals and policymakers should target more resources to disadvantaged older adults who experience involuntary occupational transition.
OLDER PEOPLE LIVING WITH HIV: THE RELATIONSHIP BETWEEN COMMUNITY-LEVEL FACTORS AND THEIR HIV HEALTH
Authors: Lee Yookyong , Walton Rick , Jackson Edward , Jackson Lindsey , Batey Scott 
Published: November 2019

Abstract
According to Centers for Disease Control and Prevention, older adults (aged 50 and older) accounted for 17% of new HIV diagnoses in 2016. The number of older people living with HIV (PLWH) is increasing because of antiretroviral therapy that allows a near normal life expectancy with HIV. Consequently, older PLWH are more likely to develop diseases associated with aging and be affected by polymedication. However, their lived experience and challenges that they face have been underexamined. In this study, we focused on community-level factors, which have potential health implications for older PLWH. We examined a subsample of participants who were at least 50 years-old (n=20; Mean=55; range 50–60) from a community-based participatory research study (n=40). Participants, who previously established HIV care, were recruited through word-of-mouth and flyers posted in the community. Interviews were recorded, transcribed, coded, and triangulated through an iterative process during team meetings. In this subsample (n=20), majority of participants were male (75%) and Black (80%). Older PLWH reported crime, social isolation (interacting with crime and stigma), and lack of access to resources (e.g., transportation, grocery store, pharmacy) as factors negatively associated with their physical and emotional health. A more holistic, complex approach to support older PLWH is essential. They should experience a greater quality of life along with longevity. Therefore, more attention to contextual and structural barriers associated with treatment and care is necessary to find a way for higher retention, (re)engagement, and adherence to care among older PLWH.
HEALTH LITERACY, MEDICAL NON-ADHERENCE, AND SELF-REPORTED HEALTH PROBLEMS AMONG OLDER INTERNET USERS
Authors: Seckin Gul 
Published: November 2019

Abstract
The Internet presents new options for the elderly to gather information to support their health care. Health information gathering is among the major motivations for using the Internet among aging baby-boomers. However, insufficient e-health literacy presents challenges for the aging baby boomers. We examined the extent to which health-related internet use and e-health literacy are associated with non-adherence and self-reported negative health outcomes. Respondents were randomly sampled from the largest national online probability-based research panel (N = 710; M= 48.8, SD= 16.4). The age range in our research allowed us to examine the hypothesized associations across the full sample while focusing on older adults (age ≥ 60; N = 194). Older adults with greater e-health literacy reported higher averages for non-compliance because of information obtained from the Internet [(t (194) = 5.06, p ≤ .0001]. Ordinary least squares regression analyses showed that older adults who reported greater averages on health-related internet use reported higher averages on self-reported health problems (β = .292, p ≤ .01). However, women reported fewer health problems (β = -.217, p ≤ .01). Non-adherence with doctor recommendations is a significant positive predictor of self-reported health problem in the full sample (β = .244, p ≤ .0001) but not among older respondents (β = .032, p ≤ .061). Older individuals will make better utilization of the Internet if health professionals guide them to credible sources for health-related information. Empowerment of individuals to utilize the Internet in an informed manner requires addressing their needs for e-health literacy skills.
PERCEIVED STRESS, SOCIAL SUPPORT, AND DRY MOUTH AMONG U.S. OLDER CHINESE ADULTS
Authors: Mao Weiyu , Mao Weiyu , Chen Yiwei , Wu Bei , Ge Shaoqing , Yang Wei , Chi Iris , Dong XinQi 
Published: November 2019

Abstract
Dry mouth is a common condition among older adults that negatively influences oral health, general health, and quality of life. The role of psychosocial factors in oral health conditions and diseases remains largely unknown. We examined the relationship between perceived stress and dry mouth among US older Chinese adults and further investigated the moderating role of social support from different sources in the relationship. Data came from baseline of the Population Study of Chinese Elderly in Chicago between 2011 and 2013 (N = 3,157). Stepwise logistic regression models with interaction terms were used. More perceived stress was significantly associated with a higher likelihood of reporting dry mouth. Friend support was protective against dry mouth. The effect of perceived stress on dry mouth varied by levels of family and friend support. To prevent or reduce dry mouth, interventions need to consider perceived stress and social support in this growing population.
A COMPREHENSIVE DIGITAL SELF-CARE SUPPORT SYSTEM FOR OLDER ADULTS: A MULTIDISCIPLINARY FRAMEWORK
Authors: Nambisan Priya , Lyytinen Kalle , Stange Kurt , Kahana Eva , Kreps Gary L 
Published: November 2019

Abstract
This paper presents an innovative conceptual framework for designing a Comprehensive Digital Self-care Support System (CDSSS) to meet the health needs -physical, mental and social health needs of older adults and their caregivers. Older adults deal with multiple co-morbidities, medications and their side effects, fragmented care and often have poor understanding of their own health and treatments. These challenges call for solutions that lead to better empowerment and pro-active engagement and for support systems that focus on wellness and preventive care. The conceptual model we offer draws on diverse disciplines including health care management and medicine, information systems, communication, consumer behavior, and sociology to identify a set of key design principles for CDSSS. A review and analysis of the literature in the different fields led to the identification of 6 CDSSS design principles: (1) Systems approach; (2) User experience; (3) Ecosystem perspective for shared resources 4) Social and contextual learning; (5) Accessible design; (6) Designing for trust and empathy. The model clarifies how these design principles (or approaches) inform the development of the three main components of a CDSSS (data integration, communication, and resource integration) and enable the key CDSSS deliverables (learning, social & emotional support and care integration). The conceptual model also helps to lay out an agenda for future research on self-care support systems for older adults.
PSYCHOMETRIC PROPERTIES OF THE OLDER ADULT TECHNOPHOBIA SCALE AND SMARTPHONE CHALLENGE TASK
Authors: Martin Kelly J , Lauderdale Sean A , Thorpe Steven , Molhman Jan 
Published: November 2019

Abstract
Older adults are especially prone to anxiety if they are unable to keep pace with technological advances and are generally more technophobic than their younger counterparts. Older adults tend to limit their use of technology, if not avoid it altogether, such as using a smartphone for calls and text messages only, while eschewing more advanced functions. Currently, there is no measure of technophobia in older adults that captures fears and concerns about the use of these up-to-date technological tools. The purpose of this investigation was to evaluate the psychometric properties of a new scale of technophobia and corresponding smartphone challenge task in a sample of older adults. Community-dwelling older adults (N = 42, 81.0% female, Mage = 77.3) completed the following: the Older Adult Smartphone Challenge Task (OASCT), Older Adults’ Technophobia Scale (OATS), Older Adult Social Anxiety Scale, Computer Anxiety Rating Scale, and the IPIP Five Factor Personality Domains. Preliminary data indicate good internal consistency for the OATS (α = .87) and the OASCT (α = .86). The OASCT was negatively correlated with age, computer anxiety, and OATS anxiety/avoidance scores, but positively correlated with education. The OATS scores were positively correlated with social anxiety, social avoidance, and computer anxiety, but negatively correlated with extraversion. To keep pace with the contemporary world, older adults must achieve a level of comfort with the use of technological devices. Administering the OASCT and OATS could be a valuable first step in identifying older adults with technology-related deficits and anxiety for individual and/or community-wide intervention.
USE OF INFORMATION AND COMMUNICATION TECHNOLOGY AND MEMORY PERFORMANCE IN OLDER ADULTS: WHICH COMES FIRST?
Authors: Choi Eun Young , Zelinski Elizabeth M 
Published: November 2019

Abstract
The topic of older adults’ information and communication technology (ICT) use looms large because of the beneficial effects of ICT use on physical health, emotional well-being, and social engagement. Previous research has shown that memory performance is also linked with ICT use, but the direction of influence is yet to be determined. Individuals with higher levels of memory function are more likely to use ICT devices, but ICT use may have protective effects on maintaining memory because using technologies includes mental exercises. The current study examined the temporal sequence of ICT use and memory performance, which can provide insight into the causation. Using three waves (2013, 2015, and 2017) from the National Health and Aging Trends Study (NHATS), a total of 4,048 community-dwelling older adults aged 65 and above were selected for the analysis. Memory performance was measured by summing scores of immediate and delayed word recall. Reciprocal 5-year lagged associations between ICT use and memory were examined, while controlling for age, gender, education, racial/ethnic minority status, and depressive symptoms. The final model showed adequate fit indices (CFI = .979 and RMSEA = .038). Word recall significantly predicted ICT use in later years. Reciprocally, greater use of ICT was significantly associated with better memory performance in following years. The effect of ICT use on memory performance was of greater magnitude in comparison with memory as a predictor for ICT use. These results suggest that ICT can have potential benefits for maintaining memory in old age.
THE INFLUENCE OF TECHNOLOGY ON QUALITY OF LIFE AND AGING IN PLACE
Authors: Mois George , Washington Tiffany R , Beer Jenay M 
Published: November 2019

Abstract
Many of the challenges that often accompany longevity can affect older adults’ quality of life (QOL). Adoption of an assistive technology ecosystem presents the potential to alleviate these challenges and improve QOL. An assistive technology ecosystem refers to the use of multiple assistive technologies to address a set of challenges affecting single or multiple characteristics of older adults’ QOL. However, little is known how technology can influence characteristics of older adult’s QOL. The purpose of this study was to investigate how using technology can improve older adults QOL. Data from the 2016 wave of the National Health and Aging Trends Study (NHATS) were analyzed using four logistic regression models. The sample included are older adults age 65+ (N=5,488). The dependent variables used in this study were QOL indicators such as self-confidence, continue improving life, likes living arrangement, and self-determination. The variables used to measure technology included computer, cell phone, tablet, and internet use. Older adults who used the internet had significantly higher odds of reporting self-determination (OR=1.68), like living arrangement (OR= 1.97) and continue improving life. Tablet users had significantly higher odds of continuing to improve their life (OR= 1.249) and increased self-determination (OR= 1.174). Cellphone users had significantly higher odds of having self-confidence (OR= 2.814). These findings support the need for a network of resources accessed through an ecosystem of technologies to address the challenges encountered by older adults aging in place. This study’s findings can inform technology education programs, interventions, and assist with the development of support networks.
PROBLEM SOLVING SKILLS AND CANCER SCREENING BEHAVIORS IN MIDDLE-AGED AND OLDER MEN IN THE U.S.
Authors: Sahoo Shalini , Millar Roberto J , Yamashita Takashi , Cummins Phyllis 
Published: November 2019

Abstract
Routine cancer screening is widely recognized as an effective strategy for reducing cancer mortality – the second leading cause of death in the U.S. Research shows cancer screening rates need to be improved, and men are less likely to uptake recommended screening than women. Cancer screening requires an array of tasks such as seeking up-to-date guidelines, making appointments, planning a hospital visit, and communicating with health care professionals in the complex health care systems. Importantly, modern health care systems are rapidly adopting technology such as web-based applications for information dissemination and communication with patients. This current study is designed to better understand the roles of problem-solving skills in the technology-rich environment (PSTRE) in two selected cancer screening behaviors among middle-aged and older men. We obtained nationally representative data with a sophisticated PSTRE assessment from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC). Binary logistic regression models with survey weights were used to estimate the association between PSTRE scores (1 – 500 points) and two cancer screening behaviors of men who meet the recommended guideline of age between 45 to 74 years old (n = 1,168). Results showed that greater PSTRE scores were positively associated with prostate cancer screening (OR = 1.005, p &lt; 0.05). Improvement in PSTRE may promote the specific cancer screening behaviors. Our findings also inform future interventions that seek to improve cancer screening among a vulnerable section of older populations.