bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creating Dementia-Inclusive Communities Using a Geriatric Workforce Enhancement Program Framework
Authors: Drost Jennifer , Sanders Margaret 
Published: December 2021

Abstract
The Geriatric Workforce Enhancement Program (GWEP) sponsored by HRSA provides an organizing framework around which dementia inclusive community initiatives can be successfully implemented and sustained. The overarching goal of all GWEPs is to improve outcomes for older adults by promoting evidence-based education that spans the continuum of care. This includes integration of academic, clinical, and community-based providers. By their very nature, all GWEPs partner across agencies throughout the state to deliver interprofessional education that will impact people living with dementia and their caregivers at the community, primary care, and acute care levels. Dementia inclusive community initiatives must have this kind of high-level interagency coordination. Our GWEP has successfully implemented Dementia Friends sessions across multiple sectors (Veterans, EMS, clergy, libraries, developmentally disabled, living alone) both in-person and virtually due to COVID-19. This symposium will share the methods to organize at the community level to deliver a unified message community-wide.
Gaps in the System: Supporting People Living With Dementia and Their Caregivers
Authors: King Madeline , Peckham Allie , Roerig Monika , Marani Husayn , Marchildon Gregory 
Published: December 2021

Abstract
As individuals are living longer, the prevalence of older adults living with dementia and other complex health and social care needs is on the rise (Alzheimer’s Association, 2020; CIHI, 2020). Correspondingly, efforts to develop supportive programming and policies for persons living with dementia (PLWDs) are of paramount importance (CIHR, 2019). The challenges faced by PLWDs and other complex health and social needs are widely known (CIHR, 2019), however, a systematic understanding of how and if current and long-standing efforts are adequately meeting the needs of these individuals remains elusive. This research sought to understand how program administrators, decision makers, PLWD, and caregivers across five North American jurisdictions (British Columbia, Ontario, Newfoundland and Labrador, New York State, and Vermont) perceived specific dementia care programs and support services within their respective jurisdictions. We performed an inductive analysis of semi-structured interviews (N=37) and identified on-going care gaps experienced by participants. We present three main gaps: 1) disconnected and uncoordinated system infrastructure, 2) lack of comprehensive services to meet the diverse needs of PLWD and their caregivers, and 3) inconsistency in how dementia is understood; with associated perceived remedies. The results suggest that even when attempts to address the needs of PLWD and their caregivers are put in place there remains significant limitations of systems. The perspectives of decision makers, program administrators and individuals with lived experience offer unique insight into how these experiences may be improved to better support the complex needs of PLWD and their caregivers.
Disparities in COVID-19 Mortality in High-Minority Nursing Homes
Authors: Lord Justin , Weech-Maldonado Robert , Davlyatov Ganisher , Ghiasi Akbar , Orewa Gregory 
Published: December 2021

Abstract
Racial/ethnic disparities in healthcare have been highlighted by the recent COVID-19 pandemic. Minorities continue to utilize nursing home services at a higher rate than White residents, contributing to existing health inequity concerns. This study examined the relationship between nursing home racial/ethnic mix and COVID-19 resident mortality using the CMS Nursing Home COVID-19 Public File. As of October 25, 2020, high minority nursing homes reported 6.5 COVID-19 deaths as compared to 2.6 deaths for nursing homes that had no racial/ethnic minorities. Four nested sequential negative binomial regressions were used to model the relationship between racial/ethnic disparities in COVID-19 deaths and the separate contributions of facility-level resident characteristics (percent of females, percent of residents 65 years and older, percent of residents with congestive heart failure, hypertension, and obesity, and the average level of residents’ acuity), resource availability (nursing homes’ payer-mix, occupancy rate, county-level Social Deprivation Index, and nursing home location), and other organizational characteristics (nursing home for-profit status, chain affiliation, and self-reported nursing, clinical, aides, and other staff shortages). After controlling for interstate differences, facility-level resident characteristics, resource availability, and organizational characteristics, high-minority nursing homes had 61% more COVID-19 deaths (Incidence Rate Ratio [IRR] = 1.61; p &lt; 0.001) as compared to nursing facilities with no minorities. From a policy perspective, nursing homes, that serve primarily minority populations, may need additional resources, such as, funding for staffing and equipment in the face of the pandemic. The COVID-19 pandemic has sharpened the focus on healthcare disparities and societal inequalities in the long-term care.
The Intersection of Older Students and Disability: How Age-Friendly Universities Can Boost Visibility and Accessibility
Authors: Barragan Cassandra , Walsh Sarah 
Published: December 2021

Abstract
The needs of older learners differ from traditional students, and many services and resources available at higher education institutions are geared towards students aged 18-25 (Silverstein, Choi, & Bulot, 2001). Age Friendly University (AFU) principles highlight the need to consider older learners at a university. Older learners face various barriers to education including balancing schoolwork with responsibilities and accessibility of campus resources (Silverstein et al., 2001). This study examined how an AFU designated university is working to better understand their older students. Methods: A web-based pilot survey of older learners (N=248) asked all students ages 40 and older a series of questions regarding motivation to attend school, barriers and supports, campus environment, and connection with AFU principles. Analysis: A t-test analysis explored differences in motivation, barriers and challenges, and connection to campus between students who identified as having a disability and those who did not. Findings: We found there were significant differences between the groups in how health impacted their education (p=.001), being able to physically access campus (p=.014), the availability of online classes (p=.047), and the hours of operation of student support services (p=.045). There were also differences between groups in how connected they felt to campus based on feeling welcomed by faculty (p = .033) and feeling satisfied with their level of engagement at the university (p = .002). Discussion: Our results demonstrate the need to fully engage older learners with a disability as part of diversity and inclusion efforts to facilitate connection to the campus community.
Provider Perceptions of Video Telehealth in Home-Based Primary Care During COVID-19
Authors: Gorbenko Ksenia , Franzosa Emily , Brody Abraham , Leff Bruce , Ritchie Christine , Kinosian Bruce , Federman Alex , Ornstein Katherine 
Published: December 2021

Abstract
The COVID-19 pandemic accelerated the adoption of virtual care. In this qualitative study, we sought to determine provider perceptions of video telehealth during the first wave of COVID-19 in NYC to inform practice for home-based primary care providers nationwide. We conducted semi-structured interviews with clinical directors, program managers, nurse practitioners, nurse managers, and social workers at 6 NYC practices (N=13) in spring 2020. We used combined open and focused coding to identify themes. Participants employed both hospital-supported and commercial technological platforms to maintain care during COVID-19. Benefits of video telehealth included improved efficiency, capacity and collaboration between providers. Barriers included patients’ physical, cognitive or technological abilities, dependence on caregivers and aides to facilitate video visits, challenges establishing trust with new patients and addressing sensitive topics over video, and concerns over missing important patient information. Considering patient, clinical, and technological conditions can help optimize telehealth implementation among older homebound adults.
Barriers to Sustained Implementation of STAR-VA and Strategies to Overcome Them
Authors: Sullivan Jennifer , Adjognon Omonyele , Pendergast Jacquelyn , Wray Laura , Karel Michele , Curyto Kimberly 
Published: December 2021

Abstract
STAR-VA is an evidence-based, interdisciplinary program helping CLC teams effectively manage DBD. We conducted interviews with 42 key informants involved with STAR-VA implementation in 20 CLCs, guided by a sustainment framework, to understand facilitators and barriers to sustained implementation. We used directed content analysis to identify barriers and mapped them to the CFIR-ERIC Mapping Tool to identify associated implementation strategies. We identified six barriers: 1) staffing issues, 2) lack of written policies, 3) staff buy-in, 4) limited leadership support, 5) exclusion of STAR-VA criteria in performance evaluations, and 6) service line silos. We identified six strategies to overcome these barriers, three strategies most frequently mapped to reported barriers to STAR-VA sustainment: 1) assessing local CLC readiness, facilitators and addressable barriers; 2) identifying and preparing new champions; and 3) altering incentive/allowance structures. The identified strategies can be packaged to further integrate STAR-VA into usual CLC care processes to optimize program sustainability.
Social Connectedness Risk Among Middle-Aged and Older Black Men With Chronic Conditions
Authors: Smith Matthew , Sherman Ledric , Goidel Kirby , Cudjoe Thomas 
Published: December 2021

Abstract
Social connectedness is a multi-factorial concept encompassing structural, functional, and quality aspects. For those with chronic conditions, threats to social connectedness can exacerbate illness symptomology and impose barriers to disease self-management. This study identified factors associated social connectedness risk among Black men ages 40+ years with one or more chronic conditions. Data from 2019 were analyzed from a national sample of 1,200 Black males collected with an internet-delivered questionnaire. Three logistic regression models were fitted to assess factors associated with not having enough people to call for help (structural), feeling isolated from others (functional), and not being content with friendships/relationships (quality). All regression models were adjusted for age, education, marital status, number of chronic conditions, self-reported barriers to disease self-management, and having cut-down or skipped social activities because of health problems. On average, participants were age 56.7 (±9.7) years and self-reported 4.0 (±2.9) chronic conditions. Approximately 23% were ages 65+ years, 45.4% cut-down or skipped social activities because of health problems, 25.2% did not have enough people to call for help, 26.0% felt isolated from others, and 23.8% were not content with friendships/relationships. Across the three regression models, men who were middle-aged (P&lt;0.05), never married (P&lt;0.01), cut-down or skipped social activities because of health problems (P&lt;0.001), and reported more barriers to disease self-management (P&lt;0.001) were significantly more likely to report social connectedness risk. Findings suggest that efforts to improve the self-management of illness symptomology may mitigate threats to structural, functional, and quality aspects of social connectedness among this male population.
The Impact of Structural and Functional Social Resources on Loneliness Among Americans Age 50 Years and Older
Authors: Zucchetto Jillian Minahan 
Published: December 2021

Abstract
Social isolation and loneliness have many negative consequences (e.g., Cacioppo et al., 2006; Griffin et al., 2018; Uchino, 2006), especially among older adults (Perissinotto et al., 2012). According to the cognitive discrepancy theory (CDT), loneliness is the negative psychological state resulting from the perceived discrepancy between one’s desired level of social resources and one’s actual level of social resources (Peplau & Perlman, 1982; Perlman & Peplau, 1998). Social resources have both structural (e.g., objective) and functional (e.g., perceptions of the quality) aspects (Holt-Lunstad, 2017). The relationship between structural and functional social resources has been described as a filtration process in which functional aspects mediate the association between structural aspects and loneliness (Cacioppo et al., 2016; Hawkley et al., 2008, Hawkley & Kocherginsky, 2018). However, this filtration model has not been empirically tested within the CDT. This study examined the relationship among structural social resources (SSR), functional social resources (FSR), and loneliness cross-sectionally and longitudinally using a sample of 3,345 Americans aged 50 years and older from the 2008 and 2012 waves of the Health and Retirement Study. Results showed that there was a significant indirect effect both cross-sectionally (β = -.07) and longitudinally (β = -.06) such that FSR mediated the relationship between SSR and loneliness. Ultimately, the CDT is useful in explaining the complex relationship between structural and functional aspects of one’s social resources with loneliness, and interventions may seek to target the functional aspects of one’s social network to improve loneliness, rather than focusing solely on structural aspects.
Cohort Differences and Similarities in Women's Attitudes About Self and Aging
Authors: Sherman Aurora , Bookwala Jamila 
Published: December 2021

Abstract
This panel focuses on four complementing and international views of women’s aging, with a special emphasis on cohort comparisons and using three different studies of women, with contrasting methodological frameworks. In so doing, we present evidence related to trends in social percepetions of aging, attitudes about aging and identity, and ideas about control and objectification. Dr. Newton presents data on older Canadian women showing the connection between physical aging and identity maintenance, using both qualitative and quantitative data and using the lifecourse perspective. Dr. Ryan, using data from the Health and Retirement Study to compare cohorts of women from the 2008 and 2018 HRS waves, reports cohort differences in negative self-perceptions of aging, and that both cohort and negative self-perfections are associated with life satisfaction, using the life course developmental framework. Ms. Tran compares younger and older cohorts of women on a measure of self-objectification, finding that the older cohort reported lower objectification, consistent with a selection, optimization, and compensation (SOC) model. Finally, Dr. Sherman, using the same data set as Ms. Tran, shows that control beliefs are associated with objectification, regardless of cohort, consistent with objectification theory predictions of consistency over time regarding the impact of objectification experiences. Dr. Jamila Bookwala will provide discussion of this group of papers.
Types of Late-Life Challenges to Aging in Place
Authors: Kim Kyeongmo 
Published: December 2021

Abstract
Many older adults prefer to live within their community because they have built strong relationships with their neighbors and neighborhood. Although housing-related factors promote aging in place, findings on the relationships of late-life challenges to aging in place (e.g., cost of living, autonomy) and relocation are mixed. Less is known about the types of challenges to aging in place and about the relationship between the types of challenges and relocation. Using data from the AARP 2015 Age-Friendly Community Surveys (N=3,190 adults aged 65 and older), this study examined the intersection of challenges to aging in place (e.g., home size, cost, safety, independence, family, transportation) and relocation (i.e., move to a different home outside of their community). Using latent class analysis (LCA), we identified five subgroups of late-life challenges to aging in place: multifaceted challenges, cost of living, independence, social connection, no concern. Findings from LCA with a distal outcome showed that older adults with multifaceted challenges (b=0.77, p&lt;.001), were more likely to move out of their community, compared to those with lower levels of challenges, even after adjusting for age, sex, education, income, and chronic diseases. Also, those with challenges regarding the cost of living (b=0.84, p&lt;.001), independence (b=0.64, p&lt;.001), and family connection (b=0.45, p&lt;.001) were more likely to expect to move out of their community. The findings highlight that older adults have different types of challenges to aging in place. Practitioners and policymakers should provide more individualized supportive services, considering the types of challenges to promote aging in place.
Ambulatory Assessment of Socio-Affective and Cognitive Aging: Zooming Into Daily Processes
Authors: Meier Tabea , Horn Andrea , Roecke Christina 
Published: December 2021

Abstract
Ambulatory assessment methods offer new possibilities to study cognitive, emotional, and social processes in the setting in which they naturally occur, namely in the daily life of individuals and couples. This allows to zoom into processes with great relevance for healthy aging and well-being over the lifespan. Research on daily psychological processes opens the door for investigating the interplay with contextual (daily stress, social resources) and stable factors (relationship quality status, accumulated discrimination) that are known to shape these dynamic processes. This symposium will present and discuss innovative contributions investigating daily emotional and cognitive functioning and their interplay with social and individual characteristics over the adult lifespan. The first study by Haas and colleagues will present experience sampling data on daily prospective memory performance in couples. Haas et al. will offer a dyadic perspective on cognitive functioning by examining how prospective memory performance is co-regulated in the daily lives of younger and older couples. Meier et al. will present another study from the same couples project; here the focus is on age differences in couples’ “we-ness” and its relationship with daily positive emotional experiences and how they are shared with the partner. The series of talks will be completed by Zavala et al. who examined associations between stress and emotional health in daily life and its interplay with prior discrimination experiences of an age-diverse sample of BIPOC adults. After these individual contributions, Christina Roecke will discuss the presented studies and provide her reflections on the results and their implications.
Age Differences in Personality Structure
Authors: Jackson Joshua , Condon David , Beck Emorie 
Published: December 2021

Abstract
Most investigations in the structure of personality traits do not adequately address age, as few studies look at the structure of personality traits a-theoretically, instead presupposing a theoretical structure e.g., Big Five. As a result, the relationship among indicators within a trait (coherence) are often highlighted but relationships across traits (differentiation) are not thoroughly examined. Using a large-scale sample of 369,151 individuals ranging in age from 14 to 90, the present study examines whether personality indicators show differential relationships as a function of age. Results indicate that coherence shows few changes across the lifespan, while differentiation weakens across adulthood into old age. These finding suggest that Big Five indicators only parallel the Big Five structure among young but not older adults. Thus, using standard Big Five personality trait assessments in older adults may, at best, not reflect reality and, at worse, undermine the predictive utility of personality traits.
COVID-19 Response In U.S. Assisted Living Settings: Key Stakeholder Perspectives
Authors: Dys Sarah , Winfree Jaclyn , Carder Paula , Zimmerman Sheryl , Thomas Kali 
Published: December 2021

Abstract
Unique regulatory requirements and scope of services within assisted living (AL) pose distinctive challenges to COVID-19 response. To identify COVID-19 issues specific to AL, we recruited stakeholders with expertise in AL operations, policy, practice, and research (n=42) to participate in remote interviews between July and September 2020. Using thematic analysis, we derived the following overarching themes: 1) Policymakers lack an understanding of the AL context; 2) AL administrators were left to coordinate guidelines with little support; 3) AL organizations faced limited knowledge of and disparate access to resources; 4) State-level regulatory requirements conflicted with COVID-19 guidelines resulting in confusion; and 5) AL operators struggled to balance public health priorities with promoting their residents’ wellbeing. To develop evidence-informed policy and avoid unintended consequences, AL operators, direct care workers, residents, and clinicians practicing in these settings should have opportunities to provide feedback through the policy development process, both state and national.
Building Friendships Through Volunteering in Late Life: Does Gender Moderate the Relationship?
Authors: Lim Emily , Peng Changmin , Burr Jeffrey 
Published: December 2021

Abstract
Friendship plays a crucial role in maintaining social connectedness in late life. Volunteering helps older adults to stay socially engaged and often times provides the opportunity to meet and make new friends. A small literature suggests that volunteering may be associated with friendship, but many studies are limited by reliance on small, non-probability samples and simplistic analytic approaches. The literature is also unclear on how volunteering behaviors relate to specific characteristics of friendships and whether there are gender differences that condition these relationships. Using the 2014 and 2018 waves of the Health and Retirement Study (N=1,638 ), we investigate whether volunteer status and hours volunteered in 2014 are associated with friendship characteristics in 2018 (i.e., number of close friends, friendship quality, and contact frequency) among community-dwelling adults aged 50 years and above (M=65.60 years old, SD=8.31). We also examine whether gender moderated these relationships. Volunteer status and hours in 2014 were positively associated with the number of close friends and contact frequency in 2018. Only those who volunteered 200 hours or more in 2014 were positively associated with friendship quality in 2018. Regarding gender differences, men who volunteered 200 hours or more in 2014 had higher friendship quality in 2018 than women, while women who volunteered 100-199 hours in 2014 had greater contact frequency in 2018 than men. Hence, our results suggest volunteering is integral in shaping late-life friendships and volunteering might be more critical for understanding friendship characteristics among older men and women.