bluuebunny/crossref_metadata_2025_split huggingface dataset:
A COMMUNITY AND TECH-BASED APPROACH FOR HYPERTENSION SELF-MANAGEMENT (COACHMAN)
Authors: Still Carolyn H , Moore Shirley M , Sattar Abdus , Wright Jr Jackson T 
Published: November 2019

Abstract
African American (AAs) are disproportionately affected by hypertension. Developing effective outreach programs with community partners is a major public health priority and ideal to educate, empower, and offer support to self-manage hypertension in AAs. The purpose of this pilot is to investigate the effectiveness of a community outreach program using a technology-based intervention for hypertension self-management (COACHMAN) to improve blood pressure (BP) control. Forty AAs with hypertension will be randomly assigned to COACHMAN or enhanced usual care (EUC). COACHMAN is comprised of four components: self-monitoring of BP; web-based education; nurse counseling; and training on a medication management application. The primary outcome is change in BP from baseline to 3-months. We hypothesize that participants in COACHMAN (compared to EUC) will have better BP control. Findings from this study, if confirmed, will provide knowledge to the scarce literature available on technology-based interventions appropriate to help AAs self-manage hypertension and improve BP control.
COMPREHENSIVE HEALTH ASSESSMENT AND MOTIVATION PROGRAM FOR PEOPLE AGING WITH DISABILITIES (CHAMP-D)
Authors: Heyn Patricia C , Carollo James J 
Published: November 2019

Abstract
We developed a Comprehensive Health Assessment and Motivation program (CHAMP-D) focused on self-health promotion and management for people aging with disabilities. The goal of the CHAMP-D is to enhance healthy lifestyle, self-health management and communications with the care team by a person-centered Health Passport tool. All study participants underwent comprehensive health, physical, and blood laboratory evaluation. CHAMP-D results were formatted into an easy to follow health passport. A follow-up survey evaluated the CHAMP-D on 59 respondents and 77% found the recommendations to be achievable and reported improved quality of life (QoL). Other improvements were noted in in self-care (54%), physical activity (49%), and diet (24%). 51% of the participants shared the Health Passport with their PCP. Overall, the CHAMP-D had a positive impact on participants’ self-reported health, self-care, and wellbeing. Empowering individuals with disabilities to take an active role in self-managing their health is feasible and can impact their QoL.
THE IMPACT OF FOOD INSECURITY ON THE HEALTH AND WELL-BEING OF OLDER ADULTS: THE GROUPS MOST AT RISK
Authors: Popham Lauren E , McGovern Erin 
Published: November 2019

Abstract
Older adults who experience food insecurity (4.6 million) often have worse health outcomes. Food insecure older adults consume less nutrients, which puts them at greater risk of developing chronic diseases. They are at increased risk of falls due the impact of poor nutrition on muscle mass, bone density, and balance. Low-income older adults are often forced to choose between buying groceries and paying other bills. The Supplemental Nutrition Assistance Program (SNAP) plays an important role in reducing food insecurity. SNAP enables older adults to buy the nutritious food they need, while freeing up resources to pay for everyday things to meet their health needs such as prescription drugs. Research shows that medication adherence increases when low-income older adults enroll in SNAP. Despite the beneficial impact of enrolling in SNAP, it’s estimated that 55% of eligible adults age 60 and older are not participating in this critical program. To understand which older adults are missing out on SNAP, the National Council on Aging engaged researchers at Leading Age LTSS Center at UMass Boston to analyze data from the 2014 Health and Retirement Study. The results show that some of the most vulnerable older adult populations are less likely to participate in SNAP even though they are eligible (i.e., Hispanic, age 75 and older, those who are not utilizing healthcare, etc.). The findings suggest that more targeted outreach to these groups is needed to ensure that the most vulnerable populations of older adults access this critical benefit.
IMPLEMENTING A GERIATRIC FRACTURE PROGRAM IN A PLURALISTIC ENVIRONMENT REDUCES LENGTH OF STAY AND TIME TO SURGERY
Authors: Rosen Sonja L , Breda Kathy , Lin Carol , Black Jeanne , Lee Jae , Chiang Aaron , Vrahas Mark , Rosen Brad 
Published: November 2019

Abstract
Geriatric-orthopaedic co-management models have been demonstrated to improve patient outcomes, but are typically implemented in closed, non-pluralistic medial systems. The Cedars-Sinai Geriatric Fracture Program (GFP) was developed through collaboration amongst a multi-disciplinary group. Cedars-Sinai is an academic medical center with a pluralistic medical staff that includes faculty, several hospitalist groups, and private practitioners. The GFP was introduced in July 2018 as a quality improvement pilot to provide standardized treatment for geriatric fracture patients. We hypothesized GFP enrollment would reduce time to surgery (TTS) and length of stay (LOS). Geriatric fracture patients were prospectively enrolled from July -December 2018. The Wilcoxon Rank- Sum test was used to compare TTS and LOS between the two patient groups. A p &lt; 0.05 was considered significant. 190 operative fractures in patients over 65 years-old were prospectively followed.56 (30%) were enrolled in the GFP, 54 (28%) were admitted to other hospitalist groups (OH), and 80 (42%) were managed by their primary care physician (PCP). There were no demographic differences between groups. Patients enrolled in the GFP had a significantly shorter LOS compared to the OH and PCP groups (4 days v 5 days v 5 days, p = 0.039) as well as a significantly shorter TTS (19.7hrs v 22.4 hrs vs 23.3 hrs, p = 0.037). Our data shows that a multi-disciplinary geriatric fracture program can be successfully implemented in a complex pluralistic environment resulting in improved patient metrics. Adherence to evidence-based protocols and close multidisciplinary teamwork are critical to program success.
IN-HOSPITAL NURSE CARE CONTINUITY: DOES IT MATTER?
Authors: Tonkikh Orly , Zisberg Anna , Shadmi Efrat 
Published: November 2019

Abstract
In-hospital cognitive decline affects up to 40% of hospitalized older adults and is associated with post-hospitalization worsening of medical and functional status. Studies pointed to the substantial role of the interpersonal relationship between older adults with cognitive impairment and the nurses who care for them. We investigated the association between nursing interpersonal continuity and cognitive outcomes in a cohort of 646 older adults aged 70 or older admitted to internal units for non-disabling conditions. Cognitive decline was defined as at least one point decline in the Short Portable Mental Status Questionnaire from at admission to discharge assessments. Nursing interpersonal continuity was measured using continuity of care index (CoC). CoC assesses the extent of different nurses assigned to take care of each patient during the hospital stay (2 shifts per day) and ranges from 0 (none of the nurses is the same) to 0.4 (highest feasible score according to full time standard shift plan and length of stay (LOS)). Multivariate logistic regression showed that achieving 25% of the highest feasible in-hospital nursing CoC was associated with lower odds of cognitive decline (OR=0.67, 95% CI=0.47-0.97), controlling for age, sex, premorbid activities of daily living status, at admission cognitive status, comorbidities, severity of illness and LOS. This study shows that in-hospital nursing continuity is negatively associated with older adults’ cognitive decline, even in low-continuity levels. Future studies should investigate in-hospital continuity patterns and interventions maintaining continuity in larger and more heterogenic samples.
TELEVISION VIEWING AND HEALTH IN LATE LIFE
Authors: Fingerman Karen , Ng Yee To L , Huo Meng L 
Published: November 2019

Abstract
Television viewing is a risk factor for poor physical and cognitive health. Yet, we know little about associations between current health and frequency of television viewing throughout the day. This study examined associations between multiple assessments of physical and cognitive well-being and television viewing. Participants (N = 313) from the Daily Experiences and Well-being Study completed an initial interview assessing their health and well-being. They also wore an Electronically Activated Recorders (EAR) to capture sound in the environment and an Actical to measure physical activity for 5 days. Coders rated the audiofiles for television viewing. Multilevel models revealed that participants who spent a greater proportion of time tuned into television had: higher BMI, poorer health, expended less energy, were more sedentary, and reported drinking more alcohol and eating more junk food. We discuss findings with regard to potential reciprocal influences between television viewing and poor health.
OH, YOU JUST GOT ARTHRITIS: OLDER AFRICAN AMERICANS LACK FAMILIAL, SOCIAL, AND PROVIDER SUPPORT FOR PAIN MANAGEMENT
Authors: Booker Staja , Herr Keela , Tripp-Reimer Toni 
Published: November 2019

Abstract
Self-management support from family, friends, and providers is a crucial element in controlling osteoarthritis pain. 110 African-Americans (50-94 years) were surveyed regarding social and provider self-management support, and 18 of the African-American participants were also individually interviewed. This mixed-methods analysis unveiled that 77% were not receiving familial/social or provider support, and a conventional qualitative content analysis confirmed the lack of expected support for self-management with sentiments such as “I’m doin’ this all on my own.” Nonetheless, older African-Americans respected providers’ professional opinion, and 82% believed that treatment from a provider would be helpful. They desired more education and treatment options because they “need somebody to help with these joints and muscles”. However, participants were forced to learn how to care for osteoarthritis pain: “I was taking pain medication, but when I went to the doctor last time he told me to stop… Told me to deal with it [pain].”
LGBT OLDER ADULTS IN RURAL SOUTHERN APPALACHIA: PERCEPTIONS OF CURRENT AND FUTURE FORMAL SERVICE NEEDS
Authors: Williams Kelly A , Dakin Emily 
Published: November 2019

Abstract
Older sexual and gender minority adults in rural communities face challenges in accessing formal health, mental health, and long-term care services (Butler, 2017; Koch & Knutson, 2016; Stein et al., 2010). Formal service providers in rural Southern Appalachia are more likely to have conservative values that are closely linked to their religious beliefs (Keefe, 2005). Some may be opposed to gender non-conformity and same-sex relationships or marriage, making it wise for LGBT older adults in rural contexts to carefully select formal service providers and settings (Willging et al., 2006). Barriers to accessing formal services for LGBT older adults residing in rural contexts include few LGBT-inclusive service providers and facilities, transportation, cost, and health insurance (Butler, 2017). When faced with the prospect of long-term care, older LGBT adults are more likely to conceal their sexual or gender identity due to fears of being mistreated (Brotman et al., 2003). This session will present results of a qualitative study examining experiences, concerns, and recommendations regarding formal services among 11 LGBT older adults residing in rural southern Appalachia. Several of the participants described experiencing discrimination from local service providers. A number of participants were fearful about the perceived lack of LGBT-inclusive services in the area and expressed that they would consider leaving the area if their own or their partner’s health declined. Many participants expressed the need for local provider education about the needs of LGBT older adults. The presenters will discuss the implications for research and for health, social, and long-term care services.
THE MANIFESTATION OF MULTI-LEVEL STIGMA IN THE LIVED EXPERIENCES OF TRANSGENDER OLDER ADULTS
Authors: Fabbre Vanessa , Gaveras Eleni 
Published: November 2019

Abstract
Transgender and gender nonconforming (TGNC) older adults experience disparities in mental health outcomes when compared to non-TGNC sexual minority older adults. Stigmatizing experiences are thought to influence these outcomes, but little is known about this process. Recent conceptualizations of stigma draw attention to multiple levels – individual, interpersonal, and structural – experienced by TGNC people of all ages. To explore how multi-level stigma manifests in the lives of TGNC older adults, we conducted a two-phase qualitative content analysis of in-depth biographical interviews with 88 TGNC adults aged 50 and older, from across the United States. Data were obtained from the photography and interview project To Survive on This Shore. Our interpretive analyses suggest that TGNC older adults’ development and well-being are impacted by multiple levels of stigma, which are dynamic and unpredictable, resulting in constant awareness of a changing social environment. Individual level stigma is experienced as ongoing vigilance about aspects of oneself that break gender norms, which is also marked by self-imposed social isolation and fears about accessing older adult services. At the interpersonal level, TGNC older adults navigate unpredictable interpersonal relationships, which manifest as fluctuating levels of love, acceptance, strain, and exclusion. Structural stigma manifests in the awareness of stigmatizing policies and systems but also in the conscious action of TGNC older adults to resist these structures. TGNC older adults promote supportive structural responses to stigma to both improve conditions for younger generations while also reducing experiences of individual and interpersonal stigma for themselves.
VARIABILITY IN ACCESS TO VA’S AID AND ATTENDANCE PENSION BENEFIT: A MIXED-METHODS STUDY
Authors: Thomas Kali S , Corneau Emily , Gidmark Stefanie , Rickard Taylor , Allen Susan 
Published: November 2019

Abstract
The Veterans Benefit Administration’s (VBA) Aid and Attendance enhanced pension benefit (A&A) is available to older, low-income Veterans who require assistance meeting their daily needs. However, reports indicate that A&A is underutilized with only 1/3 of eligible Veterans receiving this benefit. The objective of this mixed methods study is to characterize the variability in A&A enrollment across VA Medical Centers (VAMCs) and determine factors attributable to the variation. Using VA administrative data, we calculated the rate of enrollment in A&A among Veterans receiving pension. We then purposefully sampled 16 Chiefs of Social Work at VAMCs with the highest (n=7) and lowest (n=9) rates of enrollment. Interviews were transcribed, coded, and analyzed using conventional qualitative research methods. The rate of enrollment in A&A varies from &lt;1% to 23% across VAMCs. VAMCs that had higher rates of enrollment were larger and more likely to be located in the South and Mid-Atlantic regions. Respondents at sites with low rates of enrollment indicate that education around the eligibility criteria is needed for VAMC staff. They also report that outreach to Veterans about this benefit is limited. Respondents at VAMCs with high rates of enrollment indicate that the relationships with VBA and Veterans Service Organizations facilitates access. Universally, respondents viewed the A&A benefit positively and note that it helps meet Veterans’ long-term care needs. As the Veteran population continues to age, it is important that VA ensure equal access to A&A for eligible Veterans. Implications of these findings and next steps will be discussed.
SENOLYTIC DRUGS: DISCOVERY, TRANSLATION, AND APPLICATION
Authors: LeBrasseur Nathan 
Published: November 2019

Abstract
Diverse forms of molecular and cellular stress trigger senescence, a state of growth arrest in proliferation-competent cells that is often accompanied by a robust secretory phenotype. Senescent cell burden increases with age in multiple tissues and, plausibly, contributes to the pathogenesis of age-related diseases and geriatric syndromes. Discovery science efforts have identified druggable targets in senescent cells, including key nodes in anti-apoptosis pathways, that distinguish them from non-senescent counterparts and enable pharmacological approaches for their selective elimination. The therapeutic potential of senolytic interventions to improve health- and lifespan has been supported by translational research studies, including murine models of aging, atherosclerosis, osteoporosis, neurodegeneration, pulmonary fibrosis, and frailty. These studies have informed the design of first-in-human clinical trials of senolytic drugs, which have recently begun. The objective of this lecture is to highlight both the progress and challenges of advancing interventions targeting senescent cells from bench to bedside.
BIOMARKER STRATEGIES FOR GEROSCIENCE-GUIDED CLINICAL TRIALS
Authors: Justice Jamie N , Kuchel George A , Barzilai Nir , Kritchevsky Stephen 
Published: November 2019

Abstract
Significant progress in the biology of aging and animal models supports the geroscience hypothesis: by targeting biological aging the onset of age-related diseases can be delayed. Geroscience investigators will test this hypothesis in a multicenter clinical trial, to determine if interventions on biological aging processes can prevent accumulation of multiple age-related diseases and aging phenotypes in older adults. Prodigious activity is underway to develop markers of biological aging, but currently there is no aging biomarker consensus to support geroscience-guided clinical trial outcomes. We convened an expert committee to establish a framework for selection of blood-based biomarkers, emphasizing: feasibility/reliability; aging relevance; ability to predict clinical trial outcomes; and responsiveness to intervention. We applied this framework and identified a short-list of blood-based biomarkers with potential use in multicenter trials on aging. We review progress on efforts to test these candidate biomarkers of aging and development of biomarkers strategy for geroscience-guided clinical trials.
MOBILIZING COMMUNITY PARTNERSHIPS TO ENHANCE HEALTH AND REDUCE INEQUITIES IN MULTICULTURAL COMMUNITIES
Authors: Gardner Daniel S , Giunta Nancy 
Published: November 2019

Abstract
Community-based gerontological research plays an indispensable role in identifying and addressing the strengths, intersectionalities, and socio-structural inequities that shape the lives of older adults in multicultural communities around the world. This symposium highlights the innovative, global scholarship of Silberman Aging: A Hartford Center of Excellence in Diverse Aging, as the Center begins its sixth year. Through community-based research and academic-community collaborations, Center researchers examine challenges affecting the health and wellbeing of diverse and often marginalized aging communities in North America, West Africa, and East Asia. The first paper describes and evaluates a CBPR project that trains community-based natural helping networks to identify and refer older adults with dementia in East Harlem, NY. The second study explores the perceptions and strategies of community-based primary care physicians in Ulaanbaatar, Mongolia in dealing with elder abuse and neglect. The third takes a population health approach to the relationship between social capital and health among older adults in Ghana. Fourth, preliminary results from an evaluation of a nation-wide training initiative that promotes cultural-competencies among aging services providers working with LGBT elders. Finally, we present findings from a CBPR study examining barriers to palliative care among racially and ethnically-diverse community-dwelling older adults with serious illness. Although substantively and methodologically varied, these studies all demonstrate the importance of social networks in health in later life, and underscore the value of community-based research that supports collaboration, empowers communities, and ultimately transforms practice and policy to better meet the diverse needs of older adults around the globe.
EXPLORING PALLIATIVE CARE DISPARITIES IN RACIALLY AND ETHNICALLY DIVERSE COMMUNITY-DWELLING OLDER ADULTS
Authors: Gardner Daniel S , Doherty Meredith 
Published: November 2019

Abstract
Despite the growth and recognized benefits of palliative care for people with serious illness and their families, there are significant racial and ethnic disparities in access to and utilization of services, particularly among older adults living in impoverished, medically-underserved communities. This paper presents preliminary findings from a mixed-method, CBPR study exploring the experiences, supportive care needs, and service use of diverse older adults living with serious illness in an urban, medically-underserved community in the U.S. Systematic analyses of focused, semi-structured interviews with 45 older adults identified cultural, environmental, financial, and structural barriers to palliative care, and identified the critical importance of familial, social, spiritual, and formal networks of support in coping with serious illness and associated symptoms. The investigators describe implications for practice and policy that addresses palliative care disparities, and strategies for engaging with communities to extend culturally-sensitive palliative care to diverse, community-dwelling older adults and their social networks.
IT HURTS AS IF: PAIN LANGUAGE, VISUAL CHARACTERIZATION, AND STORY-TELLING IN HMONG OLDER ADULTS
Authors: Lor Maichou , Vang Xia , Rabago David , Brown Roger , Backonja Miroslav 
Published: November 2019

Abstract
Culture and language affect pain reporting, diagnosis, and treatment. Ethnic subgroup populations, such as the Hmong, are understudied in pain research. The study’s purpose is to qualitatively understand older Hmong adults’ pain expression and their pain communication with providers. Sixty-seven participants were recruited from one healthcare system and community. A directed content analysis revealed that all Hmong participants describe pain using stories with reference to the temporal context, causal attribution, co-occurring symptoms or related experiences, magnitude, and consequences of pain. Several participants also characterized their pain by associating it with visual metaphors as objects and animals. Some participants shared that their stories are often underappreciated by providers, and are therefore not understood by providers. This leads to subsequent feelings of stress, not receiving needed medication or other healthcare, and having less frequent contact with providers or switching providers. These findings have implications for more culturally attentive and appropriate pain care.