bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time Use, Gender, and Mental Health of Older Adults in Rural China
Authors: Lin Zhiyong , Chen Feinian 
Published: December 2021

Abstract
Time use is considered a valuable descriptor of people’s lifestyles, and studying how people spend their time is critical for understanding the determinants and consequences of individual well-being. In this study, we first develop a time use typology to characterize how older adults in rural Chinese families allocate their time in later life, and then examined how older adults’ time allocation influenced their mental health, with a special focus on differential implications for older women and men. Data derived from 2015 and 2018 waves of a longitudinal study of 1,007 older adults, aged 60 and older, living in rural areas of Anhui Province, China. We specifically focused on how social and solitary dimensions of time use, as well as time spent within and outside households, impacted depressive symptoms of older adults. Using the K-means cluster analysis, we identified four time use categories: “work-oriented,” “socially-active,” “homemaker/ caretaker,” and “socially-isolated.” Results from fixed-effects regression analysis demonstrated that older women involved in “socially-active” time-use category tended to report better mental than those in other time-use types, while the time spent on housework and caregiving was harmful to their mental health. For older men, more time spent on paid activities outside households (“work-oriented”) was associated with better psychological outcomes while solitary leisure time (“socially-isolated”) was associated with higher levels of depressive symptoms. These findings will be helpful for health policymakers and practitioners who seek to better identify vulnerable subpopulations and to design effective intervention strategies to reduce mental health problems.
Experiences of Black and White Family Hospice Caregivers: Anxiety, Depression, QOL, Burden, Hospice Communication
Authors: Starr Lauren , Washington Karla , Aryal Subhash , Oliver Debra Parker , Demiris George 
Published: December 2021

Abstract
Although hospice care benefits seriously ill patients and their families, growing evidence suggests anxiety, depression, and altered quality of life are prevalent among family hospice caregivers. It is unknown if Black and white family hospice caregivers experience differences in mental health, quality of life, caregiver burden, or quality of hospice communication. In this secondary analysis of baseline data collected from 717 family hospice caregivers in two randomized clinical trials, we compared anxiety (GAD-7), depression (PHQ-9), quality of life (CQLI-R), caregiver burden (Zarit), and caregiver-reported quality of hospice team communication (CCCQ) between Black and white caregivers. Black and white caregivers differed demographically across multiple variables. In bivariate analysis, we found no differences in depression (P=0.3536), anxiety (P=0.0733), caregiver burden (P=0.6680), and perceptions of caregiver-centered hospice communication (P=0.4549). White caregivers reported lower quality of life than Blacks (P=0.0386), specifically in emotional (P=0.0321) and social (P=0.0002) domains. Financial and physical quality of life did not differ. In multivariate regression analyses controlling for caregiver and patient factors, we found no racial differences in depression (P= 0.5071), anxiety (P = 0.7288), quality of life (P=0.0584), caregiver burden (P=0.9465), or hospice communication (P=0.8779). Variables explained 7.7% to 20% of variability in outcomes, suggesting research is needed to understand which other factors contribute to hospice caregiver coping and communication experiences. Results suggest Black and white informal hospice caregivers experience similar levels of anxiety, depression, burden, and perceptions of hospice team communication quality. Interventions to support hospice caregivers across racial groups are needed.
Does Level of Equality in State of Residence Relate to LGBT Health? An Analysis of Adults Aged 50+ Years from 34 US States
Authors: Nelson Christi , Andel Ross 
Published: December 2021

Abstract
Lesbian, gay, bisexual, and transgender (LGBT) health disparities have been well documented in previous research. This study examined whether the level of equality in state of residence (high, medium, fair, poor, or negative), determined by tallied LGBT-related laws and policies, was associated with health outcomes for LGBT adults. This study consisted of 3486 LGB and 959 transgender adults ages 50+ as well as 1:1 propensity matched heterosexual and cisgender participants from the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Separate logistic regression analyses for the LGB, transgender, heterosexual, and cisgender groups were conducted to assess health differences by state equality ranking. Results indicated that LGB participants in fair ranked states were more likely to report fair/poor general health (aOR=1.4, 95% CI=1.1-1.8) and 14 or more days of poor mental health in the past 30 days (aOR=1.4, 95% CI=1.1-1.9) compared to LGB in high ranked states. LGB participants in a low or negative ranked state were more likely to report fair/poor health (aOR=1.6, 95% CI=1.3-2.0), 14 days or more of poor physical health (aOR=1.5, 95% CI=1.1-1.8), and 14 or more days of poor mental health (aOR=1.3, 95% CI=1.0-1.7) in the past 30 days. Transgender participants in medium and low/negative ranked states were more likely to report fair/poor health (lowest aOR=1.75, 95% CI=1.3-2.5) compared to transgender individuals in high equality states. Similar results were not found for the matched heterosexual and cisgender groups. These results suggest that LGBT-related laws and policies may play a role in LGBT health.
Using Existing Software Systems to Collect Outcome Data in Adult Day Services
Authors: Anderson Keith , Peters-Beumer Lisa , Duff Laurie 
Published: December 2021

Abstract
Recently, there has been a resounding call for standardized outcome data collection in adult day services (ADS). Outcome data have the potential to demonstrate the effectiveness of ADS, aid in program development, and help leverage funding opportunities. Unfortunately, many ADS centers do not collect outcome data for several reasons, including the cost of data collection software and systems. In this presentation, we present one effort to utilize an existing multiuse ‘off the shelf’ software solution to collect ADS outcome data for a network of ADS providers. The researchers collaborated with software developers and ADS providers to adapt the software to incorporate outcome measures and reporting functionality on both the individual and program levels. Adaptation and adoption required attention to HIPAA compliance, workflow integration, measurement fidelity, and data management processes. Despite these challenges, adapting existing software systems may be a cost-effective way to enable expanded outcome data collection in ADS.
Inter- and Intra-racial Differences in Pain and Performance-Based Function in Older Adults With Osteoarthritis
Authors: Booker Staja , Fillingim Roger 
Published: December 2021

Abstract
Osteoarthritis (OA) contributes to movement-evoked pain, impaired function and mobility, and reduced quality of life among older adults. Assessment of pain has not traditionally considered the dynamic changes that occur with gross motor movement, and thus self-reports of pain often reflect static or resting pain. This case-control pilot study examined inter- and intra-racial differences in movement-evoked pain and performance-based function in older adults (N= 28) with knee OA. Cases consisted of Blacks and Whites with OA; controls included Blacks without OA. The Biodex Pro System 4, an isokinetic and isometric dynamometer commonly used in rehabilitative medicine, measured knee muscle function. Pain intensity was assessed pre-, ante-, and post- completion of 2 repetition sets of five alternating knee flexion and extension maximum voluntary contractions at angular velocities of 90° (greater resistance) and 180° (lower resistance). Repeated Measures Analysis of Variance with Bonferroni correction identified statistically significant differences in pain for within- and between-subjects at 90° and 180°. Pain increased during the repetitions and decreased after completion of both repetition sets; this non-linear relationship was significant (p= .004). One-way ANOVA demonstrated peak torque (extension), a muscle’s maximum strength capability, was significantly higher in White cases and Blacks controls compared to Blacks cases. Novel findings revealed that baseline pain is much higher and functional performance is significantly lower in Blacks with OA compared to White cases and Black controls. This research advances precision pain measurement and our understanding of the biological mechanisms uniquely involved in the experience of knee OA and mobility.
The Medicare Current Beneficiary Survey (MCBS): Providing Unique Access to Data on the Medicare Population
Authors: Cohen Hildie , Hoyt Sarah , Navin Sara , Titus Jennifer , Ibrahim Mia 
Published: December 2021

Abstract
The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of the Medicare population, conducted by the Centers for Medicare & Medicaid Services (CMS). It collects data on demographics, health insurance, health status, health care expenditures, satisfaction with care, and access to care for Medicare beneficiaries. The MCBS provides a unique source of information regarding beneficiaries aged 65 and over and beneficiaries aged 64 and below with disabilities residing in the United States that cannot be obtained solely through CMS administrative sources. For researchers interested in issues of health care utilization and cost, CMS releases two Limited Data Set (LDS) files for each data year and a Public Use File (PUF) freely available for download and use. Also, special topic based PUFs have been released on the impact of COVID-19 on Medicare beneficiaries. This presentation will demonstrate the importance of the MCBS for research on the Medicare population, discuss how researchers can access the data, where researchers can find published MCBS estimates, what content areas have recently been added, such as food insecurity, limited English proficiency, and COVID-19 vaccination uptake and what new content is on the horizon. The presentation will also discuss the operational challenges posed by the COVID-19 pandemic, and the content enhancement opportunities created by the public health emergency. It will conclude with a review of the suite of materials and documentation available for data users to enhance their research and utilize more timely data.
The Effect of Behavioral Activation on Older Adults' Engagement and Wellbeing: A Randomized Control Trial Protocol
Authors: Scott Julia Turner , Luszcz Mary , Mazzucchelli Trevor , Walker Ruth , Windsor Tim 
Published: December 2021

Abstract
Meaningful activity engagement in later life is widely recognized as crucial for ageing well, but age-related changes and transitions can impede such participation. A behavioral activation framework can provide a person-centred, value-consistent therapeutic approach to increasing activity engagement that is both easy to administer, cost effective and accessible to a broad audience. Although there is evidence supporting the utility of behavioral activation as a treatment for depression in older adults, this study will be the first to examine whether a behavioral activation is more effective in increasing activity engagement and psychological wellbeing among a non-clinical sample of older adults, compared to a multi component positive psychology intervention. This randomized controlled trial will examine the impact of two therapeutic approaches on activity engagement and wellbeing among older adults. One hundred and fifty adults aged 65+ who have relatively lower scores on a measure of engagement with life will be randomized to either a behavioral activation-based intervention, or a multi-component positive psychology intervention. The interventions will involve six individual weekly sessions conducted via telephone or video conference. Participants will be assessed pre-, post-intervention, and at three months follow-up. Outcome measures will include activity engagement, positive affect, and psychological wellbeing. Intra-individual variability will also be assessed via micro-longitudinal data in the behavioral activation condition. This study will be the first to provide evidence to the effectiveness of behavioral activation as an intervention to increase activity engagement and wellbeing among older adults, compared to other therapeutic approaches to increase psychological wellbeing.
The Moderation Role of Acculturation on Dietary Patterns and Stress among U.S. Chinese Immigrants
Authors: Dong XinQi , Le Qun 
Published: December 2021

Abstract
Studies have demonstrated that healthy dietary patterns are related to diminished stress. However, the potential moderation role of acculturation on dietary patterns and stress is unclear among the those whose eating habits are impacted by immigration. The aim of this study is to explore the moderation role of acculturation on dietary patterns and stress among Chinese elder immigrants in the United States. Data were conducted from the PINE Study with 3053 Chinese adults aged over 60 years in the Great Chicago area. Dietary patterns were measured via a 48-items Food-frequency questionnaire with frequency and size weighted. Items were identified into different food groups based on Dietary Guidelines. Acculturation was assessed by a 12-item short-scale among the population. Stress was measured via a 10-item Perceived Stress Scale with cutoff 14 indicating either low or high stress. Multiple logistic regression was used to examine the moderation effects on the associations with demographic characteristics, medical comorbidities, and BMI adjusted. After controlling covariates, one unit increasing in fruit consumption (OR: 0.61 (95%CI: 0.52 -0.72)) or coffee (OR: 0.49 (95%CI: 0.36 - 0.67)) was associated with lower odds of stress. However, after adding acculturation as an interaction term, the negative relationship between fruit or coffee consumption with stress was moderated by a higher level of acculturation (fruit: OR: 1.05 (95%CI: 1.02 - 1.08), coffee: OR: 1.05 (95%CI: 1.01 - 1.09) respectively). The associations between dietary patterns and stress may differentiate based on acculturation level among the elder immigrants. Further longitudinal studies should investigate potential causality.
The Association between Subjective and Objective Financial Knowledge: Path Analysis to Investor Behavior by Age
Authors: Lee Rain , Sil Jin , Jung Euijin 
Published: December 2021

Abstract
Financial literacy affects stock market participation, as well as individuals’ age, gender, income, and education level. However, measuring financial literacy is more appropriate to identify individuals with strong knowledge of finance rather than average individuals with general knowledge. This could be problematic to identify general participation of the stock market and investment as more individuals are now participating without having to have such knowledge. This study explored how individuals’ subjective financial skills and well-being affect investment participation by age. Overall, males are likely to participate more in both retirement and non-retirement investment. In between the boomer generation and younger group, the younger generation who reported participating in a non-retirement investment, such as stock market were having a higher score on subjective financial well-being (STDYX = .052, 95% CI [.07, .08]; p &lt; .05). Importantly, among the older group, subjective financial skill score becomes a predictor of participating stock market (STDYX = .09, 95% CI [.01, .17]; p &lt; .05). As the result suggest, while younger participants focus more on financial well-being, such as having security on finances, when they are participating in a non-retirement investment, whereas older adults are likely to invest based on their beliefs on financial skills regardless of secured finances. A retirement plan has shifted toward less on savings and more on investing. Older adults are now interested more in participating in investments, such as the stock market than the young population, and the proper preparedness for those older adults in participating in the investment is needed.
Engaging Stakeholders in a Pragmatic Trial of Home-Delivered Meals for Persons with Dementia
Authors: Harrison Jill , McAuliff Kathleen , Thomas Kali 
Published: December 2021

Abstract
Gathering stakeholder feedback is essential to designing and implementing relevant and actionable research. Additionally, stakeholders, particularly those directly impacted by an intervention, bring unique insights and experiences. This paper presents the process and findings of a research endeavor to co-design a pragmatic clinical trial with a Stakeholder Advisory Panel (SAP) in an effort to understand facilitators and barriers to conducting the research and implementing study findings. The proposed trial compares the impact of frozen, drop-shipped meals versus daily home-delivered meals provided by Meals on Wheels (MOW) programs on the ability of individuals living with dementia to age in place. We recruited nine SAP members, who were compensated for their time. The SAP is composed of a) MOW clients with dementia, b) family members of MOW clients with dementia, c) paid or volunteer MOW drivers, and d) MOW staff. A research team member facilitated two 90-minute meetings with the SAP members via Zoom. The topics of the meetings included potential benefits and challenges with each mode of meal delivery, the importance of the primary outcome (time to nursing home placement), topics of interest to include in interviews with clients and caregivers, and how participants would explain the study to a friend. Audio of the Zoom meetings was transcribed, and meeting summaries were shared with the SAP. Benefits of forming and engaging a SAP, as well as key lessons learned from SAP members and how recommendations were reflected in changes to the study protocol will be discussed.
Living/Eating Arrangement, Loneliness, and Mental Distress among Older Korean Immigrants: Gender Difference
Authors: Park Nan Sook , Jang Yuri , Chung Soondool , Chiriboga David , Haley William 
Published: December 2021

Abstract
Structural isolation such as living alone poses a mental health risk in diverse groups of older adults, including older immigrants. Given that those living with others might also be disengaged, the present investigation included eating alone as another source of isolation and examined the impact of the combination of living and eating alone. The proposes of the study were to examine (1) how living and/or eating alone would impact mental distress, (2) whether the impact would be mediated by feelings of loneliness, and (3) if there would be gender differences in the mediation effect. The data were drawn from the Study of Older Korean Americans (SOKA), which surveyed older Korean immigrants in five states during 2017−2018. The living/eating arrangement was classified into four-groups: living/eating with others (57%), living with others/eating alone (12.4%), living alone/eating with others (7.3%), and living/eating alone (23.1%). Using the PROCESS macro, we tested the mediation effect of loneliness and the moderation effect of gender in the relationship between the typology and mental distress controlling for background/health characteristics and social capital related variables. Two groups (living with others/eating alone and living/eating alone) had sociodemographic, health, and social capital disadvantages. Analyses demonstrated that mental distress was linked with living with others/eating alone and living/eating alone, of which relationships were mediated by loneliness only among women. Findings suggest that not only structural isolation (e.g., living alone) but also disengagement with others (e.g., eating alone) need to be considered to understand emotional well-being in older immigrant population and gender difference.
Low Friend Connection Leads to Low Functional Capacity of Older Adults: Findings From a 2-year Longitudinal Study
Authors: Takase Mai , Takahashi Kyo , Ogino Ryogo , Tanaka Tomoki , Goto Jun , Iijima Katsuya 
Published: December 2021

Abstract
Maintaining personal connections in geriatric years is important to sustain the functional capacity of older adults. In this study, we define the term functional capacity as the ability to perform tasks and activities necessary for one’s independent life. Meanwhile, the type of personal connection and its effect on functional capacity remain unclear. We classified personal connections into connections with family or friends and examined their association with the functional capacity of independently living Japanese older adults. A two-year longitudinal study (2016 and 2018) was conducted using data from the Kashiwa Cohort Study. The amount of personal connections was determined using the Lubben Social Network Scale. The Japan Science and Technology Agency Index of Competence was used to assess participants’ functional capacity. The change in functional capacity was analyzed by binomial logistic regression analysis (N=638, reference: group with high family and friend connection). The results showed a decline in the functional capacity of the group with low friend and family connections (odds ratio (OR): 0.48, 95%CI: 0.29–0.82). This trend was also seen for the group with a high family connection but low friend connection (OR: 0.43, 95%CI: 0.24–0.78). Meanwhile, there was no significant difference between the reference group and the group with low family but high friend connection (OR: 0.85, 95%CI: 0.47–1.56). The results imply the importance of having a friend for sustainable functional capacity in old age. Interventions that facilitate friend-to-friend interactions or promote new friendships among older adults can be considered as support strategies.
The Association Between Spousal Support And Attitude For Gerontechnology Via Facilitating Conditions
Authors: Joo Susanna , Kim Seong Hee , Lee Changmin , Kim Kwang Joon , Kim DaeEun , Kim YoonMyung , Jun Hey Jung 
Published: December 2021

Abstract
This study examined the mediating effects of facilitating conditions (FC) on the association between types of social support providers and attitude toward using gerontechnology (AUG) or between types of social support and AUG. The sample was 256 older Koreans having a partner and children (N=256; 66-88 years old; M=69.91; SD=4.19). The dependent variable was AUG in terms of an exoskeleton robot for exercise. There were two kinds of independent variables: 1) four types of social support provider (spouse, children, siblings/relatives, and friends/neighbors), and 2) four types of social support (emotional, instrumental, physical, and financial support). Mediating variable was calculated as the mean of FC from five questions. There were two analytic steps: 1) structural equation modeling with four latent variables about types of social support provider, and 2) path analysis with four types of social support if only for significant providers at the first analysis. The results from the first step of analysis showed that only social support from spouses had a significant effect on AUG via FC to use gerontechnology. In the second step of analysis, emotional support from spouses was associated with the higher level of AUG via FC to use gerontechnology. The findings could shed light on the salience of emotional support from spouses in terms of the positive attitude on technology usage in later life through enhancing FC for technology acceptance.