bluuebunny/crossref_metadata_2025_split huggingface dataset:
UNFAIR TREATMENT, SOCIAL COHESION, AND COGNITION IN BLACK ADULTS LIVING IN URBAN NEIGHBORHOODS
Authors: Fan Erica , Dubowitz Tamara , Troxel Wendy , Weinstein Andrea , Gary-Webb Tiffany , Ghosh-Dastidar Bonnie , Manly Jennifer , Rosso Andrea 
Published: December 2023

Abstract
Exposure to discrimination has been associated with poorer cognitive function but this association may be influenced by broader social factors, such as neighborhood social cohesion. We investigated the associations between unfair treatment, social cohesion, and cognitive function in 234 participants ≥50 years, recruited from urban, primarily Black neighborhoods in Pittsburgh, PA. Neuropsychological assessments were conducted in 2018 to create six cognitive domain z-scores, adjusted for age, sex, and education level. Social cohesion was assessed in 2013 and 2018. Change in social cohesion scores over time categorized participants into four groups: consistently high, consistently low, increasing, and decreasing scores. Unfair treatment was assessed via questionnaire in 2018. Adjusted generalized linear models assessed associations between unfair treatment and cognition. Unfair treatment was significantly associated with executive function (β=-0.041, p=0.01) and marginally associated with language (β=-0.030, p=0.07). Associations persisted with change in social cohesion in the models and we found that social cohesion moderated the association between unfair treatment and executive function (p=.06). In those with consistently low social cohesion, more unfair treatment was associated with worse executive function (β=-0.085, p=0.02). Both increasing and decreasing social cohesion showed a similar negative association between unfair treatment and executive function at a trend level (β=-0.122, p=0.08 and β=-0.082, p=0.10 respectively). There was no association for those with consistently high social cohesion. Individuals experiencing unfair treatment and consistently low levels of neighborhood social cohesion had lower executive function. These findings highlight the importance of intervening at multiple levels and addressing both interpersonal discrimination and structural sources.
LESSONS LEARNED DEVELOPING A NUTRITIONAL ADHERENCE INTERVENTION FOR DEMENTIA PREVENTION: A QUALITATIVE ANALYSIS
Authors: Sheffler Julia , Patel Juhi , Kiosses Dimitris , Naar Sylvie 
Published: December 2023

Abstract
Lifestyle interventions show considerable promise in delaying the onset and reducing risk for Alzheimer’s disease and related dementias (ADRD). Unfortunately, scalable interventions that address issues of long-term adherence have not been adequately developed or disseminated. Especially important for this effort is iterative evaluation and adaptation of interventions using participant feedback throughout the development process. Using the NIH ORBIT model for behavioral intervention development, our team has established the proof-of-concept (N=9) and pilot tested (N=58) a Mediterranean ketogenic nutrition (MKN) adherence program for older adults at risk for ADRD. This program incorporates motivational interviewing strategies and cognitive behavioral skills training to enhance uptake and long-term adherence to MKN. For each of these pilots, participants completed exit interviews at the conclusion of the 6-week, group intervention and 3-months post-intervention. Qualitative and quantitative data on the acceptability of the program, as well as detailed participant feedback about their experience and recommendations for improvements were collected. While quantitative data demonstrate high acceptability, thematic analysis of qualitative interviews demonstrate a range of recommendations for enhancing and refining important components of the intervention that will be necessary for future scaling and dissemination. We discuss important themes, future directions of this work, and implications for lifestyle intervention development more broadly.
A TOOL TO SUPPORT FAMILY AND PAID CAREGIVERS PROVIDE DAILY ORAL CARE TO PERSONS LIVING WITH DEMENTIA
Authors: Ashida Sato , Beachy Tim , Donohoe Maria , Schneider Haley , Pinho Hianca , Wilson Haley , Marchini Leonardo 
Published: December 2023

Abstract
Persons living with dementia often receive daily oral care from family caregivers or paid caregivers such as nurse aides. However, these caregivers report limited knowledge about and confidence in providing daily oral care. This study used stakeholder engaged processes to develop an app that provides information and guidance to caregivers to support their oral care provision. Contents to support oral care for persons living with dementia were developed through a collaboration between the College of Dentistry and College of Public Health based on prior research. In-depth interviews were conducted with key stakeholders including dental professionals, family caregivers, nursing home administrators, and nurse aides. Participants identified many benefits of this support tool to improve their oral care provision. Dental professionals confirmed the accuracy and importance of the information and provided additional suggestions. Family caregivers appreciated the detailed information and guidance on how to provide daily care, how to identify oral health problems, and what to do if they identify problems. Photos especially helped caregivers identify the nature of the problem to determine action steps. For paid caregivers, the app served as a good reminder and reference guide. Nursing home administrators wanted to use the app as a training tool to standardize and improve the overall care. The app was well-accepted and provided an easily accessible tool for caregivers during care provision. Additional qualitative data and pilot test results will be presented.
DOES BECOMING FRAIL MEAN THE END? SOCIAL, LIFESTYLE, AND HEALTH SURROGATES OF RESILIENCE IN THE MOST VULNERABLE
Authors: Wu Chenkai , Xue Qianli 
Published: December 2023

Abstract
Frailty is a prevalent geriatric syndrome characterized by reduced reserve to stressors and increased vulnerability to adverse outcomes. Despite many efforts, reversing the frail status remains difficult, primarily due to a lack of understanding of its etiology. Intervention efforts have primarily focused on improving functions and alleviating symptoms instead of targeting frailty-causing biology and treating the syndrome. Although no magic pill exists for treating frailty, becoming frail doesn’t mean the end of life. Frail individuals are a socioeconomically, behaviorally, and clinically diverse group. Identifying socioeconomic, lifestyle, and health features that could mitigate the frailty-induced health risks and promote resilience is critical for guiding patient-centered management of frailty. This symposium has a collection of four studies focusing on different ways to promote health and reduce risks among the most vulnerable. The first study suggested that adherence to a healthy lifestyle may provide an excellent opportunity to decrease the risk of adverse outcomes among the frail, especially those living in an unfavorable social environment. The second study found frailty to be associated with higher healthcare expenditure only among persons with poor self-rated health, suggesting individuals reporting good health are resilient to frailty-induced health risks. The third study found that physical frailty and self-rated health were overlapping but distinct constructs. Good self-rated health was predictive of low mortality among frail individuals, and the association was stronger among the frail than the non-frail. In the fourth study, intrinsic capacity, assessed by a validated, multidimensional tool, provided prognostic value for healthcare utilization beyond multi-morbidity.
ENGAGE UNDERREPRESENTED GROUPS IN TECHNOLOGY AND AGING RESEARCH: LIVED EXPERIENCE AT GEOGRAPHICALLY DIVERSE SITES
Authors: Kaye Jeffrey , Beattie Zach 
Published: December 2023

Abstract
Minoritized and marginalized older adults face multifaceted barriers that could prevent them from participating in aging research, including but not limited to not having access to research opportunities, time and transportation constraints, lack of trust with health care providers and researchers, and language barriers. When the research projects involve technology, whether as a tool for engagement or recruitment, intervention delivery, or outcome monitoring and assessment, additional challenges exist in recruiting underrepresented groups. The technology adoption gap has been widely reported. Minoritized and marginalized older adults are less likely to have internet access or feel less confident in using technology compared to their more privileged counterparts. This symposium introduces the lived experience and lessons learned from engagement and recruitment of underrepresented populations at multiple Alzheimer’s Disease Research Centers. The first presentation presents outreach and recruitment efforts at the Oregon Outreach, Recruitment & Education Core. The authors will discuss strategies and benefits to engage people of underrepresented backgrounds in the research workforce. The following two presentations focus on recruitment efforts for installing an in-home monitoring technology platform for diverse older adult populations, including African Americans in Chicago, IL, and Hispanic/Latino immigrants in San Antonio, TX. The fourth presentation describes the response, retention, and enrollment rate of an online dementia research registry and the effort to adapt the registry and build capacity in recruiting Asian American immigrants with limited English proficiency. Sharing successes and lessons learned at multiple sites will contribute to developing more effective recruitment strategies for future aging research involving technology.
FINDING COMMON GROUND: IMPROVING RESEARCHER-PRACTITIONER COLLABORATION IN ADULT MALTREATMENT RESEARCH
Authors: DeLiema Marguerite , Wilber Kathleen 
Published: December 2023

Abstract
The work of adult protection is inherently multidisciplinary–involving health care professions, social services agencies, law enforcement, criminal and civil justice systems, and the broader aging services network. Researchers seeking to develop and evaluate screening tools and interventions for elder abuse and neglect must cultivate partnerships with state and local agencies that are responsible for adult protection. In this symposium, early career researchers will share the unique challenges they have faced when collaborating with adult protective services (APS), healthcare organizations, and other state agencies on research to improve adult maltreatment outcomes. First, Reynolds and colleagues will summarize three collaborative projects involving a large healthcare system in Texas and APS agencies in Oklahoma. They will share how the research team adapted protocols to pandemic-related disruptions to data collection, and how they created new systems to standardize documentation. Liu interviewed state agencies in Montana and analyzed transcripts using thematic analysis. She will share the challenges and strategies that surfaced and relate to improving state-level collaboration in addressing the needs of mistreatment victims and survivors. DeLiema will present on planning for and navigating administrative barriers to cross-sector collaborations, including contracts and legal agreements that are part and parcel to university-government research partnerships. Last, Burnes will introduce the RISE project and share how he and his colleagues managed expectations to co-create a new outcomes measurement tool with adult protection workers. Reaching consensus necessitated honesty, openness, humor, and patience, but ultimately strengthened the collaboration to yield a more valid outcomes measurement assessment.
PARTNERING TO ADDRESS ADULT MALTREATMENT: HARD-EARNED LESSONS AND WISDOM GAINED BY APPLIED RESEARCHERS
Authors: Reynolds Courtney , Tuft Samantha , Ejaz Farida 
Published: December 2023

Abstract
We focus on three projects in which applied researchers collaborated with community-based and government partners to address adult maltreatment. In our first study with Texas, we partnered with a large healthcare system and Adult Protective Services (APS). Two APS workers served as consultants to clinicians and 529 patients were reported to APS. Researchers struggled with quantifying case notes on the consultations, pointing to the importance of creating a systematic method to document case notes for future studies. In the second grant, the same partners evaluated a case management intervention to prevent self-neglect among at-risk, adult primary care patients. A total of 477 randomly selected participants completed a baseline interview. Lessons learned included revising language in how to discuss self-neglect, particularly in consent forms and becoming more flexible in where to conduct interviews. Other challenges encountered included the time and effort it took to develop data use agreements that allowed us to access APS administrative data. Our third study with Oklahoma APS was conducted in the midst of a pandemic, requiring us to change study protocols from home to telephone-based interviews. Despite these challenges, we interviewed 188 clients over the phone. Drawing on the experiences across all three projects, we will discuss challenges – from contracting to IT issues, to recruitment and data collection – and how each one has presented an opportunity for growth and wisdom that can be applied to future research activities.
MENTAL HEALTH AND TECHNOLOGY UTILIZATION AMONG MEXICAN AMERICAN INFORMAL CAREGIVERS FOR PATIENTS WITH ADRD
Authors: Jiang Lin , Garcia-Andres Adelaido , Sarmiento Cassandra , Nasr Lubna , Moreno Isis Macias , Escobar Romeo , Longoria Denise , Gonzalez John 
Published: December 2023

Abstract

Background
The number of Latinos with Alzheimer’s disease and related dementia (ADRD) is expected to rise to 1.3 million by 2050. Mexican Americans with ADRD rely heavily on unpaid informal care. The use of information communication technology (ICT) among caregivers is associated with significant improvements in mental health and social support. However, current ICT studies focus mainly on White American caregivers. This study fills the gap. Method: From November 2021 to November 2022, we collected 115 surveys, of which 11 were collected from in-person interviews at a clinic and 104 were collected online. The survey included the UCLA Loneliness Scale version 3, the Center for Epidemiologic Studies Depression (CES-D), and the Online Social Support Scale.

Results
The participants, aged from 18 to 82 and have cared for their family members with ADRD for two years on average. About 70.4% of them use the internet daily. The results indicated that the more time spent on Instagram, YikYak, and first-person shooter online games, the higher depression the participants had. Also, the more first-person shooter online games they use, the higher is their loneliness. Other social media use is not related to loneliness or depression.

Conclusion
This study suggests that it is necessary to explore an appropriate internet-based ICT for Mexican American informal caregivers to reduce their loneliness and depression. Future research needs to examine their feelings and reflections on using internet-based ICT and discern how their caregiver’s role and Latino culture affect the utilization of technology.
ACCESS AND USAGE OF CARE AMONG OLDER MIGRANTS: CHALLENGES AND OPPORTUNITIES
Authors: Khan Mushira 
Published: December 2023

Abstract
Equitable access to care is critical to support healthy aging in underserved groups. Recent global demographic trends such as the rapid aging of the population in developing and developed countries, the growing proportion of migrants from the Global South to the Global North over the past 50 years, and increasing health inequalities between and within countries reflect a continued need to address the underlying pathways and causal mechanisms that determine access to and usage of care among migrants. This paper reviews the current state of knowledge on the micro-, meso-, and macro-level determinants that intersect and shape access to and usage of care services and programs among older migrants. It makes the case that foreign-born older adults are more likely to experience challenges accessing services and programs due to cultural and language barriers and factors related to their socio-economic status, race/ethnicity, gender, and time since immigration. Next, the paper provides a deeper exploration of the interface of structure and agency and an interrogation of how access and usage of care among older migrants may be conditioned, not simply by individual socio-economic circumstances and life course events, but also by macro-level factors like the distribution of power relationships and neoliberal public policies. The paper concludes with a call for sustained efforts to acquire a more profound understanding of individual-level, socio-economic and socio-political forces that influence access and usage of care. Finally, it provides directions for future research with the ultimate goal of supporting healthy aging among older migrants.
ADDRESSING THE CHALLENGES OF MIPS WITHIN THE GWEP PROGRAM: A CALL TO CO-CREATE MEANINGFUL WAYS TO SHOW IMPACT
Authors: Faul Anna 
Published: December 2023

Abstract
To address the challenges that unique challenges that the GWEP programs had in collecting and using MIPS data to show meaningful and quality work with older adult patients, we created a collaboration between NAGEC and the GWEP MIPS workgroup. Our primary goal was to develop a collective understanding of how GWEPs perceived MIPS as main outcomes. To better understand the collective challenges, a survey was created to examine the diversity in the sites across all GWEPs where MIPS data was collected and to quantify the types of challenges that GWEPs faced in collecting this type of patient data. From this survey we found the following issues were most prominent: 1.) Most GWEPs had primary care sites that had a difficult time pulling date from their electronic health records; 2.) Providers at participating primary care sites struggled to enter MIPS datapoints into the EHRs; 3.) Some of the participating primary sites did not collect MIPS data; 4.) Some of the participating primary care sites do not have the time to provide us with MIPS data in a timely fashion; and 5.) Some of our participating primary care sites are different than the traditional primary care sites (eg. skilled nursing facility, hospice, emergency departments), making MIPS measures irrelevant. From this survey, we were able to develop a solution focused statement to present to HRSA and to start the conversation about the difficulties and challenges in collecting MIPS data.
SLEEP AND SEXUALITY AMONG CAREGIVERS AND THEIR PARTNERS
Authors: Proulx Christine , Skoblow Hanamori , Rauer Amy 
Published: December 2023

Abstract
Older adult caregivers have increased risk of disturbed sleep, which is associated with declines in sexual frequency. Spousal caregivers engage in less sexual activity than caregivers of non-spouses. We examined whether the associations between sleep behaviors (duration, napping frequency, feeling rested) and couples’ sexual frequency, quality, and pleasure were similar among dyads in which one spouse was providing care to a spouse (n = 146) or a parent or other care recipient (n = 211). Using Wave 2 of the NSHAP and actor-partner interdependence models, we found significant differences (p &lt;.01) between dyads. For all spouses, only frequency of sharing a bed was related to frequency of sexual activity in the previous 12 months. Sleep duration was not associated with any outcomes. In both groups, frequency of sharing a bed was positively associated with reports of physical pleasure (b’s ranged from .20 to .50). In spousal caregiver couples, caregivers’ greater napping frequency was negatively associated (b = -.29, p &lt;.01) with their partner’s reports of a physically pleasurable relationship, and their reports of feeling rested were positively (b = .17, p &lt; .01) associated with their own reports of pleasure. For couples in which the caregiver was caring for a non-spouse, there were actor effects for caregivers’ and noncaregivers’ napping frequency on lower reports of sexual relationship quality (b = .19 and .49, respectively), and a partner effect for non-caregivers (b = .25). These results point to the importance of understanding the context of caregiving, sleep behaviors, and sexual relationships.
INTERPROFESSIONAL CO-LEARNING AT MULTIPLE LEVELS OF LTSS: PRO-HOME PROGRAMS AND RESEARCH
Authors: Skowronski Jordan , Zanoni Joseph , Caceres Maria 
Published: December 2023

Abstract
Promoting Seniors’ Health with Home Care Aides (Pro-Home), a randomized controlled trial (RCT) of a gentle physical activity program delivered by home care aides (HCAs) for their older clients in English or Spanish, provided unprecedented opportunities for collaboration and co-learning across multiple disciplines and professions (public health, health services research, sociology, medicine, physical/occupational therapy, kinesiology, social work, psychology, economics, medicine, nursing; frontline care workers, leaders and staff members of state and home care agencies, , social service agencies, researchers, undergraduate and graduate students). The turbulent long-term services and supports (LTSS) environment, which culminated in the COVID-19 pandemic, provided the study participants (HCAs and their older clients), multiple levels of LTSS stakeholders and the research team with rapidly evolving new contexts for the RCT. This paper presents how the Pro-Home project developed into a learning organization where individuals and organizations learn from each other to pivot at every new turn in the environment, focusing on the development of a novel interactive training for HCAs in-person or remotely. The initial training activities were conducted in-person. After adapting the material for remote delivery, we provided the latter sessions via phone with digital and physical tools. For each training session, we assessed outcome quality using an exit survey and other methods capturing HCAs’ program delivery. The presentation concludes with implications for research and practice in LTSS.
DIFFERENCES IN END-OF-LIFE OUTCOMES BETWEEN IMMIGRANT AND NONIMMIGRANT OLDER ADULTS
Authors: Suntai Zainab , Chipalo Edson , Beltran Susanny 
Published: December 2023

Abstract
Although the number of immigrants in the United States has continued to grow, few research studies have focused on the experiences of older immigrants at the end life. Research on the immigration experience shows that there are long-lasting physical, mental, and psychological symptoms that continue to affect immigrants even long after arriving in a new country. To better understand how the immigration experience may influence outcomes in late life, this study examined differences between immigrant and non-immigrant older adults in the following end-of-life outcomes: being alone at death, being in pain at the end of life, having anxiety and/or depression in their final months of life, and the quality of care received at the end of life. Data were taken from the combined 2012 to 2020 National Health and Aging Trends study, which is an annual longitudinal study of Medicare beneficiaries aged 65 and older. Chi-square tests were used for bivariate analysis, and multivariate logistic regression models were used to assess differences between immigrant and non-immigrant older adults. The results showed that immigrant older adults were more likely to die alone at the end of life, more likely to be in pain at the end of life, more likely to experience anxiety and/or depression at the end of life, and less likely to receive good quality care at the end of life. Implications for practice, policy, and research are provided.