bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Interdisciplinary Collaboration to Improve Hypertension Medication Adherence for Older Adults
Authors: Lee Jeannie , Rogers Wendy 
Published: December 2021

Abstract
Hypertension is highly prevalent in older adults (74.5% in ≥60 years) with dire consequences, and adherence to hypertension medications is low (approximately 50%). With increased smartphone use among older adults (81% for 60-69 years, 62% for ≥70 years), technology innovations can improve medication adherence. This symposium highlights the efforts of an innovative interdisciplinary team of experts (clinical, cognitive aging, human factors, health technology) to develop and implement the Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM) system to improve hypertension medication adherence for older adults. MEDSReM is a theory-based, integrated mobile application (app) and companion web portal that educates, supports missed dose decisions, reminds, monitors adherence, and incorporates blood pressure feedback. In this symposium, we describe the interdisciplinary development efforts. Insel et al. will present the theory-based intervention, technology translation, and advancement of the MEDSReM system. Lee et al. will describe the interdisciplinary team and describe the work by the decision support subteam that created the medication formulary and generated an algorithm to guide missed-dose decisions based on pharmacology of aging. Rogers et al. will discuss the education subteam’s development of educational information about hypertension, medications, and adherence for the MEDSReM system. Mitzner et al. will illustrate the instructional support sub-team’s efforts to ensure older adults can interact with both the smartphone app and online portal. Lastly, Hale et al. will describe the user testing subteam’s usability processes including the integration of blood pressure self-monitoring. These efforts will provide insights for other interdisciplinary teams developing technology interventions for older adults.
Foundational Basis for the Development of MEDSReM
Authors: Insel Kathleen , Einstein Gilles , Morrow Daniel , Lee Jeannie , Rogers Wendy , Mitzner Tracy 
Published: December 2021

Abstract
Discovering a composite of measures of executive function/working memory predicted everyday medication adherence among older adults, led to the development of a behavioral intervention, the Multifaceted Prospective Memory Intervention (MPMI) to improve hypertension medication adherence. The intervention resulted in a 35% improvement in adherence compared to an active education and attention control condition. However, adherence slowly declined over an additional five months of adherence monitoring without the presence of interventionists in the home. We proposed that the use of technology might help individuals maintain the prospective memory strategies, resulting in sustained adherence. An interdisciplinary team was formed to translate the behavioral intervention to technology, resulting in the first version of the MEDSReM system. In this presentation we describe the evolution of the project, from the components of the successful MPMI to the design and initial testing of MEDSReM. These efforts provide general insights about translating interventions into technology tools.
Using O*NET Linkages to Advance Research: An Example Evaluating Cognitive Function and Work Transitions
Authors: Carr Dawn 
Published: December 2021

Abstract
The type of work older adults engage in has potential to play a key role in shaping health and wellbeing. In this presentation, using data drawn from an O*NET crosswalk linked with the Health and Retirement Study, I show how different types of transitions out of the workforce shapes cognitive function differently for individuals retiring from different types of occupations. Based on a factor analysis of 36 job-related abilities, activities, and contexts, this paper shows that retirement has a more significant consequence for cognitive function for those who retire from jobs with low levels of cognitive complexity, but no significant consequences for those who retire from jobs with high levels of cognitive complexity. I discuss these results in the context of the ways in which O*NET classifications of jobs can provide critical insights into the potential influence of changing retirement trajectories on wellbeing in later life.
Community-Based Participatory Research on Diet and Activity With an Indigenous Pueblo Community
Authors: Kopera-Frye Karen 
Published: December 2021

Abstract
Tribal Critical Race Theory (Brayboy, 2005) supports the use of decolonizing methodologies such as Community-Based Participatory Research when collaborating with Indigenous communities. This paper highlights the underlying processes in working with a Pueblo community on an intergenerational health project. Indigenous participants included 16 Piro Pueblo individuals who collaborated on a project examining healthy diets and activity in their community. The project involved providing information on the importance of activity and healthy eating of traditional foods to promote healthy living. Thematic analysis of open-ended questions exploring the role of culture in food and activity yielded important themes of gathering, resilience, history, honoring ancestors at mealtime, cultural ways, and activities such as dancing and drumming. The results suggest that projects addressing diet and activity collaborate to ensure cultural values, e.g., connectedness, cultural ways, e.g., gathering, dancing, and Indigenous knowledge are represented in the project and viewed through an Indigenous lens.
CPBR Process in Urban Settings and the Unique Challenges and Successes
Authors: Kim Steffi 
Published: December 2021

Abstract
CBPR is a framework that allows for the collaboration of researchers and communities as co-partners and is a supported approach for Indigenous communities. The community engagement and co-partnership in this study allowed for the researcher's flexibility to be responsive to culturally appropriate practices and priorities of the communities and participants. CBPR principles, including the Elder Advisory Committee (EAC), were utilized in this urban-based project. Challenges presented in many ways, including the processes of a) entering communities, b) relationship building, c) time involvement, and d) recruitment. Successes represented the unique opportunity to enter communities at an interpersonal level, b) close community engagement, c) gathering information beneficial for the research team and the community, and d) extended community engagement. While challenges exist, this approach's benefits are far-reaching promoting trust, support, and interest in future research endeavors. The presenter will discuss strategies and processes helpful in engagement, recruitment, and data collection.
The GSA NIA R13 Diversity Mentoring and Career Development Workshop: what did we learn after 3 years?
Authors: Heyn Patricia , D'Antonio Patricia , Whitfield Keith 
Published: December 2021

Abstract
The goal of the GSA NIA R13 Diversity Mentoring and Career Development Technical Assistance Workshop (GSA Diversity TAW) is to support, promote, and advance the training of diverse students in aging research. The program’s main aim is to increase the number of early career scientists who are historically underrepresented in gerontological research. Thus, from 2018 to 2020, more than 60 trainees and 16 faculty from diverse backgrounds participated in this unique gerontological training that included peer mentoring opportunities and engagements at the GSA Annual Meeting. The workshop curriculum included scientific presentations, networking, NIH grant preparation, career planning, and effective professional communication. Trainees and faculty were involved in the evaluation of the workshop, which included electronic surveys and focus groups that informed the design and curriculum of subsequent workshops. This paper will discuss the curricular design and objectives of the GSA Diversity TAW and present a summary of the trainees’ feedback results about the program and the iterative changes made based on that data.
Impact of a Pharmacist-Led Diabetes Management Intervention to Improve Health Equity
Authors: Smith-Ray Renae , Singh Tanya , Makris Evie , Horan Jaime , Taitel Michael 
Published: December 2021

Abstract
The COVID-19 pandemic and Black Lives Matter movement brought increased recognition to the need for health equity. Diabetes, the 7th leading cause of death, is one of many conditions where health inequities are evident. A higher percentage of Black (11.7%) and Hispanic (12.5%) U.S. adults are diagnosed with diabetes compared to non-Hispanic Whites (7.5%). To address this health inequity, a nationwide pharmacy chain implemented telephonic ‘Advanced Care’ (AC) outreach for patients with diabetes. During the AC call, pharmacists used motivational interviewing techniques to counsel patients on the importance of closing gaps in care and reducing barriers to medication adherence. Gaps included timely A1C testing, exams (eye, foot, kidney), immunizations (influenza, pneumonia, Hepatitis B), and recommendation of additional therapies for patients with multiple chronic conditions (ACE/ARB, statins). Medication fill gaps were compared between the Intervention period (8/1/20-1/31/-21) and a pre-intervention period (2/1/20-7/31/20). The AC pilot occurred in 8 Chicago Walgreens locations that primarily serve Black and Hispanic patients. Eight control stores were matched on census block-level household income and race/ethnicity, patient volume, and insurance mix. A pre/post-test vs. control difference-in-difference (DID) analysis was conducted to compare on-time refill rates. Of the 1,009 older patients (age≥50) called, 59.9% were reached. The DID analysis showed that patients in pilot stores had improved pre-post on-time refill rates compared to controls (p&lt;0.0001). Diabetes self-management is key to reducing diabetes-related complications. Early findings from this pilot demonstrate that the Walgreens AC intervention improves medication adherence - an important step toward improving health equity.
A Profile of Black and Latinx Older Adults Receiving Care in Nursing Homes: 2011-2017
Authors: Travers Jasmine , Dick Andrew , Wu Bei , Grabowski David , Agarwal Mansi , Perera Gayani , Stone Patricia 
Published: December 2021

Abstract
Between the years 1999-2008, a substantial increase in nursing home use occurred among Black and Latinx older adults, while white older adults’ use of nursing homes decreased. These disparate trends suggested potential racial and ethnic disparities in options for preferred long-term services and supports (LTSS) settings. Over the last decade, several initiatives have been put in place to support LTSS needs in the community. However, it is unclear whether Black and Latinx older adults are continuing to use nursing home services at disproportionate rates. We used LTCfocus data for 2011-2017 to explore current trends in nursing home use and access among Black and Latinx older adults in light of these current initiatives. Our findings reveal a continued rise in Black and Latinx older adults’ use of nursing homes while white older adults’ use continues to decline. More notably, there has been a decline in nursing homes servicing these minority groups.
Coping and Caregiver Burden and Depression Among Chinese Caregivers of Older Adults With Cognitive Impairment
Authors: Wang Kaipeng , Gao Xiang 
Published: December 2021

Abstract
Coping strategies are important factors that influence caregivers’ mental health outcomes. The purpose of this study is to examine the association between coping strategies and caregiver burden and depression among Chinese caregivers of older adults with cognitive impairment. Data came from structured interviews with 300 primary family caregiver-care recipient dyads in Wuhan, China. We used OLS to examine the association between coping strategies and caregiver burden and depression. More positive reframing and acceptance were associated with lower caregiver burden, whereas more self-distraction was associated with higher caregiver burden. More positive reframing was associated with lower caregiver depression, whereas higher self-distraction and religion were associated with higher caregiver depression. Findings of this study suggest that a psychosocial intervention package that emphasizes on enhancing positive reframing skills and affirming acceptance may be effective in reducing caregiver burden and depression among Chinese caregivers of older adults with cognitive impairment.
Challenges Faced by Nursing Home Direct Care Workers During the COVID-19 Pandemic: A Comparison Across Care Settings
Authors: Bryant Natasha , Cimarolli Verena , Stone Robyn 
Published: December 2021

Abstract
The COVID-19 pandemic has generated awareness of the value of the direct care workforce to provide care in settings serving those most at risk from the disease. However, few studies have gauged the impact of COVID-19 on this workforce and their pandemic-related challenges. The purpose of this study was to examine the challenges and stress experienced by direct care workers (N=1,414) and their perceptions of preparation and quality of employer communication during this health crisis. Nursing home (NH) workers reported separation from family members and understaffing as the top external and work-related challenges. They felt adequately prepared and gave their employers high marks for communicating with them during the pandemic. NH direct care workers were more likely to report increased workload and understaffing as a challenge compared to workers in home and community-based settings. They also experienced a significantly higher number of work-related challenges compared to workers in assisted living.
Job Resignation in Nursing Homes During COVID-19: The Role of Employer Communication and Worker Preparedness
Authors: Cimarolli Verena , Bryant Natasha , Stone Robyn , Falzarano Francesca 
Published: December 2021

Abstract
Although research on factors mitigating the negative impact of strain/stress experienced by nursing home (NH) workers during the pandemic is emerging, there is no research on how COVID-19-related work stress and employer supports influence NH workers decision to resign. The purpose of this study was to investigate if high quality communication related to COVID-19 by the employer – a form of job support - can mitigate the impact of work stress on NH employees (N=1,730) decision to resign by optimizing employees’ preparedness to care for residents with COVID-19. Guided by the Job-Demands-Control-Support Model and employing path analyses, results indicate that higher stress was associated with greater likelihood of resigning, which operated through the paths of communication quality and preparedness. While higher stress was associated with less optimal quality of communication, good quality of communication was associated with more optimal preparedness which was associated with reduced likelihood of leaving one’s job.
Presidential Symposium: From Disruption to Transformation: Challenging and Changing the New Normal
Authors: Waldrop Deborah , Rozario Philip , Greenfield Emily 
Published: December 2021

Abstract
While the refrain “We’re all in this together” is meant to describe a sense of universality of our exposure and adaption to the Covid-19 pandemic life, the deeply rooted racial and economic injustices and ongoing health crises continue to expose the inequities experienced by many older adults. In this symposium, we focus on existing disparities and possibilities for transformation. The first paper discusses systemic racism as a structural driver of practices and policies that influence poverty, poor housing and neighborhood conditions, worse health profiles, relationship loss and social isolation among older Black adults. The second paper illuminates the importance of health equity and collaboration between aging and healthcare systems to improve the well-being outcomes and address disparities of older adults from racial-ly/ethnically diverse backgrounds. The third paper illustrates how the privatization of Medicare has created bureaucratic complexities that increase cost and burdens for beneficiaries. The fourth paper presents the ways that the pandemic has exposed the challenges of a nonexistent Long Term Services and Support system; specifically, in refocusing our attention on the working conditions of in-home and residential workers, such as poor compensation, and high turnover and mounting demands on families. The fifth paper addresses the importance of collaboration between nursing homes and assisted living communities with governmental emergency operations in times of disasters and public health crises. Each paper addresses pressing issues that have created the “new normal” for older adults; together the presenters explore the disruptions and offer solutions for renewed transformation.
Making Medicare Complicated: The Consequences of Privatization
Authors: Herd Pamela 
Published: December 2021

Abstract
Starting with policy changes in the 1980s, Medicare has largely become privatized, with nearly 40 percent of beneficiaries enrolled in private Medicare Advantage plans and another 30 percent with private supplemental coverage, including for prescription drug coverage. As a result, Medicare has become laden with administrative burdens and barriers. Beneficiaries are faced with a confusing array of plans and coverage options when they enroll, and are expected to choose a new plan every year. The choice they make has large implications for their health care costs, as well as their actual access to health care. While we typically think that targeted policies are burdensome and social insurance programs are accessible, Medicare contradicts this easy categorization. Instead, it demonstrates how private sector involvement in public programs can increase complexity and increase burdens for beneficiaries.
Birth Cohort Differences in Multimorbidity Burden Among Aging U.S. Adults
Authors: Bishop Nicholas , Haas Steven , Quiñones Ana 
Published: December 2021

Abstract
Multimorbidity is the co-occurrence of two or more chronic health conditions and affects more than half of the US population aged 65 and older. Recent trends suggest increased risk of poor self-reported health, physical disability, cognitive impairment, and mortality among later born birth cohorts, yet we are unaware of work examining cohort trends in multimorbidity among aging US adults. Observations were drawn from the Health and Retirement Study (2000–2018) and included adults aged 51 and older across 7 birth cohorts (1923 and earlier, 1924–1930, 1931–1941, 1942–1947, 1948–1953, 1954–1959, and 1960–1965). Multimorbidity was measured as a count of 9 chronic conditions including heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer (excluding skin cancer), depression, and cognitive impairment. General linear models adjusting for repeated measures and covariates including age, sex, race/ethnicity, and education were used to identify whether trends in multimorbidity varied across birth cohort. 31,923 adults contributed 153,940 total observations, grand mean age was 68.0 (SD=10.09), and mean multimorbidity was 2.19 (SD=1.49). In analyses adjusted for age and other covariates, adults born 1948–1953 reported .34 more chronic conditions (SE=.03, p&lt;.001), adults born 1954–1959 reported .42 more chronic conditions (SE=.03, p&lt;.001), and adults born 1960–1965 reported .55 more chronic conditions (SE=.03, p&lt;.001), than those born 1931–1941, respectively. Our preliminary results confirm increasing multimorbidity among later birth cohorts of older Americans and should help guide policy to manage impending health declines among older Americans.
The Interaction of Life Course Socioeconomic Status and Leisure Activities on Cognitive Performance in Old Age
Authors: Sun Rongjun , Zhang Zhenmei 
Published: December 2021

Abstract
While the separate effects of socioeconomic status and engaging in leisure activities on cognition have been well documented, their interaction effect has rarely been examined. After examining life course socioeconomic status (SES) on cognitive impairment in old age, this paper is focused on exploring the interaction effects between life course SES and leisure activities. We use data from the Chinese Longitudinal Healthy Longevity Survey, which covers five waves of interviews of adults aged 65 or older between 2002 and 2014. Cognitive impairment is measured by the Chinese version of Mini-Mental Status Examination. Two sets of variables are used to reflect an older person’s life course SES in childhood and adulthood, respectively. Seven leisure activities are included in this analysis. We adopt the lagged independent variable approach and a Generalized Linear Mixed Model to examine the association between leisure activity and cognitive impairment over time. Results show that there is an independent impact of SES in both childhood and adulthood on cognitive decline in Chinese older population. Furthermore, as the focus of this study, there are substantial interactions between life course SES and engaging in leisure activities with a consistent pattern: those of higher life course SES enjoy extra benefits from engaging in leisure activities. The interactions between life course SES and leisure activities promise a competing approach accounting for cognitive health inequality among older adults.
Next Level Health: a holistic health and wellbeing program to empower New Zealand women
Authors: Chinn V , Neely E , Shultz S , Kruger R , Hughes R , Page R , Coad J , Thunders M 
Published: December 2021

Summary
Improving equity in women’s health requires gender-specific and empowering approaches. However, health programs often disempower women by adopting a ‘one-size-fits-all’ approach that emphasizes diet, exercise and weight loss over other important aspects like sleep and mental wellbeing. This article reports on the design of Next Level Health (NLH), a program that aims to empower women through developing a wide range of health behaviors to support their holistic wellbeing. NLH is grounded by ethics, theory and evidence to support women to make achievable, sustainable changes that are relevant to their everyday lives. Women utilized the NLH framework to develop an integrative health routine across six domains: physical activity, sleep, nutrition, eating behavior, self-care and stress management. The framework guided them to set small, incremental goals that were adaptive to their needs and built from their existing circumstances. Participants reflected on their progress with a facilitator during monthly meetings, accessed a social media support page and received monthly text messages. Health programs remain an essential approach to improving women’s health alongside community- and policy-level strategies. The development of NLH exemplifies how evidence may partner with modern health promotion values to inform relevant and ethical program design for women.