bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE POWER OF ARTS-BASED ACTIVITIES: APPLICATIONS OF AN INTERGENERATIONAL HAIKU-MAKING ACTIVITY
Authors: Matsumoto Yoshiko , Maeda Harumi 
Published: January 2025

Abstract
The power of arts- and humanities-based activities for enhancing the well-being and quality of life of older adults is well documented in the existing literature (e.g., Fraser et al., 2015; Letrondo et al., 2023; Young et al., 2016). An intergenerational haiku-making activity designed and implemented by the authors et. al. (2021, 2024) is one such activity. In this activity, 2-3 older adults living with mild cognitive impairment (MCI) interact with 2-3 university students to create haiku poems based on seasonal photos of their choice, followed by short one-on-one feedback interviews. Analysis of the recorded activity sessions demonstrates how the activity created meaningful outcomes for both older and younger participants, including increased emotional well-being, intergenerational understanding, and self-expression. This presentation discusses two applications of the intergenerational haiku-making activity in two different settings. First, we designed and taught a community-engaged learning course in which undergraduate and graduate students learned first-hand how humanities-based intergenerational activities enhance intergenerational communication and mutual understanding. Second, the activity was re-designed to target older Japanese immigrants living with cognitive impairment by incorporating elements that encourage them to draw upon their Japanese language heritage. The bilingual version will be implemented in a local Japan-focused adult day services program. This presentation highlights the effectiveness of arts- and humanities-based activities by showing the ways in which one particular activity can be expanded and applied in different settings to offer tailored benefits to people of varying ages and cognitive conditions.
AGE-FRIENDLY HEALTH SYSTEMS 4MS IMPLEMENTATION: THE NEED FOR BOOSTER STRATEGIES
Authors: Pohnert Anne , Schiltz Nicholas , Dolansky Mary 
Published: January 2025

Abstract
This study describes the implementation of the Age-Friendly Health System (AFHS) 4Ms Framework within the largest convenient care health system in the U.S. Implementation and improvement science methods were used to facilitate adoption of the 4Ms into ~1,100 MinuteClinics located in 35 states and DC, and to educate the ~3,300 providers working at these locations. Modifications to the electronic health record enabled the comprehensive documentation of assessments and actions related to the AFHS 4Ms. Formative evaluation utilized Tableau dashboards for provider and manager reporting. In the initial year, the project employed a quality improvement design. Only 22% delivery of the 4Ms was achieved after the first year indicating that “booster” strategies were needed. Following 18 months of implementing additional booster strategies to enhance 4Ms uptake, the system received IHI Regional Committed to Care Excellence recognition, achieving significant improvements across all 4Ms. As of 2024 Q1, 38.0% of eligible patients visits receive all 4Ms, while XX% receive at least one of the 4Ms. While improvement and implementation science methods facilitated initial implementation, further understanding and enhancement strategies are essential for scaling up and widespread adoption.
AN IMPLEMENTATION BOOSTER TO EMPOWER THE PATIENT AND CAREGIVER: 4MS ADVOCACY TIP SHEET
Authors: Napoleon Betty , Zonsius Mary , Zimmerman Elizabeth , Foradori Megan , Dolansky Mary 
Published: January 2025

Abstract
Consumer driven reminders are another way to increase the uptake of evidence-based practices. With that in mind, our patient advocacy council engaged in the development of an Age-Friendly Advocacy Tip Sheet. Patients shared that they were unaware as to how to ensure that they received AFHS 4Ms care. Patients’ views enhance insights into booster strategies for implementation of the 4Ms. It is not only essential for providers to have access to resources to deliver the 4Ms of care, but it is equally important for consumers to have tools to boost 4Ms care. Through multiple iterations, feedback sessions, and on-going qualitative analysis, we supported our Patient Advisory Council to create an Age-Friendly Health Systems Advocacy Tip Sheet to empower older adults to prioritize the 4Ms of care during appointments. This Tip Sheet includes self-advocacy suggestions, information on the 4Ms of care, and a work-sheet style space to list questions and concerns before the visit. There is also a space for note taking during the visit, along with next steps for acting on what matters. A scannable QR Code on the back of the Tip Sheet provides access to additional resources and information on Age-Friendly Health Systems. Feedback from both providers, patients, and other older adults has been overall positive, with remarks such as it is helpful, user-friendly, colorful, easy to understand, and applicable to pre-appointment preparation.
THE EFFECT OF ETHNIC ENCLAVE ON COGNITION AND EVERYDAY FUNCTIONING DIFFERS ACROSS NEIGHBORHOOD DISADVANTAGE
Authors: Clark Alexandra , Morriss Emily , Grant Jeremy , Esiaka Darlingtina , Ajrouch Kristine , Tarraf Wassim 
Published: January 2025

Abstract
Ethnic enclaves represent concentrated geographic areas where Hispanic community members reside in close proximity to same group peers. Previous research has revealed evidence of a “barrio advantage” where living in an ethnic enclave is associated with better health outcomes. However, there is some evidence to suggest (1) the protective effects of enclave may be moderated by neighborhood-level socioeconomic factors and (2) the impact of ethnic enclave on cognitive and functional outcomes remain poorly understood. The present study leveraged data from the Hispanic Established Populations for the Epidemiological Study of the Elderly to examine the effects of ethnic enclaves on cognitive and functional outcomes. We examined associations between tract-level segregation (Hispanic-Specific Getis-Ord Gi*) and baseline cognitive and functional outcomes, as well as change over time. Analyses included cluster adjusted linear regression models sequentially adjusted for neighborhood and individual level sociodemographic measures. Findings showed a positive association between enclave residence and baseline cognitive status, controlling for neighborhood and individual level socioeconomic disadvantage. The enclave effects did not extend to baseline functional status. Despite positive enclave effects at baseline, enclave residence was associated with faster rates of cognitive and functional decline. Markers of socioeconomic disadvantage were not consistent modifiers of associations between the enclave effect and cognitive and functional outcomes. Results will be discussed within the ecological system theory to emphasize environmental contexts are important for late life cognitive and functional outcomes, and further highlight potential points of intervention that may promote equitable aging outcomes in Hispanic older adults.
IMPROVING ASSISTED LIVING RESIDENTS QUALITY OF LIFE: RESULTS FROM AN MN ASSISTED LIVING REPORT CARD
Authors: Shippee Tetyana , Woodhouse Mark , Skarphol Tricia , Moeller Kelly , Glass Lauren , Shands Rachel 
Published: January 2025

Abstract
In 2019, Minnesota enacted new legislation resulting in creation of an online Assisted Living Report Card. As part of this work, two surveys, the Resident Quality of Life Survey and Family Satisfaction Survey, were developed to assess AL residents’ quality of life (QOL) and family satisfaction. Our study presents the development and analysis of these surveys in Minnesota AL communities from 2020-2023. Resident respondents (N=12,091) were predominantly female (68.6%) and White (81.4%), with mean age 82.8 years; family satisfaction survey respondents (N=11,935) were mostly female (64.2%) and White (91.1%), with a mean age 63 years. Respondents rated various survey items with scores from 0 (lowest) to 2 (highest) for resident QOL, and 0 (lowest) to 3 (highest) for family satisfaction, with mean scores calculated for each of the domains. Overall, resident quality of life and family satisfaction scores were high, yet “overall satisfaction” (1.22), “engagement” (1.48), and “food” (1.53) domains had the lowest scores, while “environment” (1.88), “finances” (1.85), and “security” (1.82), had the highest mean scores among residents. Among family members, having one’s “personal needs met” (2.12) and “finances” (2.13) had the lowest mean scores, while “choice” (2.36), “housekeeping” (2.38), and “environment” (2.39) had the highest mean scores. Insights from our study highlight areas for improvement to enhance well-being and satisfaction among AL residents and their families.
MINNESOTA’S ASSISTED LIVING LICENSE: ENGAGEMENT OF SMALL ASSISTED LIVING PROVIDERS
Authors: Moone Rajean , Shippee Tetyana , Hakanson Megan 
Published: January 2025

Abstract
When Minnesota passed State Statute 144G in 2019 it fundamentally changed the licensure of assisted living communities in the state. This new regulatory framework was developed by a group of stakeholders representing consumer advocates, provider advocates, and state government. However, assisted living providers who served culturally specific persons in small communities were largely absent from the development of this new license. As a result, several unintended consequences and challenges have emerged in implementation in these settings. We interviewed a sample of 14 licensed assisted living directors operating small, culturally specific communities to understand their experiences with the regulatory framework. After a qualitative analysis four main themes emerged: (1) lack of participation in the initial license development, (2) challenges to implementation of license requirements, (3) inconsistency in and preparation for survey inspections, and (4) inadequate reimbursement and funding. To address these concerns, several recommendations were identified which ranged from ensuring all stakeholders are engaged in policy development to developing a new rate setting methodology for Medicaid waivers. Although these recommendations are specific to Minnesota, they do have implications for other states and agencies that are developing similar regulations.
OFFERING ACCREDITATION TO ASSISTED LIVING COMMUNITIES IN NORTH CAROLINA
Authors: Efird-Green Lea , Zimmerman Sheryl , Sloane Philip , Reed David , Tian Yuke , Davis Scott , Preisser John 
Published: January 2025

Abstract
In 2021, the North Carolina Legislature approved and funded the Adult Care Home [Assisted Living] Accreditation Pilot Program. Across the state, the program’s goal is to evaluate the effectiveness of accreditation through quality outcome measures to determine whether accreditation achieves compliance with licensure requirements and improves or maintains quality of care compared to a control group. Assisted living communities were selected using stratified random sampling that accounted for geographic region and state-assigned quality rating. A total of 146 communities originally agreed to participate. Of the 73 communities randomly assigned to the accreditation arm, to date 39 (53%) either withdrew or chose to not go through the process of accreditation; 4 (5%) withdrew after beginning the accreditation process; 24 (33%) achieved accredited status; and 6 (8%) are delayed in completing the process or not likely to do so. The key reason for withdrawal from the accreditation process is the time and effort required in the context of staffing shortages, which has implications for long-range implementation even if accreditation is found to be beneficial. This session will present the aims and methods of the evaluation; the accreditation process itself (including benefits, potential administrative burden, and types of deficiencies found during surveys); the feasibility of becoming accredited for diverse participating communities; and potential strategies to bolster capacity for accreditation. (Additional contributors to this and the outcome presentation include Teresa Hoosier [ACHC], Jeff Horton [NCSLA], Frances Messer [NCALA], Barbara Sylvester [ACHC], and London Grantham, Aja Johnson, Danielle Owens, Toni Parker, and Katrice Perry [UNC].)
THE BRIDGE CARE MODEL: TRANSITIONAL CARE FOR PERSONS EXPERIENCING HOUSELESSNESS
Authors: Leutwyler Heather , Cuffaro Taylor 
Published: January 2025

Abstract

Introduction
Persons experiencing houselessness (PEH) are well-understood to prematurely age, experiencing higher rates of geriatric conditions at a younger age, considered “older” by age 50. Based on the rigorously-tested Transitional Care Model for older adults, UCSF Street Nursing provides low barrier care to PEH during transitions from emergency departments (ED) and in-patient admissions. Our practice focuses on: nurse-led early assessment and engagement; continuity and coordination of care; the patient-clinician relationship; holistic focus on individual patient’s needs; education and promotion of self-management; active engagement of patients and their support network; and patient-driven evidence-based care planning to address health problems and risk factors that contribute to frequent ED visits and hospital readmissions among PEH.

Methods
UCSF Street Nursing meets patients in the ED or in-patient prior to discharge and follows them for 6-12 months, supporting integration into community outpatient care. Clinical activities include: medication administration, wound care, street-based syphilis and STI treatment, complex care coordination, complex medication management, health education focused on self-management, and co-attending primary and specialty care visits both virtually and in-person. Outcomes: The average age of the 58 patients referred to our practice was 52 (sd=12.5). Given the premature mortality and accelerated aging of PEH, our sample represents an older adult population. Our practice produced a greater than 50% reduction in ED visits in the first 6 months following discharge.

Conclusion
UCSF Street Nursing is a promising nurse-led novel approach to care for unhoused older adults with potential to reduce hospitalization and improve health for an overlooked population.
DISTRIBUTION AND DETERMINANTS OF LONG-ACTING INJECTABLE ANTIPSYCHOTIC MEDICATION USE AMONG OLDER ADULTS
Authors: Lohman Matthew , Verma Mansi , Jones Paige , Scott Victoria , Fields Eve 
Published: January 2025

Abstract
While long-acting injectable antipsychotic medications (LAIs) are important components in the management of schizophrenia and related disorders, little is known about LAI use among older adults in real-world settings. We analyzed electronic health records from the South Carolina Department of Mental Health comprising 41,401 patients (n=8,481 aged &gt; 60) who received ambulatory psychiatric services at one of 16 regional mental health centers in 2022. We compared use of eight types of first- and second-generation LAIs by demographic (age, race/ethnicity, gender, zip code, insurance source) and clinical characteristics (primary and secondary diagnoses, oral antipsychotic use). Logistic regression models were used to estimate associations between individual characteristics and likelihood of using LAI medications. In total, 1,400 adults age &gt; 60 used LAIs in 2022, including 1,231 with schizophrenia or another psychotic disorder. Compared to younger adults, older adults were less likely to use LAIs but more likely to use first vs. second-generation LAIs (OR=2.19, p&lt;.001). Controlling for diagnosis, insurance provider, and total services, older adults were significantly more likely to use LAIs if they were male (OR=1.40, p=.002), Black (OR=2.46, p&lt;.001), Asian (OR=9.79, p=.001), and living in a suburban area (OR=1.33, p=.009). There were no significant demographic differences in oral antipsychotic use. Results suggest that LAI use among older adults differs substantially by sociodemographic characteristics while oral antipsychotic use does not. Understanding reasons for differences is important to determine and promote equitable access to and use of LAIs across racial/ethnic, geographic, and other sociodemographic groups of older adults.
BIOLOGICAL SEX MODERATES THE EFFECT OF EXERCISE ON COGNITIVE FUNCTION IN ADULTS WITH CHRONIC STROKE
Authors: Gamboa Rebeca Hernández , Falck Ryan , Dao Elizabeth , Liu-Ambrose Teresa 
Published: January 2025

Abstract
Exercise (EX) and cognitive/social enrichment (ENRICH) are promising strategies for promoting cognitive function post-stroke. The effects of these interventions on cognitive function may vary by biological sex, i.e. males (M) vs females (F). We conducted a secondary analysis of a three-arm, six-month, assessor-blinded, randomized clinical trial among 120 community-dwelling adults aged 55+ years with chronic stroke (i.e., ≥12 months since stroke), to examine if biological sex moderates the effects of EX or ENRICH on cognitive function. Participants were randomly assigned to 2x/week EX (N=34, M=21, F=13), 2x/week ENRICH (N=34, M=23, F=11), or 2x/week balance and tone control (BAT, M=30, F=22). Our primary outcome of cognitive function was the Alzheimer’s Disease Assessment Scale Cognitive Subscale Plus (ADAS-COG-Plus) at baseline, end of intervention (6 months), and follow-up (12 months). Using linear mixed models, we examined if biological sex moderated the effects of EX or ENRICH on cognitive function using planned contrasts. Baseline ADAS-Cog-Plus and Mini Mental State Exam score were included as fixed-effect covariates. Biological sex moderated the effect of EX, but not ENRICH, on ADAS-Cog-Plus (F = 5.75, p&lt; 0.01). The effects of EX compared to BAT were significantly larger for females than males (estimated mean difference: -0.394, 95% CI: -0.778, -0.011, p&lt; 0.05). EX females had better ADAS-COG-PLUS performance at end of the intervention (estimated mean difference: -0.463, 95% CI: -0.758, -0.168, p&lt; 0.005) compared with females in the BAT group. Findings suggest that exercise may be a key strategy to promote cognitive function among older females living with stroke.
EXPLORING NOVEL DETERMINANTS OF EXERCISE BEHAVIOR: A LAGGED EXPOSURE-WIDE APPROACH
Authors: Lee Harold , Kim Eric , Conroy David , VanderWeele Tyler 
Published: January 2025

Abstract
Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method that is particularly useful for identifying determinants. We used data from 13,771 participants in the Health and Retirement Study (HRS), a diverse, national panel study of adults aged &gt;50 in the United States, to evaluate 62 candidate predictors of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2:2014/2016) on baseline candidate predictors (at t1;2010/2012) controlling for all covariates in the previous wave (t0;2006/2008). Some health behaviors (e.g., ever exercising), physical health conditions (e.g., physical functioning limitations and lung disease), psychological factors (e.g., health mastery, purpose in life, and positive affect), and social factors (e.g., helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise. To conclude, we identified potentially novel exercise determinants, such as purpose in life and helping others, that have not been captured using a theory-driven approach. Future studies validating these findings in older adults are needed.
A CRITICAL CARE PATHWAY BASED ON ICOPE TO PROMOTE HEALTHY AGING OF OLDER ADULTS
Authors: Yu Doris Sau Fung , Tang Yiting , Chen Shuangzhou , Chen Feng 
Published: January 2025

Abstract
The United Nations Decade of Healthy Aging 2021-2030 calls for proactive and collaborative strategies to optimize the functional capacity of older adults. Aligning with the World Health Organization advocacy of optimizing the functional capacity of older adults through increasing the compatibility of their intrinsic capacity (IC) of older adults and the environment, the research team has developed the 12-week Pathway to Healthy Aging to translate the ICOPE care model to the Chinese community. The 12-week Pathway to Healthy Aging is a health-social collaborative model that adopts the WHO-ICOPE approach, together with the concepts of clinical critical care pathway, case management, empowerment-based behavioral modification and health-oriented peer coaching to promote healthy aging to the older adults with signs of accelerated aging. From September 2022 to June 2023, the care model was provided to 806 targeted clients recruited from a territory-wide region in Hong Kong. The speaker will share experiences and challenges of translating the WHO ICOPE care model in a Chinese community. More specifically, she will share the insights on: i) how to integrate the ICOPE assessment data to identify the health care priority of older adults, ii) method to develop the critical care pathway to promote person-center care and longer-term behavioral change for healthy aging promotion, iii) strategies to optimize effective collaboration between the nurses and health-oriented peer coach in case management. The presentation will conclude with remarks to inform future initiatives aimed at preparing society for an aging population.
IMPACT OF THE CRITICAL CARE PATHWAY ON INTRINSIC CAPACITY ON HEALTHY AGING PROMOTION
Authors: Zhai Xiangyu , Tang Yiting , Chen Shuangzhou , Chen Feng , Yu Doris Sau Fung 
Published: January 2025

Abstract
The United Nations Decade of Healthy Aging prompted the implementation of the “Pathway to Healthy Aging”, a 12-week health-social collaborative care program. This program, based on the Integrated Care for Older People (ICOPE) care pathway by the World Health Organization, incorporated clinical critical pathways, empowerment-based behavior modification, and health-oriented peer support. Intrinsic capacities of older adults were used as health indicators for effectiveness evaluation. From January 2023 to January 2024, 1024 older adults (female = 868; Mage = 75.5, SD = 7.52) participated, with 493 completing a six-month follow-up. Outcome-based evaluations demonstrated significant improvements across three time-points in locomotor capacity based on Timed Up and Go Test (χ²(6)=73.49, p&lt;0.001, Cramér’s V=0.16) and Short Physical Performance Battery (χ²(4)=31.83, p&lt;0.001, Cramér’s V=0.12), cognitive capacity (measured by Montreal Cognitive Assessment 5-minute protocol; F(2, 984)=52.93, p&lt;0.001, partial η²=0.11), and psychological capacity (measured by 15-item Geriatric Depression Scale; F(2, 984)=11.31, p&lt;0.001, partial η²=0.09). No significant change in hand grip strength (χ²(4)=6.15, p=0.188). Vitality capacity, based on Mini Nutritional Assessment, improved immediately after the program (χ²(4)=7.45, p=0.047, Cramér’s V=0.09) but showed no significant further change at the six-month follow-up, based on pairwise comparison analyses (Bonferroni’s correction). Insomnia (The Insomnia Severity Index) also significantly improved (χ²(6)=77.42, p&lt;0.001; Cramér’s V=0.16). This program demonstrates the effectiveness of the ICOPE care model in promoting healthy aging in real-world settings, emphasizing the potential of collaborative care models to enhance the elderly population’s intrinsic capacities. These findings have critical implications for stakeholders working towards the United Nations’ goal of fostering healthy aging.