bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPLEMENTING GRIEF SERVICES FOR OLDER ADULTS: TRANSLATING SURVEY FINDINGS INTO TARGETED PROGRAMMING
Authors: Weiskittle Rachel 
Published: December 2023

Abstract
This presentation will identify and describe the team’s ongoing efforts in actuating the Implementation phase of the EPIS Framework. Evidence-based strategies include formulating a multidisciplinary implementation team, organizing purveyor and intermediary support, and developing a Monitoring, Evaluation, and Learning (MEL) plan. We will highlight the ways in which survey findings were disseminated to the general public and organizational leaders, such as presenting result summaries at city council meetings and in local newspaper articles. The challenges of negotiating survey findings into cohesive program implementation will be discussed, as well as management strategies towards age-related gaps in the implementation process that had not been identified previously. Recent program launches and the ways in which survey results directly informed their delivery will also be reviewed, namely, a free educational guest-speaker event for which over 700 community members attended and a grief-support holiday vigil hosted at a local long-term care facility. This presentation will also review considerations for the project’s next steps as it continues to hone its program delivery parameters and eventually enters into the last EPIS phase, Sustainment. Specific foci will include deciding the long-term methods of quality assurance evaluation and program adaptations to revolving community bereavement needs.
EXPLORING INEQUALITIES IN HEALTHY AGING: MANY APPROACHES BUT WHICH IS MOST USEFUL FOR POLICY?
Authors: Hanratty Barbara , Muniz-Terrera Graciela 
Published: December 2023

Abstract
Promoting healthy ageing requires an in-depth understanding of health inequalities. There are many different ways in which experiences of health and care may be inequitable, and numerous ways of studying this. In this symposium, we present findings from five disparate studies, united by an intention to shed light on unequal ageing. Our work utilises individual characteristics (frailty), aspects of care received (polypharmacy), access to services (digitalisation), different data sources (social care) and evidence synthesis methods, to characterise inequalities in later life, and inform policy. We start with a multi-method study of digitalisation in health services during the coronavirus pandemic, examining the impact of digital exclusion on inequalities in later life. Analysis of cohort data from the English Longitudinal Study of Ageing investigates associations between socio-economic measures and frailty free life expectancy in the over 50s. The impact of years of education on polypharmacy is explored in the Cognitive Function and Ageing Studies, and the value of information on social care provision exploited in analysis of real-world data. The final presentation will cover the development of a conceptual framework to ensure inequalities are considered within evidence synthesis Discussion will draw together the commonalities and differences of these approaches, and consider which have utility for policy makers, and how methods and approaches can be combined to produce an in-depth understanding of inequalities in healthy ageing.
DEVELOPING A HEALTH INEQUALITY/INEQUITY CONCEPTUAL FRAMEWORK TO SUPPORT EVIDENCE SYNTHESIS STUDIES
Authors: Kunonga Tafadzwa Patience , Bower Peter , Hanratty Barbara , Craig Dawn 
Published: December 2023

Abstract
This study aimed to develop a conceptual framework to guide people conducting evidence syntheses, to enable them to visualise links, and intersectionality between various factors that affect health inequality or inequity. Currently, there is no clarity or guidance on how health inequality or inequity should be defined or considered in evidence synthesis, despite recent improvement in reporting standards. In addition, current guides are limited in their ability to provide a roadmap for reviewers that enables them to visualise the links and intersectionality between various factors that affect health inequality or inequity. A series of consensus development workshops were conducted in Spring 2023. Experts in evidence synthesis and health inequality or inequity participated. The workshops were based on methods used previously by researchers developing clinical guidelines. Workshop discussions were centred on (1) important issues/barriers that prevent researchers from having a consensus definition for health inequality or inequity, and (2) how researchers could consider intersectionality of factors affecting health inequality or inequity? Thematic analysis of workshop data and a prioritisation workshop informed the development of a novel conceptual framework. This will be presented and address in particular, ideas around the accumulation of advantage and disadvantage across the life course alongside other dimensions of health and health inequality or inequity.
NOVEL BEHAVIORAL HEALTH APPROACHES FOR OLDER ADULTS IN UNDERSERVED COMMUNITIES
Authors: Mace Ryan , Vranceanu Ana-Maria , Heffner Kathi 
Published: December 2023

Abstract
Chronic conditions and related stressors among older adults are leading drivers of disability, morbidity, and healthcare costs in the US. Underserved communities have the highest rates of chronic conditions and are at the greatest risk for negative health outcomes. Novel behavioral health approaches are needed to address barriers faced by these communities (e.g., stigma, discrimination, structural inequalities) that exacerbate health disparities. Consistent with the GSA 2023 theme, this symposium will showcase multidisciplinary initiatives to build bridges to clinical care, catalyze community-engaged research, and empower underserved older adults. Presenter 1 will present the protocol, preliminary results, and “lessons learned” recruiting ethnoracially diverse older adults for a fully-powered efficacy RCT (target N=260) of Active Brains, a virtual group mind-body walking program aided by Fitbit targeting comorbid chronic pain and early cognitive decline. Presenter 2 will present focus groups with patient and medical provider stakeholders to culturally adapt a mind-body activity program (GetActive) for disadvantaged older adults with chronic pain in community clinics. Presenter 3 will present the rationale, design, and challenges of an RCT testing the effectiveness of a peer support program (Peer Enhanced Depression Care) to alleviate depressive symptoms in ethnoracially diverse and/or low-income older adults (N=160). Presenter 4 will present a stakeholder-partnered approach to equitable home care for older adults and caregivers in diverse communities by eliminating transportation-related barriers. The Discussant will contextualize these initiatives in the broader field of gerontology and share research from their Roybal Center to engage community agencies and ethnoracially diverse older adults.
ADDRESSING COMORBID CHRONIC PAIN AND EARLY COGNITIVE DECLINE IN OLDER ADULTS: THE ACTIVE BRAINS EFFICACY TRIAL
Authors: Mace Ryan , Vranceanu Ana-Maria , Choukas Nathaniel , Rochon Elizabeth , McDermott Katherine , Hooker Julia , Ritchie Christine 
Published: December 2023

Abstract
Chronic pain (CP) and early cognitive decline (ECD) are costly, highly prevalent, and challenging to treat among community-dwelling older adults. CP and ECD commonly co-occur, exacerbate each other, and can accelerate dementia. Our interdisciplinary team has developed Active Brains (AB), a virtual group mind-body walking program aided by Fitbit, to address this comorbidity. We are conducting a single-blinded, NIH stage 2 RCT to establish the efficacy of AB versus a time- and dose-matched education control (Health Enhancement Program; HEP) in 260 older adults with CP and ECD. In this symposium, we will describe the study design, recruitment numbers, and maximizing the inclusion of racial and ethnic minoritized older adults (38% benchmark). Participants are recruited through providers, social media, and community partnerships. Participants wear an ActiGraph to monitor steps and are randomized to 8 weeks of AB or HEP delivered via Zoom by an MGH psychologist. The AB group receives a Fitbit to reinforce activity goals. Primary (multimodal physical function) and secondary (cognitive and emotional function, pain) outcomes are collected at baseline, post-intervention, and 6 months. We have recruited 37 participants (4 cohorts). All 37 completed the baseline, 26 completed the post-test, and 9 are currently enrolled (total dropout = 5%). Session attendance (92.8%) and watch adherence (93.5%) have been excellent. The trial will establish efficacy, test mechanisms, and inform a future multi-site effectiveness-implementation trial. Consistent with the GSA 2023 theme, AB has the potential to catalyze non-pharmacological interventions for CP–ECD and empower older adults to maintain active and meaningful lives.
ADDRESSING THE CHRONIC PAIN EPIDEMIC AMONG OLDER ADULTS IN UNDERSERVED COMMUNITY HEALTH CENTERS
Authors: Vranceanu Ana-Maria , Greenberg Jonathan , McDermott Katherine , Ehmann Madison , Lecvy Nadine , Brewer Julie , Ritchie Christine 
Published: December 2023

Abstract
Current nonpharmacological treatments are inadequate for addressing chronic pain among older adults from disadvantaged backgrounds. These treatments have been developed for affluent populations and are not implemented in underserved community health centers (CHCs) where most older adults with chronic pain seek care. We conducted 4 focus groups with 23 providers (e.g., primary care doctors, nurse practitioners, medical interpreters and support staff) and 4 focus groups with 15 English- and Spanish-speaking patients at a CHC. Our goals were to: 1) understand barriers and facilitators to sustained implementation of the GetActive+ mind-body activity program delivered by a nurse practitioner; 2) gather perceptions of program skills to facilitate cultural tailoring; and 3) gather information to support a future hybrid type 1 effectiveness implementation trial of GetActive+ versus usual care to improve pain outcomes. Qualitative analyses were conducted using a deductive-inductive approach and the Framework method. Questions were informed by Aaron’s implementation model and the Socioecological model. Results revealed multiple barriers at the individual (e.g., pain misconceptions, perceived bias, stigma, shame, treatment expectations and loneliness, language barriers, food and financial insecurity), health clinic (e.g., provider burnout, understaffed clinic, budget cuts, multiple languages) and environmental levels (e.g., lack of technology, lack of reliable transportation to clinic, billing challenges). Clinic providers felt unprepared to support older adults with chronic pain. Both patients and providers endorsed the need for, and skills of GetActive+. Nuanced differences between patient-provider and English-Spanish patients as well as modifications to the program manual, protocol, and interventionist training will be discussed.
ASSESSING MOTOR FUNCTION IN FRAIL OLDER ADULTS IN THEIR HOME SETTING: CHALLENGES AND OPPORTUNITIES
Authors: Yin Lijuan , Song Woojin , Skowronski Jordan , Caceres Maria 
Published: December 2023

Abstract
Motor function is essential for older adults to perform daily activities and remain in their home as they age. Mounting evidence suggests that physical activity (PA) helps maintain motor function in older adults. However, few evidence-based PA programs exist for home-bound older adults who have difficulties walking or standing. They are typically excluded from randomized controlled trials (RCT). Evidence is difficult to establish, because of the lack of instruments and protocols for assessing motor function safely and effectively in this population. The goal of this paper is to present challenges and opportunities that we encountered in assessing motor function in 119 participants of the Pro-Home study right before the COVID-19 pandemic. As expected, participants had significant physical limitations. One third of the participants did not feel safe doing balance tests or chair stand test included in the Short Physical Performance Battery. Of those who did the balance tests, two thirds had to use compensatory movement or hold on to an object to maintain balance. Interestingly, 30% of participants had cognitive impairment as defined by 1.5 Standard Deviation below the normative mean measured by NIH Toolbox Cognition Battery, although they passed a six-item cognition screener to be eligible for Pro-Home. The challenges of assessing frail older adults have led to opportunities to adapt assessment protocols. We made instructions clear and easy-to-follow and developed a new measure appropriate and safe for our target, frail older participants. Additional safety measures are needed to facilitate motor function assessments in frail older adults.
PALLIATIVE CARE IN RESIDENTIAL CARE HOMES: IMPLEMENTATION CHALLENGES AND EARLY FINDINGS IN THREE CLINICAL TRIALS
Authors: Unroe Kathleen , van der Steen Jenny 
Published: December 2023

Abstract
This symposium will describe, compare and contrast three active clinical trials implementing palliative care models for people with dementia in residential care facilities and nursing homes. SPA-LTC is a pragmatic clinical trial in three Canadian provinces, providing training to palliative care teams and a process for triggered palliative care conferences. EMBED-Care, based in the United Kingdom, is testing a digital clinical support tool to improve integrated palliative care for people with dementia using holistic assessment and promoting shared decision-making. UPLIFT-AD is a multi-state U.S. based clinical trial, providing training for in-facility Palliative Care Leads and facilitating specialty palliative care clinician consults for people with moderate to advanced dementia. This symposium provides an opportunity to compare methodologic choices in study design, including intervention design, use of internal (care facility) based resources vs. external supports, and outcome assessment. Presenters will describe implications of these design choices for the implementation of the trial and for longer term sustainability. Implementation experience, including barriers and facilitators to palliative care programs for people with dementia, will be described.
WORKPLACE EMOTIONAL EXPERIENCES, TIME SAVORING, AND HELPING BEHAVIORS IN AN AGE-DIVERSE SAMPLE OF ADULTS
Authors: Growney Claire , Chu Li , Carstensen Laura 
Published: December 2023

Abstract
Socioemotional selectivity theory suggests that as future time perspective grows limited with age, older adults place greater priority on emotionally meaningful experiences and social relationships. Older adults are also theorized to savor time spent in emotionally meaningful activities and social interactions. A preliminary study found that age was associated with higher experience of positive emotion at work. In addition, we found that age was positively associated with trait-level reports of time-savoring, which in turn predicted higher engagement in helping behaviors. We will present findings from a study utilizing the day reconstruction method (DRM) that examines associations between time-savoring at work and engagement in positive workplace behaviors in full-time workers. For one full workweek, participants (N = 200, aged 25–80) complete a survey at the end of each day asking about their workdays parsed into three segments. They report on their social and emotional experiences, the extent to which they were savoring their time engaged in different workplace activities, and their helping (e.g., providing advice to a co-worker) and learning (e.g., developing new ideas or solutions to problems) behaviors during each segment of their workday. Findings have implications for workplace productivity in increasingly age-diverse workplaces. Time-savoring at work may be conducive to intergenerational transfers of knowledge.
FUTURE PREOCCUPATION AND WELL-BEING: EXPANDING CONCEPTUALIZATION OF FUTURE TIME PERSPECTIVE
Authors: Chu Li , Matteson Tyler , Carstensen Laura 
Published: December 2023

Abstract
Socioemotional selectivity theory posits that people prioritize emotionally meaningful goals as time horizons grow shorter and this shift in goals contributes to enhanced well-being. However, studies using the future time perspective (FTP) scale have yielded mixed findings regarding the association between time horizons and well-being. The present study aims to explore alternative constructs of time horizons to better understand well-being across the life span. In this preliminary study, a sample of 101 adults (age M = 46.99, SD = 19.20; 33 males, 66 females, and 2 indicated other gender identity) filled out an online questionnaire regarding time horizons and well-being. Exploratory and confirmatory factor analyses resulted in a new time horizon construct - time preoccupation, which captures the worries and fixations associated with future preparation. Serial mediation modeling shows the trend that people experience reduced future preoccupation with age, which contributes to more time savoring, and thus better well-being outcomes. Together, our findings suggest a promising role of future preoccupation in people’s well-being across the life span. These findings have important implications for future interventions that aim to improve younger adults’ well-being.
TECHNOLOGY-BASED ASSESSMENT OF EMOTIONS AND SOCIAL BEHAVIORS IN OLDER ADULTS’ AND COUPLES’ HOMES
Authors: Chen Kuan-Hua , Levenson Robert 
Published: December 2023

Abstract
As people age, emotions and close social interactions are increasingly important because our social circle tends to shrink. Research on social and emotional aging typically relies on questionnaires and laboratory assessments. However, most emotions and social behaviors occur in naturalistic and interpersonal contexts. Advances in modern technologies, including telecommunications, mobile or embedded devices and sensors, provide researchers with exciting opportunities for naturalistic, long-term, objective, and timely assessment of emotions and social behaviors outside of the lab. Increased accessibility of technologies further allows community-based, large-scale assessment. The proposed symposium highlights recent advances in-home assessment of emotions and social behaviors from four different institutions that leverage various active (e.g., ecological momentary assessment, portable lab) and passive (i.e., motion and door sensors, wearables) technologies to assess multiple aspects of emotions and social behaviors (e.g., physiological responses, emotional experience, behaviors and interpersonal behavioral synchrony, apathy, agitation) in healthy and clinical aging. Four presentations covering four different exemplary studies will be given by researchers at different career stages with diverse ethnic/cultural and training backgrounds (e.g., mechanical engineering, psychology, neuroscience). An integrated discussion will be given by a senior researcher and leading expert in the area. Together, the symposium will provide the general audience with an overview of recent advances in in-home assessment technologies. This symposium will also launch communication and collaborations between researchers from different disciplines who use (or plan to adopt) contemporary technologies to conduct research in naturalistic settings to promote a better understanding of human social and emotional aging.
THINKING ABOUT TIME INFLUENCES EMOTIONAL EXPERIENCE DIFFERENTLY IN OLDER AND YOUNGER ADULTS
Authors: Chen Enna , Growney Claire , Carstensen Laura 
Published: December 2023

Abstract
According to socioemotional selectivity theory (SST), as future time horizons shorten with age, people come to prioritize present-oriented, emotionally meaningful goals. SST posits that present orientation contributes to emotional well-being. Using experience sampling, the present study examined (1) age differences in momentary time orientations, (2) associations between momentary time orientations and emotional well-being, and (3) age moderation of these associations. A sample of 190 people, aged 18 to 94 years, participated in an ecological momentary assessment study where they simultaneously reported time orientations and experienced emotions at five randomly selected times every day for seven days. . We found that age was not associated with time orientation. However, on occasions when people thought about the past, they experienced less positive affect and more negative affect. On occasions when people thought about the present, they experienced more positive affect. All of these effects were weaker for older as compared to younger participants. However, the association between thinking about the future and positive or negative affect did not vary by age. Findings suggest that younger adults, even more than older adults, benefit emotionally from focusing on the present.
SOCIAL CONNECTEDNESS ACROSS THE LIFE COURSE: CORE NETWORKS AND EVERYDAY SOCIAL INTERACTIONS OF AMERICAN ADULTS
Authors: Peng Siyun , Roth Adam , Perry Brea 
Published: December 2023

Abstract
Scholars have been monitoring the signs of social isolation and weakening of family ties among Americans. This paper asks: (1) Do Americans socially disengage from society as they age? (2) Are family ties replaced by work or friends as Americans grow out of their original family? Using a state representative sample of egocentric network data (Person to Person Study: P2P) and a national representative sample of time dairy data (American Time Use Survey: ATUS) during 2018-2021, we found that although people spent less social time with others as they age, they maintained a stable sized core network of confidants for discussing important and health matters. This refutes the view that old age has a universal negative influence on social connectedness. We found little evidence that family ties are replaced by non-kins at any age in both core network and daily social contact. By combining core network and time dairy data, we found that although people spent substantial time with coworkers daily when they enter the workforce, they rarely included even a single coworker into their core network. This suggests that people’s core network is less influenced by current daily social interactions than many theories on social contact would predict. We speculate that people may organize their core network based on cumulative time they spend with a particular person over the life course rather than current time. The roles of life events and age in shaping changes in daily interactions and core network over the life course are further discussed.