bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE AND MANAGEMENT OF HYPERTENSION AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA
Authors: Cheng Jianjia , Choi Jungtae , Li Lydia 
Published: November 2019

Abstract
The study aimed to examine hypertension prevalence and management in China. Data were from a national survey of a probability sample of 45+ in China (N = 17,047). Self-reported hypertension diagnosis and readings from electronic blood pressure monitors were used to create four variables: diagnosed, measured (&gt;=140/90 as high), undiagnosed, and overall (diagnosed + undiagnosed) hypertension. Respondents with diagnosed hypertension were asked about medication use, blood pressure monitoring, and lifestyle advice from doctors; and were considered inadequate blood pressure control if having measured hypertension. Weighted descriptive statistics and multivariate logistic regression were conducted. The prevalence of diagnosed, measured, undiagnosed and overall hypertension was 27%, 37%, 14%, and 51%, respectively. Across all four, older age adults, women, and urban residents had higher rates. Among hypertensive patients, 82% took anti-hypertensive medications, 91% monitored blood pressure, 60% received lifestyle advice, and 53% had inadequate blood pressure control. Compared to the 45-54 years old, the 75+ was less likely to receive lifestyle advice (OR=0.63, 95% CI=0.43-0.95) and the 65-74 was less likely to have adequate control (OR=0.75, 95% CI=0.73-0.98). Men were less likely to use medications (OR=0.77, 95% CI=0.63-0.95) but more likely to receive lifestyle advice (OR=1.48, 95% CI=1.23-1.78) than women. More education and urban (vs. rural) were associated with better hypertension management and control. In conclusion, hypertension affects half of the middle-aged and older population in China. More than half of hypertensive patients have inadequate blood pressure control. People who are older, women, low-educated, and rural residents are disadvantaged in hypertension management.
EXERCISE EFFECTS ON WELL-BEING ON CANADIAN WOMEN OVER THE AGE OF 65
Authors: Bardutz Holly A , Corley Constance 
Published: November 2019

Abstract
Two groups of Canadian women, over the age of 65, were interviewed (n = 20) in a study focused on brain health. The first group (n = 12) regularly attended exercise classes and met the exercise standards of the Canadian Society of Exercise Physiologists for the age group over 65 years for at least six months. Women in the comparison group (n = 8) had been taking adult education classes twice a week or more for at least six months. Thematic coding was used to analyze the results. Both groups reported benefits from their participation in their respective groups. However, the results show that the group who exercised regularly consistently reported improved mood, increased mental alertness, a better ability to handle stress, less pain, and improved sleep. These factors were not reported by the non-exercise group, which did benefit by gaining new knowledge, making new friends and feeling good because they were learning new things. This study suggests that Canadian women over the age of 65 who have been exercising regularly report many of the effects of exercise on the brain that are beneficial to their well-being. They did not specifically mention the new brain cells being made (neurogenesis) nor did they note neuronal rewiring (neuroplasticity), however they did self-report some psychological benefits that the Comparison Group did not report, as noted above. This research has implications for both practice and research.
ASPIRIN BENEFIT IS NOT AFFECTED BY BODY WEIGHT IN HEALTHY OLDER PERSONS
Authors: Woods Robyn L , Polekhina Galina , Nelson Mark , Wolfe Rory , Ernst Michael E , Murray Anne M , McNeil John 
Published: November 2019

Abstract
Recent meta-analysis (Rothwell et al, Lancet 2018;392:387-99) of aspirin trials in predominantly middle-aged people suggested that aspirin’s effects on clinical outcomes vary according to dose and body weight, concluding that under dosing in heavier people may be responsible for reduced efficacy of aspirin. Data from ASPREE (ASPirin in Reducing Events in the Elderly; randomized primary prevention trial of low dose aspirin versus placebo in 19,114 healthy older participants, mainly aged 70+ years) were analyzed for interaction of body habitus on the main outcomes after 4.7 years of study treatment. Increases in body weight, BMI or waist circumference (WC) did not influence cardiovascular endpoints or incident cancers in the aspirin group compared with placebo. In ASPREE men, an increase of 10 kg body weight elevated the risk of major hemorrhage with aspirin (HR 1.20; 95% confidence interval 1.01-1.43; P=0.04) and 10 cm increase in WC elevated all-cause mortality by 23% with aspirin (HR 1.23; 95% confidence interval 105-1.44; P=0.01), driven by cancer-related deaths (HR 1.39; 95% confidence interval 1.11-1.73; P=0.004). These effects of increased abdominal girth were not seen in women. Evidence from ASPREE does not support increasing the dose of aspirin in larger older people to improve the drug’s efficacy. Our results point to a link between central adiposity, hemorrhage risk and cancer-related death in older men taking aspirin.
HEALTH INTERVIEWING IMPROVES THE MEDICAID HOME AND COMMUNITY-BASED SERVICES HOME CARE AIDE-CLIENT RELATIONSHIP
Authors: Danilovich Margaret , Johnson Rebecca E , Diaz Laura , Boyken Lara 
Published: November 2019

Abstract
We investigated the feasibility of a Medicaid Home and Community-based Services home care aide (HCA) led health interview with clients (n=21) during usual care services provided by a single provider. We provided interview training in English and Spanish and HCAs (n=21) conducted five interviews using a card sort methodology to elicit client care preferences. The interviews consisted of five topics relative to care: 1) food and drink, 2) physical activity and mobility, 3) self-care, 4) home environment, and 5) how I spend my time. HCAs audio-recorded interviews and photographed card sorts for analysis. We conducted semi-structured interviews by telephone with clients and focus groups with HCAs, to evaluate the health interviewing experience. We transcribed interview recordings and evaluated fidelity to the health interview script. We administered the Your Health Orientation, Willingness to Communicate, and PROMIS-global health to clients and the Active Empathetic Listening Scale to HCAs. We used t-tests to investigate changes in survey outcomes pre and post interviews. Results show it is feasible to train English and Spanish speaking HCAs in a simple, health interviewing technique to elicit care preferences from clients. Doing so contributes new knowledge on client preferences. Clients desire HCAs who provide empathy, compassion, and motivation, and HCAs observed that interviewing clients helped them to better understand their care recipient’s needs. Future work should determine how embedding health communications training as part of orientation to client care, would influence HCA retention rates, as well as modify client health outcomes.
SURROGATES’ DECISION-MAKING CONFIDENCE AND COLLABORATIVE WILLINGNESS ON THE POST: THE ROLE OF SOCIAL NORMS
Authors: Spalding Rachael , Wilson Jenna , Edelstein Barry 
Published: November 2019

Abstract
When patients become incapacitated due to illness or frailty, “surrogates” work with patients’ providers to make medical decisions on their behalf. In surrogate decision-making situations, surrogates’ decision-making confidence predicts collaborative willingness, or the extent to which they are willing to work with the patient’s providers when making decisions (Spalding & Edelstein, under review). In an attempt to explain this finding, the current study examined whether perceived social norms for patient-physician collaboration and another psychological variable, consideration of future consequences, mediated the relation between decision-making confidence and collaborative willingness. Participants (n= 172) from Amazon’s Mechanical Turk completed self-report measures and a hypothetical surrogate decision-making task. A parallel multiple mediation analysis using 5000 bootstrapped samples with the PROCESS macro (Hayes, 2013) was conducted. The overall model explained 43.4% of the variance in collaborative willingness, F(4, 166) = 9.59, p&lt; .001. There was a significant indirect effect of decision-making confidence on collaborative willingness through perceived social norms (b= .068, SE= .034, 95% CI [.014, .154]). There was not a significant indirect effect through consideration of future consequences. After including the significant indirect path through perceived social norms, the direct effect (b= .348, p&lt; .001) of decision-making confidence on collaborative willingness was reduced (b= .243, p= .003). Thus, perceptions of social norms partially accounted for the relation between decision-making confidence and collaborative willingness. This finding illustrates how social perceptions of patient-provider collaboration can facilitate desirable medical decision-making behaviors, such as collaboration.
DOES THE ASSOCIATION BETWEEN AGE AND MAJOR ILLNESS VARY BY NATIONAL HEALTHCARE QUALITY?
Authors: Andersson Matthew A , Wilkinson Lindsay R , Schafer Markus H 
Published: November 2019

Abstract
Though the risk of chronic disease and disability accelerates once adults are in their 60s, 70s, and 80s, researchers have long suspected that economic, social, and institutional variation — even among high-income Western nations — may powerfully influence the likelihood that people remain healthy at advanced ages. This study builds on comparative research into global aging, by offering a multiple-indicator test of whether national healthcare quality modifies the association between age and major illness. Recent individual-level data on morbidity among respondents aged 50 or older (16 countries; 2014 European Social Survey) are merged with nation-level healthcare indicators. Healthcare quality is assessed using a subjective, evaluation-based approach (based on the 2011 International Social Survey Programme) and an objective, attributable-mortality approach (2010 Healthcare Access and Quality, based on the Global Burden of Disease Study). Lagged nation-level economic and health indicators are controlled to help isolate healthcare effects. Multilevel logistic and linear regression models of any major health condition and morbidity reveal that while older individuals showed approximately a 10% reduction in probability of major illness when residing in countries with higher healthcare quality, associations between age and morbidity indices combining number and severity of illness showed greater modification by healthcare quality, with reductions around 18%. Results across subjective and objective approaches to healthcare quality are strikingly consistent. Taken together, results are suggestive of healthcare’s protective role in reducing age-related illness and disability. Future research should illuminate pathways by which healthcare quality may lead to differences in healthy aging among advanced nations.
THE EFFECT OF SENSE OF COHERENCE ENHANCEMENT PROGRAM BASED ON SALUTOGENESIS FOR ELDERLY WITH METABOLIC SYNDROME
Authors: Yun Jungmi , Park Hyoung Sook 
Published: November 2019

Abstract
This study aimed to develop and verify a sense of coherence (SOC) enhancement program based on salutogenesis for elderly with metabolic syndrome. This study was a quasi-experimental study. The inclusion criteria were patients with metabolic syndrome aged 60 or over who visited the outpatient department of a university hospital and a public health center located in an urban area. The intervention group (n=24) attended the SOC enhancement program. The health promotion theoretical framework, salutogenesis, provided the program structure and conceptual framework of this study. This program included comprehensibility, manageability, and meaningfulness which were core concepts of salutogenesis and consisted of multiple tailored behavior interventions composed of education, Tai-Chi exercises, individual activities, self-monitoring, self-help groups, and individual counseling. This program was provided once a week over 10 weeks, but Tai-Chi exercise was conducted twice a week. The control group (n=25) was provided with general health information once. The interactions between groups and measurement time showed significant differences in self-efficacy (p=.001), perceived social support (p&lt;.001), SOC (p&lt;.001), health behavior (p=.010), and the physical health-related quality of life (p=.001). The metabolic-related physiological indicators showed significant improvement in total cholesterol (p=.004) and LDL-cholesterol (p=.009). This study showed that the SOC enhancement program strengthened the self-efficacy, social support, and SOC in the elderly with metabolic syndrome, improved the health behavior, and was effective in improving some metabolic-related physiological indicators. Based on the results of this study, I suggest to expand the scope of the sense of coherence program and conduct the intervention longer.
PARTICIPANTS’ PERCEPTIONS OF A COMMUNITY-BASED DANCE PROGRAM
Authors: Bewernitz Megan R , Freiberger Cari 
Published: November 2019

Abstract
Parkinson’s disease (PD) is a progressive disease that targets many aspects of the nervous system, both motor and non-motor functions. Dance as an intervention provides a creative outlet that can be more motivating than other interventions by allowing people an opportunity for not only increased movement and activity, but also socialization. Creative expression through dance also has the potential to improve not only motor capabilities like balance, but also non-motor aspects like self-efficacy, cognition, and quality of life. For the community program described in this presentation, dance faculty led the dance and choreography components of the program while an occupational therapist (OT) served to maximize options for adaptations, safety, and accessibility. OT faculty also led efforts in gathering and analyzing data regarding community participation and program design utilizing a qualitative approach by conducting semi-structured interviews with five participants (four with PD, one with hydrocephalus, all over age 65) in the program. Content analysis of the data suggests some emerging themes which include: 1) forming common bonds and making friendships within the class due to PD diagnosis and similar enjoyment of the class, 2) increased appreciation and enjoyment of music, 3) appreciation of dance instruction, and 4) how transportation options, or lack thereof, impact participation in the class. These themes will assist in informing future program delivery with the hopes of reaching a larger contingent of the community who may also be interested in dance.
MAINTAINING HEALTHY LIFESTYLE: RACIAL AND GENDER DIFFERENCES IN PHYSICIANS’ ADVICE TO OLDER ADULTS
Authors: Iqbal Asif , Oladimeji Abolade , Kahana Eva , Kahana Boaz 
Published: November 2019

Abstract
Older adults are often excluded from physicians’ preventive health promotion recommendations. The influence of patient race and gender on the physician-patient relationship in maintaining good health has been extensively researched, but little is known about the influence of patient race and gender on physicians’ health promotion advice to the elderly. This study explored whether patient race and gender influence primary care physicians’ health promotion advice to older adults. The sample of 536 respondents (µage = 75.51, 75.2% female) was obtained from a NCI funded study of “Health Care Partnerships in Cancer Prevention and Care of Aged. Respondents were randomly selected community dwelling older adults who attend Senior Center programs, sponsored by Area Agencies on Aging (AAA) (Kahana, Lee, Kahana, Langendoerfer, & Marshall, 2015). Multivariate logistic regression analyses were used to control for sociodemographic and health factors while accounting for a complex sampling design. African American patients had greater odds than whites for receiving recommendations to eat a healthy diet (OR = 1.62) and exercise more (OR = 1.83). Elderly women reported fewer recommendations to eat a healthy diet (OR = .81) & exercise more (OR = .45) than did men. Notably, respondents of both races and genders believed that maintaining a healthy lifestyle is very effective. These findings demonstrate that African American and female older adults receive differential health promotional advice from physician and suggest the need for raising physician awareness about the value of prevention advice for all patients.
ACCEPTABLE CHARACTERISTICS OF INTERVENTIONS FOR MIDDLE-AGED HISPANIC MEN: RESULTS FROM KEY INFORMANT INTERVIEWS
Authors: DerAnanian Cheryl , Vega-Lopez Sonia , Valdez Hector , Vega-Soto Shandel , Delgado Ferdinand , Hooker Steven 
Published: November 2019

Abstract
Hispanics are the fastest growing segment of the aging population. Little is known about acceptable intervention approaches for Hispanic men. Purpose: To explore perceptions of acceptable intervention characteristics for middle-aged Hispanic men. Methods: Eighteen key informants (KIs) with expertise in delivering programs to the Hispanic community participated in semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. Themes were identified using a grounded theory approach. Results: “Cultural sensitivity/competency” or “biculturalism” were fundamental characteristics of an acceptable intervention (n=17 KIs). KIs indicated program facilitators need to understand and relate to the culture, and to establish the trust of the community by demonstrating mutual understanding, respect and dignity. Facilitators must be bilingual and use the same level of language as the participants. KIs highlighted the importance of the literacy level of the materials and indicated intervention content should tap into the participants’ unique cultural experiences. Including the family in the intervention, especially the spouse or partner, was considered essential for engaging the men (n=18 KIs). The KIs consistently indicated an intervention should be in-person, in either a group (n=7 KIs), one-on-one (n=5 KIs) or hybrid (group and individual; n=6) format. Only text messaging (n=10 KIs), phone calls (n=5 KIs), and Fitbits (n= 7KIs) were perceived as acceptable forms of technology for an intervention. Finally, the intervention needs to be appealing (N=5KIs), interactive (n=8KIs), and safe, fun and supportive. Conclusion: The KIs identified several important culturally relevant considerations when developing interventions for Hispanic men. Funded by the National Institute on Aging (R21 AG050084-01A1).
STRATEGIES TO INCREASE MINORITY PARTICIPATION IN A HEALTHY AGING AND NEIGHBORHOOD STUDY
Authors: Churchill Linda C , Siden Rachel , Aguirre Annabella , Ruiz Marline , Cheng Jie , Clarke Anthony , Kane Kevin , Li Wenjun 
Published: November 2019

Abstract
Adequate minority participation is critical to health disparity research. Conventional direct mails are less effective in minority recruitment. The Healthy Aging and Neighborhood Study developed a multifaceted, community-engaged, culturally and linguistically appropriate method to recruit community-living older adults (≥65y) in Worcester County, Massachusetts. The research team is bilingual, racially and culturally diverse. A direct mail campaign was conducted in a geographically diverse random sample of residents from neighborhoods with high concentrations of minorities, stratified by rurality. To increase minority participation, the mailings included an invitational letter or a flyer with a graphic that portrays diverse racial/ethnic background. We engaged communities by presenting the study at senior and community centers, and faith-based organizations that are frequented by minorities and by posting study information in minority social media groups (e.g., Chinese resident associations). Participants promoted the study to friends while staff promoted through professional or social networks. To recruit non-English speaking minorities, all materials were printed in age-friendly large fonts in Spanish or Chinese, and interviews were conducted using their preferred language. Within 9 months, we enrolled 326 participants, including 216 Whites, 57 Hispanics, 21 Blacks, 31 Asians, and 1 Native American. An additional 38 Asians are on the waiting list. Blacks were more likely to respond to community presentations. Hispanics were most likely to respond to the colorful flyer. Older minorities (&gt;76y) were more likely to respond to presentations (57%) while the younger (&lt;75y) to the mailings (60%). In summary, this multifaceted recruitment approach is effective in minority recruitment.
FOOD ASSISTANCE PROGRAMS AND REDUCED HOSPITALIZATIONS FOR OLDER ADULTS WITH DIABETES
Authors: Johnson Monyca L , Walsh Sarah E 
Published: November 2019

Abstract
Diabetes is a an increasingly common and costly condition for older adults. Each year, as many as 1 in 3 Medicare dollars is spent to treat and manage diabetes and associated comorbidities for people with diabetes. To control health care spending in the US, it is imperative that we identify factors for reducing hospitalizations for these individuals. We used data from round five of the National Health and Aging Trends Study to identify predictors of hospitalization in the past 12 months for Medicare recipients ages 65 and older with diabetes. Previous research on the social determinants of health has demonstrated that social stressors like poverty and exposure to racism are associated with poorer health outcomes overall, but we did not find a statistically-significant association between race, gender or Medicaid dual-eligibility and hospitalization for our study population. Notably, receipt of SNAP benefits, Meals on Wheels services or other food assistance was associated with a 43% reduction in the risk of hospitalization in the past 12 months. As previous research has linked food insecurity with poorer medication adherence among individuals with Type II diabetes, food assistance programs appear to be an effective strategy for reducing hospitalizations associated with diabetes and its comorbidities.
RACIAL DIFFERENCES IN CONTEMPLATIVE PRACTICES IN LATER LIFE: EXAMINING THE ROLE OF SES AND HEALTH DISADVANTAGE
Authors: Lekhak Nirmala , Bhatta Tirth , Goler Timothy 
Published: November 2019

Abstract
Substantial scholarly attention has been placed on prayer as a buffer of life events’ adverse influences on well-being in later life. The disproportionate distribution of adverse life events among Black adults has also attracted scholarly interest in racial differences in contemplative practices. Black adults have been found to more likely engage in private prayer than White adults, whereas studies have observed an opposite pattern for meditation. The contribution of stratification in socioeconomic status and health to racial differences in contemplative practices, especially in meditation has received relatively less attention. Drawing from a subsample from Health and Retirement Survey (N = 1102), this study takes a next necessary step to assess the contribution of socioeconomic status, multimorbidity, and depressive symptoms to racial differences in both prayer and meditation use in later life. Consistent with prior studies, the odds of engaging in private prayer (OR=2.78, p&lt;0.01) was higher among Blacks than White older adults. Our findings of higher odds (OR=2.92, p&lt;0.001) of meditation among Black older adults than White older adults, however, do not align with previous studies. The disadvantage in socioeconomic status, health, and psychological well-being completely explain racial differences in prayer, but this difference in meditation persist even after adjusting for those factors. Our findings call for further research on contextually influenced underlying individual motivations that drive older adults of different racial and social economic groups to engage in various contemplative practices. Further research is also warranted on how older adults, particularly Blacks differentiate between private prayer and meditation.