bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOW FRONTLINE STAFF PERCEIVE AND REDUCE GAPS IN KNOWLEDGE AND PRACTICE IN LOCALLY INITIATED QUALITY IMPROVEMENT
Authors: Kramer B Josea , Douglas Joseph 
Published: January 2025

Abstract
We evaluated local quality improvement projects that were conducted as part of continuing professional development (CPD) for disciplines that support primary care in Veterans Health Affairs (VA) clinics and medical centers with the goal of understanding how the workforce perceives areas for improvement. The VA Geriatric Scholars Program (GSP) provides core training in its longitudinal CPD through intensive didactic courses in geriatrics, interactive workshop in quality improvement (QI) and coaching to implement a local QI project. Unlike most CPD that includes a QI component in focused training on a specific new clinical intervention, participants in GSP had wide latitude to determine the change to be implemented to enhance healthcare for older Veterans. Using a qualitative approach and applying thematic analysis, we analyzed 740 QI projects at 468 VA facilities undertaken by 809 GSP participants. Clinician-initiated projects indicated the workforce perception of gaps in primary care knowledge and prior training of its interdisciplinary workforce to provide care for older adults in the choice of clinically oriented projects, such as reducing potentially inappropriate medications or instituting fall prevention activities. Other projects focused on enhancing processes within the healthcare system, such as timely lab reports or referral protocols. Our results indicate that educational needs assessments can be conducted at the interprofessional team level, identifying the needs for CPD that are perceived as relevant by the workforce.
VETERAN- AND CAREGIVER-REPORTED FACTORS IMPACTING VETERAN-DIRECTED CARE (VDC) PROGRAM ENROLLMENT AND EXPANSION
Authors: Hathaway Wendy , Tyagi Pranjal , Bouldin Erin , Nasr Samer , Dang Stuti 
Published: January 2025

Abstract
The Department of Veterans Affairs (VA) is increasing access to Home- and Community-Based Services (HCBS) as an alternative to long-term institutional care (LTIC). Veteran Directed Care (VDC) is a self-directed HCBS program that empowers veterans at risk of LTIC to hire their own care providers. The VA is increasing VDC access by expanding the program to all VA medical centers (VAMCs) nationally. As part of a multi-aim and mixed-method evaluation project examining barriers and facilitators to expanding VDC, qualitative semi-structured interviews were conducted across seven VAMCs in Florida, South Georgia, and Puerto Rico with two groups of veterans who were referred to VDC: those that enrolled in the program (n=2) and those that declined (n=2). We also interviewed family caregivers of veterans in both groups (n=2 each). Interviews were conducted via Microsoft Teams from January-March 2024 and recorded with auto-transcription. Data were analyzed using rapid qualitative analysis techniques. Enrolled veterans and their caregivers pointed to several facilitators including the ease of enrollment; user-friendly management tools; compensation for care; role recognition; the ability to choose their caregiver and schedule; the reliability and trustworthiness of self-selected care providers; and relationships formed. Those who declined to enroll identified several barriers such as the program complexity; burdensome employee management tasks; fear of losing eligibility for other programs and services; and feeling the compensation was inadequate. Interviews are still ongoing. Understanding the veteran and caregiver perspectives on enrollment will inform strategies and mechanisms to support VA’s goal of increasing VDC access and veteran participation.
EXAMINING SELF-REPORTED SLEEP QUALITY WITH COGNITIVE PERFORMANCE IN OLDER HISPANIC ADULTS: THE COMPADRE STUDY
Authors: Young Vanessa , Gaona Carlos , Serrano-Rubio Luis , Wang Chen-Pin , Kautz Tiffany , Kaye Jeffrey , Beattie Zachary , Gonzales Mitzi 
Published: January 2025

Abstract
Poor sleep quality has been associated with worse cognition performance. As sleep quality is multidimensional, examining separate factors captured by the PROMIS™ Sleep Disturbance 8b scale, insomnia, and sleep dissatisfaction, may provide greater insight into aspects most pertinent to cognitive health. Herein, we evaluated the associations between self-reported sleep quality, dissatisfaction, and insomnia with cognition in older Hispanic adults and examined whether self-reported physical activity modifies these associations. Participants completed self-report measures of sleep quality (PROMIS-Sleep Disturbance 8b) and physical activity (Rapid Assessment of Physical Activity). The National Alzheimer’s Coordinating Center UDSv3 measured cognitive abilities. Associations between self-reported sleep with cognition were examined using linear regression models adjusted for age, sex, and education. Interactions with physical activity were evaluated. A total of 85 participants were included (mean age 69.9[SD 4.8] years; 72% Female; 100% Hispanic). Self-reported sleep quality, dissatisfaction and insomnia were not significantly associated with any cognitive outcomes (p&gt;0.05) and there were no significant interactions with physical activity (p&gt;0.05). Although self-reported sleep quality measures were not associated with cognitive performance in this exclusively Hispanic cohort, previous research using objective sleep measures has shown a connection. This highlights the need for objective assessments that capture various aspects of sleep, such as architecture, microarousals, and sleep-disordered breathing. Digital biomarkers of sleep and physical activity, currently underway in the COMPADRE study, may increase precision into their impact on cognitive health in this at-risk, underrepresented, population; reduce cultural bias in measurement and outcomes; and facilitate targeted interventions to promote healthy aging.
PARENTHOOD AND SLEEP IN A POPULATION-BASED SAMPLE OF OLDER ADULTS
Authors: Duckett Jacquelyn , Sneed Rodlescia 
Published: January 2025

Abstract
Numerous studies have examined the association between parenthood and health-related outcomes in young and middle-aged adults; however, there has been less inquiry into how parenthood is associated with health-related outcomes among adults aged &gt;50. Further, few studies have explored how various aspects of the parenthood experience (e.g., number of children, geographic proximity, frequency/nature of contact, relationship quality) are differentially associated with health-related outcomes. The current study aimed to evaluate associations between parenthood and sleep, a critical factor in maintaining health among adults aged &gt;50. We addressed our research questions via secondary analysis of data from the 2016 and recent waves of the Health and Retirement Study, a nationally representative population-based study of community-dwelling U.S. adults aged &gt;50 (n= 4,201). Both parenthood measures and sleep outcomes were measured via self-report. We used multiple linear regression to investigate how various aspects of parenthood were differentially related to sleep outcomes, controlling for demographic characteristics, chronic health conditions, and baseline sleep scores. We observed that more positive interactions and fewer negative interactions with children were associated with better sleep. None of our other parenthood measures were associated with sleep outcomes. Our findings suggest that interaction quality, but not other aspects of the parent-child relationship, is important for the sleep hygiene of older adults.
POTENTIALLY PREVENTABLE HOSPITALIZATIONS IN A CONNECTICUT MEDICAID HOME AND COMMUNITY-BASED SERVICES POPULATION
Authors: Dillon Ellis , Fortinsky Richard , Barry Lisa , Lee Chae Man , Porter Martha , Migneault Deborah , Robison Julie 
Published: January 2025

Abstract
State Medicaid programs address the needs of older adults, and people with disabilities or chronic illnesses through a range of home and community-based services (HCBS) and aim to prevent adverse health outcomes. This study determines rates of potentially preventable hospitalizations (PPH) for Connecticut residents receiving Medicaid-funded HCBS and compares rates across HCBS programs using a CMS Home Health quality measure. This retrospective cohort analysis linked Medicaid and Medicare fee-for-service claims, Medicaid administrative data, and uniform clinical and functional assessment data for 33,688 Connecticut residents. PPH rates between 4/1/2022-9/30/2022 were compared across six HCBS programs via logistic regressions adjusted for the 8-point InterRAI Risk of Hospital Use Scale (Hosp-RiskHC) score. Rates of PPHs ranged from 0.8% (Autism Waiver) to 15.7% (Personal Care Attendant Waiver, PCA). Individuals with PPHs represented over half (55.6%) of all hospitalized individuals. PCA participants were more likely (OR=1.3, 95% CI:1.13-1.58) and Acquired Brain Injury Waiver participants were less likely (OR=0.7, 95% CI:0.48-0.93) to have a PPH compared to Elder Waiver recipients. Likelihood of experiencing a PPH increased with each successive Hosp-RiskHC score (OR=1.2, 95% CI:1.16-1.22). Controlling for risk factors, rates of PPH varied across HCBS programs, potentially due to the nature of their disabilities, differing services provided by each program, or a combination of individual and structural factors. Identifying variations in PPH rates is a critical step toward building a Value-Based Payment (VBP) program for HCBS providers, who have historically been excluded from VBP opportunities, and identifying systemic gaps and opportunities for coordinated interventions across healthcare providers.
LIFE SATISFACTION AMONG BLACK AND WHITE AMERICANS: FINDINGS FROM THE 2020 HEALTH AND RETIREMENT STUDY
Authors: Ward Chesney 
Published: January 2025

Abstract
The U.S. population is living longer, yet data are limited regarding life satisfaction among older adults. Understanding this construct for older adults is essential given the greater longevity and notable risks of reduced satisfaction as one ages. The purpose of this study was to examine racial differences between middle-aged and older White and Black Americans on life satisfaction and explore the correlation of religious beliefs and perceived control over one’s life and health with self-reported life satisfaction. The study presents results utilizing data from the 2020 Health and Retirement Study, a nationally representative sample. The sample (N=1163) was a comparative analysis of Black and White respondents. Findings indicated factors that contribute to overall life satisfaction, differences in race, and gender differences. Black respondents when compared to White respondents reported lower overall life satisfaction but higher religious beliefs. The current study helps to fill this gap by examining the relationship between psychosocial and demographic factors and life satisfaction among the sample. By drawing on the literature and the study data, implications on the impact of religious belief on overall life satisfaction are discussed. This study proposes ways in which researchers, practitioners, and policy advocates can improve life satisfaction for Black and African American populations in the United States by employing a religious aspect.
A KNOWLEDGE GRAPH–BASED DEMENTIA CARE INTELLIGENT RECOMMENDER SYSTEM FOR MANAGING DEMENTIA CARE
Authors: Sun Yue , Wang Zhi-wen 
Published: January 2025

Abstract

Background
Caring for people with dementia is perceived as one of the most challenging caring roles, so effective and practical support is essential. One such innovative approach to internet-based tailored health intervention is the use of recommender system. Objective: This study develops a mobile-based dementia care intelligent recommender system (DCIRS) that can provide personalized and timely care interventions recommendations for caregivers when they encounter difficult various care problems.

Methods
A knowledge graph was constructed using the 1023 personalized care plan set for dementia patients as the source material. The graph embedding method was used to introduce the constructed domain knowledge graph of dementia care into the recommender model. The graph embedding module learned the features of the knowledge graph through the TransR translation model, and the recommender module interacts with the learned features of the graph and the recommended items to realize personalized recommendation of care plans with the help of the above recommender algorithm.

Results
The core function of the DCIRS was to recommend personalized care plans according to the personalized characteristics of people with dementia, such as gender, disease severity, hobbies, walking ability, and care problems. Conclusions: This study was a pioneering research to develop a comprehensive recommender system for caregivers of people with dementia. According to the evaluation results, our DCIRS showing high specificity and accuracy. This system can provide a novel perspective for patient-centered and needs-based support of caregivers of people with dementia.
ASSOCIATIONS OF PREVENTION FOCUS TRAITS WITH SEDENTARY BEHAVIOR IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Suarez Jethro Raphael , Blount Amber , Park Joon-Hyuk , Thiamwong Ladda 
Published: January 2025

Abstract
Sedentary behavior is prevalent among older adults and can increase the risk of developing health conditions, such as muscle atrophy and heart disease. Beyond physical factors, it is important to determine mental factors that could be associated with excessive sedentary behavior. The Regulatory Focus Questionnaire (RFQ) is an 11-item instrument that allows an individual to self-report the frequency of occurrences of specific events in their life. The RFQ yields 2 separate scores: a promotion focus score and prevention focus score. A higher promotion focus score describes an individual who is goal-motivated, open to change, and willing to take risks. A higher prevention focus score describes an individual who is motivated by avoiding losses, more cautious, prefers constant routine, detail-oriented, and avoids risks. A cross-sectional study was conducted with 94 community-dwelling older adults aged 61 to 89 years (84 women, 10 men; mean age = 74.87 ± 6.76 years) to determine the relationship between total measured sedentary behavior and promotion and prevention focus, respectively. Sedentary behavior was objectively measured for each participant using the ActiGraph GT9X Link wireless activity monitor over 7 consecutive days. Kendall’s Tau test revealed that sedentary behavior had a significant positive correlation with prevention focus scores (p = 0.00819, τ = 0.194), but not with the promotion focus scores (p = 0.647, τ = -0.0335). These findings suggest that certain personality traits, such as being loss-avoidant, detail-oriented and less accepting of change, can be associated with older adults that engage in increased sedentary behavior.
INFORMATIVE, DULL, INCOMPREHENSIBLE: SEEKING A COMMON VOCABULARY AROUND DATA IN LATER LIFE
Authors: Dalmer Nicole , Biruk Cal 
Published: January 2025

Abstract
With the domestication of digital devices into the everyday, this paper offers critical reflections from two, related studies that both sought to explore how older Canadians communicate their experiences and understandings about the digital technologies and related data they encounter and use. The first study, a virtual, qualitative survey with 70 older Canadians highlighted their understandings of data, and the second, a pilot interview study with 7 older adults in their homes explored how and where data circulates in their everyday lives. Not only do our daily activities and routines rely on data, our routines are often, in turn, converted into data through our many devices (Burgess et al., 2022). Living with data, however, is an experience that differs from person to person and from group to group. Given these differences, how might we communicate about data with different groups? In both studies, we sought to explore and document participants’ own diction, images, metaphors, and concepts they articulate when thinking with and about their own data; giving them a space to speak and share “their own data stories louder than those that are being told about them by others” or by other devices (Thorp, 2021, p. 19). In this paper, we offer our observations on the challenges and difficulties (and potential ways forward) in finding a common vocabulary in research relationships between participants and researchers to speak about data and to the many ways that data circulate in and around older adults’ everyday lives.
THE IMPACT OF IMMERSIVE VIRTUAL REALITY MEDITATION ON MENTAL HEALTH OF PEOPLE LIVING WITH DEMENTIA
Authors: Kim Yongseop , Lee Jungjoo , Kim Dylan , Kim Junhyoung 
Published: January 2025

Abstract
Non-immersive, technology-based mindfulness meditation programs have been shown to effectively reduce depressive symptoms and improve the emotional health of older adults. Still, little research has been conducted to assess the mental health benefits of an immersive virtual reality meditation (IVRM) program among persons living with dementia (PLWD). The present study investigates the impact of the IVRM on depression, emotional health, and quality of life among PLWD. This study is based on a single-arm design. PLWD (n=8) received six sessions (three times a week for 2 weeks) of an IVRM program lasting 30-40 minutes each. The IVRM program is used as an individualized, customized meditation tool that provides more than 300 audio tracks, meditation process monitoring, and a selection of meditation environments. The findings indicated significant changes between pre and post interventions, showing a decrease in depression (M = 2.25, SD = 2.12; t(7) = 3.0, p &lt;.05, d = 1.06) and an increase in emotional health (M = -3.87, SD = 4.05; t(7) = -2.71, p &lt;.05, d = -0.95). However, a significant difference was not found in quality of life. This study provides suggestive evidence that the IVRM program led to the improvement in emotional health and a reduction in depression among PLWD. Healthcare professionals need to become more aware of the impact of the use of individualized VR-based meditation programs and learn how they might be integrated into their services to improve the emotional health and well-being of their clients.
VESTA: A GROUNDBREAKING TOOL FOR ENHANCING FINANCIAL LITERACY AND SCAM RESILIENCE AMONG OLDER ADULTS
Authors: Barnett Michael , Van Vleet Samuel , Griffin Rebekah , Fontanese Matthew , Mallender William , Boynton Harrison , Coldiron Allyson 
Published: January 2025

Abstract
VESTA (Virtual Economic Simulation and Trust Assessment) is a groundbreaking assessment tool designed to address the escalating challenges faced by older adults in the realm of modern financial capacity and digital literacy. VESTA replicates real-world scenarios in a smartphone setting to assess older adults’ ability to safely navigate virtual financial transactions, detect financial scams, and share information securely. This preliminary study explores older adults’ (N = 20) initial reactions and 5-point ratings of VESTA. Results indicate that older adults positively rated VESTA as applicable to real life (M = 3.70, SD = 0.92) with realistic representations of messaging, mobile banking, and a smartphone layout – demonstrating the effectiveness of VESTA in simulating real-world scenarios. Older adults agreed that the application provides a good assessment of users’ risk for financial scams (M = 4.05, SD = 0.76), as well as their money management, ability with banking technology, trust judgment, and ability to share information safely. Additionally, older adults viewed VESTA as easy to use, easy to interact with, easy to understand, and an enjoyable gameplay experience, reaffirming its applicability across diverse older adult populations. Older adults positively rated VESTA as useful for everyday life by gathering useful information, testing abilities with financial technology, and educating people on their risk for financial scams (M = 4.70, SD = 0.57). In the modern financial landscape dominated by new technologies, VESTA enhances financial literacy and detects scam susceptibility among older adults, offering tangible benefits for their financial well-being in the modern financial technology landscape.
ADDRESSING THE NURSING WORKFORCE GAP IN SKILLED NURSING FACILITIES WITH AN AGE-FRIENDLY CURRICULUM
Authors: Brown Diane , Fosnight Sue , Drost Jennifer , Gergis Mary , Hovland Cynthia , Sanders Margaret , Kropp Denise , Gareri Michele 
Published: January 2025

Abstract
Skilled nursing home quality and staffing are positively correlated. Staffing shortages have been a long-standing problem however, COVID-19 exacerbated the issue. Currently, more than one in four US nursing homes report staff shortages, especially those in direct care to residents, nurse aides and nurses. To encourage workforce growth, a 12-module virtual curriculum was developed including Age-Friendly Health Systems care, interprofessional teamwork, and other relevant topics. Each module included a recorded didactic, pre-post module quizzes, discussion boards, and supplemental videos and articles. Trainees also spent 10 hours shadowing the interprofessional team in a skilled nursing facility. Two cohorts of undergraduate senior nursing students (n=18, and n=35), nurse assistants in training (n=9, cohort 1), and social work students (n=9, cohort 2) have been trained. Outcome measure were pre and post-education using surveys: Nursing Home Attitude, PES-NWI work environment, and ISVS-9 for teamwork attitude. Results of the first nursing cohort rated the highest nursing home attitude items: ability to provide comfort, flexible scheduling and spending time with clients with the lowest rating for working with persons with dementia. The PES-NWI survey showed highest concern for teamwork, adequate staffing and supportive administration with the lowest concern related to use of nursing diagnoses. The ISVS showed similarities pre and post with highest scores for client involvement in care and importance to work as a team, and lowest for comfort leading a team. Administrators of skilled nursing and educators can use this information to close the gap on improving interest in this setting for new graduates.