bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Racial and Ethnic Disparities Among Older Adults in Long-Term Care Facilities
Authors: Lee Kathy , Mauldin Rebecca , Connolly John , Tang Weizhou 
Published: December 2020

Abstract
Background: Nearly half-million older adults from minority racial and ethnic groups in long term care face disparities in quality of life and quality of care. However, there is little information about the associations between a resident’s race/ethnicity and the types of official complaints lodged. Methods: This project was a mixed methods study using a sequential explanatory design to examine ethnic and racial differences in types of complaints and rates of complaint resolution in a local Ombudsman Program. First, resident race/ethnicity and complaint data were collected from the Ombudsman Program and analyzed. Then, we conducted focus groups with Ombudsman Program staff and volunteers to provide a more complete interpretation of findings from the first phase. Results: Residents from ethnic/racial minority groups were less likely to generate Resident Care complaints and more likely to generate Resident Rights complaints, compared to non-Hispanic White residents (p&lt;.05). Resident Rights, Quality of Life, and Administrative complaints were less likely to be disposed satisfactorily, compared to Resident Care complaints (p&lt;.05). Themes emerged from our qualitative findings include language barriers and more efforts required for residents’ rights due to concerns raised more frequently among minority residents. Implications: Cultural competence training for Ombudsmen as well as care professionals should focus on skills and knowledge that value diversity, understand and respond to their unique concerns. Ombudsmen play an important role as they create an avenue for the residents to discuss their concerns. Implementation research may improve our understanding of the development and delivery of the Ombudsman Program.
Sex Difference in Self-Reported Sexual Functioning Among Frail Older Adults
Authors: Olivieri-Mui Brianne , Shi Sandra , McCarthy Ellen , Kim Dae 
Published: December 2020

Abstract
Frailty may differentially impact how older adult males and females perceive sexual functioning, an important part of well-being. We assessed the level of frailty (robust, pre-frail, frail) for anyone with data on 11 sexual functioning questions asked in wave 2 of the National Social Life, Health, and Aging Project, 2010-2011 (n=2060). Questions covered five domains: overall sexual function (OSF), sexual function anxiety (SFA), changes in sexual function (CSF), erectile/vaginal dysfunction (EVD), and masturbation. Logistic regression identified sex differences in frailty and reporting worse sexual functioning. Linear regression predicted the number of domains reported as worse. Among males (n=1057), pre-frailty meant higher odds of reporting SFA (OR 1.8 95%CI 1.2-6.6), CSF (OR 1.7 95%CI 1.1-2.7), and EVD (OR 1.5 95%CI 1.0-2.2). Among females (n=1003), there was no difference in reporting by frailty. Females were more likely to report worse OSF (Robust: OR 7.4, 95%CI 4.8-11.4; Pre-frail: OR 6.2, 95%CI 3.9-9.9; Frail: OR 3.4 95%CI 1.7-6.6), but less likely to report SFA (Robust OR .3, 95%CI .2-.5; Pre-frail OR .2, 95%CI .1-.3; Frail OR .2 95%CI .1-.3). Pre-frail and frail females reported fewer domains as worse (Pre-frail coefficient -0.21 SE 0.09, Frail -0.43 SE 0.14). As frailty worsened, males reported more domains as worse (Pre-frail 0.24 SE 0.07, Frail 0.29 SE 0.08). Self-reported sexual functioning differs by sex at all levels of frailty, and reporting by males, but not females, changes with frailty. Providers should be aware that sexual functioning is of importance to both sexes despite varying degrees of frailty.
Sexual Expression in Old Age: A Qualitative Study
Authors: von Humboldt Sofia , Ribeiro-Gonçalves José Alberto , Costa Andrea 
Published: December 2020

Abstract
Objective: This study aims to analyze how older adults express themselves sexually. For this purpose, a qualitative research was carried out, which analyzes their perspectives at a cross-national level. Methods: Four hundred and ninety five older participants aged 65 to 98 years, were interviewed. Participants were of three different nationalities and lived in the community. All the interviews went through the process of verbatim transcription and subsequent content analysis. Results: Results of content analysis produced nine themes: Tender and care (k = .91, p &lt; .01); altruism and gratitude (k = .81, p &lt; .01); attractiveness (k = 94, p &lt; .01); positive communication (k = .89, p &lt; .01); sexual activity (k = .88, p &lt; .01); good health and physical condition (k = .96, p &lt; .01); supportive relationship (k = .84, p &lt; .01); eroticism (k = .94, p &lt; .01); and feeling active and alive (k = .92, p &lt; .01). Conclusions: This study stressed different ways on expressing sexuality in old age and underlined the importance of tender and care and eroticism for older adults who are sexually active. Keywords: Content analysis; older adults; qualitative study; sexual expression.
Exploring Application of Smart Companion Robots to Facilitate Faith-Based Ministries for Older Homebound Adults
Authors: Adebayo Christianah , Bishop Alex 
Published: December 2020

Abstract
This study examined perceptions regarding application of smart robot companions to facilitate homebound religious ministry programming to older adults. A total of N= 7 participants consisting of ministers, pastoral volunteers, and older adult members from Methodist, Presbyterian, and Roman Catholic traditions engaged in a 60-minute focus group. One key goal was to address the question: If you could design a robot for ministry to homebound older adults what would you want it to do? All responses were recorded, transcribed and coded for thematic content. Three core themes emerged relative to spiritual privacy, prospective intervention, and inclusive monitoring. Relative to spiritual privacy, participants expressed concern regarding robotic ability to maintain the spiritual privacy of the older homebound adult, especially when engaged in faith-based behaviors such as private prayer, confession, and pastoral counseling. Second, participants suggested that a robot companion serve as a memory aide for older homebound members. In particular, participants acknowledged a need for robot intervention relative to sending alerts concerning prayer requests, reminders of upcoming church-related events, and notices concerning future homebound ministry visitations. Finally, participants indicated an interest for the robot to actively monitor community inclusion, noting that many older homebound adults are left out of weekly church-related services or events and experience seclusion, yet most “retain a desire be included and remain an integral part of their faith community.” Results will be used to present a conceptual model for a smart robotic faith assistant designed for delivery of homebound ministries to older adults.
Long-Term Care Financing for an Aging Population: The Experience of Singapore
Authors: Chia Ngee Choon , Cynthia Chen Huijun 
Published: December 2020

Abstract
Singapore has a rapidly aging population. Long-term care (LTC) is one of the largest financial risks facing elderly in Singapore. Singapore implemented Eldershield, a long-term care insurance scheme which provided defined cash benefit payouts in the event of severe disability; but capped at a maximum of six years. Eldershield enrolled people at age 40, but offered an opt-out option. As of 2015, 65% of those aged 40 to 83 opted to be covered by Eldershield, making Singapore as having the highest voluntary LTC insurance rate in the world. This paper uses an actuarial multi-state disability model and calibrates the transition probabilities and duration-of-stay at various health (disability) states to assess the adequacy and comprehensiveness of Eldershield. The time-limited cash benefit design in Eldershield helped defray about 13% of LTC costs. Removing the time cap will help defray 23% and 26% of the LTC costs for elderly male and female respectively. Furthermore, the simulation results demonstrate that relaxing the trigger benefit and having staggered payouts will improve the adequacy of long-term care insurance. The experience of Singapore’s LTC insurance offers insights into the challenges of designing an insurance that tends to occur at higher age and insuring against a cost that could range from zero to a significantly large sum over a long period. Even with the enhanced Careshield Life, which provides cash payouts for life, other policy designs, for example caregiver grants, may be needed to ensure more adequate financing of long-term care.
Patterns of Internet Use, Loneliness, and Mental and Physical Health Among Korean Baby Boomers
Authors: Kim Jeehoon , Kim Jwakyum , Lee Ji Hyun , Han Gyounghae 
Published: December 2020

Abstract
Introduction. Korean Baby Boomers are more affluent and gained higher education than past generations. Their relatively younger age (born between 1955 and 1963), coupled with more personal resources can help the Boomers have easier access to digital devices, but little is known about their patterns of online activities and how diversity in online activities is associated with health status among Korean Boomers. Methods. Using data from the 2012 Korean Baby Boomers Panel Study (n=3,272), we conducted latent class analysis based on ten online activities. Three classes were identified with different patterns of online activities; namely, maximizers (n=315), selective users (n=1,435), and rare users (n=1,522). Multinomial logistic regression analysis was performed to examine factors associated with different groups. Ordered probit regression and multiple regression analysis were employed to predict depressive symptoms and self-reported health of Korean Boomers, respectively. Results. Selective users used the internet for information search, e-mail, SNS, streaming music, or gaming, whereas maximizers engaged actively on all activities. Rare users were minimally engaged in information search. Both selective users and maximizers were more actively engaged with social relationships and social group activities compared to rare users. Maximizers were more likely to experience loneliness than rare users. Selective users were less likely to report depressive symptoms and had better health than rare users. Discussion. Moderate engagement with digital technology supported Korean Boomers in maintaining social relationships and better health. Intervention strategies for alleviating loneliness and preventing social isolation for maximizers, thus helping them maintain better health, will be discussed.
Social Isolation and Its Related Factors in Participants of a Senior Citizens’ College in Japan
Authors: Uchida Hayato , Fujiwara Yoshinori , Matsuura Shinro 
Published: December 2020

Abstract
The aim of this study was to clarify the social isolation and its related factors of participants in senior citizen’s college in Japan. The participants were 104 persons (age 73.3+/-4.3) aged sixty-five years or over living in Hyogo Prefecture, Japan. They were the students of a senior citizens’ college established by Himeji City, Hyogo Prefecture in 1981. We conducted a cross- sectional study that included age, family structure, employment status, financial status, self-related health, presence of chronic disorders, instrumental activities of daily living, dietary variety score (1-10). The mental health well-being was assessed using the Japanese version of the World Health Organization Mental Health Well-being Index-five items (WHO-5). We defined social isolation as seeing friends or relatives less than two or three times a month. We carried out the survey in November in 2019. Selected variables were compared after dividing the participants into “socially isolated group” and “not socially isolated group”. A t-test, a chi-square test, and logistic regression analysis were conducted to examine the related factors of social isolation in this study. Of the 104 participants who were analyzed for social isolation, 21 (20.2%) were found to be socially isolated. From the results of multivariate logistic regression analysis, “lower mental health” (OR=4.013, 95%CI=1.745-10.435) and “lower self-related health” (OR=2.583, 95%CI=1.103-9.564) were independently associated with social isolation. These results suggest that, to prevent the social isolation of the participants in senior citizen’s college in Japan, it is necessary to develop and implement the approach which promote mental health and self-related health.
Associations Between Subjective Age, Contact With Older Adults, and Age Stereotypes Among Younger Adults
Authors: Kurth Maria , Intrieri Robert 
Published: December 2020

Abstract
Subjective aging (SA) has generally focused on middle-age and older adults in relation to physical and psychological health for the last 70 years (see Barak & Stern, 1986). Kornadt et al. (2019) recently called for more research examining: co-development of age stereotypes and SA, and this association across the lifespan. Literature examining SA and age stereotypes among younger adults is limited and suggests that age stereotypes are not directly associated with SA (Packer & Chasteen, 2006). Increased contact with older adults, however, is associated with less ageist attitudes (Bousfield & Hutchinson, 2010). This study examined SA and the associations between contact frequency and ageism. The sample consisted of 467 undergraduate students (Mage = 21.48, SDage = 2.63). Subjective age was assessed by asking How old do you feel compared with others your age?, and was scored on a 5-point scale from younger all the time (5) to older all the time (1). Ageism was assessed with the Aging Semantic Differential (ASD), which contains four factors. Results showed significant effects across felt age for contact frequency (F(4, 406) = 3.841, p = .004). Results for the ASD factors were mixed with Autonomy and Integrity showing significant effects for SA (F(4, 405) = 2.763, p = .027; F(4, 405) = 2.773, p = .027 respectively). Instrumentality and Acceptance were nonsignificant. Results suggested feeling older all the time is related to more contact, but more negative attitudes- this increased contact might providing priming for more ageist attitudes (Eibach et al., 2010).
Cross-Validation of a Scale to Measure Contact With Older Adults
Authors: Intrieri Robert , Kurth Maria 
Published: December 2020

Abstract
According to Allport (1954) intergroup contact would reduce prejudice that in-group members would experience toward out-group members. Allport also theorized that positive intergroup contact would follow after four conditions were met: (a) equal group status within the situation, (b) common goals, (c) intergroup cooperation, and (d) the support of authorities, law, or custom. While contact with older adults is a principal influence on attitudes toward older people, there is a paucity of adequate contact measures. This study assessed the cross-validity of the factor structure of an instrument to measure contact with older adults. The convenience sample consisted of 470 participants (61% male) from an undergraduate student subject pool (M = 20.67, SDtotal = 3.37). Participants were predominantly Caucasian (n=176, 48.9%), African American (n=103, 28.6%), and Hispanic/Latino/a (n=51, 14.2%). Results of a confirmatory factor analysis showed the three-factor model exhibited a reasonable fit to the data □□ (41, n = 360) = 191.797; p&lt;.0001, CFI =.971; TLI =.961; RMSEA = .101 (90% CI, 0.087-0.116) SRMS = .042. An additional model examining the relationships between a single indicator of contact frequency and the three-factor COA scale revealed similar fit statistics □□ (41, n = 360) = 191.797; p&lt;.0001, CFI =.967; TLI =.955; RMSEA = .092 (90% CI, 0.079-0.105) SRMS = .044. The findings provide clear and consistent evidence across independent samples that the covariances among the items are best explained through a latent structure that consists of three meaningful factors (“General Contact”, “Positive Experience, and “Negative Experience”).
Asian American Older Adults and Social Isolation: A Systematic Literature Review
Authors: Kwon Simona , Min Deborah , Chong Stella 
Published: December 2020

Abstract
Asian Americans are the fastest growing racial and ethnic minority group in the United States, whose population is aging considerably. Previous studies indicate that social isolation and loneliness disproportionately affects older adults and predicts greater physical, mental, and cognitive decline. A systematic literature review using PRISMA guidelines was conducted to address this emerging need to understand the scope of research focused on social isolation and loneliness among the disparity population of older Asian Americans. Four interdisciplinary databases were searched: PubMed, CINAHL, PsycINFO, and AgeLine; search terms included variations on social isolation, loneliness, Asian Americans, and older adults. Articles were reviewed based on six eligibility criteria: (1) research topic relevance, (2) study participants aged &gt;60 years, (3) Asian immigrants as main participants, (4) conducted in the United States, (5) published between 1995-2019, and (6) printed in the English language. The search yielded 799 articles across the four databases and 61 duplicate articles were removed. Abstracts were screened for the 738 remaining studies, 107 of which underwent full-text review. A total of 56 articles met the eligibility criteria. Synthesis of our review indicates that existing research focuses heavily on Chinese and Korean American immigrant communities, despite the heterogeneity of the diverse Asian American population. Studies were largely observational and employed community-based sampling. Critical literature gaps exist surrounding social isolation and loneliness in Asian American older adults, including the lack of studies on South Asian populations. Future studies should prioritize health promotion intervention research and focus on diverse understudied Asian subgroups.
Pneumococcal Pneumonia Vaccination Among Older African American and Hispanic Men With Chronic Conditions
Authors: Smith Matthew , Sherman Ledric , Cauley Daunte , Badillo Brittany , Goidel R Kirby 
Published: December 2020

Abstract
The CDC estimates that 70% of adults ages 65 years and older received the pneumococcal pneumonia vaccination (PPV). However, documented PPV rates are substantially lower for men, especially non-white men. This study examined common and unique factors associated with PPV among racial/ethnic minority men age 65 and older with one or more chronic conditions. Data were analyzed from a national sample of 470 African American (n=267) and Hispanic (n=203) males using an internet-delivered questionnaire. Two binary logistic regression models were fitted to compare factors associated with PPV. On average, participants were age 70.1(±4.5) years and reported 3.9(±2.6) chronic conditions. PPV rates were 56.8% and 43.2% among African American and Hispanic males, respectively. Across models, men who received vaccines for influenza (P&lt;0.001) and shingles (P&lt;0.01) were more likely to receive the PPV; whereas, those who reported more disease self-care barriers were less likely to receive the PPV (P&lt;0.05). Among African American males, those who were widowed (OR=3.80, P=0.022) and had an annual eye examination (OR=3.10, P=0.001) were more likely to receive the PPV; whereas, divorced/separated men were less likely to receive the PPV (OR=0.33, P=0.003). Among Hispanic males, those who took more medications daily (OR=1.36, P=0.005), reported higher disease self-management efficacy (OR=1.15, P=0.011), and had a colon cancer test in the past 12 months (OR=3.55, P=0.007) were more likely to receive the PPV. Findings suggest the need for culturally tailored education and self-management interventions to increase PPV and preventive healthcare service utilization among older racial/ethnic minority men.
Caregiver Relationships and Distress Moderated by Collectivism
Authors: Kim Eunbea , Rogers Mary , Szkody Erica , McKinney Cliff 
Published: December 2020

Abstract
The number of older populations raising their grandchildren has increased. Past research has indicated the distress custodial grandparents’ experience is related to their family relationships (Hayslip, Shore, & Emick, 2006). Family relationships are also influenced by a variety of factors such as social history, culture, family structure, and individual differences (Uhlenberg & Kirby, 1998). The current study evaluated the influence of culture on the relationship between caregiver relationship quality and mental health by examining 885 children (18-25 years; M=18.93). This study also compared the difference in cultural impact between custodial grandparents-grandchildren and biological parents-children. Measures included the Network of Relationships Inventory, Hofstede Cultural Questionnaire, and Adult Behavior Checklist. Path analysis was conducted using AMOS 26.0 which resulted in an interaction between relationship closeness and collectivism to predict custodial grandparent depressive symptoms. Custodial grandparents who reported a lower level of closeness with their grandchildren in a higher collectivistic culture reported a significantly higher level of depression symptoms than those in a more individualistic culture, particularly for custodial grandmothers. However, custodial grandparents who reported a higher level of closeness with their grandchildren in a higher collectivistic culture reported significantly lower levels of depressive symptoms than those in a more individualistic culture. Furthermore, compared to biological parents, custodial grandparents reported significantly lower levels of depressive symptoms when reporting higher collectivistic culture. These findings will inform the need for more research to assess factors of cultural features that reduce psychological problems and support family relationships to adapt psychological therapies in older adults.
Oregon's Behavioral Health Initiative for Older Adults and People With Disabilities at 5 Years: Where to From Here?
Authors: Dawson Walter , Stodola Allyson , Hasworth Serena , Kyler-Yano Jason , Winfree Jaclyn , Dreyer Linda 
Published: December 2020

Abstract
Oregon’s Behavioral Health Initiative for Older Adults and People with Disabilities is entering its fifth year. This novel state-level Initiative seeks to better coordinate services and resources for older adults and people with disabilities who have behavioral health needs by assigning a Behavioral Health Specialist (BHS) for every 60,000 adults 65 + and embedding them within local service agencies around Oregon. BHS primary job functions include improving coordination and collaboration between local service agencies, providing complex case consultations (CCC), and delivering workforce development training and community education. Five years of data from Portland State University’s Institute on Aging’s ongoing evaluation of the Initiative suggests significant impact in terms of workforce development trainings, community education, and new community partnerships. Data are collected from BHS and Initiative stakeholders (e.g., aging services agencies). Data collection tools include quarterly reports from the BHS, including a CCC reporting instrument; semi-structured interviews with stakeholders assessing Initiative involvement; and an electronic post-training survey (and two-month follow-up survey) for stakeholders attending BHS trainings. After five years, the evaluation appears to show the Initiative has delivered an abundance of innovative collaborations, workforce trainings, and educational opportunities aimed at better supporting the behavioral health of older Oregonians. It also highlights several persistent systemic barriers including a need for additional public funding of behavioral health, the challenges of accessing Medicare for behavioral health, and siloed agencies and organizations. Future evaluative efforts could explore adding outcomes-based assessments of the Initiative, including local-level quality improvement projects initiated by BHS within their communities.