bluuebunny/crossref_metadata_2025_split huggingface dataset:
Texting Older Sisters to Step (TOSS) Using Fitbits to Promote Physical Activity: A Feasibility Study
Authors: Bowen Pamela , Opoku-Agyeman William , Mixon Veronica , Affuso Olivia , Clay Olivio 
Published: December 2021

Abstract
Black women are disproportionately diagnosed with obesity (BMI ≥ 30 kg/m2). Obesity is a preventable but complex, public health problem that is multifaceted, chronic, and approximately 58% of Black women 60 years and older are classified as obese, compared to 38% of their White counterparts. This 12 week, pre/post, 2-group study aimed to determine if a peer-informed physical activity (PA) intervention with peer support would be feasible among community- dwelling, obese, older Black women to promote regular PA. Forty-eight potential participants were screened, 24 categorized as obese were enrolled and completed the study. The mean age was 64 (SD 3.0) years. Steps were measured by a Fitbit-Inspire with data successfully collected on 98% of days with the treatment group averaging a daily increase of 700-steps more than the control. Evaluation of intervention’s acceptability revealed that 100% enjoyed the study and using the Fitbit device. Text message readability was 100% and 95% said the study was motivational. Additionally, 8.3% said daily prompts were too frequent, 12% indicated that future studies should include additional social support, and 88% did not comment on the Fitbit community option for support, suggesting that this feature was not practical. Findings demonstrated that this intervention meets the criteria of being scalable, low cost, feasible, and acceptable for the older Black women. Using self-monitoring techniques in combination with at least one other behavioral strategy, such as our TOSS messages (cues for motivation) as the delivery channel for health promotion messages are a promising approach to increase PA behaviors.
Does Closing the Donut Hole Reduce Financial Burdens Among Medicare Part D Beneficiaries?
Authors: Zhang Yalu , Liu Lan , Sun Jingjing , Zhang Xinhui , Sun Jiling , Song Xinming , Chen Gong 
Published: December 2021

Abstract
The Medicare Part D donut hole has been gradually closed since 2010. But it is still unclear how it has impacted the beneficiaries’ relative financial burdens, especially in the later stage of the closing plan. The measurement of catastrophic health expenditure induced by prescription drugs (CHE-Rx) reflects the relative financial burdens to beneficiaries’ household income, which bears more information than the measure of dollar-value expenses or the absolute poverty line used in prior studies. Using the Medical Expenditure Panel Survey 2008-2017 longitudinal national representative data and the method of difference-in-differences, this study found that the donut hole closing policy was associated with more usage of prescription drugs (b=2.84, p=0.023) and a higher likelihood of experiencing CHE-Rx (b=2.4%, p=0.011) among those who fell in the donut holes. Besides, the results show that the donut hole closing policy did not generate any immediate effects on prescription drug usage, CHE, and CHE-Rx. For the first time, this paper examined both the aggregated and marginal impact of the policy implementation, which had closed by an additional 35% between 2013 and 2017, on the relative financial burden among the beneficiaries.
Leadership among Directors of Social Work in Long Term Care Facilities
Authors: Abenojar John Paul 
Published: December 2021

Abstract
Long term care facilities (LTC) provide ongoing care for seniors and chronically ill. To maximize the quality of the care, LTC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies and interactions of facility administrators and nursing directors there is a substantial gap in the literature on the leadership styles and strategies employed by Directors of Social Work (DSW). The aim of this phenomenological study was to address this gap in research by exploring how DSW influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influence decision making in patient care, and believed that communication amongst LTC staff about patient care could be improved.
Resilience among older adults with Type 2 Diabetes from the Look AHEAD trial
Authors: Olson KayLoni , Howard Marjorie , Mccaffery Jeanne , Dutton Gareth , Espeland Mark , Johnson Karen , Simpson Felicia , Wing Rena 
Published: December 2021

Abstract
There is growing interest in identifying factors protecting against aging-related decline. This cross-sectional study evaluated associations of self-reported resilience (ability to bounce back) with factors linked to aging-related decline among older adults with Type 2 diabetes (T2DM). Participants were 3,199 adults (72.2±6.2 years, 61% female, 61% white, BMI 34.2±8.2 kg/m2) enrolled in Look AHEAD (a multi-site RCT comparing weight loss to diabetes education among individuals with T2DM), who were followed observationally after the 10-year intervention was discontinued. The following items were assessed approximately 14.4yrs post-randomization: Brief Resilience Scale; overnight hospitalizations in past year; physical functioning measured objectively (gait speed, grip strength) and via self-report (Pepper Assessment Tool for Disability; Physical quality of life (QOL; SF-36)); a composite measure of phenotypic frailty based on having ≥3 of unintentional weight loss, low energy, slow gait, reduced grip strength, physical activity. Depressive symptoms (PHQ-9) and mental QOL (SF-36) were also measured. Logistic/linear regression was used to evaluate the association of these variables with resilience adjusted for age, race, and gender. Greater resilience was associated with lower BMI (p=.01), fewer hospitalizations (p=.02), better physical functioning (i.e., lower self-reported disability, better self-reported physical QOL, faster gait speed, greater grip strength and lower likelihood of meeting criteria for frailty; all p&lt;.001), fewer depressive symptoms and greater mental QOL. Resilience is associated with better performance on indicators of overall functioning and risk for decline among older adults. Findings correspond with efforts to shift narrative on aging beyond ‘loss and decline’ to highlight opportunities to facilitate healthy aging.
The role of laughter for successful aging of Alaska Native Elders
Authors: Lewis Jordan 
Published: December 2021

Abstract
During a visit over tea and pilot bread, discussing successful aging and well-being, an Inupiat Elder shared that “It’s better to live a happier life, enjoy life all you can.” These wise words inspired the theme of this chapter which explores the role of laughter in the resilience and wellbeing of Alaska Native Elders. Based on a decade of research, this chapter introduces the concept of Alaska Native Eldership and provides an overview of the five strands of Alaska Native successful aging that contribute to their ability to remain resilient. Laughter is a universal emotional experience, and Alaska Native Elders have taught us that is has different functions that enable us to be resilient and age successfully. Laughter is woven throughout the strands of successful aging as a key to health and well-being and this chapter discusses the four types of laughter used to protect themselves, including redirecting conversations, practicing humility, taking away the power of stressful topics, as well as sharing happiness and laughter with others. This chapter concludes with reflections on how laughter contributes to our ability to find meaning and purpose in life and strengthening our relationships with family and community so we can remain resilient as we age.
Racial and Ethnic Differences in Retirement Satisfaction among Older US Adults
Authors: Van Vleet Samuel , McLaughlin Sara 
Published: December 2021

Abstract
Along with population aging, the diversity of the older US population is increasing. Research suggests that racial and ethnic minorities experience disadvantages over the life course that can negatively impact later life. Despite this, little research has examined racial and ethnic differences in satisfaction with retirement. Using data from the 2016 wave of the Health and Retirement Study, we compared retirement satisfaction among Black (n = 1,068), Hispanic (n = 674), Other (n=161), and White (n = 4,833) older adults (age 65+). Retirement satisfaction was measured with the following item: “All in all, would you say that your retirement has turned out to be very satisfying, moderately satisfying, or not at all satisfying?” Responses were categorized as very satisfied vs. all others. Approximately 43% of Black, 35% of Hispanic, 39% of Other, and 56% of White Americans reported being very satisfied with retirement (χ2(2.4)=58.9; p &lt; .0001). In multivariate logistic models controlling for age, educational level, gender, household income, marital status, and functional limitations, the odds of being very satisfied with retirement were 32% lower for Hispanic (OR=0.68; 95% CI= 0.55, 0.85) and 37% lower for Other Americans (OR=0.63; 95% CI= 0.43,0.92) relative to their White counterparts. No significant difference was evident for Black and White Americans in adjusted analysis (OR=0.96; 95% CI=0.76,1.20). Our findings indicate that inequalities in the retirement experience exist by race and ethnicity in the United States. More research is needed to understand the factors responsible for lower retirement satisfaction among Hispanic and Other Americans.
Factors Associated With the Use of Telehealth in Middle-Aged and Older Adults During the COVID-19 Pandemic
Authors: Du Yan , Yang Rumei , Xu Qingwen , Xie Bo 
Published: December 2021

Abstract
The COVID-19 pandemic has promoted the adoption and use of telehealth, particularly in the early months of the pandemic. However, people with diverse characteristics may, or may not, be able to use telehealth, presenting digital divide in health care and potential health equity-related issues. This study aimed to assess the use of telehealth among middle-aged and older adults during COVID-19, and to explore factors associated with their telehealth utilization. We used publicly available data from the California Health Interview Survey collected during January 2019 and December 2020 (N=15, 279; mean age= 64.23±11.59; female: 52.7%). Approximately 11.0% of the sample used telehealth at least once. Bivariate and multivariate logistical regression analyses found that, compared with non-users, telehealth users were more likely to be having higher numbers of chronic conditions, with self-reported mental distress, living in urban areas, born in the US, with higher English proficiency, higher education, and having higher incomes. Age, race/ethnicity, and gender were not significantly correlated with telehealth usage. Logistic regression revealed that having mental distress (OR=1.48, 95% CI=1.29-1.71, p&lt;0.01), more chronic conditions (OR=1.48, 95% CI=1.29-1.71, p&lt;0.001) and living in an urban area (OR=1.93, 95% CI=1.36-2.74, p&lt;0.001) were independently related to telehealth use. These findings suggest that telehealth, while being beneficial during the pandemic, might also introduce new challenges that exacerbate existing health inequity and disparities. Policy and community-based interventions are needed to promote the use of telehealth among middle-aged and older adults with diverse characteristics.
Cumulative Effect of Loneliness and Social Isolation on Health Outcomes among Older Adults
Authors: Barnes Timothy , MacLeod Stephanie , Tkatch Rifky , Ahuja Manik , Albright Laurie , Schaeffer James , Yeh Charlotte 
Published: December 2021

Abstract
Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies examine each construct separately; however, less research has been dedicated to exploring their impacts together. Using survey and claims data among adults age 65+ (N=6,994), the cumulative effects of loneliness and social isolation on late-life health outcomes were examined using Chi-square and multivariate regression models. Loneliness and social isolation were measured using the UCLA-3 Loneliness Scale and the Social Network Index. Participants were grouped into four categories of loneliness and social isolation based on overlap, including: lonely only (L), socially isolated only (SI), both lonely and socially isolated (LSI), or neither (N). Outcomes included quality of life and healthcare utilization and costs. Among participants, 9.8% were considered L, 20.6% SI, 9.1% LSI, and 60.5% N. Respondents were primarily female (55.0%) and 70-74 years of age (27.1%). Those considered LSI were more likely to be older, female, less healthy, depressed, with lower quality of life and greater healthcare utilization patterns. Participants who were L or LSI had higher rates of emergency room visits compared to the N group; LSI had the highest medical costs. Results demonstrate the cumulative effects of loneliness and social isolation among older adults. Findings not only fill a gap in research exploring the impacts of these constructs later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.
Marital Support Reciprocity and Life Satisfaction Among Older Koreans
Authors: Lee Hye Soo 
Published: December 2021

Abstract
The importance of reciprocity in social support for well-being has been shown, but few studies have investigated marital support reciprocity in older Korean samples. This study examined the associations between three types of marital support reciprocity and life satisfaction, stratified by age and gender. The sample consisted of 1,578 men and 1,464 women from the 2017 National Survey of Older Koreans, divided into young-old (65-74) and old-old (75+) groups (M age = 75.06, SD = 6.35). Participants self-reported emotional, instrumental, and physical support provided to and received from spouses, and life satisfaction (LS). Regression models controlling for covariates showed that results varied by age and gender. For young-old males, received emotional and provided instrumental support were positively associated with LS. For young-old females, both received and provided emotional support, and received instrumental support, were positively associated with LS, but provided physical support showed negative associations. For old-old males, providing emotional support was positively associated with LS; for old-old females, only received emotional support was significant. Using interaction terms to assess reciprocity, young-old females and old-old males showed reciprocity effects for instrumental support. When participants provided and received high levels of support, life satisfaction levels were high. However, when participants provided low levels of support, received support was not significant. Thus, the effects of receipt and provision of support on LS varied by age and gender among older Koreans, but reciprocity of instrumental support was only important for young-old women and old-old men.
Social Connectedness and Communication Technology Among Paid and Unpaid Caregivers of Middle-Aged and Older Adults
Authors: Lee Shinduk , Ory Marcia , Dahlke Deborah Vollmer , Smith Matthew 
Published: December 2021

Abstract
Objective: To examine differential relationships between communication technology use and social connectedness among paid and unpaid caregivers providing care for middle-aged and older adults. Methods: This nationwide study utilized a cross-sectional Qualtrics panel survey from caregivers, ages 50 years and older (n=504) of middle-aged and older adults. About 17% were paid (n=86) and 83% (n=418) were unpaid caregivers. Primary outcomes were caregivers’ sense of belonging to their local community and social bonds. The primary predictor of interest was caregivers’ use of communication technology (texting/communication applications). A multivariable regression analysis was performed to predict each outcome based on communication technology use, separately among paid and unpaid caregivers. Multivariable regression analyses were repeated after including the caregivers’ payment status (paid/unpaid) and the interaction term between the caregivers’ payment status and the use of communication technology. The models were adjusted for caregivers’ age, education, financial status, place of residence, and total weekly hours of caregiving. Results: Use of communication technology had a statistically-significant positive association with sense of belonging only among paid caregivers (b=25.8, p=.005). The relationship between use of communication technology and sense of belonging was significantly different between paid and unpaid caregivers (p=.005). Use of communication technology was significantly associated with social bonds only among unpaid caregivers (b=0.4, p&lt;.001). There was no statistically-significant differential association between communication technology use and social bonds. Conclusion: Communication technology may play differential roles in linking paid and unpaid caregivers with their community and interpersonal groups. Additional efforts should examine mechanisms that provide meaningful caregiver support.
Nursing Students Visiting People with Dementia Online during COVID-19: A Qualitative Study
Authors: Kimzey Michelle , Patterson Jodi , Mastel-Smith Beth 
Published: December 2021

Abstract
The coronavirus disease 2019 (COVID-19) crisis has impacted the daily routines of students, people living with dementia, and their care partners. Social distancing results in fewer interpersonal interactions and enjoyable activities which makes life more challenging for those living with dementia. The purposes of this multiple case study were to understand how nursing students, people with dementia, and care partners (a) describe online visits between nursing students and people with dementia during stay-at-home directives in response to COVID-19 and (b) the perceived visit benefits. Nursing students participated in online visits to socially engage with their mentor (person living with dementia). During the visits it was anticipated that care partners would enjoy a brief respite. After 12 visits, investigators completed one-to-one online interviews with students (n = 10), care partners (n = 8) and mentors (n = 8). All cases reported a positive experience, perceptions of the conversations, improved social connection and meaning and purpose, mentor’s enhanced cognition and planned future connections. Relationships were formed between students, people with dementia, and care partners during online visits, an activity that might be implemented outside of a crisis to prevent social isolation across generations. Future efforts to engage people with dementia in residential facilities should be formally integrated into the care plan and staff dedicated to help with technology assigned.
Older Adult’s Marital Status, Support Exchanges and Psychological Well-being in Everyday Life
Authors: Ng Yee To , Fingerman Karen 
Published: December 2021

Abstract
Social support exchanges are an integral part of older adults’ well-being. Yet, we know little about how older adults' marital status may influence their support exchanges with different social partners in everyday life, and whether the effect of support exchanges on daily well-being vary by marital status. Adults aged 65+ (N = 278) completed an initial interview about their background and close social networks; then, participants reported whether they provided or received support from their close social partners and rated their psychological well-being for 5 to 6 days. Multilevel logistic models revealed that married older adults were more likely to provide or receive daily support from their close partners than widowed or divorced older adults. However, with respect to specific non-spousal ties, married older adults were less likely to provide support to siblings, friends or others (acquaintances, neighbors) compared to divorced older adults. Although married older adults were more likely to receive support from children than divorced older adults, they were less likely to receive support from siblings and friends compared to widowed or divorced older adults. Furthermore, receiving support from other familial ties (grandchild, other relatives) was associated with reduced daily well-being for widowed older adults whereas married older adults were able to maintain their daily well-being in such situation. Findings highlight the central role siblings and friends play in unmarried older adults' daily support networks and suggest that receiving support could have differential impact on daily well-being depending on older adults’ marital status.
Can Working Together Buffer Depression Among Older, Religious African American Couples?
Authors: Skipper Antonius , Rose Andrew , Jones Ethan , Reeves Alex , Joiner Jhazzmyn 
Published: December 2021

Abstract
Depression is a growing concern among older African Americans, as many within this group hesitate to seek professional help from psychiatrists or counselors. Instead, existing literature notes that older African Americans frequently utilize informal social support networks (e.g., church leaders) to respond to stress and buffer the negative effects of depression and depressive symptoms. Yet, little is known about the shared coping practices of older African American couples in relation to depression. Given the commonly noted high levels of religiosity among African Americans, this study examined communal coping as a mediator between sanctification and depression for older African American couples. This study utilized the dyadic data of 194 (146 married and 48 cohabiting) African American couples between the ages of 50 and 86 years. Capturing data with the Revised Sanctification of Marriage scale, the Communal Coping scale, and the Major Depression Inventory, bias-corrected bootstrap analysis revealed that men’s relationship sanctification and women’s depression was partially mediated by men’s, as well as the sum of men’s and women’s, communal coping in married couples. Further, men’s relationship sanctification and men’s depression was partially mediated by men’s, as well as the sum of men’s and women’s, communal coping. In addition, women’s sanctification was positively associated with men’s depression, directly. These findings are valuable in understanding the complex buffers, and contributors, to depression among older African American couples who may identify closely with religion but prefer the support of a partner over professional care.