bluuebunny/crossref_metadata_2025_split huggingface dataset:
High School Quality and 56-Year All-Cause Mortality Risk Across Race and Ethnicity
Authors: Seblova Dominika , Peters Kelly , Lapham Susan , Zahodne Laura , Gruenewald Tara , Glymour Maria , Chapman Benjamin , Manly Jennifer 
Published: December 2020

Abstract
Having more years of education is independently associated with lower mortality, but it is unclear whether other attributes of schooling matter. We examined the association of high school quality and all-cause mortality across race/ethnicity. In 1960, about 5% of US high schools participated in Project Talent (PT), which collected information about students and their schools. Over 21,000 PT respondents were followed for mortality into their eighth decade of life using the National Death Index. A school quality factor, capturing term length, class size, and teacher qualifications, was used as the main predictor. First, we estimated overall and sex-stratified Cox proportional hazards models with standard errors clustered at the school level, adjusting for age, sex, composite measure of parental socioeconomic status, and 1960 cognitive ability. Second, we added an interaction between school quality and race/ethnicity. Among this diverse cohort (60% non-Hispanic Whites, 23% non-Hispanic Blacks, 7% Hispanics, 10% classified as another race/s) there were 3,476 deaths (16.5%). School quality was highest for Hispanic respondents and lowest for non-Hispanic Blacks. Non-Hispanic Blacks also had the highest mortality risk. In the whole sample, school quality was not associated with mortality risk. However, higher school quality was associated with lower mortality among those classified as another race/s (HR 0.75, 95% CI: 0.56-0.99). For non-Hispanic Blacks and Whites, the HR point estimates were unreliable, but suggest that higher school quality is associated with increased mortality. Future work will disentangle these differences in association of school quality across race/ethnicity and examine cause-specific mortality.
Cardiovascular Health at the Intersection of Race and Gender: Life-Course Processes to Reduce Health Disparities
Authors: Lee Chioun , Park Soojin , Boylan Jennifer 
Published: December 2020

Abstract
Objective: Higher cardiovascular health (CVH) scores are significantly associated with reductions in aging-related disease and mortality but racial minorities exhibit poor CVH. We examine the degree to which (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods: We used biomarker subsamples from the Midlife in the United States (MIDUS) core study and Refresher studies (N=1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or adult SES between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results: White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs reduces the disparities: White men vs. Black women (30% of reduction) and White women vs. Black women (15%). Intervening on adult SES provides large disparity reductions: White men vs. Black men (79%), White men vs. Black women (70%), White women vs. Black men (25%), and White women vs. Black women (32%). Among these combinations, interventions on ELAs and adult SES are robust to unmeasured confounders. However, intervening on discrimination makes little change in initial disparities. Discussion: Economic security in midlife for Blacks helps reduce racial disparities in cardiovascular health. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to Whites.
Testing the Missing Mechanism of Demographic and Health Variables in the Health and Retirement Study
Authors: Lu Peiyi , Shelley Mack 
Published: December 2020

Abstract
Studies using data from longitudinal health survey of older adults usually assumed the data were missing completely at random (MCAR) or missing at random (MAR). Thus subsequent analyses used multiple imputation or likelihood-based method to handle missing data. However, little existing research actually examines whether the data met the MCAR/MAR assumptions before performing data analyses. This study first summarized the commonly used statistical methods to test missing mechanism and discussed their application conditions. Then using two-wave longitudinal data from the Health and Retirement Study (HRS; wave 2014-2015 and wave 2016-2017; N=18,747), this study applied different approaches to test the missing mechanism of several demographic and health variables. These approaches included Little’s test, logistic regression method, nonparametric tests, false discovery rate, and others. Results indicated the data did not meet the MCAR assumption even though they had a very low rate of missing values. Demographic variables provided good auxiliary information for health variables. Health measures (e.g., self-reported health, activity of daily life, depressive symptoms) met the MAR assumptions. Older respondents could drop out and die in the longitudinal survey, but attrition did not significantly affect the MAR assumption. Our findings supported the MAR assumptions for the demographic and health variables in HRS, and therefore provided statistical justification to HRS researchers about using imputation or likelihood-based methods to deal with missing data. However, researchers are strongly encouraged to test the missing mechanism of the specific variables/data they choose when using a new dataset.
Measuring Age-Friendly Communities in New England: Promising Pilot From the New Hampshire Alliance for Healthy Aging
Authors: Davie Laura , Rataj Alison , Dugan Beth , Pepin Renee , Porter Josephine , Rabalais Jennifer , Tecca Matha 
Published: December 2020

Abstract
The New Hampshire Alliance for Healthy Aging is a statewide coalition building partnerships that support and promote healthy aging throughout the state. Through a collective impact approach, six domains (fundamental needs, living arrangements, caregiver support, social and civic engagement, physical and mental wellbeing, and advocacy) were defined to characterize and support the ongoing evaluation of age friendly communities. This poster describes a measurement framework and the development of a strategy to support gathering data across northern New England. A committee of state and national experts has convened to identify the best available indicators and measures for each of the domains and to expose gaps in available data. Representation includes individuals representing the University of New Hampshire, Tri-State Learning Collaborative on Aging (TSLCA), UMass Boston’s Department of Gerontology, and the 100 Million Healthier Lives Initiative (Institute of Healthcare Improvement). Researchers scanned national and state level sources for credibility, consistency, and availability of comparison information. Across the six domains, 43 indicators were selected. 26 did not have available data. Factors measuring social determinants of health are central and especially difficult to quantify, demanding new strategies and data collection approaches. Funding is essential for efforts to define and pilot a new data module to capture a broader set of meaningful data to measure and evaluate age friendly communities. Comprised of grassroots efforts across the fastest aging region of the country, Northern New England, under the Tri-State Learning Collaborative on Aging, is a prime location to use as a pilot project for this module.
Care Team Members’ Perceptions of an Informatics Intervention to Improve Geriatric Care Across Multiple sites
Authors: Franzosa Emily , Traylor Morgan , Aquino Vivian Guerrero , Judon Kimberly , Schwartzkopf Ashley , Dixon Brian , Boockvar Kenneth 
Published: December 2020

Abstract
Electronic health information exchange (HIE) may improve care for geriatric patients receiving care across multiple sites by reducing test duplication, medication prescribing errors, and adverse events. This project evaluated the implementation of an HIE intervention at two VA medical centers offering VA providers real-time notification of non-VA inpatient or ED use, followed by post-hospital geriatric care coordination. We interviewed 23 providers (physicians, nurses, social workers and other care team staff) about their experiences with the program. Interviews were analyzed using the Consolidated Framework for Implementation Research (CFIR) to examine 1) goals and expectations for notifications and transitional care; 2) barriers to effective use of notifications and coordination; and 3) suggestions for improvement. Overall, care team members were positive about the intervention, noting it cut down on time searching for outside medical records and that care coordination visits were helpful in answering patients’ questions and clarifying discharge instructions. However, some providers were not aware of the alerts, found the HIE interface challenging to use, or were concerned that expanding the program would create workflow issues. Suggestions for improvements included sharing information about newly prescribed medications, lab and radiological tests, and progress alerts during the episode of care; and including non-VA providers to facilitate care coordination. Social workers also asked to be included on alerts to improve follow-up. Our findings suggest HIE can be a useful tool for coordinating care across sites, provided information can be easily shared between all care team members and HIE interfaces are streamlined to reduce additional work.
Evaluation of Online Palliative Care Training for Certified Nursing Assistants
Authors: Kim Jinsook , Gray Jennifer 
Published: December 2020

Abstract
Palliative care for older adults is increasingly needed due to a burgeoning older adult population. Certified nursing assistants (CNAs) in skilled nursing facilities (SNFs) provide assistance with activities of daily living and comfort care. There, however, is a significant gap in evaluated palliative care trainings for CNAs. We used a waitlisted control group design to evaluate the effectiveness of an 8-module online palliative care training. CNAs (n=102) from 6 SNFs were randomly assigned to an experimental (n=51) and a control group (n=51) and completed a baseline evaluation. The experimental group took a posttest about palliative care knowledge upon training completion and a 1-month follow-up assessment about palliative care self-efficacy. The control group completed the assessments at the same time as the experimental group prior to receiving the training. The majority of the participants were female (92%). On average, participants were 31 years old, with 6.5 years tenure in the field. The retention rate was 90% at the posttest (n=92) and 82% at the 1-month follow-up (n=84). Palliative care knowledge (scored 0–100) significantly increased in the experimental group (mean 4.1, p &lt; 05), with no significant change in the control group. Palliative care self-efficacy (scored 20-100) significantly improved from the baseline to follow-up in both groups (mean 4.3 and 5.8 respectively, p &lt; 05) with no significant difference between study groups. The results indicate the effectiveness of an online palliative care training to improve CNA knowledge. Improvement in palliative care self-efficacy regardless of training participation warrants further exploration.
Assessing Cardiometabolic Health Risk Among U.S. Children Who Live in Grandparent-Headed Households
Authors: Song MinKyoung , Lyons Karen , Hayman Laura , Dieckmann Nathan , Musil Carol 
Published: December 2020

Abstract
Many interventions have been designed to leverage parent-caregivers as change agents for improving children’s cardiometabolic health (CMH), however very few have been designed to leverage grandparent-caregivers for that purpose. This is surprising since there has been a steady increase in children living in grandparent-headed households. As a first step in assessing the potential impact of interventions with grandparent-caregivers, we used data from the National Survey of Children’s Health (2018) to compare CMH measures in children living in grandparent-headed households with CMH measures in children living in parent-headed households. Our hypothesis was that CMH risk might be higher in grandparent households – given that research shows that grandparents taking over caregiving from parents is associated with worse overall health outcomes for both grandparents and their grandchildren. Additionally, since research indicates that children who experience ≥ 4 adverse childhood experiences (ACEs) have significantly worse health outcomes, we assessed levels of ACEs. Our analytic sample included children aged 10-17 years (n=14,941). Adjusting for age, sex, race/ethnicity, and health insurance coverage status, children living in grandparent households were more likely to be obese (Adjusted Odds Ratio [95% confidence interval]= 2.04 [1.02, 4.09]), exposed to secondhand smoke (2.32 [1.49, 3.59]), and less likely to meet recommended age-appropriate standards for sleep (0.42 [0.27, 0.67]). The children living in grandparent households were more likely to experience ≥ 4 ACEs (8.59 [5.42, 13.62]). Our results provide indirect evidence that interventions with grandparent-caregivers may be particularly critical for improving CMH risk in families.
Accelerating Translation of Interventions: Does It Need to Take 17 Years for Older Adults to Benefit From Science?
Authors: Bettger Janet , Bettger Janet Prvu 
Published: December 2020

Abstract
Translation of evidence refers to widespread dissemination, adoption and implementation of interventions that can have a significant effect on population health. However, effective translation has been slow; significant lags and inconsistent uptake impede intended benefits for older adults. In response, interest and investments in implementation science as the study of methods to promote the adoption and integration of evidence into real-world settings have rapidly increased. By definition, the methodology applies to evidence-based practices, interventions, and policies. But the process of evidence generation can still be prolonged. This paper introduces a framework being tested at the Duke Roybal Center that integrates a model for behavioral intervention development and testing with principles of implementation science in order to accelerate translation across all phases of behavioral research. Attendees will first learn about the NIH Stage Model supported by NIA that guides researchers to identify, define, and clarify an array of activities across six stages of behavioral intervention development. These stages define components of intervention generation, pilot and then efficacy testing, effectiveness research and ultimately implementation of potent theory-driven interventions that improve health and well-being. With this foundation, the Duke framework will be presented to illustrate how concepts of several common implementation science frameworks and models can be integrated within the different stages. Interactive case studies will be used to illustrate application of this new integrated framework for evidence generation, accelerated implementation and scale-up, and pathways for translation. Integrating the Stage Model with principles from implementation science can accelerate translation.
Recent Pain Among Older Women and Men in the United States by Sexual Orientation
Authors: Galinsky Adena , Goldsen Karen Fredriksen , Dahlhamer James , Norris Tina 
Published: December 2020

Abstract
Pain is not only a result of other health problems but an independent condition that can negatively impact quality of life. Lesbian, gay, and bisexual older adults report more pain compared to their straight counterparts when pain is measured in the aggregate (e.g. “one or more of the following types of pain”). However, scant national research has examined if specific types of pain vary by sexual orientation among older adults. Using 2015-2018 National Health Interview Survey (NHIS) data, we used logistic regression to separately model four types of pain among women 50+ and men 50+ (lesbian/gay women: n=377, bisexual women: n=142, straight women: n=33,216; gay men: n=508, bisexual men: n=115, straight men: n=25,998) as functions of sexual orientation, controlling for age, race, education, and income. Lesbian women and bisexual men were more likely (AOR=1.46, 95% CI:1.03, 2.08; AOR=2.95, 95% CI:1.08, 3.79, respectively), but bisexual women were less likely (AOR=0.6, 95% CI:0.33, 1.05), than their straight counterparts to have had a migraine or severe headache in the past three months. Bisexual men were also more likely than straight men to report lower back pain in the past three months (AOR=1.66, 95% CI: 1.02, 2.72). Sexual minority women were more likely than straight women to report joint pain in the past 30 days and lower back pain in the past three months. Future research may examine why the prevalence of specific types of pain vary by sexual orientation among older adults.
A Longitudinal Analysis of SF-36 scores Within the Candrive Cohort: An Example of Survivor Bias
Authors: Bedard Michel , Maxwell Hillary , Gelinas Isabelle , Marshall Shawn , Naglie Gary , Porter Michelle , Tuokko Holly , Vrkljan Brenda 
Published: December 2020

Abstract
A bias inherent to prospective studies is focusing only on individuals who remain in the study; these individuals may differ from those who leave early. To examine this issue, we analyzed SF-36 scores by completion status for individuals enrolled in the seven-year Candrive cohort. The SF-36 provides a self-reported evaluation of health and well-being along two subscales, the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Of 928 participants in the cohort, 887 had at least two consecutive years of data starting at baseline (age=76.17, SD=4.81; 61.9% male). A total of 142 participants had 7 years of data. Study discontinuation (due to withdrawal, driving cessation, or death) happened least in early years, and peaked after 6 years (n=235). When analyzed according to completion status, patterns of change in SF-36 scores varied. For example, participants with 7 years of data had mean PCS scores ranging from 51.41 (SD=7.92) at baseline to 46.93 (SD=9.46) at year 7, a change of 0.75 points per year. For those with only two years of data, scores were lower and dropped from 45.82 (SD=9.98) to 43.59 (SD=10.90), a change of 2.23 points over a single year (p&lt;.001). Differences are also evident for other groups. While the results indicate relative stability of SF-36 scores among participants who remained in the study, participants who dropped out reported greater deterioration in scores. These results highlight important differences between participants based on completion status.
Physical Activity Patterns After Retirement: The REGARDS Study
Authors: Shiroma Eric , Rhodes J David , Bennet Aleena , Safford Monika M , MacDonald Leslie , Hooker Steven P , Howard Virginia 
Published: December 2020

Abstract
Major life events, such as retirement, may lead to dramatic shifts in physical activity (PA) patterns. However, there are limited empirical data quantifying the magnitude of these changes. Our aims were to objectively measure PA before and after retirement and to describe changes in participation in various types of PA. Participants were employed black and white men and women enrolled in REGARDS (REasons for Geographic and Racial Differences in Stroke), a national prospective cohort study (n=581, mean age 64 years, 25% black, 51% women). Participants met inclusion criteria if they retired between their first and second accelerometer wearing (2009-2013 and 2017-2018, respectively) and had valid accelerometer data (&gt;4 days with &gt;10 hours/day pre- and post-retirement). Accelerometer-based PA was categorized into average minutes per day spent in sedentary, light-intensity, and moderate-to-vigorous PA. Participants reported changes (less, same, more) in 12 types of PA. After retirement, participants decreased both sedentary time (by 36.3 minutes/day) and moderate-to-vigorous PA (by 5.6 minutes/day). Conversely, there was an increase in light-intensity PA (+18.1 minutes/day) after retirement. Participants reported changes in their participation level in various PA activities. For example, 41% reported an increased amount of TV viewing, 42% reported less walking, and 31% reported increased participation in volunteer activities. Findings indicate that retirement coincides with a change in the time spent in each intensity category and the time spent across a range of activity types. Further research is warranted to examine how these changes in physical activity patterns influence post-retirement health status.
The Effect of Theory-Led Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial
Authors: Wang Limin , Chen Hongbo , Lu Han , Chen Jieru , Shang Shaomei 
Published: December 2020

Abstract
Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. This two-arm cluster randomized trial study was to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptom (pain intensity and joint stiffness) and knee function (lower limb muscle strength and balance) in Chinese older adults diagnosed with KOA. A total of 189 community-dwelling older adults with KOA (intervention group: n = 103, control group: n = 86) were enrolled from 14 community centers in Beijing, China in 2018. The intervention was a two-stage and 24-week transtheoretical model-based exercise program, and the control group underwent a same length but non-theory-based exercise program. Exercise adherence was measured at weeks 4, 12, 24, 36, and 48 after the program started, KOA symptoms and knee function were measured at baseline, week 24, and week 48. Results showed that the growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p &lt; 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function. This study provided an effective strategy for KOA intervention.