bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonverbal Communication in Dementia Family Caregiving: Using the VNVIS-CG Scale for In-Home Video Observations.
Authors: Coleman Carissa , Williams Kristine , Inderhees Kacie , Richardson Michaela 
Published: December 2021

Abstract
Communication is fundamental for dementia care and identifying communication behaviors is key to identifying strategies that facilitate or impede communication. To measure caregiver nonverbal communication, we adapted the Verbal and Nonverbal Interaction Scale for Caregivers (VNVIS-CG) for second-by-second behavioral coding of video observations. The VNVIS-CG was adapted for computer-assisted Noldus Observer coding of video interactions captured at home by family caregivers from the FamTechCare clinical trial. Operational definitions for nonverbal communication behaviors were developed and inter-rater reliability was excellent (Kappa = .88) using two independent coders. Videos N=232 were coded featuring 51 dyads; caregivers who were primarily female (80%) spouses (69%) of men (55%) diagnosed with moderate to severe dementia (64.7%). Mean caregiver age was 65 years. Emotional tone conveyed by caregivers was primarily respectful, occurring 68.1% of the time, followed by overly nurturing (9%), bossy, harsh, or antagonistic (6.2%), and silence occurred 16.7 % of the time. Caregiver gestures and positive postures (i.e., animated facial expressions, head nodding, or caregiver body movements) were the most commonly occurring overt behaviors (46.5%), followed by changing the environment to help the PWD (19.9%), and expressing laughter/joy (18.9%). The least common nonverbal behaviors were negative posture, aggression, compassion, and rejecting. The adapted behavioral coding scheme provides a reliable measure that characterizes dementia caregiver nonverbal communication behaviors for analysis of video observations. Ongoing research will identify strategies that facilitate communication as well as determine how strategies vary by dementia stage, diagnosis, and dyad characteristics.
Transforming Aging: Increased Access to Care Minimizes Rural and Urban Differences in Cognitive Change
Authors: Ly Timothy , Allen Rebecca , Jackson Barbara , Albright Amy , Bell John , Carroll Dana , Halli-Tierney Anne 
Published: December 2021

Abstract
Rural-urban disparities in cognitive health outcomes, such as greater prevalence of cognitive decline among rural-dwelling older adults, have been linked to inequity in access to care. However, few studies have demonstrated whether longitudinal increased access to care may mitigate such disparities. This paper presents data from ongoing systematically collected behavioral health data on new and returning patients at an interdisciplinary geriatrics clinic at the University of Alabama Medical Center. The aim of this study was to determine baseline predictors of cognitive change across three annual visits (n = 42, mean age of 75.63 years (SD = 9.15)). Adjusting for baseline cognitive status, baseline subjective health literacy, and baseline depression and anxiety, results from a univariate ANCOVA showed that age at first visit (B = -.024, 95% CI [-.041, -.008], t(35) = -2.990, p = .005) and rural-urban status (B = .555, 95% CI [.123, .988], t(35) = 2.608, p = .013) predicted cognitive change at timepoint three (T3). Specifically, individuals from rural areas were less likely to experience cognitive decline and scored .555 points better than individuals from urban areas on cognitive screeners at T3 compared with baseline cognitive status. These results suggest that increased access to and utilization of care may ameliorate traditional disparate rates of cognitive decline between rural- and urban-dwelling older adults. Moreover, behavioral health screenings in primary geriatrics clinic care may help identify patient cognitive needs and facilitate integrated care through combined medical, pharmacological, and behavioral interventions to promote positive cognitive health outcomes.
Disparities in COVID-19 Related Worry Among Older Adults in the United States
Authors: Wheaton Felicia , Scatliffe Terika , Johnson Matilda 
Published: December 2021

Abstract
Racial disparities in COVID-19 exposure, illness, hospitalization and mortality have been well-documented, however, less is known about whether African Americans and other minorities experience greater worry related to the COVID-19 pandemic. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between race (white, African American, and other) and ethnicity (Hispanic/Non-Hispanic) and COVID-19 related worry among older Americans (N=2,069). Participants were asked, “because of the coronavirus pandemic how worried are you about 1) your own health, 2) the health of others in your family? 3) Your financial situation? 4) Being able to get help if you needed it from family, friends, or others? 5) What will happen in the future?” (0=not at all worried and 10=very worried). Results from OLS regression controlling for age, gender and education showed that compared with whites, African Americans had significantly higher average worry for all items except the last (other race did not differ). On the other hand, Hispanics had significantly lower worry, on average, for each of the five items. In addition, women had significantly higher average worry, while age was negatively associated with all items except the first. These findings indicate that in addition to the previously documented disparities in COVID-19, older African Americans experienced more worry. This has important implications for long-term physical and mental health.
Cross-National Perspectives on Health and Well-Being in Later Life
Authors: Ailshire Jennifer , Zhang Yuan 
Published: December 2021

Abstract
Cross-national comparisons are increasingly being used to re-evaluate whether our theories of aging are dependent on sociocultural context and to develop new insights into both long-standing and emerging issues in aging. The papers in this symposium use harmonized data from the Gateway to Global Aging to examine a range of topics in aging and provide new insights into key questions in aging research. Liu et al., determine whether social relationships mediate the association between early life adversity and later life health and well-being using longitudinal data from the U.S. and England. Considering multiple domains of the social determinants of health, such as socioeconomic status, social relationships, and health care access, Cho et al. identify which are related to self-rated health in China, Japan, and South Korea. Cheng et al. test the age-as-leveler hypothesis for explaining how socioeconomic differentials in health change in older ages in China and 19 European countries to determine if the protective effect of socioeconomic status on multi-morbidity changes with age. Harmonized data facilitate international comparisons papers, but additional efforts are sometimes needed to calibrate specific measures across international surveys. A major challenge in cross-national aging research, for instance, has been the limited ability to compare cognition across countries. Nichols and colleagues present a novel method for cocalibration of cognitive function across the U.S., England, and India that could be used for additional cross-national comparative research. The papers in this symposium demonstrate both the potential and challenges of cross-national studies of health and well-being among older adults.
East Meets West: Community-Based Programs for Dementia Prevention and Support
Authors: Sun Fei , Batchelor Melissa 
Published: December 2021

Abstract
This East Meets West Symposium presents cross-cultural evidence of community-based programs developed to address cognitive health needs of older adults or to support dementia family caregivers. It includes five studies from mainland China, Taiwan, and the U.S.A. The first study explored the adherence to computerized cognitive training to promote cognitive health among Chinese older adults using a qualitative approach. External encouragement, and self-awareness of performance improvement were found influential to older adults’ adherence. The second study spearheaded by American Association of Retired Persons (AARP) in the U.S.A shed further light on technology use in promoting brain health by comparing in-person versus online cognitive training to older Americans during the COVID-19 pandemic. The third study tested the effectiveness of a cognitive health management model for community-dwelling older adults including healthy and mild cognitively impaired (MCI) ones in Shanghai, China. Older adults with MCI who received the management service showed better cognition outcomes compared to their counterparts in the control group. The fourth study focused on a community program named “Carer Café”, developed to support dementia family caregiver in Taiwan. Participants (n=375) reported reduced stress and increased access to service referrals. The last study examined the stakeholders’ perceptions of dementia friendly initiatives (DFI) being implemented in U.S.A, mainland China, and Taiwan to support persons with dementia and family caregivers. The impacts of DFI made, challenges DFI faced, and strategies DFI used during COVID-19 pandemic were discussed. The discussant will comment on each article’s contributions and limitations in the context of literature.
Migration and Health: Freedom of Movement and Social Benefits for Chinese Migrant Workers
Authors: Qiu Fengxian , Zhan Heying , Liu Jing 
Published: December 2021

Abstract
Nearly 30% of China’s workforce consists of China’s rural-to-urban migrant workers, accounting for nearly 300 million of China’s population. Even though they have gained freedom of movement since the 1980s, they still have no access to healthcare in urban areas where they work. This study utilizes a mixed method of a survey with a sample of migrant workers from three Chinese emigration provinces (n=817) in 2018 and follow-up interviews with 30 migrant workers in 2020 to examine factors of migration experience affecting migrant worker’s health and healthcare. Using binary logistic regression, we found that migrant workers’ longer work experience is correlated with poorer self-rated health, their better financial status and level of hopefulness towards the future are positively correlated to self-rated health. Qualitative findings shed light on the cumulative effect of the length of work experience and fear of medical cost on migrant workers’ declining health. The lack of portability in health insurance and different reimbursement rates in health care access are structural barriers in health-seeking behaviors among migrant workers. Policy implications are presented in the global context of social rights and freedom of movement.
Person-Centered Care for Family Caregivers: Evaluating an Education Program for the Healthcare Workforce
Authors: Anderson Sharon , Parmar Jasneet , Pollard Cheryl , Dobbs Bonnie , Leslie Myles , McGhan Gwen 
Published: December 2021

Abstract
Background: While family caregivers [FCGs] provide 75-90% of care for people living in the community, most healthcare providers are not trained to provide person-centered care to FCGs. We followed research recommendations that the healthcare workforce receive competency-based education to identify, assess, support and partner with FCGs. Objective: Mixed methods evaluation healthcare workforce education program. Approach: We began by coining the concept “caregiver-centered care,” defining it as a collaborative working relationship between families and healthcare providers aimed at person-centered support for FCGs. From this definition, interdisciplinary stakeholders including FCGs (n=101) co-designed the Foundational Caregiver-Centered Care education. Learning resources included six competency-aligned educational modules with videos and interactive exercises that encourage reflection. Kirkpatrick Barr’s healthcare training evaluation framework underpinned our mixed methods evaluation. We measured participant’s reaction to the education (Level 1) and changes in learner’s knowledge and confidence to work with FCGs (Level 2). Results: 352 healthcare providers completed the education online (caregivercare.ca). Learners were satisfied with quality of education (Mean 4.75/5; SD=.5) and the education increased their motivation to learn more about caregiver-centered care (Mean 4.75/5; SD .5). Student’s paired samples T-test indicates pre-post education changes in knowledge and confidence to work with FCGs were significant [Pre (M=37.8, Sd=7.6) to post (M=47.2, SD=3.5) t (125) = -14.39, p&lt;.0005 (two-tailed)]. Qualitative results derived from open responses mirrored the quantitative results. Conclusion: The Caregiver-Centered Care education provides a foundation for educating healthcare providers working with FCGs to provide care to FCGs to maintain their wellbeing and sustain care.
Advancing State and Local Home Modification Practice and Policy: Findings From Aging Network Surveys
Authors: Overton Julie , Pynoos Jon , Nabors Emily , Terzaghi Damon , Blair Elizabeth , Wilson Traci , Steinman Bernard , Kunkel Suzanne 
Published: December 2021

Abstract
Home modification (HM) can promote older adults’ functioning as their needs change, reduce fall risks, and support caregivers. A supportive home environment is increasingly important as homes become healthcare delivery sites for home and community-based services (HCBS). HM is funded and administered by disparate agencies, often hindering access to HM services for at-risk older adults who need them the most. The Aging Network (State Units on Aging (SUAs), Area Agencies on Aging (AAAs), and Title VI organizations serving Native American older adults) plays an important but not well understood role in HM. To address this lack of research, the USC Leonard Davis School of Gerontology, ADvancing States, and the National Association of Area Agencies on Aging in cooperation with Scripps Gerontology Center conducted three national surveys, with support from the Administration for Community Living: 1) directors of the 56 SUAs with an 89% response rate; 2) directors of the 618 AAAs with a 79% response rate; and 3) directors of 276 Title VI programs with an 84% response rate. Exemplary practices included HM advocacy through interagency coalitions; state and local plan priority setting; creative HM financing with housing, disability, and health care sectors, including partnerships with Medicaid agencies; and integration of HMs into state and local HCBS, including nursing home transition and caregiver support programs. Findings on the types of HM activities, service delivery barriers, funding sources, collaborations, and targeted populations will inform HM policy and practice for the Aging Network’s critical state and local agencies serving low-income older adults.
Education of Caregivers and Veterans to Improve the Care of the Geriatric Psychiatric Patient
Authors: Sorocco Kristen 
Published: December 2021

Abstract
The geriatric psychiatry outpatient clinic provides assessment of the elderly Veteran with mental illness and behavioral and psychological symptoms of dementia. I will describe strategies developed and implemented in this setting to provide education to the caregiver (family) to improve early identification of delirium, depression and cognitive impairment. This education proved to reduce the number of pharmacological treatment and increase the use of nonpharmacological interventions based on "what matters to the patient" and following the BEERS criteria guidelines. One of the most important outcomes of the education and evaluation in the geriatric psychiatric clinic was a decrease in number of emergency room visits of elderly, specifically those with dementia.
Using Implementation Science to Inform and Evaluate Health Policy
Authors: Bobitt Julie , Prusaczyk Beth 
Published: December 2021

Abstract
Public health policies can be a tool for the promotion and protection of older adult’s well-being but how can we ensure that policies will be effective and applied as intended? This presentation will discuss how implementation science can be used to both inform and evaluate health policies. Scientific evidence developed by applying dissemination and implementation frameworks can be used to inform policy makers as they develop legislation. When used to evaluate policy, D&I frameworks can be applied to examine policy diffusion, how a state, community, or individual organization chooses to carry out the policy, and the impact that policy has on the intended population. D&I frameworks are an effective way to measure the difference between policy intent and what actually happens when a policy is implemented. Examples of how D&I frameworks have been used to inform and evaluate policy will be shared.
Age-Tastic: An Evidence-Based Intervention to Improve Health, Safety, and Well-Being in Older Adults
Authors: Pardasani Manoj , Berman Jacquelin , Powell Mebane , Gates Madison 
Published: December 2021

Abstract
Age-Tastic! is a holistic intervention that enhances the well-being, health and safety of older adults. Most evidence-based interventions aimed at older adults have focused on singular aspects of health such as cognitive health, falls prevention, depression, advanced care planning, etc. There are few interventions that encompass a holistic approach to health and safety. Age-tastic! is one such intervention that encompasses various aspects of health – social support, financial well-being, physical safety, mental health, health care management, and nutrition. Designed as a competitive board game to entice older adults, this intervention integrates concepts of cognitive restructuring, behavioral activation and game theory to educate, motivate and encourage healthful behaviors. At the core of this intervention is a focus on increasing awareness of health and safety issues, improving health literacy and changing harmful behaviors. A randomized control trial was conducted with 98 older adults assigned to an experimental and control group. Interviews were conducted at baseline, right after the intervention ended (8 weeks) and again after a short time (8 weeks after intervention ended). The results showed significant increases among experimental group participants in knowledge of healthy behaviors (p=0.05), perception of self-efficacy for engaging in healthful behaviors (p&lt;0.001) and engagement in health behaviors (p=0.001). Regression analyses demonstrated that greater knowledge and self-efficacy were associated with behavioral change within the intervention group (p&lt;0.001). Knowledge about the importance of preventing falls and communication with medical providers was positively correlated with the corresponding behavioral change (p&lt;0.05). Implications for health literacy among older adults will be shared.
Gender, Tobacco Control Policies, and Recalcitrant Smoking Among Older Adults in 20 European Countries
Authors: Gao Manjing , Lee Chioun , Park Soojin 
Published: December 2021

Abstract
Little is known about sociodemographic and macro-level predictors of “recalcitrant smoking,” defined as persistent smoking when one has developed a health condition that is likely caused by smoking. We aim to investigate the impact of gender, education, and tobacco control policies on recalcitrant smoking among older adults in Europe from 2006 through 2013. Data from 33,839 respondents—aged 50 years and older with a smoking history and at least one smoking-related health condition—were pooled from the 2006–07, 2011, and 2013 waves of three harmonized longitudinal studies on ageing (SHARE, ELSA, and TILDA). We fitted gender-specific logistic regression models with two-way fixed effects and tested interaction terms between gender, tobacco control policies, and education, adjusting for age, marital status, GDP per capita, smoking prevalence, country, and year-fixed effects. Compared to men and individuals with higher levels of education, women and less educated individuals were more likely to be recalcitrant smokers. The association between education and recalcitrant smoking was stronger for women than men. The inverse association between the TCS and recalcitrant smoking was stronger for those having upper secondary education (for men: OR = 0.905, CI = 0.849–0.965; for women: OR = 0.897, CI = 0.834–0.964) and tertiary education (for men: OR = 0.802, CI = 0.717–0.898; for women: OR = 0.739, CI = 0.603–0.907), compared to those having less than upper secondary. As women and less educated individuals are vulnerable to recalcitrant smoking, future policies targeting these marginalized groups are needed to prevent recalcitrant smoking in old age.
Elders or Old Men?
Authors: Cole Thomas 
Published: December 2021

Abstract
Thomas R. Cole, GSA Abstract, 3.9.2021 Elders or Old Men? My book Old Man Country is about 12 successful, respected older men who think back on their lives and current aging. When starting my research, I first questioned my own aspirations for aging: What would my aging be like? Who would I become? What would be my purpose as an old man? Although I expected that strength and resilience would be the common thread of elderhood, it was actually their vulnerabilities that defined them (accepting losses, acknowledging dependency.) More so, these vulnerabilities did not demarcate a descent but rather a continuous uphill struggle that differentiates elderhood from growing old. Ultimately, I argue that elderhood is not a life stage or a right of passage but rather an individual process to be worked through, if one so chooses.
Elderhood in Protestant Religious Contexts: Stepping Stones in Religious Language
Authors: Spännäri Jenni 
Published: December 2021

Abstract
Elderhood is an emerging concept for making meaning in older age, often contextualized in spiritual but not religious traditions. But what kinds of frameworks for elderhood are woven into protestant religious contexts? This paper explores 943 texts written by Finnish older adults in study groups organized by a pensioners’ organization. A key finding is that religious language – known through religious songs and prayers learned by heart at school – offers a medium to explore and express their elderhood. The writers creatively use the rhythm and wordings of these textual patterns to position themselves as a group of older persons with a special contribution to make to society. These results will aid examining elderhood and its potential in various contexts where the concept might not be explicitly used. This examination potentially leads to new ways to support experiences of elderhood and thus to offer an alternative view to countering ageism.
Leveraging Free Public Use Data for Aging and Life Course Research
Authors: Cleveland Lara , Cagney Kathleen 
Published: December 2021

Abstract
This symposium will showcase life course and aging research that is possible using freely available integrated census and survey data available via IPUMS. This session is organized by the Network for Data-Intensive Research on Aging (NDIRA) initiative at the University of Minnesota’s Life Course Center. NDIRA seeks to build and support an interdisciplinary community of scientists leveraging powerful data resources in innovative ways to understand health outcomes at older ages, as well as the demography and economics of aging. The session features papers that illustrate how to examine aging-related topics including health at older ages, work and socioeconomic conditions, and living conditions with a common thread of examining heterogeneity within groups. These papers all leverage freely available census and nationally-representative survey data, highlighting the potential value of these data for studying aging and the life course. By combining papers on an array of topics from a variety of data sources, this symposium highlights exemplar papers that demonstrate the types of novel research possible using public use census and survey data that NDIRA seeks to foster.