bluuebunny/crossref_metadata_2025_split huggingface dataset:
RESPONSE AND RETENTION OF AN ONLINE RESEARCH REGISTRY: ADAPTATIONS MADE FOR RECRUITING ASIAN AMERICANS
Authors: Yu Kexin , Gothard Sarah , Tupper Emily , Golonka Ona , Lindauer Allison , Pierce Aimee 
Published: December 2023

Abstract
Challenges in recruiting research volunteers, especially racial/ethnic minority older adults, have been documented as one of the most significant obstacles to developing effective treatments for Alzheimer’s Disease and Related Dementia (ADRD). To address the need for recruitment and raise awareness about ADRD research, the Layton Aging and Alzheimer’s Disease Research Center built the online dementia research registry, Alzheimer’s Comprehensive Treatment Network of Oregon and Washington (ACTNOW). Individuals aged 18 and above are eligible to join, and prospective participants self-initiated enrollment into the registry. As of March 2023, there are 497 participants (mean age 63.9, 71.6% female, 74% had bachelor’s or above degree, 12% residing in a rural area) registered in ACTNOW, with an average follow-up period of 1.8 years (SD=1.2, Max=5). To date, 20 research projects have used ACTNOW for their recruitment, and 93% of registry volunteers have been referred to at least one requesting study. The current ACTNOW participants are predominantly non-Hispanic White (92.4%). We will describe ACTNOW’s infrastructure expansion to improve the registry’s capacity for engaging and recruiting older Asian American adults with limited English proficiency. We tested the feasibility of using translated informed consent forms and questionnaires, reconciling data collected in different languages with existing data structures, and the effectiveness of community outreach sessions. Developing the capacity to recruit underrepresented populations for future ADRD research projects can be critical to addressing health disparities in dementia awareness, prevention, diagnosis, and care. Standardizing communications with all registry stakeholders, both researchers and volunteers, helps engagement and accurate recruitment efforts.
APPLIED METHODS FOR HEALTH EQUITY AND END-OF-LIFE OUTCOMES RESEARCH USING MEDICARE DATA
Authors: Jarrín Olga , Kim Hyosin 
Published: December 2023

Abstract
This symposium brings together four related and complementary projects on the development of new data sources and methods to analyze the new data to study health equity and end-of-life outcomes research. The first abstract presents the development of the Care Setting Trajectory Database, which integrates data from various CMS data sources for Medicare beneficiaries to create a longitudinal care experience for older adults across healthcare settings. The second abstract describes the creation of a new race/ethnicity variable to augment the Medicare administrative data for minority populations using harmonized, self-reported race/ethnicity data. The third abstract describes the development of harmonized datasets to study geriatric syndromes’ prevalence, cost, and health outcomes over time. The fourth abstract identifies and predicts place of care trajectories during the last three years of life among Medicare beneficiaries, identifying dual trajectories of inpatient/institutional care and skilled home healthcare/home hospice. Finally, the fifth abstract includes an application of the care setting trajectory database and our new, harmonized, self-reported race/ethnicity variable to evaluate the impact of home health care on later use of hospice and place of death in a large cohort of Medicare decedents. This symposium introduces innovative approaches for harmonizing and merging CMS data sources for Medicare beneficiaries. The methodological advances described in this symposium aim to support health services researchers and policymakers to generate and evaluate research improving care coordination, continuity, and quality of life for older adults with serious illnesses.
DEVELOPMENT OF THE MEDICARE BENEFICIARY CARE SETTING TRAJECTORY DATABASE
Authors: Jarrín Olga , Zafar Anum , Kim Hyosin , Lin Haiqun 
Published: December 2023

Abstract
Despite national efforts to shift from fragmented to value-based/coordinated care, there is a lack of understanding of older adults’ longitudinal aging experience across diverse healthcare settings in their last years. To improve patient care and gain insights into areas for improvement in care coordination and management, it is crucial to have evidence about older adults’ longitudinal care experience and healthcare transitions. This study outlines the development of the Care Setting Trajectory File, which combines information on service dates and discharge destinations from various Medicare administrative, assessment, and claims data. The data sources include MedPAR, Hospice, Minimum Data Set (MDS), MDS-Swing Bed (SB), Outcome and Assessment Information Set (OASIS), and the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI). The Care Setting Trajectory File contains a day-level summary of care settings, including inpatient hospice, inpatient-short stay, inpatient-long stay, inpatient-SNF, inpatient-VA, inpatient, rehab facility, nursing home, home health, hospice home, and home. This day-level file can then be utilized at various levels of granularity, i.e., monthly, quarterly, or yearly periods, for further analysis. For illustration, the file construction method is detailed for a cohort of Medicare decedents who died in 2019. Examples of how this analytic file can be used to generate important insights for policymakers and healthcare providers on improving care coordination, continuity, and quality of life for older adults with serious illnesses will be discussed.
HARMONIZATION OF SELF-REPORTED RACE/ETHNICITY TO ENHANCE HEALTH EQUITY RESEARCH USING MEDICARE DATA
Authors: Zafar Anum , Jarrín Olga , Kim Hyosin , Setoguchi Soko , Harvey Marie , Wu Bei , Lopez Maria , Lin Haiqun 
Published: December 2023

Abstract
Collection of valid race and ethnicity data is critical to understanding and promoting health equity. However, current administrative data often misclassifies members of the racial/ethnic minority groups. To address this issue, the Research Triangle Institute (RTI) developed an imputed race variable, which improves on administrative race data for Hispanic and Asian beneficiaries, but still has limitations. This study compares the RTI race with our new, harmonized, self-reported race/ethnicity data collected during Medicaid enrollment and post-acute and long-term care assessments. Out of 2,322,071 Medicare beneficiaries aged 18 and older who died in 2019 in the U.S., self-reported race/ethnicity was available for 75.1% (1,745,327) who formed the study population. Compared to the RTI race variable, our new race variable categorized more Medicare beneficiaries as non-Hispanic white (79.5% vs. 77.9%) and Asian American/Pacific Islander (2.5% vs. 2.3%), a similar percentage as American Indians/Alaska Native (0.5% vs. 0.5%), and slightly fewer as Black (11.1% vs. 10.9%) and Hispanic (7.2% vs. 6.5%). Using our new race variable as the gold-standard, RTI race had good validity (k=0.81), however sensitivity was highest for non-Hispanic white (96.5) and Black (95.8) beneficiaries, and lower for Hispanic (87.2), Asian American/Pacific Islander (76.2), and American Indian/Alaska Native (58.7) beneficiaries. These findings are consistent with prior work, comparing RTI race with self-reported race from a single data source. Our study provides empirical evidence to support the U.S. Office of the Inspector General’s recommendations to the Centers for Medicare and Medicaid Services to incorporate self-reported race/ethnicity data available to reduce error and bias.
HARMONIZATION OF CHRONIC CONDITIONS WAREHOUSE DATA FOR OUTCOMES RESEARCH ON GERIATRIC SYNDROMES
Authors: Ahmad Suzan , Kim Hyosin , Setoguchi Soko , Kobylarz Fred , Zafar Anum , Lopez Maria , Lin Haiqun , Jarrín Olga 
Published: December 2023

Abstract
Geriatric syndromes such as cognitive impairment, falls, depression, urinary incontinence, pressure ulcers, and polypharmacy are common conditions and syndromes that affect older adults. Studying geriatric syndromes in Medicare beneficiaries may provide important insights for improving health outcomes and quality of life. As a result of the Improving Medicare Post-Acute Care Transformation Act of 2014, it is now easier to compare standardized geriatric assessment data (including information about geriatric syndromes) collected in post-acute and long-term care settings with corresponding data from claims, encounter, Part D, and durable medical equipment files. However, to our knowledge, methods to link and harmonize post-acute and long-term care assessment data (available for 75% of decedents) are yet to be utilized in the health services research community. The goal of this project is to develop harmonized datasets that can be used to identify geriatric syndromes and study their prevalence, cost, health outcomes, and service delivery factors over time. This work will allow our team and other researchers to fully leverage these data for use in predictive algorithms and artificial intelligence and machine learning (AI/ML) research. The project uses the five most recent years of data available from the Centers for Medicare and Medicaid Services (CMS) Chronic Conditions Data Warehouse. Data sources include Medicare and Medicaid claims, encounter, MedPAR, Hospice claims, Minimum Data Set (MDS), MDS-Swing Bed (SB), Outcome and Assessment Information Set (OASIS), Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI), Pharmacy (Part D), and Durable Medical Equipment (DME).
INTERPROFESSIONAL HEALTH CARE: INTEGRATING AUDIOLOGY AND GERIATRICS IN INTERNATIONAL SETTINGS
Authors: Arnold Michelle , Deal Jennifer , Pichora-Fuller Kathleen 
Published: December 2023

Abstract
Hearing is fundamental to communication and important for quality of life and overall health of older adults. Despite a potentially large role in how patients engage in healthcare, its importance is underrecognized in healthcare settings. Decreased patient-provider communication and poor treatment understanding may drive decreased satisfaction with healthcare services and avoidance of routine medical care, resulting in poorer health outcomes for older adults with hearing loss. Additionally, despite a high prevalence of hearing loss, less than 20% of those who could potentially benefit from hearing healthcare use hearing aids, potentially exacerbating sequalae of hearing loss in healthcare settings. Amidst growing recognition of the need for inter-professional healthcare collaboration, this session will focus on how audiologists and hearing specialists may partner with other healthcare providers (pharmacists, nurses, physicians) to address hearing needs in primary care, specialty care and hospital settings. We will include perspectives from the United Kingdom, the United States and Canada. We will describe factors that facilitate and impede communication between pharmacists and patients with hearing loss in the community pharmacy. We will also present results of a mixed-methods study from an interdisciplinary team (gerontology, public health, audiology, and otolaryngology/ear nose throat (ENT)) to inform primary care/ENT physicians about preferences for hearing treatment among Black women in the United States. Within a hospital setting, we will present how audiologist-nurse partnerships impact delirium. We will conclude with a discussion of how policy for hearing aid coverage impacts primary care providers recommendations for hearing healthcare in the United States.
INTERDISCIPLINARY MANAGEMENT OF OLDER ADULTS WITH HEARING LOSS: POLICY MATTERS
Authors: Arnold Michelle 
Published: December 2023

Abstract
Hearing aids are an efficacious approach for treating hearing loss yet are underutilized in the US due to high out-of-pocket costs. Lack of hearing aid insurance coverage is one source of the breakdown in the interdisciplinary management of older adults with hearing loss, causing hesitation among primary care providers to refer patients to audiology for treatment. Recently, access and affordability of hearing aids for adults has gained traction, with several states mandating private insurance coverage of hearing aids. The purpose of this study was to understand state-level variability in private insurance hearing aid mandates and to quantify yearly averages of the share of privately insured adults aged &lt;65. We conducted a longitudinal policy surveillance of state statutes for mandates through January 2023. Policy data were then combined with individual-level age, insurance, state, and year variables from American Community Survey and Medical Expenditure Panel Survey Insurance Component to estimate the share of privately-insured adults covered by a mandate from 2008-2022. We identified 25 states and 1 territory with effective private insurance hearing aid mandates. There was substantial variability in these mandates, including in exceptions, maximum age eligibility, allowable frequency of benefit use, and total coverage reimbursement amount. Between 2008-2022, we estimated that &lt;10% of privately-insured adults lived in a state with coverage. We conclude that hearing aid mandates are covering a small but growing share of Americans. A federal mandate would be the fastest way to ensure access, but states can improve access by adopting exception-free mandates with limited utilization management.
AN INTERDISCIPLINARY APPROACH TO ADDRESSING HEARING LOSS IN THE INPATIENT SETTING TO IMPROVE COMMUNICATION
Authors: Reed Nicholas 
Published: December 2023

Abstract
Nearly half of all adults over 60 years of age have hearing loss which is associated with decreased satisfaction with care, higher risk of readmission, and longer length of stay. These associations may be mediated by the barriers hearing loss places on patient-provider communication. There is a paucity of sustainable programs focused on addressing hearing loss among older adults in the inpatient. An interdisciplinary collaborative team comprising audiologists, geriatricians, and nurses developed and implemented a quality initiative to address hearing loss in the inpatient setting in two medical inpatient units at Johns Hopkins Bayview Medical Center that started with offering 16 training session slots to raise awareness of hearing loss and teach technologic, environmental, and communication considerations for adults with hearing loss. Over a 3-month period, 543 of 644 admitted patients were screened for hearing loss using a sustainable model built into the admission process. Those without hearing loss (52.6%) received no intervention, those with mild loss (31.3%) received signage in the room reminding providers of training, and those with moderate or greater loss (16.1%) received signage and an amplifier. At discharge, 79% and 81.6% of those with mild and moderate hearing loss indicated improved communication during their current stay relative to previous stays. Notably, a larger proportion of those without hearing loss (52.9%) also indicated improved communication. A post study survey among 18 nurses suggested themes of moderate (33%) desiring more training and overwhelming perceptions (94.4%) the program didn’t interfere with other duties and made communication with patients easier.
EXAMINING A PERSON-CENTERED MODEL OF COMMUNITY SUPERVISION FOR OLDER ADULTS
Authors: Helmly Victoria 
Published: December 2023

Abstract
Though research in aging and the criminal legal system is growing, there is still limited data on how the carceral system impacts this population. In this presentation, I will discuss my dissertation research on older adults on parole and probation (community supervision). This qualitative research study examines both the experiences of older adults under community supervision and the experiences of the officers who supervise this population. This data is collected through semi-structured interviews with community supervision officers and older adults under supervision. In addition to learning about the unique experiences of older adults impacted by the criminal legal system, this research aims to better understand a “person-centered model of community supervision” in the Southeastern United States. The interviews inquire about how this model is implemented, perceived, and understood by the participants. This research aims to inform policy and practice of community supervision and stimulate additional research in this area. In this presentation, I will discuss the study’s relevance to Gerontology, the research methodology, and the findings from the participant interviews. I will also discuss how this research can inform practice and future studies.
CROSS-TISSUE COMPARISON OF AGING BIOLOGY MEASURES AS NOVEL BIOMARKERS FOR HEALTHY AGING
Authors: Waziry Reem 
Published: December 2023

Abstract
We compared the role of aging biology biomarkers measured in saliva (N=5,808) and blood (N=9,934) as novel biomarkers for prevention of stroke and heart disease in a sample of older adults (aged 50 and older) from the Health and Retirement Study (HRS). Individuals who consented for blood and saliva draw in the HRS 2016 Venous blood and 2008 Telomere length studies were included. Measures in saliva included telomere length. Measures in blood included DNA methylation and physiology biomarkers. The main outcomes included stroke, heart disease and disease-free aging. Cases and disease-free adults were matched on age and sex using a probit link and propensity scores. No association was observed between saliva-based telomere length with stroke or heart disease. In contrast, blood-based biomarkers of aging biology showed strong associations with stroke and heart disease. Biologically older individuals had 3- and 2.5-times higher odds of stroke based on DNA methylation Grim Age (aOR=3.00, 1.87, 4.82, P&lt; 0.001) and Physiology-based Phenotypic Age (aOR=2.50, 1.57, 3.98, P&lt;0.001). Individuals who were biologically older had 3.6- and 2.3-times higher odds of heart disease according to physiology-based Phenotypic Age (aOR=3.64, 95% CI 2.68, 4.94, p &lt; 0.001) and DNA methylation Grim Age (aOR=2.36, 95% CI 1.73, 3.23, P&lt;0.001). Findings of the present study suggest that saliva-based telomere length and blood-based DNA methylation and physiology biomarkers likely capture different aspects of individual aging and vary in their precision and sensitivity as novel biomarkers for prevention of stroke and heart disease in older adults.
BUILDING A STRATEGIC PARTNERSHIP: TURNING CHALLENGES INTO OPPORTUNITIES
Authors: Elfenbein Pamela 
Published: December 2023

Abstract
The University of North Georgia’s Institute for Healthy Aging (IHA) and the Georgia Department of Human Services, Division of Aging Services (DAS), have partnered to address critical workforce needs in the program areas of Elder Abuse, Neglect and Exploitation and Public Guardianship. Working together they have aligned requirements a new University System of Georgia degree, the Nexus degree, with the educational and experiential requirements of employment in these DAS program areas. The University System of Georgia’s Nexus Degree, a new academic credential and the first new degree program in the United States since the 1890s when the associate’s degree was added, was designed to help more Georgians access careers in high demand areas. Creation of this degree is in direct response to talent demand analysis with employers in high demand career areas. The Division of Aging Services faces many challenges that hamper finding and retaining the right workers for the difficult but rewarding roles in Adult Protective Services and Public Guardianship. This presentation will outline the DAS needs and UNG academic program, and how working together to meet the needs of at-risk elders, a direct pipeline to employment has been developed. This paper will discuss and provide insight into this unique collaboration and newly created training approach.
DEVELOPMENT AND EVALUATION OF AN INTERPROFESSIONAL LEADERSHIP IN HEALTH CARE CERTIFICATE
Authors: Keefe Bronwyn , Slater Craig , Jacobs Karen 
Published: December 2023

Abstract
Leaders of healthcare teams have a critical role in coordinating services to deliver high-quality care to the patients and communities they serve. Leading teams can be challenging in the context of complex healthcare systems, increasing costs, resource limitations, and workforce issues. We created the Interprofessional Leadership in Healthcare Certificate for health professionals who lead, or aspire to lead, interprofessional teams. Learners complete courses relating to interprofessional collaboration, effective communication, mentoring and supervision, business acumen, and contemporary leadership models. The live classroom sessions use Project ECHO® to facilitate technology-enabled, collaborative learning. Participants completed an evaluation survey that included questions about course learning objectives, engagement in learning activities, application of content to professional practice, and interprofessional learning. The survey included open-ended questions about the most helpful aspects of each course and suggestions for changes. Evaluation data for each of the courses were collated across four cohorts. Participants represented over 10 healthcare professions. There was over 90% agreement that content met all of the learning objectives for each course. There was over 90% agreement that participants learned from other professions and engaged in interprofessional collaboration. The qualitative data indicated that learners found that the content helped them to be more intentional with their collaborative and leadership practices in their workplaces. The certificate program had a positive impact on participants’ knowledge, skills, and workplace practices relating to interprofessional collaboration and leadership. This may be attributable to intentional interprofessional collaboration in both program development and learning experiences and the use of the project ECHO model.
PLANNING FOR OLD AGE BY GRADUATES OF A MASTER’S GERONTOLOGY PROGRAM IN ISRAEL
Authors: Cohn-Schwartz Ella , Sagi Doron , Meiry Lian 
Published: December 2023

Abstract
The master’s programs in gerontology in Israel were founded in 1999 in response to the challenges brought by extended life courses and the accompanying accelerated growth of welfare and health services for the aged. Since its beginning, thousands of students graduated from the programs and occupy central positions in the gerontological field. However, no empirical data exists on the extent of the involvement by graduates in employment in the field of aging. The current study aims to provide a first-time assessment of the experiences of graduates in Israel following their studies, as well as examine the level of preparedness to old age among graduates, since their work and study of older adults might make their own future old age more salient. We collected data using online surveys from 197 graduates of the gerontology programs. Participants were asked about their work experience in the gerontology field and about the extent to which they prepare for old age. The findings showed that most graduates (80%) currently work in the field of aging, and are overall pleased with the jobs. However, most of the graduated (68%) also reported difficulties in finding employment. Logistic regressions showed that those who currently work in aging and who graduated before less years were also less likely to make preparations for needing nursing care in old age and talking with relatives about their death. Thus, working and studying about aging could be related to being less likely to make preparations for old age.