bluuebunny/crossref_metadata_2025_split huggingface dataset:
FACTORS ASSOCIATED WITH UNMET HEALTHCARE NEEDS IN OLDER ASIAN AMERICANS
Authors: Yoon Hyunwoo , Yoon Hyunwoo , Jang Yuri , Choi Kwangyul 
Published: November 2019

Abstract
Older Asian Americans are the fast-growing but understudied population in health disparities research. Using a sample that reflects cultural/linguistic diversity, the present study explored general (health insurance, usual place for care, income) and immigrant-specific (nativity, length of stay in the US, English proficiency, acculturation) risk factors of unmet healthcare needs in older Asian Americans. Data were drawn from the Asian American Quality of Life survey (N = 533). With the inclusion of a considerable number of non-English-speaking individuals, the present sample presented a high rate of unmet healthcare needs. Those with a shorter stay in the US, limited English proficiency, and lower level of acculturation had increased odds of having unmet healthcare needs than their counterparts after controlling for background characteristics. Challenging the myth of model minority, findings highlight the importance of immigrant-specific factors in identifying risk groups of unmet healthcare needs and demonstrate vulnerability in access to healthcare.
DEVELOPMENT AND EVALUATION OF EDUCATIONAL MATERIALS REGARDING MENTAL HEALTH MOBILE APPS AMONG OLDER VETERANS
Authors: Scales Ashley , Loup Julia , Juang Christine , Sakai Erin , Ma Flora , Gould Christine E 
Published: November 2019

Abstract
The number of older adults using mobile devices has doubled over recent years; however, many need assistance in learning how to use their device. To address this gap, we developed patient education materials teaching older Veterans how to download apps and the basics of mobile device and app use. For example, we developed step-by-step guides for three Veteran Affairs mobile apps that target mental health symptoms. Material development involved feedback from providers and older Veterans using a multi-step mixed methods evaluation process. Local technology and geriatric content experts provided initial feedback; all experts agreed the materials would be helpful to teach Veterans about mental health apps. We subsequently interviewed older Veterans (M = 78.5 years) who evaluated the materials. Over 50% of Veterans found the guides clear, articulate, and useful; 83.3% noted they would recommend to others. Lastly, providers who see older Veterans regularly rated the materials; 79% of providers rated the materials as helpful, with an average rating of 4.3 (1 = Strongly Disagree to 5 = Strongly Agree). Providers viewed the materials and apps as useful supplements to psychotherapy and especially useful for individuals who are unable to return to clinic. Overall, both providers and Veterans found the materials easy to understand and valuable for those new using mobile apps or devices. Findings from the evaluation process suggest the design of the materials may be vital to increasing the use of mental health mobile apps among older Veterans.
THE UNCANNY VALLEY REVISITED: AGE-RELATED DIFFERENCE AND THE EFFECT OF FUNCTION TYPE
Authors: Tu Yun-Chen , Chien Sung-En , Lai Yueh-Yi , Liu Jen-Chi , Yeh Su-Ling 
Published: November 2019

Abstract
Due to declined birthrate and the increased aging population, solving the problem of labor shortage has become important. Introducing robotic labors could effectively help older adults’ daily lives. However, older adults’ acceptance of robots was lower than younger adults. Robot’s appearance might be one of the reasons. The Uncanny Valley (UV) refers to the phenomenon that people rate more positively as robots become more humanlike, but only up to a certain point; as it approaches near-perfect similarity of human appearance, likeability drops and forms an uncanny valley. Nonetheless, previous results supporting the UV were mainly from younger adults. We examined whether the UV is also applicable for older and middle-aged adults. We also examined whether the acceptance of function (companion vs. service) would change based on robot appearance, and whether robot-induced traits have any relation with the acceptance of robot function. We asked younger (N= 80, age 18-39), middle-aged (N= 87, age 40-59), and older (N= 88, age 60-87) adults to view each picture of 84 robots and evaluate their impression of each robot and intention of use regarding robot function. Contrary to the UV found for younger and middle-aged adults, older adults did not show UV–they preferred humanlike over non-humanlike robots, regardless of the robot function. Scores on each trait–except for authoritativeness–showed positive correlations with the acceptance of functions. These findings imply that the design of assistive robots should take UV into consideration by customizing robots’ appearances and functions to different age groups.
A MAGIC GATHERING: PILOTING AN AUGMENTED REALITY ENGINE TO PROMOTE MENTAL HEALTH AND WELL-BEING
Authors: Chan Thomas , Matook Daniel , Argueta Isaac , Kennedy Jonathan , Argueta Jeremy , Chan Thomas 
Published: November 2019

Abstract
Augmented reality (AR), superimposing digital assets onto the real-world (i.e., holograms)—offers a paradigm shift in delivering immersive interventions for aging adults. Reminiscence and life review are robust intervention techniques that have decades of empirical support to boost mood and meaning in older adults. In this presentation, we demonstrate the applied research and technology development process to create an AR reminiscence and life review engine for aging adults and their caretakers. We conducted 25 needs assessment interviews with community-dwelling older adults, and assisted living facility directors, nurses, and residents. Initial analyses revealed the need for: (1) finding scalable and cost-effective solutions to alleviate time burden for caregivers; (2) increasing variety of activities that do not need much instruction; (3) producing activities that grab and maintain attention; and, (4) generating more personalized activities that do not divert too much time from caretakers. We integrated the findings to develop a working prototype AR engine called “Project Phonado.” From preliminary user testing, Project Phonado aids in boosting mental health and meaning in aging adults—at least temporarily (immediate and one day follow-up). We will show clips of some pilot user testing of the engine and discuss the next evaluation and development steps.
DIFFERENT ASPECTS OF ACCULTURATION AND COGNITIVE HEALTH AMONG MINORITY OLDER IMMIGRANTS
Authors: Wang Bei , Dong XinQi , Simon Melissa A , Li Mengting 
Published: November 2019

Abstract
Immigration and acculturation process in host society have been closely linked to health consequences among the immigrant populations. However, it has been inadequately examined regarding its relationships with cognitive outcomes. Data were drawn from PINE Study. Linear regression analyses were used to examine associations between acculturation levels (media use, ethnic social relations, and language proficiency) and cognitive performance. After adjusting for potential confounding variables, higher levels of acculturation were associated with better cognitive performance. More specifically, higher levels of acculturation in aspects of media use and ethnic social relations were associated with better cognitive performance, whereas it has no significant association with the language preference aspect. Research and practice addressing health disparities and cognitive impairment should leverage efforts to provide culturally relevant resources to less acculturated populations in the US. More longitudinal studies are needed to clarify the influence of acculturation on cognitive performance and its mechanism.
WRIST-WORN TRI-AXIAL ACCELEROMETER VALIDATION IN YOUNG, MIDDLE-AGED, AND OLDER ADULTS
Authors: Manini Todd M , Saldana Santiago , Corbett Duane , Wanigatunga Amal A , Navarro Eduardo , Mardini Mamoun T , Casanova Ramon 
Published: November 2019

Abstract
Purpose: This study evaluated wrist-worn accelerometers for estimating metabolic intensity and classifying activity types across a wide age spectrum. Methods: Participants (n=141, 67% women, aged 20-89 yrs) performed a battery of 31 common daily activities (e.g. washing dishes, walking) in a standardized laboratory setting. A tri-axial accelerometer was worn on the right wrist during each activity whiel a portable metabolic unit was used to measure oxygen consumption (ml/kg/min), which was converted into metabolic equivalents (METs). Random forest analyses estimated metabolic intensity and classified activity type based on seven data features. Resulting estimates were cross-evaluated on a separate sample of 16 participants who performed a sub-set of activities in their home. Results: In the laboratory setting, mean differences between measured and predicted MET value for sedentary (0.36), lifestyle (0.02) and locomotor (0.30) activities were low, but the 95% limits of agreement ranges were relatively large (+/-1.0, +/-1.8, +/-3.1, respectively). Data features were 85%, 88%, and 71% accurate for identifying sedentary, lifestyle and locomotor activities. Prediction equations had an overall mean difference of 0.19 METs (95% limits of agreement = -1.3 to 1.7) when activities were performed at home. Conclusion: Data features extracted from a wrist worn tri-axial accelerometer provide a moderate-to-high group estimate of metabolic intensity and had modest accuracy in identifying activity types across a variety of daily activities. However, significant between person variations were evident. Additional work is needed to refine wrist-worn accelerometers for estimating physical activity type, intensity, duration and frequency across the age spectrum.
FEASIBILITY OF MOBILE HEALTH FOR LOW-INCOME MINORITY HISPANIC PATIENTS WITH A STROKE
Authors: Dang Stuti , Sarhadi Kasra , Kenya Sonjia , Dong Chuanhui , Ferras Natalie , Romano Jose , Carrasquillo Olveen 
Published: November 2019

Abstract
Stroke is a leading cause of death and functional impairment that disproportionately impacts Hispanics. Several studies have supported the feasibility of mobile health interventions (mHealth) to provide health monitoring and patient education for improving chronic disease management, but none have focused on Latino stroke patients. The Hispanic Secondary Stroke Prevention Initiative is a randomized study of 200 stroke patients designed to evaluate the impact of a 12-month multi-modal Community Health Worker (CHW) and mHealth intervention on blood pressure control. Eligible participants were Latinos who experienced a mild-moderate stroke within the last five years. The CHW component included home visits, telephone calls, and daily text messages to obtain home blood pressure readings and provide patient navigation and health education. Feasibility was defined as the proportion of patients that responded to at least half the messages. Pre-post paired t-tests assessed improvements in question accuracy while correlation coefficients highlighted improvements in response rates. Among the 65 participants randomized to the intervention, the response rate was as follows: 37% - &gt;50% response, 21% - 25-50%, 19% - 10-25%, and 23% - &lt;10%, This finding suggests that mHealth interventions may be challenging in this population. However, the proportion of questions answered correctly increased from 63% to 84% in the intervention period’s last two months (p&lt;0.05). There was a positive correlation between increased response rates and response accuracy to patient education assessments (r=0.82, p&lt;0.05). These improvements in health knowledge suggest that a subset of patients may benefit from mHealth interventions, and the benefit correlates with use.
NOVEL REMOTE ASSESSMENT OF THE STANDING POSTURAL CONTROL IN YOUNGER AND OLDER ADULTS USING SMARTPHONE APPLICATION
Authors: Zhou Junhong , Yu Wanting , Zhu Hao , Lo On-Yee , Travison Thomas , Lipsitz Lewis , Manor Brad 
Published: November 2019

Abstract
In older adults, assessment of standing postural control under various task and/or environmental conditions provides valuable insight into cognitive-motor function. To date, however, such assessments have been limited primarily to laboratory or clinical settings. We therefore created a smartphone App to enable remote assessments of postural control. This App provides users with standardized multi-media instructions and harnesses the phone’s internal motion sensors to capture postural sway, with the phone placed in the user’s pants pocket, during trials of standing with eyes open, eyes-closed, and while performing serial-subtractions (i.e., dual tasking). We then established the test-retest reliability of several metrics of postural sway derived from this assessment tool, as well as their sensitivity to the effect of age and standing condition. Fifteen healthy younger and 15 older adults completed multiple standing trials in two separate laboratory visits and on three separate days in their own homes. Postural sway metrics included the mean distance from the center of the trajectory and root mean square were derived from both transverse-plane acceleration and angular velocity time series. Each sway metric demonstrated excellent test-retest reliability, even when analyzed separately by group and standing condition (ICCs: 0.78-0.89). Moreover, each metric was sensitive to age group and standing condition, such that greater sway was observed in older adults as compared to younger adults (p&lt;0.03), and in more challenging standing conditions (p&lt;0.0001). These results suggest that sensitive metrics of standing postural control may be reliably obtained from remote smartphone-based assessments in both younger and older adults.
DEVELOPMENT AND TESTING OF AN ACCELEROMETER-BASED POSITIONAL MONITORING SYSTEM
Authors: Jarvis Leighanne , Moninger Sarah , Throckmorton Chandra , Pavon Juliessa M , Caves Kevin 
Published: November 2019

Abstract
Health and fitness are contributing factors to physical resilience, or the ability to resist or recover from functional decline following health stressors. Accelerometer based activity monitors have been used in both the in-patient and outpatient setting to monitor mobility. While using sensors to track mobility is increasing, most clinical settings rely on patient reported outcomes. These measures often under or overestimate movement. The lack of a clinically meaningful way to measure mobility in the in-patient setting is a barrier to improving the mobility of hospitalized individuals. This is especially important when considering that over one-third of hospitalized older adults are discharged with a major new functional disability in performing activities of daily living. Our goal was to automatically determine if the subject is laying, reclining, sitting, standing, and walking to better reflect actual activity. Other platforms and studies indicate the ability to determine a difference in activity vs. inactivity or laying and reclining vs. standing and walking, but not all five phases of movement defined here. The aim of this study was to use accelerometer data to train a machine learning algorithm to automatically classify the postural changes (i.e. laying, reclining, sitting, standing, and walking). Preliminary results demonstrate that our trained algorithm is overall 95% accurate in determining each position from unlabeled data from the subject population. Additionally, this algorithm will be applied to in-patient hospitalized older adults for tracking of positions throughout the day.
VETCONNECT: A VA TELEHEALTH PROGRAM PROVIDING TREATMENT, EDUCATION AND TRANSITIONS OF CARE TO NURSING HOME VETERANS
Authors: Levy Cari , Hale Anne , Galenbeck Emily , Haverhals Leah M 
Published: November 2019

Abstract
Transporting nursing home Veterans to hospitals for outpatient care can present many challenges, including lengthy time in transit, coordination difficulties between the hospital and nursing home, and travel burden on Veterans. In June 2017, the VetConnect program began offering Veterans in Colorado residing in Department of Veterans Affairs (VA) contracted Community Nursing Homes (CNHs) and State Veteran Nursing Homes (SVHs) telehealth appointments in Geriatrics, Mental Health, Palliative Care, and Psychiatry via clinicians at the Rocky Mountain Regional VA Medical Center (VAMC). Then in June 2018, VetConnect expanded to offer Virtual Tours for Veterans transitioning out of inpatient care to CNHs the opportunity to virtually tour the CNH, connecting with CNH staff through video for a more stress-free and informed transition from hospital to CNH. In winter 2018, VetConnect expanded once more to include Dementia Educational Outreach Series for CNH and SVH staff, allowing them to connect virtually to VA staff with expertise in dementia care and other Veteran-specific topics such as treating post-traumatic stress disorder (PTSD). To date, VetConnect has provided 502 telehealth visits, 18 Virtual Tours, and 4 dementia ECHO trainings (with 58 nursing home staff participants). Evaluation measures to be presented include collection and analysis of telehealth nurse field notes (who are present with Veterans at CNHs/SVHs during telehealth visits), creation of process maps, conducting key stakeholder interviews, and identification of potential impacts the VetConnect program has had on VA to CNH and SVH relationships and Veteran health.
TECHNOLOGY FOR HOME MONITORING
Authors: Charness Neil H 
Published: November 2019

Abstract
Healthcare is increasingly moving away from expensive hospitals into the home. Although there are advantages to managing chronic health conditions in homes, there are also a number of disadvantages, beginning with aging adults’ unfamiliarity with the technologies being deployed. Too often, designs and instructional materials are not developed with aging users’ capabilities in mind. Health technology also confronts users with significant challenges including just-in-time learning when users are under significant stress. Technology support is often lacking. Also, care coordination for multiple chronic conditions is challenging. For instance, patients are often provided with multiple electronic health record portals. I discuss the reliability of and some of the practical challenges for a home health monitoring system used by older adults and those with heart failure over a 6-month interval. The system featured components such as a wrist-worn sensor package, daily tablet surveys, blood pressure cuff, weight scale, and bed sensors.
SOCIAL ISOLATION AMONG THE RECIPIENTS OF THE MINIMUM LIVELIHOOD GUARANTEE PROGRAM IN CHINA
Authors: Zhang Yalu , Mui Ada 
Published: November 2019

Abstract
The eligibility for the minimum livelihood guarantee program in China is generally based on means testing, including a complicated income test and a household registration test. Even though the fiscal budget for this program steadily increased in the last two decades, the number of beneficiaries has decreased in both rural and urban areas since 2011. The recipients were stigmatized because their names are reported in the public domain and are known to their neighbors. Some beneficiaries tended to reduce social participation for fear of losing the eligibilities due to the stricter criteria or the stigma associated with receiving benefits. This paper examined the adverse impact of this welfare program on social isolation among Chinese middle-aged and older adults (n=8,447) using the panel data from the China Health and Retirement Longitudinal Study and the propensity score weighted difference-in-differences method (PSM-DID). The results present disparities between urban and rural older adults—The older program recipients in urban areas significantly reduced social participation by 20.53%, while the adverse impact was not statistically significant among rural recipients. Compared to older adults (aged 60 and above), middle-aged adults (aged between 45 and 60) were not socially isolated due to program enrollment in both rural and urban areas at the 95% confidence level. This paper for the first time addresses the causal relationship between program enrollment and the adverse impact of social isolation. It also alerts policymakers and local program administrators to protect older program recipients from stigma, sense of shame, and reduced social connection.
HOW DOES MODE OF SERVICE DELIVERY IMPACT CAREGIVER STRAIN? A MIXED-METHODS STUDY OF CAREGIVERS IN LOS ANGELES
Authors: Gallo Haley B , Chen Chia Ying , Benton Donna 
Published: November 2019

Abstract
As the number of people living with Alzheimer’s disease and related dementias increases, so too will the number of people who care for them. This growing population requires instrumental and emotional support as they fulfill their caregiving duties. CareJourney is an online platform that provides this support; it can be used either alone, or with traditional in-person and phone-mediated consultations with family care navigators (FCNs). The intent of CareJourney is to provide a greater opportunity for self-directed services, as well as flexibility for working caregivers and those who prefer using technology. Satisfaction surveys (N=222) were analyzed to evaluate caregivers’ perceptions of CareJourney and the traditional service delivery modes. Additionally, five 30-minute interviews with caregivers were coded by two researchers (kappa=0.84) for a more in-depth understanding. Ten percent of survey respondents used CareJourney, and preliminary results from both the interviews and the survey suggest that caregiver burden, lack of time, and desire for a personal connection with FCNs influence mode of service delivery. Although a quarter of users relied on CareJourney to find caregiving resources and email their FCNs because it was more convenient than traditional modes, the interviews and surveys revealed that the caregivers most valued the personal touch that came from interacting with FCNs. Speaking with FCNs over the phone or in-person allowed caregivers to feel “reassured,” “less isolated,” and “comforted” as they discussed caregiving strains. Future interventions and services for caregivers should be offered using multiple modes to accommodate a range of time-demands and preferences for personal connection.
HOW AN INDIVIDUAL’S SENSE OF CONTROL INFLUENCES THEIR PERCEPTION OF SUCCESSFUL AGING
Authors: Harris Alexandra P , Nuccio Alexandria , Stripling Ashely M 
Published: November 2019

Abstract
Factors like physiology, mental health, personal resources, and social support have been identified to contribute to perceived successful aging (Cosco, Prina, Perales, Stephan & Brayne, 2015); however, sense of control’s role in these relationships remains underexplored. Studying the impact of sense of control is crucial, given that many factors associated with well-being are correlated with later life success. The current study investigates associations among sense of control and constructs known to define successful aging. The data was derived from the Survey of Midlife in the US database (MIDUS3). Participants were primarily Caucasian (88.7%) and female (54.9%) with a mean age of 63.64 years (SD=11.35). A series of hierarchical multiple regressions revealed that sense of control impacts physical health (F = 87.734, p&lt;0.001), depression (F =43.944, p&lt;0.001), anxiety (F =24.680, p&lt;0.001), social actualization (F = 66.450, p&lt;0.001), and instrumental activities of daily living (IADL) (F = 135.963, p&lt;0.001) over demographic correlates (i.e., age, sex, and race). The present findings suggest that higher levels of control results in increased comfort in social atmospheres, absence of mood symptoms, good health, and limited issues with IADL. Implications of the current findings include a deeper understanding of how psychological factors, such as sense of control, can impact physical and mental health in order to improve care and promote wellbeing in late life.