bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEIGHBORHOOD SOCIAL INTEGRATION, SOCIAL NETWORK, AND COGNITION: DOES THE INTERACTION EFFECT MATTER?
Authors: Chen Jenhao , Crimmins Eileen , Li Mengting , Dong XinQi 
Published: November 2019

Abstract
Social integration of neighborhoods and social network properties are associated with better cognitive function but the two factors are often investigated separately. This study examines the interaction between neighborhood social integration and quantity and composition of social network on cognitive domains by analyzing Population Study of Chinese Elderly, a population-based epidemiological study of over 3000 US Chinese older adults aged 60 and above in Chicago metropolitan. Regression results show that larger network size, volume of contact and smaller proportion kin and proportion co-resident were associated with higher level of global cognition. Higher sense of community was associated with higher level of global cognition. The interaction term of volume of contact and neighborhood cohesion was negative and statistically significant, suggesting the protective effect of volume of contact may decrease in high cohesion neighborhoods. Similar moderation effects were observed in specific cognitive domains, including episodic memory, working memory and executive function.
THE ASSOCIATION OF RESILIENCE AND SOCIAL NETWORKS WITH PAIN OUTCOMES AMONG OLDER ADULTS
Authors: Musich Shirley , Wang Shaohung , Slindee Luke , Kraemer Sandra , Yeh Charlotte 
Published: November 2019

Abstract
Depression, stress and poor sleep are associated with increased pain among older adults with chronic pain. Positive resources may help buffer the impacts of negative attributes on pain. Our primary objective was to determine effects on pain outcomes (severity; interference) of positive resources (resilience; social networks) on negative attributes among older adults with pain. The sample (N=15,000) came from older adults≥65 years with AARP®Medicare Supplement and AARP®MedicareRx plans (insured by UnitedHealthcare Insurance Company) with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis. Members received a survey assessing positive resources, negative attributes and outcomes of pain. Depression, stress, sleep, resilience, social networks, pain severity and interference were measured. Opioid and other medications were determined from claims. The population was propensity weighted to adjust for survey non-response; weighted to be generalizable to members with diagnosed pain. Multinomial logistic regression was used to determine associations of positive/negative attributes on pain. Among respondents (N=4,161; 29%), prevalence of pain severity and interference for no/mild, moderate and severe categories was 61%, 21% and 18% for severity and 67%, 16% and 17% for interference. In bivariate models adjusted for demographics/health status, negative attributes of depression, stress and poor sleep had stronger associations with pain severity and interference than moderating effects. In full multivariate models, the strongest associations with moderate and severe severity and interference remained depression, stress and sleep. Based on results, multidimensional pain management strategies should include management of depression, stress and poor sleep along with enhancement of positive resources and analgesics as needed for pain management.
HOME CARE SOCIAL WORKERS CLAIM MEDICARE IGNORES PATIENT NEEDS
Authors: Cabin William D 
Published: November 2019

Abstract
There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 29 home care social workers between January 2013 and May 2014 in the New York City metropolitan area. Results indicate social workers believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs. Policymakers are urged to consider adding coverage of SDOH to Medicare home health primarily through expanded social work coverage.
ELECTRONIC PERSONAL HEALTH RECORD USE AMONG ELDERLY CANCER SURVIVORS AND NON-CANCER SURVIVORS
Authors: Luo Yan 
Published: November 2019

Abstract
Background Electronic personal health records (ePHRs) are potential tools to improve clinical outcomes through increasing patients’ self-management. Although elderly people, especially elderly cancer survivors, is a growing population who can benefit from ePHRs, little is known about its utilization among the elderly, particularly among those diagnosed with cancer. Objective By applying Anderson’s Behavioral Model of Health Services Use, this study aims to examine and compare the associated factors with ePHRs use among elderly cancer survivors and non-cancer survivors. Methods The data collected from the 2018 Health Information National Trends Survey (HINTS) was analyzed. The level of access to ePHRs among the elderly were assessed. Predictors of ePHRs use among elderly cancer survivors and non-cancer survivors were compared by conducting multiple linear regression. According to Anderson’s Model, predisposing factors, enabling factors, and need factors were included in the statistical model. Results The overall use of ePHRs remained low among 577 participants (mean = .87, SD = 1.72, range from 0 to 4). Non-Cancer survivors reported lower ePHRs use (mean = .83, SD = 1.77, range from 0 to 4). Race/ethnicity, education, regular health care providers, health insurance, social support, and medical conditions were associated with ePHRs use among non-cancer survivors, while age, gender, social support, and self-reported health status were related to ePHRs use among cancer survivors. Conclusion This study suggests additional efforts to increase ePHRs utilization among the elderly, especially the elderly cancer survivors. The predictive findings reported in this study will contribute valuable implications to enhance the ePHRs use.
INTERNET USE AND NEGATIVE HEALTH PERCEPTIONS: THE MODERATING ROLES OF EDUCATION AND HEALTH LITERACY
Authors: Seckin Gul , Bell Valarie , Hughes Susan 
Published: November 2019

Abstract
There is a mixed support regarding the effect of Internet use on health and well-being. We estimated the extent to which e-health literacy predicted two domains of negative assessment of well-being: negative affect and self-reported experience of health problems. Respondents were randomly sampled from the largest national online probability-based research panel (N = 710). Hierarchical ordinary least squares regression analyses were employed for hypothesis testing. We computed interaction terms (e-health literacy x strain; e-health literacy x education; and education x strain) as determinants of negative subjective assessment of well-being. Older adults with higher levels of e-health literacy reported significantly more health information consumerism [(t (194) = 7.32, p ≤ .0001] but less strain in medical encounters [(t (194) = 2.92, p ≤ .004]. They reported less negative affect [(t (194) = 2.11, p ≤ .036] and more satisfaction with medical encounters [(t (194) = 4.70, p ≤ .0001]. The effect of perceived strain in medical encounters on negative affect was weaker among those with higher levels of education (β = -.314, p ≤ .01). Education had a significant moderating effect on the association between perceived strain in medical encounters and self-reported health problems, (β = -.550, p ≤ .05). Those who reported lower averages for e-health literacy but higher educational levels indicated lower averages on negative affect (β = -.597, p ≤ .05). Given that conventional methods of acquiring health-related information shift to the Internet, our study holds significant health and social implications for a rapidly growing Internet-connected older population.
CAREGIVER RESPONSES TO REMOTE ACTIVITY MONITOR ALERTS OF PERSONS WITH DEMENTIA
Authors: Zmora Rachel , Finlay Jessica M , Mitchell Lauren L , Gaugler Joseph E 
Published: November 2019

Abstract
The benefits of technology to alert family caregivers to the needs of persons with Alzheimer’s disease or related dementias (ADRD) are unclear. Previous research indicates that remote activity monitoring (RAM) system alerts can be alternately reassuring and highly stressful for caregivers. We conducted a parallel convergent mixed-methods analysis of 62 primary caregivers of persons with ADRD to evaluate the association between the number of alerts and caregiver outcomes after 6 months. We assessed caregiver-reported usability of the system as well as self-efficacy, sense of competence, and distress as primary outcomes. Linear regression models tested the association between the number of alerts and caregiver-reported usability and primary outcomes. The number of alerts declined over the first 6 months of system use and was not associated with a change in system usability or primary outcomes. Thematic analysis of caregiver-reported perceptions of RAM use simultaneously probed for more in-depth understanding of caregiver experiences of and feelings towards RAM. Preliminary analyses reveal that 28% of caregivers comments were positive, noting benefits such as early warning of health concerns and peace of mind. 34% of comments were neutral or mixed, and 38% were negative. Concerns included false alarms and accidental triggers, losing sleep due to alarms, and difficulties using the system. These findings help characterize the adjustment period to use RAM technology. The mixed-method results inform future research studies and applications of RAM systems so that researchers and caregivers can better understand the initial adjustment period, address concerns, and avoid discontinuing RAM use prematurely.
IDENTIFYING CARE ACTIVITIES THAT WERE SUPPORTED BY AMAZON ECHO FOR CARE PARTNERS AFTER ONSET OF COGNITIVE IMPAIRMENT
Authors: Madjaroff Galina 
Published: November 2019

Abstract
There are several important challenges when addressing the needs of older adults with cognitive impairment and their care partners including the potential for diminishing emotional well-being and loss of autonomy, which could potentially lead to a lower overall quality of life for both care partners (CPs). The motivation of this study was to identify the care activities that were supported by home based technology for care partners after the onset of cognitive impairment. This work was done through gathering multiple sources of qualitative and quantitative data, including mobile application dialogue history logs, pre and post interviews, user feedback groups and home visits. The technology deployed in the home of the care partners was a Voice User Interface Intelligent Agent, specifically the Amazon Echo with its intelligent agent “Alexa.” This technology was selected because it was not built from a traditional care model, yet embodies functions that could be used for all potential forms of care, including those that achieve a higher level of quality of life goals for care partners. From this study, we can further our understanding of how to deploy and design technology that shifts the perspective from “cure to care” with a focus on the older person and their lived experience, monitoring wellness, and not just addressing illness. Results and findings indicated that daily care activities of dyads that are seemingly fundamental are actually complex care activities that emerge from using the technology that support the care partners on multiple levels in satisfying multiple needs.
USE OF TECHNOLOGY BY FOUR DIVERSE COHORTS OF OLDER ADULTS: FINDINGS FROM THE CART STUDY
Authors: Wild Katherine , Mattek Nora , Sharma Nicole , Marcoe Jennifer , Wall Rachel , Kaye Jeffrey 
Published: November 2019

Abstract
Early studies of technology adoption and computer use identified a “digital divide” between older adults and the general population. As that gap has narrowed, other demographic variables have been identified as continuing to foster disparities in access to and use of computers and related technologies. For example, gender, socioeconomic status, education, and ethnicity have been recognized as predictors of computer use among community living older adults. The ORCATECH Collaborative Aging (In Place) Research Using Technology (CART) initiative was designed to develop and validate an infrastructure for research utilizing technologies to facilitate healthy and independent aging. The CART program tests innovative technology applications in four diverse populations: residents in low income, section 202 housing in Portland; isolated, rural veterans in the Pacific Northwest; urban African American seniors in Chicago; and socially isolated, ethnically diverse low income seniors in Miami. As part of their participation in the CART project, older adults complete an annual survey of health and technology use. A total of 214 participants were enrolled and agreed to have their homes instrumented with the CART platform of monitoring technologies. Across all four cohorts 166 answered the technology survey thus far: 82 - 97% of participants own a cell phone; 64 - 78% perform some online banking activities. There were no differences among cohorts in computer use or cell phone ownership, or in other measures of technology use. Inclusion of ethnically and economically diverse populations in future technology research will be critical in the development of effective digital health interventions.
EXAMINING DISCREPANCIES IN SOCIAL ROBOT VERSUS HUMAN ASSESSMENTS OF GERIATRIC WELL-BEING
Authors: Harrington Erin , Do Ha , Bishop Alex J , Reese-Melancon Celinda , Sheng and Weihua 
Published: November 2019

Abstract
Socially assistive robotic (SAR) technologies represent a viable tool for monitoring the safety and health of older adults. However, it is unclear whether SARs can comprehensively screen geriatric well-being as effectively as trained human clinicians. The purpose of this study was to compare SAR versus human assessment of geriatric well-being. Participants included 30 older adults (Mage = 73.40, SD = 7.88) who completed a robot-administered well-being assessment session during which human-administered evaluation was simultaneously performed. Standardized clinical screening assessment tools common in geriatric care were administered (e.g., Short Blessed Test (SBT), UCLA Loneliness Scale, Geriatric Depression Scale, PHQ-4, Iowa Fatigue Scale, Fall Risk). Multiple dependent sample t-tests were used to explore variability in assessment scores between SAR and human evaluation. Assessment scores significantly differed on several measures, including the SBT (t(29) = -9.33, p &lt; .001), UCLA Loneliness scale (t(19) = 2.37, p &lt; . 05), and fall risk assessment (t(29) = 3.03, p &lt; .01). Specifically, the SAR indicated that older adults were significantly more cognitively impaired, less lonely, and more likely to fall compared to the human administrator. Other observed differences and hypothesized explanations will be discussed in greater detail. The current study indicates that there is a divergence in geriatric assessment outcomes based on human versus SAR administration. Findings have implications relative to further developing SAR technology to align with human-based evaluations to enhance cognitive well-being, social connectedness, and falls prevention.
CROSS-COUNTRY COMPARISON OF INTERNET USE AND DEPRESSION BY GENDER: THE ROLE OF INTERGENERATIONAL FACTORS
Authors: Shim Hyunju , Ailshire Jennifer A , Crimmins Eileen 
Published: November 2019

Abstract
Technology may offer one approach to reducing depression as it provides medium to maintain connections (Cotton et al., 2014). Yet, depression, internet use, gender roles, and expectation of intergenerational interaction all differ across countries. Using nationally representative data from the U.S (Health and Retirement Study: HRS) and South Korea (Living Profiles of Older People Survey: LPOPS), the study examines 1) association between internet use and depressive symptoms by gender in two countries; 2) and whether intergenerational factors moderated this association. In the U.S., more than half of men and women aged 65+ used the internet, while approximately 30% of women and 47% of men used the internet in Korea. Using the internet was associated with lower depression for those living far from the closest child for women in the U.S., and for men in Korea. The findings indicate that the association of internet use on depressive symptoms can be influenced by intergenerational factors that may differentially affect men and women depending on the sociohistorical contexts.
CALL A TEENAGER . . . THAT’S WHAT I DO!: GRANDCHILDREN HELP OLDER ADULTS USE NEW TECHNOLOGIES
Authors: Portz Jennifer D , Fruhauf Christine , Bull Sheana , Boxer Rebecca S , Bekelman David , Casillas Alejandra , Gleason Kathy , Bayliss Elizabeth 
Published: November 2019

Abstract
As older adults increasingly show interest in technology for their well-being, families will play an important role in promoting the adoption and use of beneficial health technologies. The purpose of this study was to conduct a sub-analysis of data collected from a large-scale qualitative project regarding older adults’ experiences using health information technology. Specifically, the sub-analysis explored older adults’ experiences with technology support from family members to inform strategies for promoting older adult engagement with new health technologies. While the primary analysis of the original study was theoretically driven, this paper reports results from the inductive, open-coding analysis. Twenty-four older patients (≥65 years) with multiple chronic conditions (Charlson Comorbidity Index &gt; 2) participated in a focus group conducted at patients’ primary clinic. While conducting the primary theoretically-driven analysis, coders also utilized an open-coding approach to ensure important ideas not reflected in the theoretical code-book were captured. Open-coding resulted in a primary theme, “family support”, that was furthered categorized by who and how the tech-support was provided. Participants were not specifically asked about family support, yet family assistance and encouragement for technology emerged from every focus group. Participants repeatedly mentioned that they called their grandchildren and adult children for help with technology. Participants also reported that family members experienced difficulty when teaching technology use. Family members struggled to explain simple technology tasks and were frustrated by the slow teaching process. Family support, specifically via grandchildren, may have a key role in the successful adoption and use of emerging health technologies.
IT’S MY BUDDY: EXPLORING THE PERCEPTIONS OF PEOPLE WITH DEMENTIA ABOUT THE SOCIAL ROBOT PARO IN A HOSPITAL SETTING
Authors: Hung Lillian , Chaudhury Habib 
Published: November 2019

Abstract
New technology such as social robots opens up new opportunities in hospital settings. PARO, a robotic pet seal, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perceptions of persons with dementia about PARO’s role in a hospital setting. Video-ethnographic methods were applied. We had conversational interviews with and video observations of 10 older people with dementia in the geriatric unit of a large Canadian hospital. Also, semi-structured interviews and two focus groups were conducted with 10 staff members in the local unit to gain contextual information. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”—the robot helps people with dementia uphold a sense of self in the world; (b) “it’s a conversation piece”—the baby seal facilitates social connection; and (c) “it’s all about love”—PARO transforms and humanizes the clinical setting. Our findings help provide a better understanding of the direct perspectives of patients with dementia on the use of social robots. Instead of substituting human contact, the social robot complements emotional care and supports our fundamental human need for love.
AN INNOVATIVE DATA-DRIVEN FALL PREVENTION COMMUNICATION TOOL FOR ADMINISTRATORS, NURSE MANAGERS, AND STAFF NURSES
Authors: Bjarnadottir Ragnhildur , Lucero Robert 
Published: November 2019

Abstract
Falls are the leading cause of injury among older adults, resulting in 3 million emergency department visits and 800,000 hospitalizations each year in the United States alone. In the hospital setting, falls are among the most common adverse events, causing longer stays and higher costs of care. Substantial efforts have been made to reduce falls in the past decade but with limited sustained effect. This may in part be due to limitations of existing tools for fall-risk assessment and evidence-based fall prevention. Therefore, there is a need to strengthen the evidence on risk factors for hospital-acquired falls and address barriers to translating the best available evidence into practice. To this end, we undertook the development of an innovative dissemination tool to implement fall-related evidence generated through state-of-the-art data science and information visualization approaches. Through a multidisciplinary academic-clinical partnership, we have developed an infographic to disseminate empirical evidence to nurses and administrators in the hospital setting. The infographic was developed based on principles of user-centered design and persuasive communication, and focuses on providing clear and accessible information about factors contributing to a patients’ risk of falling in the hospital. This innovative dissemination approach is intended to foster dialogue between administrators, mid-level nursing management and staff nurses as well as evidence-based practice at the bedside. Future use and evaluation of this fall prevention tool will focus on adapting the infographic as an interactive digital tool for education and engagement of patients and families in the hospital setting.