bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Technology Use and Colon Cancer Screening
Authors: Sun Na 
Published: December 2020

Abstract
Population aging is accompanied by an increase in chronic diseases such as cancer. Colon cancer is the third most common cancer and a leading cause of cancer death. Screening tests can aid early detection and treatment. It is unclear how information and communication technology (ICT), especially media through mobile devices, influences cancer screening. This study analyzes the relationship between ICT usage and colon cancer screening among U.S. adults. Data are from the second cycle of the Health Information National Trend Survey 5. Cancer screening included having one of the following: colonoscopy, sigmoidoscopy and/or stool blood test to check for colon cancer. Approximately 70% of respondents had at least some college education, 51% were female, and the mean age was 48 years. More than half of respondents report using apps on a tablet or smartphone for health and wellness purposes, and around 70% of them used apps for health communication and decision-making. Based on results of a binary logistic regression model, people who use mobile apps for discussions with health care providers (p&lt;0.01), who use the internet to look for information about cancer (p &lt;0.01), and who do not use mobile apps to make decisions about how to treat an illness or condition (p&lt;0.01) are more likely to conduct cancer screening. ICT usage may enable people to gather information about cancer screening and improve patient and physician communication. Future studies should explore longitudinal associations between ICT usage, cancer screening, and cancer outcomes.
Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study
Authors: Xiang Xiaoling , Lai Patrick Ho Lam , Sun Yihang , Dunkle Ruth 
Published: December 2020

Abstract
The purpose of this study was to identify patterns of changes in social isolation and dementia and the interrelations between these developmental trajectories. The study sample included 7,609 Medicare beneficiaries age 65 and older from the National Health and Aging Trends Study 2011 through 2018 surveys. A group-based dual trajectory modeling approach was used to identify distinct groups of developmental trajectories for social isolation and dementia status over the 8-year period. The dual model provided estimates of conditional and joint probabilities linking the two sets of trajectory groups. Changes in social isolation over an 8-year period followed four trajectories: rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%). Changes in dementia risk also followed four trajectories: persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%). Over two-third (68%) of the persistently low dementia group were also in the rarely isolated group. Both increasing dementia groups were composed mainly of individuals from the increasing social isolation group (40-43%) and persistently isolated group (24-29%). The persistently high dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). For the most part, social isolation and dementia evolve in the same direction for older adults over an 8-year period. However, the pattern of associations between these developmental trajectories is complex and may be reversed among long-term dementia survivors.
The African Immigrant Memory Loss Project: A University-Community Partnership
Authors: Nkimbeng Manka , McCarron Hayley , Bustamante Gabriela , Russell Wynfred , Shippee Tetyana , Gaugler Joseph 
Published: December 2020

Abstract
The few studies on dementia prevalence in immigrant communities show that immigrants from diverse racial/ethnic backgrounds have a higher prevalence of dementia compared with their U.S.-born counterparts. However, this body of work is small, resulting in a lack of reliable estimates of dementia prevalence among African immigrants. The AIMLP is a partnership between the African Career, Education, and Resources, Inc. (ACER) and the Families and Long-Term Care Projects (FLTC) of the University of Minnesota School of Public Health. Guided by an advisory board, the goal of this project is to develop culturally informed instruments, and use these to collect data to identify dementia care needs, knowledge, and resources in the African immigrant community. Study implementation started in August 2019, five advisory board meetings have been convened and 2 pilot focus groups have occurred. Twelve individuals participated in the focus groups. The majority (90%) were from Liberia and 60% were over the age of 55. Two participants currently care for a family member with dementia. Preliminary findings reveal a great need for education on dementia, and general lack of awareness on management, and limited access to services/supports. Focus groups will be finalized in March and the study survey will be developed and administered in the summer. These survey findings will be available and presented at the conference in November 2020. This is the first project to identify the extent of dementia care needs and resources among African immigrants; which will inform interventions for this population.
The Gendered Effects of Education and Acculturation on Older Korean Immigrants’ Cognitive Function
Authors: Choi Eun Young , Jang Yuri , Chiriboga David 
Published: December 2020

Abstract
This study advances knowledge concerning older immigrants’ cognitive health by examining the role of gender in the context of education, acculturation, and cognitive function. Guided by an emerging Gendered Process of Acculturation framework, we hypothesized that the cognitive health of men and women would benefit differently from a high level of education and acculturation. Cognitive health was measured with the Mini-Mental State Examination. Data were drawn from the Study of Older Korean Americans (SOKA), a multi-site survey of Korean Americans aged 60 and over (N = 2,061). Multivariate linear regression analyses were conducted to investigate the moderating role of gender in the effects of (1) education, (2) acculturation, and (3) the association of education and acculturation on cognitive function. Gender was found to be a significant moderator in the relationship of education and acculturation with cognitive health: the positive effect of both education and acculturation was greater among women than men. Furthermore, the three interaction among education, acculturation, and gender was significant: the positive impact of education on cognition was particularly pronounced among women with low acculturation and eliminated gender differences in cognitive status. Our findings suggest that gender plays a critical role in determining the cognitive health benefit arising from education and acculturation singularly and in concert, highlighting the vulnerability of women with low education and acculturation. These findings have implications for social interventions targeting immigrant populations.
The Mediation Role of Socioeconomic Status on Racial and Ethnic Differences in Advance Care Planning
Authors: Han Junghee , Nam Taekbeen 
Published: December 2020

Abstract
Background. Most research on EOL care planning has focused on racial/ethnic differences in completing advanced directives (AD) rather than the pathways of the disparities. Therefore, this study aims to examine the mediating role of education and income in racial/ethnic differences in EOL care planning. Methods. A secondary data analysis of Health and Retirements Study (HRS) 2004-2014 wave was used. The sample included 6,518 participants ((≥ 65 years old). The independent variable measured the respondents’ race and ethnicity and the dependent variable measured the completion rate of living wills or the Durable Power of Attorney of Health Care (DPAHC). Covariates included gender, age, marital status, religion, place f birth, educational attainment, income, cognitive function, limitations in physical functioning, geriatric syndromes, and the number of progressive chronic disease. Results. The hierarchical logistic regression analysis showed that race/ethnicity was a significant predictor of completing AD (p≤0.001). Mediation analysis, Karlson, Home, and Breen (KHB), revealed that both education and income explained 14.4% of racial/ethnic differences in completion of living wills for non-Hispanic Blacks and 17.6% for Hispanics. Similarly, education and income accounted for 17.6% of racial/ethnic disparities in completion of DPAHC for non-Hispanic Blacks and 20.9% for Hispanics. In particular, education had stronger mediating effect on the outcome variables than income. Discussion. The findings suggest the importance of targeted educational interventions for people of color with lower SES to raise their awareness of benefits of advance care planning and increase their access to higher quality of EOL care.
Toward a Comparative Study of Collective Memory and Citizenship Among Older Adults With Dementia
Authors: Robbins Jessica 
Published: December 2020

Abstract
This poster explores new directions for understanding possibilities for citizenship among older adults with dementia, who often experience loss of citizenship and diminishment of personhood due to their diagnosis. Drawing on data from two distinct ethnographic studies—one on memory and personhood in a day center for people with Alzheimer’s disease in Poland, and the other on gardening and wellbeing among older African Americans without cognitive impairment in Detroit—this poster asks how the collective past may shape experiences of dementia and possibilities for citizenship in the present. In Poland, practices of remembering involving collective memory can sustain personhood and foster ties of relatedness among people with dementia. This apparent paradox between people with dementia’s loss of memory and their capacity to build social relations based on remembering can be resolved through expanding understandings of personhood to include practices of remembering involving collective pasts (e.g., shared national frameworks, embodied practices of sociality). In Detroit, gardening fosters connections with the past, as older African Americans are reminded of deceased loved ones through practices and the plants themselves. These intimate connections and everyday activities are situated in racialized histories of migration, disinvestment, and “revitalization,” even as they provide the means to cultivate life in the present. This poster concludes that the potential for collective pasts to generate life in the present can become evident through ethnographic research among people with dementia, and in particular, through studying gardening among people with dementia.
Aging With HIV: Inflammation Is Associated With Pain, Poorer Physical Function, and Frailty
Authors: Derry Heather , Johnston Carrie , Burchett Chelsie , Siegler Eugenia , Glesby Marshall 
Published: December 2020

Abstract
With advances in antiretroviral therapies, people living with HIV have life expectancies similar to their HIV-negative peers. Yet, they experience elevated multi-morbidity that can compromise quality of life as they age. Links between inflammation and accelerated aging may inform interventions, but these links are understudied in older adults with HIV. We investigated cross-sectional relationships between inflammation, well-being, and geriatric syndromes among 161 HIV-positive older adults. Participants provided fasting blood samples (for serum cytokines and CRP) and completed surveys (MOS-HIV; falls) and cognitive (MoCA) and frailty assessments (using Fried criteria). Adjusted linear and logistic regression models tested relationships between inflammatory markers and age-related health outcomes, controlling for age, gender, BMI, race, comorbidity burden, statin use, and smoking status. 93% had suppressed viral load. 11% had CRP levels suggesting possible acute illness (&gt;10 mg/L) and were excluded from analyses. Participants with higher IFN-γ reported greater pain (p=0.003), greater cognitive complaints (p=.02), and worse physical function (p=0.04), than those with lower IFN-γ. Similarly, higher IL-6 levels were related to worse physical function (p=0.01) and slightly greater cognitive complaints (p=0.06), but were not significantly related to pain in adjusted models. Compared to those with lower IL-6, those with higher IL-6 levels were more likely to be frail (p=0.04). CRP was not significantly related to these outcomes. Six-month fall history and objective cognitive scores were not significantly related to the assessed inflammatory markers. Our results illustrate key, expected links between inflammatory processes, frailty, physical function, and pain among older adults with HIV.
Racial Disparities in Cognitive Functioning: The Mediating Role of Social Resources
Authors: Haq Kazi Sabrina , Penning Margaret 
Published: December 2020

Abstract
Despite frequent recognition of disparities in cognitive functioning between White and non-White older adults, the pathways or mechanisms through which race affects cognitive functioning have yet to be elucidated. The research questions addressed in this paper are: 1) Is there a relationship between racial minority status and cognitive functioning in middle and later life? 2) To what extent do social resources (i.e., social support, social networks, and social participation) mediate the relationship between racial minority status and cognitive functioning? 3) Finally, drawing on intersectionality theory, if social resources do mediate the relationship between racial minority status and cognitive functioning, to what extent is this mediation effect moderated by the interaction of gender and Socioeconomic Status (SES)? Using cross-sectional data drawn from the Canadian Longitudinal Study on Aging (CLSA) with a sample of over 50,000 Canadians (2010-15) aged 45 to 85 years, multivariate regression analyses (OLS, logistic, multinomial logistic) assess the mediating effect of social resources on the relationship between racial minority status and cognitive functioning. Controlling for age, gender and other relevant determinants, preliminary results reveal that racial disparities in cognitive functioning (i.e., lower cognitive test scores) exist in Canada and that this relationship is partially mediated by some indicators of social resources (e.g., functional social support, emotional social support). Our findings suggest the need for interventions targeted at increasing social resources for racial minority groups to cope with the risk of developing cognitive impairment in later life.
Older Adult Volunteers in Intergenerational Programs in Educational Settings Across the Globe
Authors: Lee Youjung , Kim Young-Mi , Bronstein Laura , Fox Vince 
Published: December 2020

Abstract
Volunteerism is a global phenomenon that aids multiple generations. Considering the positive evidence of volunteering among older adults and their desire for intergenerational engagement, it is important to explore older adult volunteers’ experiences in intergenerational programs with a specific focus on the cultural and social impacts of volunteering in educational settings in later years. Using a phenomenological qualitative approach, 43 interviews with older adult volunteers (23 in Korea and 20 in the USA) in intergenerational programs were conducted. Participants were recruited from the Beautiful Story Grandma (BSG) in Korea and the Foster Grandparent Program (FGP) in the USA in 2019. Due to the prescribed nature of the BSG, all of the Korean volunteers were female. The USA volunteers from the FGP included three African Americans, one Asian, and 16 White older adults. Two FGP volunteers were male. Korean participants lived primarily in Busan Metropolitan city (mean age: 63, range: 61-73). The USA volunteers were from urban/suburban areas New York State (mean age: 74, range: 60-84). Two major themes emerged from the interviews revolving around the role of culture and other demographics in the experience of volunteering: (1) Older adults experience benefits from volunteering to support the younger generation that transcend demographic and geographic differences; and, (2) distinctive cultural views of education lead to different experiences of volunteering in the two countries. The comparative research highlights the need for development of a model for culturally responsive practice with older adult volunteers in a global context.
Understanding Nursing Turnover: The Case of Home Health Care
Authors: Spetz Joanne , Bergman Alon , Song Hummy , Rose Amber , David Guy 
Published: December 2020

Abstract
Only a few studies of nursing turnover have examined post-acute home health care. This study examines factors that are associated with home health licensed nurse turnover using linked employee-level and patient-level data from one of the five largest home health companies in the US. The data include variables from human resources and payroll systems, visit logs, discharge records, physical and mental health assessments, care plans, and patient encounters and is organized at the employee-day level. We measured turnover using human resources data, including measures of voluntary and involuntary job separation, and from exit interviews that allow classification of whether turnover was associated with agency-related factors (e.g., pay, schedule, supervisor, coworkers) versus personal factors (e.g., family needs, relocation). In bivariate and multivariate analyses, explanatory variables included nurse demographics, patient population characteristics, and the degree to which nurses can delegate tasks to home care aides. We found a downward trend in turnover for licensed nurses between 2016 and 2019. Attrition in the first year was 34% for full-time nurses and 45% for part-time nurses, most of it occurring in the first 180 days of employment. The rate of voluntary turnover was nearly four times as great as involuntary turnover. We found that agency factors accounted for 26% of monthly turnover on average, while personal factors accounted for 74%. In states in which licensed nurses could delegate more tasks to home care aides, turnover rates were slightly higher than in states with little delegation.
Assessing the Impact of Older Americans Act–Funded Services on Caregiver Stress
Authors: Chubb Racheal , Wilmoth Janet 
Published: December 2020

Abstract
Funding for OAA programs that support caregivers and care recipients has steeply declined since 2010. This is potentially problematic given these programs provide services that may reduce caregiver stress. To better understand what and for whom caregiving services reduces stress, we used data from the National Survey of Older Americans Act Participants (NSOAAP) to estimate logistic regression models predicting caregiver stress. These models include the following measures: services provided to the care recipient, services received by the caregiver, and caregiver satisfaction with services received; caregiver health, age, race, and gender; and care recipient health, age, gender, relationship to the caregiver, and coresidence with the caregiver. The results indicate that caregivers who were satisfied with services were less likely to be stressed compared to those who are not satisfied with services. Those who received respite care and counseling services were less likely to be stressed than those who attended classes and training. Consistent with the literature, caregivers who reported better health or cared for someone in better health were less likely to be stressed. Caregivers were also more likely to be stressed if they provided help with medical care compared to ADLs or if they lived with the care recipient. Overall, the results underscore the importance of continued, and possibly expanded, OAA funding for caregiver support services, especially those that provide respite and counseling to individuals who are providing care to frail and co-residential older adults.
Caregiver Knowledge of Long-Term Services and Supports: Effects of Rurality and Support
Authors: Stratton Lauren , Richter Nichole , Shelley Mack , Margrett Jennifer 
Published: December 2020

Abstract
Caregivers often lack knowledge regarding available long-term services and supports (LTSS). Certain barriers, such as rurality and levels of social support, may contribute to a lack of knowledge and accessibility of LTSS. The Caregiver Beginnings Workshop, held in 12 communities throughout 11 counties in Iowa, was a one-time educational session created to increase knowledge and awareness of LTSS. Data were collected from pre- and post-tests completed during the workshop (N = 98). To assess caregivers’ initial knowledge of LTSS, a hierarchical regression model was estimated to examine knowledge of LTSS in caregivers as predicted by caregiver education, number of health problems in care recipient, relationship type, feelings of social support, and rurality. Results showed that rurality (β = 0.33, p = 0.047) and infrequent or no support (β = -0.30, p = 0.02) were significant predictors (R2 = 0.21), indicating that caregivers living in rural areas reported higher knowledge of LTSS and those who reported infrequent or no support reported less knowledge. Additional analyses examined county-level data to better understand the availability of community resources in rural areas. County-level variables (e.g., number of home healthcare services, education level, income, health status) were included in a regression model to predict knowledge of LTSS. The results indicated that median income (β = -0.32, p = 0.002) and an educational attainment of an associate’s level degree or higher (β = -0.30, p = 0.004) were significant predictors. Discussion focuses on the importance of support and accessible resources for caregivers in all geographic areas.
Challenges of Recruiting Caregiver and Care Receiver Dyads for a Randomized Clinical Trial
Authors: Fruhauf Christine , Schmid Arlene , Prabhu Neha , Swink Laura , Portz Jennifer , Leach Heather , Hidde Mary , Van Puymbroeck Marieke 
Published: December 2020

Abstract
The recruitment of participants for chronic disease clinical trial research is often challenging. Further complicating participant recruitment occurs when the intervention is dyadic (i.e., simultaneously includes both care receivers and caregivers or recruiting pairs of people). Despite the strong support in favor of dyadic interventions for certain chronic diseases (e.g., among cancer and stroke survivors and their caregivers), researchers have not systematically shared challenges and opportunities for dyadic recruitment. During the recruitment for a yoga and self-management education intervention for people with chronic pain and their caregivers, several steps were taken to recruit and screen potential participants for the study. In this presentation, we will provide an overview of common recruitment challenges for physical activity and chronic disease self-management studies as well as the actual challenges encountered and our procedures for overcoming these obstacles. We will present our consort figure with attention toward inclusion and exclusion criteria of both care receivers and caregivers. Additional discussion will include specific challenges encountered when recruiting and screening caregivers (i.e., after the care receiver has been screened). The need for innovative clinical trial research with caregivers and care recipient dyads is essential as new care practices continue to evolve and demands on health care utilization increase. Lessons learned from this study may prove useful for future researchers as they embark on developing and testing dyadic interventions among adults with chronic disease and their caregivers.