bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUCCESSFUL COMPLIANCE OF FAMILY CAREGIVERS IN DEMENTIA RESEARCH
Authors: Armah Henrietta , Winstead Vicki , Yildiz Mustafa , Vickers Jasmine , Pickering Carolyn 
Published: December 2023

Abstract
Attrition is an issue for all longitudinal studies. One concern with intensive protocols with many repeated measures is that participants will drop out before completing the protocol, or will not complete enough of the surveys to provide meaningful data. Features of the study design can be important in increasing compliance with study participations. These features include incentives, survey windows, clear direction, ease of use of the data collection platform, and reminder protocols. This presentation examines compliance, defined as completion of &gt;50% of all surveys, among 3 different micro-longitudinal daily diary studies. Compliance was high for all three studies (78%, 88%, 89%). The lowest compliance rate of 78% was an 8-day protocol with four diaries each day; three diaries were sent out randomly each of the eight days and the one nightly recap was sent at the same time each night. This suggests having multiple surveys in a single day reduce compliance with the study protocol. Compliance did not vary by other study features such as incentives, reminder method or length of the study. For daily diary studies, findings suggest that by doing once-a-day surveys, data collection protocols can be longer and total incentives ranging from $82-$91 are acceptable for maintaining high compliance.
DEMENTIA FAMILY CAREGIVERS’ REASONS FOR PARTICIPATION IN RESEARCH
Authors: Vickers Jasmine , Winstead Vicki , Armah Henrietta , Pickering Carolyn 
Published: December 2023

Abstract
Recruitment of participants with Alzheimer’s and Related Dementias (ADRD) and their family caregivers can pose significant challenges to the successful completion of research, particularly for intensive protocols like daily diary research. Understanding the reasons ADRD family caregivers are willing to participate in research can provide researchers with the tools for successful recruitment efforts. In this study, we assessed the reasons ADRD family caregivers (N=123) participated in a 21-day diary study and the translatability of the findings for informing the development of recruitment materials to address recruitment challenges. We conducted a thematic analysis of responses to the question “Tell us in a few words why you are interested in participating in this study” as an addendum to the consent form. Thematic analysis was conducted by two independent coders. Participants were mainly women (86%) and biological children of the care recipient (46%). Findings revealed four predominate motivations for participation in the research project: 1) finding meaning for their caregiving experiences by sharing them through the study, 2) altruistic motivations for helping others, 3) personal benefits including helping their care recipient or learning more about caregiving, 4) and the meaningfulness of the study’s focus. Caregivers were motivated to participate in this intensive protocol for a variety of meaning-making reasons. Recruitment materials should focus on language that emphasizes opportunities for caregivers to share their experiences and practical relevance of potential study findings.
VIGOROUS PHYSICAL ACTIVITY, DEPRESSION, PRO-INFLAMMATORY CYTOKINE AND RACIAL/ETHNIC VARIATIONS IN FALLS
Authors: Malatyali Ayse , Cidav Tom , Xie Rui , Thiamwong Ladda 
Published: December 2023

Abstract
Physical activity plays a key role in preventing falls among older adults as it supports muscle strength and improves balance and postural control. Recent studies have revealed that physical activity modulates Interleukin-6 (IL-6) levels and reduces the incidence of falls among older adults. This study describes the relationships between vigorous physical activity, IL-6 plasma levels, depression, and falls among older adults. We conducted a cross-sectional study on Health and Retirement Study participants aged 65 and above (n= 9,942) using datasets from the 2016 interviews. Of the sample, 37.7% reported falling in the last 24 months. Mean ages were: 77.4 (8.14) years in participants who had a fall and 75 (7.31) years in participants without a fall. Participants engaging in regular vigorous physical activity were 24% less likely to have a fall than those not engaging in vigorous activity. We quartiled the IL-6 levels and presented quartile-4 as the most elevated IL-6 levels. Compared to quartile-1 (lowest), participants in quartile-3 were 24%, and those in quartile-4 were 45% more likely to fall. The effect of IL-6 was insignificant in quartile-2. Having depression was also significantly associated with falls (OR=2.40). We observed a significant inverse relationship between ethnic/racial minorities and odds of falling: Hispanics were 16%, and African Americans were 36% less likely to fall than non-Hispanic whites. The likelihood of falling among people living in rural was significantly higher than among those living in urban (OR= 1.15). Interleukin-6 may be incorporated to fall prevention interventions as an indicator of fall risk.
VIRTUAL GERAS DANCING FOR COGNITION EXERCISE (DANCE) FOR OLDER ADULTS: A FEASIBILITY RANDOMIZED CONTROL TRIAL
Authors: Hewston Patricia , Ioannidis George , Kennedy Courtney , Papaioannou Alexandra 
Published: December 2023

Abstract

Background
GERAS DANcing for Cognition and Exercise (DANCE) was developed with rehabilitation and geriatric medicine expertise for older adults (age 60+) looking to improve brain health or mobility. Our primary aim of this study was to assess the feasibility of virtual GERAS DANCE.

Methods
This study utilized a single-center, prospective, parallel-group randomized controlled trial (RCT) feasibility approach. We recruited 50 older adults. Participants were randomized to receive 6-weeks (1-hour class twice weekly) of virtual GERAS DANCE or usual care. Feasibility was assessed using pre-defined criteria for process, outcomes, and acceptability, and the effect of GERAS DANCE on mood, balance confidence, and fear of falling.

Results
Our study recruitment period occurred over 8 weeks to recruit 50 older adults (mean age = 75.02(5.89) years, range: 63-92, 92% female). The enrollment-to-screening ratio was calculated as 25:103 and the retention rate of participants was 84%. The average class attendance of the study cohort was 77%. One adverse event was reported unrelated to the study intervention. The program had a high-fidelity score and adhered to the standardized curriculum. Both the intervention and usual care groups improved mood (Depression, Anxiety and Stress Scale – 21). The intervention-group had higher balance confidence and lower fear of falling.

Discussion
Pre-determined thresholds for feasibility were met for all outcomes providing evidence that virtual GERAS DANCE is feasible, well-accepted, and safe for older adults. Improved balance confidence and reduced fear of falling through dance can have significant implications for fall prevention, healthcare costs, and overall quality of life.
OLDER ADULTS’ UNDERSTANDING OF SIGNALS COMMUNICATED BY ROBOT COMPANIONS FOR CAREGIVING
Authors: Malle Bertram , Chi Vivienne , Rebola Claudia B 
Published: December 2023

Abstract
Robotic animal-like companions for older adults are promising technologies to address companionship and new models of care. Our project, Affordable Robotic Intelligence for Elderly Support, aims to design smart communication capabilities in an Ageless Innovation Joy for All™ robotic cat. The cat robot with enhanced capabilities uses intuitive digital cues, including display screen, sound, and LED to create affordances to communicate various interaction intents to engage users into desirable actions. We conducted a study with 315 participants to understand the efficacy of designed affordances. A total of 8 affordances for 8 task scenarios, each with 3 variations of complete or incomplete information, simulating possible experiences were tested with users. Participants were randomly assigned to the conditions “full” (=display+sound+LED), “no_display” (=sound+LED), and “no_sound” (=display+LED) and were asked to provide a response interpretation of the experience signals and rank a list of potential interpretations in order of possibility. Results indicate that participants in the full experience group liked the robot the most (M=6.95 on a scale of 1-10) and gave the highest probability of the robot being a pleasant companion to older adults (M=7.17), compared to the no_display group (M_likability=6.01; M_companionship=6.58) and the no_sound group (M_likability=6.35; M_companionship=6.96). Participants in “no_display” had the greatest difficulty at inferring the robot’s intent. However, the no_sound group had less difficulty understanding the robot than the “full” experience group. Sound (e.g., meowing) appeared to be ambiguous, and removing it improved the communicability of the designed interface of this robot companion.
USER EXPERIENCES OF OLDER ADULTS NAVIGATING AN ONLINE DATABASE OF COMMUNITY-BASED PHYSICAL ACTIVITY PROGRAMS
Authors: Connelly Denise , Lowndes Ashley 
Published: December 2023

Abstract
As cataloguing health care services becomes more internet-based, older adults are increasingly expected to navigate services online. Previous studies have outlined the needs, barriers, and facilitators of older adults using eHealth, however, none included user experiences in navigating websites. Connecting community-living older adults with local, high quality, community-based physical activity programs is a gap in efforts to promote physical activity by older adults. This study aimed to: 1) explore older adult user experiences navigating an online health database of local physical activity programs; 2) compare navigational feedback with age-friendly website design guidelines; and 3) assess online database completeness. Focus groups, including guided navigation tasks and a semi-structured interview script, gathered user experiences of fifteen older adults (≥65). A literature review produced three age-friendly best practice website design guidelines. A website search for local physical activity programs was completed. The design of the online database website was challenging for older adult participants to navigate and was not ’intuitive’. In navigating the online database, the older adults identified multiple discrepancies with established guidelines for designing age-friendly websites. A total of 187 local physical activity programs were missing from the database. Findings provide novel insight into user experiences of older adults navigating online health and physical activity program websites. Redesign following age-friendly website recommendations would empower older adults in use of online databases and promote awareness of local physical activity programs. Health care providers need reliable and age-friendly online resources to link their patients with local physical activity programs to promote healthy aging.
BIAS AND GENERALIZABILITY IN MEDICARE-BASED ANALYSES ACROSS THREE POLICY PERIODS
Authors: Gorbunova Galina , Yashkin Arseniy , Kravchenko Julia , Yashin Anatoliy , Akushevich Igor , Stallard Eric 
Published: December 2023

Abstract
Administrative Big Health data such as that drawn from the Medicare program is an invaluable resource for the study of population health. Although the Medicare program provides near universal health coverage for older U.S. adults age 65+, for most types of care data is collected only for individuals enrolled in traditional Medicare (TM) plans, with those enrolled in private Medicare Advantage (MA) plans being effectively censored in terms of the extent of available data. This presents two potential problems for health outcomes research: bias and generalizability. In this study we use Health and Retirement Study data (1998-2015) to assess the presence and magnitude of group-specific differences between MA and TM beneficiaries as well as plan switchers across three policy-specific periods (Balanced Budget Act; Medicare Modernization Act; Affordable Care Act). We found that the MA population was characterized by higher diversity, adverse behavioral habits, lower education, and economic disadvantage. Initially, lower morbidity levels converged with the TM average over time. Individuals, switching into MA after TM had much larger morbidity levels and mortality risk than any other Medicare group. We found significant loss of generalizability with respect to the Hispanic population; such estimates could be further biased to the extent that MA Hispanics differ from TM Hispanics. Of great concern is the combination of low education and low economic status in MA beneficiaries – a combination also found in many disadvantaged minorities. Care is needed in the design of TM-based studies, especially those focused on ethnic differences.
NEIGHBORHOOD QUALITY AND WEEKLY PATTERNS OF PHYSICAL ACTIVITY AMONG BLACK AND WHITE ADULTS
Authors: Surachman Agus , Jenkins August , Armendariz Marina 
Published: December 2023

Abstract
Engaging in regular moderate to vigorous physical activity across the week is recommended for maintaining health. This analysis examined whether objective and subjective neighborhood quality was associated with different patterns of weekly physical activity across the week among middle and older Black and white adults. We leveraged data from the National Study of Daily Experiences (NSDE), in which 833 Black and white American adults (Mage = 62.65; n Black = 167) reported their daily moderate to vigorous physical activity across eight consecutive days. The objective and subjective measures of neighborhood quality were the area deprivation index (ADI) and personal belief in the neighborhood, respectively. Hypotheses were tested using the latent class analysis (LCA) framework. Weekly patterns of daily physical activity were classified into four different groups: Active Every Day (group size = 35.75%), Active on Weekdays (26.63%), Active on the Weekend (11.76%), and Less Active (15.85%). Lower ADI rankings, but not personal beliefs about one’s neighborhood, were associated with a higher probability of being in the three more active relative to the Less Active group, an association stronger among white adults. Finally, the three more active groups showed higher self-rated physical health than the Less Active group. Within-race analyses showed that this association was only evident among white adults. Neighborhood deprivation is an important structural context that may strongly limit adults’ engagement in daily physical health.
SELF-COMPASSION, DAILY STRESS APPRAISALS, AND ODDS OF ELDER ABUSE AND NEGLECT IN DEMENTIA FAMILY CAREGIVING
Authors: Pickering Carolyn , Yildiz Mustafa , Yefimova Maria 
Published: December 2023

Abstract
Stress related to behavioral symptoms is often found to be a risk factor for elder abuse and neglect in dementia family caregiving. The stress-process model suggests that stressful events alone do not determine caregiving outcomes, rather, they are impacted by personal factors which influence the response to stress. Self-compassion represents how one responds to themselves in moments of distress, with compassionate self-responding consisting of treating oneself with self-kindness (vs. judgement), feelings of common humanity (vs. isolation), and mindful awareness (vs. overidentification). Self-compassion is a modifiable intervention target with efficacious interventions available. We hypothesize that self-compassion can buffer the effects of daily stress on a caregiver’s likelihood of using abusive and neglectful behaviors. To test this hypothesis, a generalized linear mixed model with days (n=9513) nested in dementia family caregivers (N=453) was used. Self-compassion was measured at baseline with the Self-Compassion Scale – Short Form, and daily stress appraisal of behavioral symptoms and occurrences of elder abuse and neglect were measured on 21 sequential daily diary surveys. Having higher self-compassion reduced the likelihood of a caregiver using abusive and neglectful behaviors on a given day by 40% (p=0.001, CI 0.45-0.80). Daily stress appraisal of behavioral symptoms significantly increased the odds of abuse and neglect (OR 1.05, CI 1.02-1.09, p=0.002), while the interaction term showed self-compassion significantly lowered the effect of daily stress (OR 1.01, CI 1-1.02, p=0.029). Given the large effect size, self-compassion should be a priority area for future interventions to reduce elder abuse and neglect in dementia family caregiving.
FROM CRISIS TO CONTROL THROUGH COVID-19: NURSING HOME LEADERSHIP PERSPECTIVES ON DELIVERING QUALITY CARE
Authors: Behrens Liza , Heilbrunn Emily , Van Scoy Laruen , Grewal Ashmita , Osevala Nicole , Whitaker Janice , Calo William , Kraschnewski Jennifer 
Published: December 2023

Abstract
A year after the US Government announced that the COVID-19 pandemic has transitioned to an endemic phase, nursing home (NH) leaders are still challenged to deliver quality care. This study aimed to describe NH leadership perspectives on preparing and maintaining quality care during times of diminishing resources as experienced through the COVID-19 pandemic to gain a perspective on how best to support NHs moving forward. We used convergent mixed methods to explore experiences of NH leaders (N=15) participating in the Project ECHO (Extension for Community Health Outcomes) study. Data were collected through publicly reported survey data and individual interviews conducted at 12-month follow-up. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using verbatim transcripts and inductive thematic coding subsequently organized by a guiding framework. Convergent analysis indicates that participating NHs (N=136) align with national trends in infection rates of residents, staff, access to resources such as personal protective equipment and testing supplies. Leadership from a sub-sample of these homes (N=14; 43% rural; 71% not-for-profit) perceived their NH to be in varied states of operations needed so support quality infection control at the transition to endemic COVID-19 phase. Leadership reported continued challenges in addressing resident & staff vaccinations, securing testing supplies, obtaining financial resources to maintain acceptable levels of personal protective equipment, and isolation practices. Leadership valued providing person-centered care even in times of crisis. These results indicate socio-cultural reasons behind why NHs continue to struggle delivering quality care post-pandemic and offers areas to focus support efforts.
WELL-BEING IN NURSING HOME RESIDENTS THROUGH THE COVID-19 PANDEMIC
Authors: Heilbrunn Emily , Behrens Liza , Felix Laura , Lehman Erik , Osevala Nicole , Whitaker Janice , Calo William , Kraschnewski Jennifer 
Published: December 2023

Abstract
The SARS-CoV-2 (COVID-19) pandemic has disproportionately impacted residents in nursing homes. As a result of the vulnerable nature of congregate living, and to reduce resident morbidity and mortality, the Centers for Medicare and Medicaid Services (CMS) published Quality, Safety, and Oversight (QSO) guidance. Unfortunately, these restrictions may have had unintended negative consequences on the well-being of residents. Significant evidence illustrates that social isolation and loneliness have serious adverse health implications for older adults. We used GEE ordinal logistic regression modeling to examine the trends of depressive symptoms in nursing homes through the COVID-19 pandemic using the CMS Minimum Data Set (MDS). The PHQ-9 was leveraged to measure depressive symptoms, which was then transformed into a categorical variable (no depression = scores 0-4, mild depression = scores 5-9, moderate-severe depression = 10-27). We compared this with the 4-week incidence of COVID-19, transformed into a categorical variable (0 cases, 1-10 cases, 11-40 cases, &gt;40 cases). The odds of depressive symptoms were elevated when comparing some cases to none (1-10 cases vs. 0 cases, OR 1.33 (1.31, 1.36), p-value &lt; 0.001), 11-40 cases vs. 0 cases, OR 1.16 (1.14, 1.18), p-value &lt; 0.001, &gt;40 cases vs. 0 cases, OR 1.19 (1.18, 1.21), p-value &lt; 0.001). While it is important to acknowledge that isolation-based practices are an effective means to reduce disease transmission, it is vital to recognize that they are in conflict with many quality-of-life goals. With this being said, nursing homes worked dutifully to protect residents’ health and well-being.
ASSESSING THE IMPLEMENTATION OF COVID-19 INFECTION CONTROL BEST PRACTICES IN NURSING HOMES
Authors: Heilbrunn Emily , D’Souza Gail , Francis Erica , Kraschnewski Jennifer , Behrens Liza , Calo William 
Published: December 2023

Abstract
The COVID-19 pandemic has claimed over a million lives in the United States, with nursing homes suffering over 158,000 deaths through 2022. In a cluster randomized controlled trial (RCT) with 136 nursing homes, we delivered best-practice training to improve COVID-19 infection control practices. We sought to assess the implementation of infection control practices in participating nursing homes using Project ECHO (Extension for Community Health Outcomes) as an implementation strategy. We delivered a 16-week infectious disease and quality improvement training via real-time, interactive videoconferencing. We surveyed nursing home administrators (NHAs) and nursing staff at baseline and 6-month follow-up. Using validated items from the Centers for Disease Control and Prevention (CDC), the surveys inquired about 80 infection control best-practice activities (yes/no) related to preparedness, visitation policies, communication, protocols, management of deceased residents, education, staffing, personal protective equipment (PPE), and hygiene practices. We also assessed readiness for change and implementation climate in nursing homes with validated scales. We assessed changes in infection control practices and implementation scale scores between baseline and 6-month follow-up. A total of 197 unique participants from 126 nursing homes responded to our surveys. We found that visitation decisions were less likely made on a case-by-case basis by the end of 6 months (91% vs.76%, p=0.025) and an increase in informational materials developed for residents and families at the appropriate reading level (88% vs. 100%, p=0.021) was observed. We also saw changes in some individual items, e.g., an increase in delegating to non-physician staff
EMANCIPATORY PEDAGOGY IN GERONTOLOGICAL SPACES
Authors: Pond Brittney , DiCarlo Nicholas , Pond Brittney 
Published: December 2023

Abstract
Awareness of the field of gerontology has been bolstered by increased training and education programs and other critical pedagogies in several disciplines in higher education. Public and philanthropic initiatives have also supported the development of scholars and researchers in this field (Gross & Eshbaugh, 2011; Merz et al., 2017; Snyder, Wesley, Lin & May, 2008; Wesley, 2005). Furthermore, research notes that incorporating experiences of LGBTQ+ older adults in gerontological spaces can help to address a lack of representation in higher education and provide critical training to support LGBTQ+ older adults (Lipinski, Wilson, Kortes-Miller & Stinchcombe, 2022; Smith, Altman, Meeks & Hinrichs, 2019). This symposium aims to discuss critical pedagogies and emancipatory gerontology in higher education through an intersectional lens. We aim to address the question, where do critical pedagogies flourish, where are they needed, and in what ways? Presenters discuss multiple aspects of this question, describing the ways in which access is a critical component of emancipatory pedagogies, including 1) how we learn and teach abolitionist gerontology in interdisciplinary spaces 2) confronting ableism and ageism in gerontological spaces as part of intergenerational pedagogical praxis and 3) highlighting the need for LGBTQ+ aging education in curricula by discussing a student-led “queering gerontology” campaign with tangible outcomes.