bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Assessment of Attendee Experiences With a Workshop to Reframe Aging-Related Communications
Authors: Chesser Stephanie , Porter Michelle 
Published: December 2020

Abstract
The Centre on Aging at the University of Manitoba adapted the FrameWorks Institute’s Gaining Momentum toolkit into an interactive workshop that was delivered to aging-related stakeholders (e.g., health professionals, educators, researchers, advocates, older persons) across the province of Manitoba, Canada. The purpose of this study was to complete a qualitative assessment of attendee experiences with the workshop and its impact, if any, on their aging-related communication behaviors. Study participants recruited from four communities (two urban, two rural) completed two telephone interviews—one approximately two weeks and one approximately three months post-workshop—about their experiences, motivations for attending, and short and long-term communication goal setting. Through the interviews, most participants expressed positive experiences with the workshop content, as well as an enjoyment of its interactive elements (e.g., self-introduction activity, reframing short and long form aging-related communications, group feedback). Several also shared specific examples of how workshop content was influencing their short/long-term aging communication strategies. Some participants, however, also identified ways that local culture could impact the interpretation of and, thus, potential success of workshop language and/or framing recommendations in specific communities. Overall, the findings from this study suggest that the Gaining Momentum workshop was a valuable experience for attendees that inspired critical assessment of, and changes to, the ways they communicated about aging in their professional and personal lives. Future research is warranted to explore the ways its content could be adapted to better meet the unique communication considerations within the province of Manitoba (e.g., cultural, geographic, and language-related implications).
Spatial Analysis of Healthcare Offer and Request for Older People Aged 65 Years and Over in Quebec
Authors: Duc Juliette , Barbat-Artigas Sébastien , Bosson-Rieutort Delphine 
Published: December 2020

Abstract
With years, the health-needs of an individual become numerous and more complex, resulting in the requirement of an even more appropriate offer of health services. However, it is known that different factors make the services and the request of the population to health care unequally, especially the interregional variations. These are represented by a gap between the offer of healthcare and the need of the populations. The aim of this study was 1) to map the relationship between the location of the healthcare services in Quebec and population aged 65 years and over, and 2) to identify the characteristics related to the geographic variations in access to healthcare. We used data from “statcan.gc.ca”, “donneesquebec.ca” and “msss.gouv.qc.ca” regarding the facilities, their capacity, their services, and the populations’ characteristics. Analyses were performed on QGIS and R software. As expected, our results showed that there is a gap between the healthcare needs and the services: older people need a large amount of diverse services which are not always provided by secluded areas. Moreover, it also appeared that the deprivation index is related to the offer of health care. As this project takes part in a global project studying the health care trajectories of older people in Quebec using their administrative health databases, those findings will help better understand the impact of the geographic factors for the interregional variations of healthcare.
Impact of Age on Community Diabetes Prevention Program Attendance and Weight Loss Goals
Authors: Napoleone Jenna , Strotmeyer Elsa , Miller Rachel , Devaraj Susan , Rockette-Wagner Bonny , Arena Vincent , Venditti Elizabeth , Kriska Andrea 
Published: December 2020

Abstract
The Diabetes Prevention Program (DPP) lifestyle intervention demonstrated that meeting the weight loss (WL) and activity goals prevents/delays type 2 diabetes. Older DPP participants, 60-85 years, reduced the risk of developing diabetes by 71% versus 58% in those &lt;60 years. Currently, community translated DPP-based lifestyle interventions including Group Lifestyle Balance (DPP-GLB), are reimbursed by Medicare for overweight/obese older adults with prediabetes. This effort examined the impact of age group (60-65: reference, 66-70, ≥71 years) on both DPP-GLB maintenance session attendance (months 7-12) and achieving the 5% WL goals at 6- and 12-months. Data were combined from two identical 12-month DPP-GLB intervention trials involving overweight/obese adults with prediabetes and/or metabolic syndrome. Participants ≥60 years attending ≥4 sessions (months 0-6), with complete data on session attendance and WL were included (n=145; age=68.7 + 5.8 years, range 60-88; 79% women). Participants aged 66-70 years (N=46) were more likely to meet the 6-month 5% WL goal (67.4%) vs. 60-65 years (N=51; 45.1%; p=0.03). Participants aged 66-70 (69.6%) and ≥71 years (N=48; 60.4%) were more likely to meet the 12-month WL goal vs. 60-65 years (35.3%; 66-70: p=0.0007; ≥71: p=0.01). Maintenance attendance did not vary by age group with approximately 30% of each group attending ≥4 of 6 maintenance sessions (p=0.55). In conclusion, adults 66+ vs. 60-65 years more successfully met the clinically meaningful 5% WL goals at 6 and 12 months. With nationwide implementation of community-based “real-world” DPP-GLB lifestyle interventions, better understanding of program success across older adult age groups will enhance program reach and effectiveness.
Moderating Effect of Race and Ethnicity Between Technology Use and Social Isolation
Authors: Cho Sunghwan , Buckley Tommy , Kim Kyeongmo 
Published: December 2020

Abstract
Social isolation among older adults has brought about poor outcomes of their health and well-being. Information and Communication technology (ICT) is known to alleviate social isolation of older adults. However, it is unknown how ICT access and use are associated with social isolation by race. This study examined the association of ICT and social isolation from the National Health and Aging Trends Study (NHATS), estimating moderating effects of race and ethnicity. The sample for this study was community dwelling Medicare beneficiaries aged 65+ (n=5,567). An index for ICT was formed from five domains: social network websites, email and texting, working cellphone, tablet devices and online computer use (range 1-5, mean=3.96, SD=0.927), and social isolation was derived from responses to five areas: living arrangement, attending religious activities, numbers of important people to talk with, attending other activities such as club participation and volunteer work (range=0-2, mean=1.74, SD=0.927). Race and ethnicity included White (69.6%), African-American (20.7%), Hispanic (5.5%) and Asian/Pacific Islander (2.5%). Multiple linear regression was used using a moderating effect of race/ethnicity, including relevant covariates. Findings revealed increased ICT use was associated with lower social isolation (b=0.05, p&lt;0.05), and race/ethnicity was a significant moderator in the association between ICT and social isolation for African-Americans (b=0.08, p&lt;0.05) and Hispanics (b=0.15, p&lt;0.05) compared to White older adults. The findings indicate that racial differences should be considered when applying technology use to reduce older adults’ social isolation. Practitioners can provide racially competent ICT services for older adults interested in tech-based communication.
Adding Life to Years: Adopting Age-Friendly Public Health in Washington State
Authors: Ham Carolyn , Getz Marci , Bardi Janna 
Published: December 2020

Abstract
Age-Friendly Public Health is an emerging concept and practice aiming to equip the public health infrastructure to more readily address aging issues. In 2019, the Washington State Department of Health (WA DOH), began operationalizing Age-Friendly Public Health within the agency. Work entailed bringing together a cross-agency workgroup on healthy aging and drawing on expertise from agency programs including environmental health, immunizations, falls prevention, emergency preparedness, chronic disease and many others. The workgroup conducted an internal assessment of ‘touch points’ regarding aging work within WA DOH. The Life Course Perspective was used as a theoretical framework to categorize current efforts, and existing research on social determinants of health in aging were used to identify potential areas for future impact. In addition, the Healthy Brain Initiative (HBI) Road Map for public health was used to identify current and potential approaches to addressing Alzheimer’s Disease and Related Dementias. This workgroup inventoried WA DOH’s current efforts that align with the HBI agenda, and identified 88 opportunities to promote healthy aging and brain health. This work contributes to the emerging field of Age-Friendly Public Health by demonstrating strengths and challenges of advancing healthy aging through state public health agencies.
Bringing Older Adults to the Table: Opportunities for Consumer Engagement in Planning and Policy Making
Authors: Prendergast Alice , Fuller Kristi 
Published: December 2020

Abstract
Efforts to include community voice in health policy and service planning are gaining recognition and support in the United States. Findings suggest community involvement can contribute to a better understanding of systems and factors that impact health, and, subsequently, more effective and sustainable policy and program design. Additionally, engagement can increase community buy-in, and community members can gain a greater awareness of services; increased confidence navigating systems; feelings of social connectedness; and capacity to advocate around issues through participation. Despite these findings, the extent to which community members are engaged in planning and decision-making varies considerably. Researchers from Georgia State University conducted a review of state plans on aging using the Person-Centered Outcomes Research Initiative (PCORI) Engagement Principles and the Health Research & Educational Trust’s Community and Patient Engagement Spectrum as frameworks to assess evidence of community engagement. The frameworks recognize engagement throughout the planning process, including design, data collection and interpretation, and dissemination. The review revealed that few planning processes described significant engagement, but rather met the minimal requirements established by federal policy. Federal guidance on community-informed planning practices is sparse, as are resources to support states in adopting these processes. To address this gap, the research team drew on the frameworks and other promising practices to design two community engagement projects, both in partnership with Georgia’s Division of Aging Services. Methods for participant engagement, data collection, interpretation and application of results, and lessons learned through both projects will be discussed, as well as potential implications.
Economics Risks of and Growth of the High Deductible Health Plan Among Patients With Cognitive Impairment
Authors: Lu Kevin , Li Sam , Yuan Jing , Li Minghui 
Published: December 2020

Abstract
OBJECTIVES: High Deductible Health Plan (HDHP) is characterized by higher deductibles and lower monthly premiums. Nevertheless, health economists are concerned that HDHPs may reduce or delay needed care, which will ultimately lead to poorer access to care for chronically affected participants. The objectives of this research are 1) to investigate the HDHP enrollment trend over the past decade; and, 2) to determine the effects of HDHP on risks of financial access risks among adults with cognitive impairment (CI). METHODS: Data were obtained between 2010-2018 from National Health Interview Survey (NHIS). Financial access to healthcare was assessed based on 6 survey questions by CDC. For data analysis, simple T tests and Chisq tests were used where appropriate, with multi-variable logistic regressions implemented to evaluate the effects of HDHP on risks of financial access. RESULTS: Of the 103,649 enrollments, 1,148 were with cognitive impairment and 102,501 were without CI diagnosis. A 55% increase in HDHP registers with cognitive impairment was observed from 2010 (30.50%) to 2018 (47.24%). After controlling for confounding variables, patients with HDPHs were more likely to have risks of financial access compared to those without HDHP (OR= 1.313, 95% CI, 1.002-1.719, p=0.0483). CONCLUSIONS: HDHPs are intended to support effective care options and reduce health care costs. Our research among CI patients with HDHP experienced more financial access risks than those without HDHP, indicating that HDHPs might have unintended consequences of healthcare usage. Employers and health care decision-makers may need to consider providing compensation to those HDHP enrollers with CI.
Social Characteristics, Health and Mortality among Male Centenarians using Veterans Affairs (VA) Healthcare
Authors: Gagnon Lien Quach David , Dugan Elizabeth , Cho Kelly , Gaziano Michael , Spiro Avron , Ward Rachel , Driver Jane 
Published: December 2020

Abstract
Studying health and mortality among centenarian Veterans is critical to understanding the limit of the male human life span and Veterans’ extraordinary model of successful aging. The majority of VA users are male, but little is known about social characteristics and health among male centenarians in general. We investigated the annual mortality rate of male centenarian Veterans seeking care from the VA and identified social characteristics and health conditions that influenced the risk of mortality. This longitudinal study used VA Electronic Health Record (EHR) data from 1997 – 2012 (n=1858). Dates of death were obtained from the EHR, aggregated by the Corporate Data Warehouse from multiple sources. Independent variables included age, race, marital status, and periods of military service. Health conditions consisted of cancer, congestive heart failure (CHF), diabetes, chronic renal disease, chronic pulmonary disease, peripheral vascular disease, dementia, myocardial infarction, liver diseases. The mean age was 100.4 (range: 100-115), 76% were white and 49% married. The average annual mortality rate was 32 per 100 person-years. The annual mortality rate was stable and not affected by race, but did differ by marital status. Divorced or separated centenarians had a 21% higher rate of death than married centenarians [Hazard Ratio (HR):1.21, 95% CI 1.07 - 1.36]. A diagnosis of dementia increased the mortality risk by 37% (HR: 1.37, 95% CI: 1.04 - 1.81) and CHF by 37% (HR: 1.37; 95% CI: 1.13 - 1.66). Providers should consider prevalent health conditions, as well as marital status, in managing care of centenarian veterans.
Money Follows the Person and Informal Caregivers: Insights Into a New Stage of the Caregiving Career
Authors: Robison Julie , Shugrue Noreen , Fabius Chanee , Fortinsky Richard , Porter Martha , Baker Kristin 
Published: December 2020

Abstract
The Money Follows the Person (MFP) program transitions people to the community after extended institutional stays. This study examines effects of this transition on informal caregivers in this new caregiving career stage. Analyses explore whether and how MFP affects caregivers according to caregiver race/ethnicity, and care recipient age and disability type. Data come from surveys with 686 caregivers of persons in Connecticut’s MFP from November 2014-November 2018. Using Pearlin’s Caregiver Stress Process Model, bivariate and multivariate analyses examine predictors of multiple caregiver well-being indicators. Care recipients: older adults (50%), and younger persons with physical (35%), mental health (8%) or developmental (7%) disabilities. Caregivers: non-Hispanic White (62%), non-Hispanic Black (24%), and Hispanic (14%). Caregivers’ average assistance is 5 days/week, 6 hours/day, with 3 activities of daily living and 5 instrumental activities; 11% are paid for caregiving. Compared to other community-based samples, they report low mean levels of burden (4.7 of 16), anxiety (2.2 of 18) and depressive symptoms (31%), and high positive feelings about caregiving (9.5 of 12). A majority feel less stressed (60%) or no change in stress (20%) compared to before and during the institutional stay. Caregivers across the four care recipient groups don’t differ on most outcomes, although more caregivers of people with developmental disabilities (82% vs. 55-61%) report less stress once the person transitions. Black and Hispanic caregivers report more intensive caregiving, but White caregivers report more burden and subjective stress. Findings illustrate the benefits of programmatic support during a newly defined post-institutionalization caregiving career stage.
Patterns of Court Monitoring of Guardianship Practice in Iowa
Authors: Swenson Tami 
Published: December 2020

Abstract
Guardianship, as a best practice, should provide persons with medical incapacity support for better medical care decision making, but the examination of health outcomes for those under guardianship has a dearth of evidence in practice and within the research literature. This study addresses this gap by using the publicly-available Iowa Courts online database to collect data elements useful for the investigation of the process of guardianship practice. A systematic random sample using the 99 counties within Iowa as strata was extracted for all open guardianship cases. Most of the sampled cases (96%) had private appointed guardians. Approximately 28% had case histories over 10 years, 26% 5 to 10 years, 12% 3 to 5 years, 22% 1 to 2 years, and 12% were open cases for fewer than 12 months. Court monitoring of medical conditions varied with annual, biannual, triennial, or 5 year requirements. Delinquencies in filing required medical condition documentation was common and over half of all cases had at least one delinquency in their case history and 33% had a filing delinquency within the past 2 years. Local judicial courts vary in the amount of supervision they provide guardians, and the findings from this research provide needed research to inform guardianship practices as demand increases for these services with the demographic imperative of an aging population and increasing prevalence of dementia-related health conditions.
Changes in Physical Activity during COVID-19 Pandemic in Urban and Rural Older Veterans and their Cohabitants
Authors: Wu Chao-Yi , Wall Rachel , Beattie Zachary , Mattek Nora , Kaye Jeffrey , Dodge Hiroko , Silbert Lisa 
Published: December 2020

Abstract
Background: The COVID-19 pandemic has changed the health security of older adults. Few have examined how older US veterans have reacted and coped with the COVID-19 pandemic. We aimed to identify changes in physical health and their differential impact by rurality of older veterans. Method: Participants were veterans (aged ≥ 62 years) and their cohabitants, living in the Pacific Northwest, enrolled in the Collaborative Aging Research using Technology (CART) initiative. Daily step counts via actigraphy were collected from January 1st to July 8th, 2020. COVID-19 time periods were determined by stay-at-home orders issued on March 13th, 2020. Generalized estimating equation models were used to examine changes in physical activities associated with COVID-19 time periods and rurality indicated by the rural-urban commuting area score. Results: A total of 102 participants were included in the analysis (mean age = 71.0 years, 56% male, 32 living in urban areas). Daily average step counts were 2318 and 3012 before and after COVID-19 stay-at-home orders (t=4.85, p&lt;.001). After controlling for covariates, participants living in large rural (β=.26, p=.03) and small/isolated areas (β=.23, p=.02) walked more than those living in urban areas after COVID-19 stay-at-home orders. Conclusion: Older adults cope differently during the COVID-19 pandemic based on rurality, with those living in large rural and small/isolated rural areas have an increased physical activity. Reasons for increased step counts (e.g., mood, visitors, size of the house) require further investigation. This result demonstrates the potential utility of real-world monitoring to objectively inform interventions for COVID-related secondary health changes.
COVID-19 Worries and Behavior Changes in Older and Younger Men and Women
Authors: Barber Sarah , Kim Hyunji 
Published: December 2020

Abstract
The case fatality rate of COVID-19 is higher among older than younger adults, and is also higher among men than women. However, worry, which is a key motivator of behavioral health changes, occurs less frequently for older than younger adults, and less frequently for men than women. Building on this, we tested whether older adults – and particularly older men -- would report the least amount of COVID-19 worry and also fewer COVID-19 behavior changes. To do so, from March 23-31, 2020, we administered an online questionnaire assessing COVID-19 perceptions, worries, and behavior changes. Participants were a convenience sample of United States residents, who were community-dwelling younger adults (18-35) or older adults (65 to 81). Analyses included 146 younger adults (68 men, 78 women) and 156 older adults (82 men, 74 women). Participants was predominately White, living in suburban/urban areas, and had completed some college. Our results showed that during the early phase of the outbreak in the United States, older adults perceived the risks of COVID-19 to be higher than did younger adults (e.g., thought COVID-19 was different than the flu). Despite this, older men were comparatively less worried about COVID-19 than their younger counterparts. Compared to the other participants, older men had also implemented the fewest behavior changes, such as wearing a mask. These tesults suggest that interventions are needed to increase COVID-19 behavior changes in older men. These results also highlight the importance of understanding emotional-responses to COVID-19, as these are predictive of their behavioral responses.
COVID-19-Related Free Telephone Consultations by Public Health Nurses
Authors: Sumikawa Yuka , Honda Chikako , Yoshioka-Maeda Kyoko , Iwasaki-Motegi Riho , Yamamoto-Mitani Noriko 
Published: December 2020

Abstract
Public health centers are located in each municipality in Japan and are responsible for infectious disease control including COVID-19. Public health nurses (PHNs) are stationed at the centers and work at the forefront, covering a variety of services from individual consultations to hospital escort for those tested positive. Starting January, PHNs at A city (population approx. 210,000) established a free telephone consultation hotline for COVID-19. This study aims to review the PHNs’ telephone consultations during the first wave of COVID-19. The number of calls were aggregated weekly and their time-trend was examined. The study was approved by the University of Tokyo Ethics Review Board. During the first wave between January and May, there were 3,242 calls, with the highest number of calls (n=491/week) in the second week of April. At this point the regular PHNs were not enough to meet the hightened needs of consultations and PHNs from other departments were temporalily transferred for support. The number of consultation calls fluctuated weekly. The increase of calls seemed to preceed the increase of positive cases by one week. We consider that the call may be an initial action of those who suspected possible infection, and the consultation by the PHN might have led them to proper clinic visits and PCR testing. Telephone consultation is an easy tool to use for general public, especially older persons. Having health professionals respond directly to calls may have had the advantage of providing appropriate guidance for infection control and PCR testing and mental support.