bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to Achieve the Desired Outcomes of a Complex Intervention in Nursing Homes: A Theory of Change
Authors: Dichter Martin , Hylla Jonas , Berg Almuth , Eggers Daniela , Möhler Ralph , Meyer Gabriele , Köpke Sascha , Halek Margareta 
Published: December 2020

Abstract
Background Recent systematic reviews suggest the effectiveness of complex psychosocial interventions to reduce sleep disturbances in people with dementia (PwD) living in nursing homes. However, it is unclear how and under which circumstances these interventions work and which components and processes are crucial determinants for effectiveness. Objectives To develop a Theory of Change (ToC) that describes a causal chain for the reduction of sleep disturbances. Design and Methods The ToC approach is a participatory method in intervention development to generate knowledge about how, why, and under which circumstances interventions are effective. We conducted two expert workshops, a subsequent expert survey (n=12), a systematic literature review, and expert interviews (day and night nurses). Results Necessary preconditions for the reduction of sleep disturbances were identified on staff, management and cultural levels of nursing homes. Intermediate goals like “individual knowledge on PwD is available”, “a specific institutional concept to promote sleep is implemented”, “person-centred care is implemented” and “sleep preferences of PwD are fulfilled” were defined. The intermediate goals, interventions, promoting and inhibiting factors as well as rationales were sorted into a causal chain. All intermediate goals were rated as relevant or highly relevant based on the expert survey. Conclusions The ToC model displays how a complex psychosocial intervention is likely to be effective in reducing sleep disturbances and meeting sleep preferences of PwD in nursing homes. The model is the basis for the development and evaluation of a planned complex psychosocial intervention to prevent and reduce sleep disturbances in PwD.
Social Relationships and Alcohol Abuse in Older Ages
Authors: Vogelsang Eric 
Published: December 2020

Abstract
In an aging world, researchers and practitioners often extol the health benefits of social relationships (e.g., family ties, social participation) for older adults. Yet, they generally ignore how these same bonds and activities may contribute to negative health behaviors, such as alcohol use and abuse. Using data from the Wisconsin Longitudinal Study (16,065 observations from a cohort of 7,007 respondents), I examine how family structure, family history, and participating in certain social activities predict alcohol consumption and symptoms of alcoholism between ages 53 and 71. I find that having children and taking part in two particular social activities (meeting friends and group exercise) are associated with problematic drinking behavior. Moreover, religious participation and ever living with alcoholics were associated with reporting negative alcohol consequences, but not with alcohol consumption itself. These findings contextualize the increasing rates of alcohol abuse among older adults.
What’s Driving SNF Readmission Rates? Exploring Differences in Processes Between High and Low Performing Hospitals
Authors: Manges Kirstin , Ayele Roman , Lee Marcie , Leonard Chelsea , Galenbeck Emily , Burke Robert 
Published: December 2020

Abstract
Despite the increasing national focus on improving post-acute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this rapid ethnographic study was to observe processes used to prepare older patients for post-acute care in SNFs, and to explore differences between hospital-SNF pairs with high or low thirty-day readmission rates. We stratified hospitals according to readmission rates from SNF and used convenience sampling to identify two high and two low performing sites and associated SNFs (n=5). We conducted intensive multi-day observations (n=148 hours) and key informant interviews (n=30 clinicians) to describe hospital processes for discharging patients to SNF. We used thematic analysis of interviews and fieldnotes to identify differences in transitional care processes of hospitals discharging patients to SNFs. Hospitals used five major processes prior to SNF discharge that could affect care transitions for older adults: recognizing the need for post-acute care, deciding level of care, selecting SNF facility, negotiating patient fit, and coordinating care with SNF. During each stage, high-performing sites differed from low-performing sites by focusing on: 1) earlier, ongoing, systematic identification of high-risk patients; 2) discussing the decision to go to a SNF as an iterative team-based process; and 3) anticipating barriers with knowledge of transitional and SNF care processes. Identifying variations in processes used to prepare patients for SNF provides critical insight into the best-practices for transitioning patients to SNFs and areas to target for improving care of older adults.
Lessons From Whakapapa and Filial Piety: Can Social Work Capitalize on the Connection That Survives Death?
Authors: Park Hong-Jae 
Published: December 2020

Abstract
Ageing is part of life, and so is death. Although death will involve all of us over time, it is often regarded as a taboo topic, and bonds with the dead are seldom acknowledged in contemporary times. The paper presents selected insights on the connection that survives death, learned from a qualitative study on two indigenous knowledges—whakapapa (genealogical connections in Maori) and filial piety (respect/care for ancestors). Data were collected from interviews with 49 key informants (Maori=25; Korean=24) in 2018/19 in New Zealand and South Korea. The research findings indicate that the connectedness with ancestors or deceased loved ones is a significant part of the participants’ mental and social lives. Māori (the first nation people of New Zealand) have established the unwritten convention of whakapapa as the core value that places whānau (family) at the centre of social relationships. In Korean culture, its filial piety/ancestor veneration tradition has emphasised the connection between deceased and living family members. Criticism about the traditions of whakapapa and filial piety was also raised by a few participants. The significance of this study is situated in the innovative perspective that the post-mortem relationship can be embodied, not only by the living who practise memorial respect for the dead, but also by those older people who establish after-life legacy before death. To help capitalise on this whakapapa connection, the so-called concept of “memorial social work” is presented as a potential area of social work practice, which has critical implications in the ageing/end-of-life related fields.
Qualitative Interview Analysis: Unpacking Packed Interviews
Authors: Silver Michelle 
Published: December 2020

Abstract
Retirement is an ever-evolving, dynamic, and complex social construct we associate with the end of one’s career. Exploring what retirement means to different people can contribute to a better understanding of the implications of this important transition at the individual and societal level. However, sifting through participants stories is not always a straightforward endeavor, particularly in the case when participants have something to hide. This paper examines the value of qualitative research methods in unpacking complex personal narratives. As the landscape surrounding mature workers’ experiences continues to change, this paper extends policy debates about retirement, as well as scholarly conversations about the richness and complexity of qualitative research.
Association Between Medication-Related Problems and Emergency Room Visits Among Community-Dwelling Older Adults
Authors: Zhu YuJun , Meyer Marsha , Likar Denise , Enguidanos Susan 
Published: December 2020

Abstract
Medication-related problems (MRPs) remain one of the largest health risks for older adults, yet there are few studies that identify the complete myriad of problems associated with medication use among community-dwelling older adults with chronic diseases. The aim of this study is to identify the range and quantity of MRPs among community-dwelling older adults and determine the relationship between number of MRPs and emergency room (ER) visits. Primary data were collected from a community medication program for diverse older adults (N=206). A comprehensive medication review was conducted to identify MRPs including adverse drug reaction, inappropriate storage, and non-adherence. We conducted multivariate logistic regression to examine the relationship between the number of MRPs and ER visits controlling for health conditions and demographic information including age, gender and race. The mean age of participants was 74.2 (SD=8.8) and 65% were female. Racial groups include Whites (39%), Blacks (21%), Hispanics (29%) and Asian/Pacific Islanders (11%). On average, participants had 5.3 (SD=2.3) health conditions and 18.8 (SD=5.9) MRPs, among which adherence (36%) and coordination of care (28%) were most commonly identified. About 30% had at least 1 ER visit in the previous 6 months. The number of MRPs was significantly associated with ER visits (OR=1.08, p=.03). Older adults experienced a variety of MRPs and for each problem experienced, the odds of having an ER visit increased by 8%. Interventions are needed to assess the myriad of MRPs among community-dwelling older adults and address those potential risks.
Elder Abuse and Neglect: Training First Responders in Rural Arkansas to Recognize, Respond, and Report
Authors: McAtee Robin , Claar Valerie , Spradley Laura , Thomasson Whitney 
Published: December 2020

Abstract
As the incidence of elder abuse and neglect continue to rise and plague our country’s older adults, it is imperative that their plight is recognized, reported and elicits an appropriate response. At least 1 out of 10 older adults suffer from at least one type of abuse each year (DOJ, 2020) and only 1 in 24 cases of elder abuse is ever reported to authorities (National Center on Elder Abuse, 2019). Since 41% of Arkansas’ population live in rural areas, reaching and educating first responders who work in these areas is a priority, yet has been a challenge. It has been ascertained that virtually no elder abuse or neglect related training for first responders occurs in Arkansas. In 2015, the Arkansas Geriatric Education Collaborative (a HRSA Geriatric Workforce Enhancement Program) developed an education program and mobilized it to multiple first responder groups including the AR State Police, multiple city and county paramedics’ organizations, EMTs, local police officers and fire fighters. The program was further enhance late in 2019 when the training was made available on-line in conjunction with dementia training. The content and methods of training and test results revealing knowledge gained will be reviewed. Follow-up stories from first responders who have put their training into action in the field will be told as they reveal how they have used their training to identify potential abuse, neglect and self-neglect cases and how they have recognized, reported and addressed specific cases.
Piloting the Adult Protective Services’ Identification, Services, and Outcomes Matrix: Focus Group Findings
Authors: Yeh Jarmin , Liu Pi-Ju , Perkins Jacques , Butler Andrew , Stratton Sara , Conrad Kendon , Conrad Karen , Iris Madelyn 
Published: December 2020

Abstract
The historical lack of outcomes-related data in Adult Protective Services (APS) has affected funding coming to the program. Without data quantifying the effectiveness of APS services, policymakers have been unable to justify budget increases to improve wages for workers or professionalize the field. For the first time in APS history, the U.S. Administration for Community Living sponsored a pilot project to implement a novel evidence-based assessment tool into APS electronic systems, called the Identification, Services, and Outcomes (ISO) Matrix. The goal was to improve APS’ ability to reduce harm of abuse and neglect and maintain client’s independence to live in the community. APS workers in San Francisco and Napa Counties were trained and phased into using the ISO Matrix over a six-month implementation period. This poster presents findings from six focus groups conducted between February 13 and March 28, 2019, with 34 San Francisco and Napa County APS workers and supervisors. Utilizing semi-structured, in-depth interviewing techniques, APS workers and supervisors expressed their views and experiences. Facilitators and barriers of implementing the ISO Matrix were assessed and opportunities for improvements were identified. Findings revealed a tension between their hopefulness that the ISO Matrix could modernize APS data-tracking and yield evidence of improved client outcome to bolster the field, and their frustrations about new burdens the ISO Matrix placed on their labor and workflow. Understanding frontline perspectives of APS workers and supervisors has practical and policy implications for adopting the ISO Matrix in other counties and states across the U.S.
A Scoping Review of Aging in Place: Is the Current Literature Inclusive of African American Women?
Authors: Tucker-Seeley Reginald , Davis Carlene , Ahazie Jubilee , Robi Matti , Steinberg Leora 
Published: December 2020

Abstract
Approximately 80% of adults aged 50+ report a desire to stay in their homes as long as possible, or to “age in place.” Yet, as the US aging population becomes more racially and ethnically diverse, the frameworks used to describe “aging in place” will require explicit recognition of the issues specific to racial/ethnic minorities. For example, given the intersection of historical discrimination related to race, gender, age, and lower socioeconomic status, older African American women are at increased risk for poor health outcomes as they attempt to “age in place.” We conducted a scoping review of “aging in place” studies in the US (N=479), to determine whether current “aging in place” frameworks included issues relevant to racial/ethnic minorities generally, and African American women, specifically. Our inclusion criteria for articles were as follows: 1) a definition of “aging in place”; 2) a conceptual framework related to “aging in place” and/or 3) the incorporation of racial/ethnic minorities generally and African-American women specifically in the research sample. We adapted the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) framework for our review to search the PubMed database for “aging in place” studies. After applying our inclusion/exclusion criteria (N=244), the findings from our review showed that approximately 40% of studies included an explicit definition of “aging in place” (N=100), but few studies focused on African American women (N=20). Future studies on “aging in place” should consider the unique challenges that African American women face as they navigate the challenges of “aging in place.”
Creating an Age-Friendly Community in Affordable Housing Using a Resident Health Risk Assessment Focused on the 4Ms
Authors: DeGennaro Jennifer , Pomerantz Sherry , Avallone Margaret , Handberry Melonie , Perweiler Elyse 
Published: December 2020

Abstract
The NJGWEP team in partnership with Fair Share Housing/Northgate II (NGII), an affordable housing complex in Camden, NJ, employed an iterative quality improvement process to collaboratively develop a Resident Health Risk Assessment (RHRA) to meet the needs of the housing facility and incorporate the essential elements of the 4Ms framework (Mentation, Medication, Mobility, and What Matters). Using the RHRA, NG II social services staff and Rutgers School of Nursing (RSoN) students were trained to collect health information and administer several evidence-based screening tools (i.e., MiniCog, TUG, PHQ-2). A final element of the RHRA still in development is the documentation process of referral and follow-up based on personalized care plans. Since July 2019, 43 RHRAs have been completed (60% female, mean age 66, age range=43 to 88). Almost all residents (94%) have at least 1 chronic condition (HTN, DM, COPD, CHF), although only 26% have an advance care plan. Most (81%) were screened for future fall risk; function (ADLs/IADLs) was assessed for all (100%). Every resident who was able or did not refuse (88%) was screened for cognitive impairment. Just 7% were taking a high-risk medication (i.e., an opioid or benzodiazepine). The NJGWEP team has initiated an age-friendly community at NGII by providing education on geriatric-focused topics and implementing the 4Ms-focused RHRA to detect issues impacting the resident’s well-being. Establishing a follow-up process to track referrals to available resources will enable NGII to allow residents to age in place with appropriate supports.
Factors That Influence Length of Membership in a Customer-Driven Organization: A Village
Authors: Cho Joonyoung , Dunkle Ruth , Harlow-Rosentraub Karen 
Published: December 2020

Abstract
Membership is a critical feature of the survival of customer-driven organizations. As a membership-driven organization based on neighbors helping neighbors, many Villages express difficulty in having enough members and lack confidence in sustainability. This is the first study examining the association between length of membership and motivation for becoming a Village member. ShareCare, the first Village, was founded in 1994. We used an open-ended questionnaire to gather information from a representative sample of current Sharecare members (N=100). Three researchers were involved in coding responses with discrepancies resolved via collaborative discussion. Length of membership was categorized as: less than 10-years, and more than a 10-year membership. Motivations to join membership in ShareCare were categorized as: instrumental, social, and altruistic. We conducted three separate logistic regressions with covariates controlled to examine associations between length of membership and various motivations to become a ShareCare member. While the most frequent reason for joining was instrumental where the member would receive service (e.g., care coordination, and home visit), the least motivation for joining was altruism, where the member could help other members (e.g., running errand, and lawn care). More than a 10-year membership was not associated with social or instrumental motivation to join ([OR] 0.50, p = 0.27, [OR] 0.94, p = 0.95) whereas more than a 10-year membership was associated with altruistic motivation to join ([OR] 5.31, p = 0.02). Our findings provide guidance regarding motivating members to join and maintain membership in a consumer-driven organization.
Creative interventions: increasing enrollment, serving students & community, reaffirming gerontology education
Authors: Abushakrah Jan , Faber Mike 
Published: December 2020

Abstract
The session will focus on innovative ways to increase student enrollment, better meet the needs of students and the communities served, and raise awareness of the crucial role of gerontology education in addressing the needs of a rapidly aging society. A panel of Community College and University gerontology professionals will share the innovative ways that they are working to address the three focus areas of this symposium. We will also include opportunities for discussion with participants about their experiences with and ideas for addressing these issues. Community College Interest Group Sponsored Symposium.
Strategies to Overcome Enrollment Barriers
Authors: Cummins Phyllis 
Published: December 2020

Abstract
The importance of postsecondary education for economic vitality and individual opportunity has received increased focus with over 40 states embracing postsecondary attainment goals for their populations in alignment with Lumina Foundation’s goal that 60% of individuals ages 25-64 have a recognized credential by 2025. Credentials that both meet the needs of an aging society and move the country towards achieving attainment goals are widely available at community colleges. Community colleges are not only important sources of training and education for adult learners, they also work closely with employers to meet their workforce needs. However, adult learners face many barriers to college enrollment, including poor pre-enrollment advising and lack of understanding of financial aid options. Examples of successful strategies to facilitate enrollment will be discussed, including navigators who serve as holistic advisors and work with students from pre-enrollment to graduation, and also guide the prospective student through the financial aid process. Part of a symposium sponsored by the Community College Interest Group.
Advocacy Training as a Way to Increase Dementia Literacy Among College Students
Authors: Kuo Tsuann 
Published: December 2020

Abstract
In 2017, WHO passed the Global Action Plan on Dementia and declared the effort to increase dementia literacy around the world. Although dementia is mostly associated with older adults, the prevalent rate of the early on-set and the need to take care of people with dementia has mostly fallen on younger family members. Therefore, the purpose of this paper is to develop an intervention aiming to increase dementia awareness among college students. Through training and action plans, 85 university students from 9 different departments formed 12 groups to develop creatively and to conduct advocacy or public education in various communities. A questionnaire of pre- and post-test was conducted after students had completed their action plans. The response rate was 86% and the results were three-folds: (1) 31% of the students had someone in the family with dementia; (2) 35% of the students indicated that they were familiar with dementia; and (3) the pre- and post-scores on dementia awareness (p&lt;0.001) and dementia attitudes (p&lt;0.001) had significant improvement. This study demonstrated that there is a need to start the effort to increase dementia literacy because one-third of college-age students might be potential caregivers for their family loved ones with dementia. Preparing the students before graduating from college is a good entry because they can become health professionals to take better care of dementia patients and their family members. In conclusion, policy and practice implications will be discussed so the communities can become more dementia friendly in the future.
The Development of a Stakeholder Member Organization to Advocate for Geriatrics Education
Authors: Waters Leland , Perweiler Elyse 
Published: December 2020

Abstract
The National Association of Geriatric Education Centers organization was established in 1990, to promote interdisciplinary geriatric education and to provide a unified voice for Geriatric Education Centers (GECs). In 2005, the GECs voted to form two non-profit organizations due to restrictions related to lobbying activities. An umbrella organization was created, the National Association for Geriatric Education, that includes all geriatric related education programs, and maintain a lobbyist in Washington DC to protect the GECs interests. It was a pivotal time, as we had a year (2006) without federal funding that summarily dismantled the DHHS-HRSA geriatrics programs, including the entire GEC network, the geriatric fellowship program, and Geriatric Academic Career Awards. This resulted in a GEC-wide and national geriatrics movement that succeeded in restoring the geriatrics line item in the President’s budget. Our advocacy efforts not only had the line item restored, but obtained an increase in funding for geriatrics.