bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ROLE OF SOCIAL DETERMINANTS OF HEALTH ON CANCER RISK BEHAVIORS AMONG OLDER NIGERIAN MEN
Authors: Esiaka Darlingtina , Nwakasi Candidus , Chidebe Runcie 
Published: December 2023

Abstract
Despite the growing cancer incidence and mortality rate in Nigeria, there exists prevalence of imminent and aggressive stage of cancer diagnosis among Nigerian men due to cancer risk behaviors and lack of cancer preventive behaviors such as early screening. This adds to the increasing rates of cancer disparities in Nigeria and Sub-Saharan Africa. Research links social determinants of health (SDOH) to myriad of cancer outcomes including cancer detection and prevention behaviors. To contribute to our understanding of the complexity of cancer risk behaviors, this cross-sectional study aimed to determine the relationship demographic (age, education, employment, income), health (cancer knowledge, cancer beliefs, illness attitudes) and social determinants of health (health insurance, public health infrastructure, rural vs. urban dwelling) have on cancer risk behaviors among older Nigerian men (N=411, age 50+). Results show a significant association between SDOH and cancer risk behaviors. Lack of insurance, absence of health infrastructures, and rural dwelling were correlates of cancer risk behaviors. Also, cancer beliefs, illness attitude, income, and employment had significant relationships with cancer risk behaviors. Our findings point to the detrimental effects of these factors on the fight against cancer disparities. Understanding the mechanisms by which older Nigerian men experience health, requires efforts in identifying constructs that influence their daily-lived experiences and their impact on health-related behaviors. Our data can inform global health actions to eliminate cancer disparities at the individual, organization, and government levels.
ESPO AND BEHAVIORAL AND SOCIAL SCIENCES SECTION SYMPOSIUM: BRIDGES TO ELDER JUSTICE: BUILDING COLLABORATIONS AND COALITIONS TO CATALYZE ELDER MISTREATMENT RESEARCH
Authors: Chang E-Shien , Hackett Sara 
Published: December 2023

Abstract
Elder mistreatment is a widespread public health problem, affecting 1 in 6 older persons every year. Despite its high frequency and severity, relatively little attention has been paid to ensuring that the findings of elder mistreatment research can be implemented in routine care and clinical practice. Forging meaningful partnerships with health care systems may hold promise to facilitate this translational process, and ultimately improve health outcomes for older persons. In this symposium, we will identify proven approaches and mechanisms to successfully build, maintain, and sustain elder mistreatment research-to-practice partnerships with various health care system stakeholders. Dr. Karl Pillemer will describe best approaches in forging researcher-practitioner collaboration with long-term care providers to implement and disseminate evidence-based resident-to-resident aggression intervention program. Dr. Lena Makaroun will examine lessons learned from four high-impact Veterans Health Administration-led collaborations to accelerate applied elder mistreatment research. Dr. Kristen Lees Haggerty will discuss strategies and successes in developing a novel elder mistreatment screening and response tool for emergency departments nationwide in partnership with the National Collaboratory to Address Elder Mistreatment. Finally, Dr. Zach Gassoumis will describe his experiences with conducting intervention and observational research as well as provide advice to early career scholars looking to build partnerships with health care systems. Taken together, these presentations will shed light on the practice, policy, and research implications in strengthening health care system partnerships to closing the discovery-delivery gap.
USING THE ELECTRONIC MEDICAL RECORD OF NURSING HOME RESIDENTS FOR IMPROVED MEASURE OF BEHAVIORAL SYMPTOMS
Authors: Yun Hyunkyung , McCreedy Ellen , Mor Vincent , Mitchell Susan 
Published: December 2023

Abstract
Behavioral symptoms as study outcomes are measured by routinely collected data such as the Minimum Data Set (MDS), the standardized assessment of nursing home (NH) residents. However, MDS under-detects neuropsychiatric symptoms in people with dementia, and better identification in this outcome measurement is needed. This work aims to determine if the electronic medical record (EMR) NH data, the Interventions to Reduce Acute Care Transfers (eINTERACT) form, could improve the identification of agitated behaviors (behaviors). 77,936 assessments of the MDS and the EMR of 19,705 long-stay residents with dementia from 322 NHs, conducted between January 2020 and August 2022, were used. MDS behaviors were defined as any verbal or physical behaviors directed at others, resistance to care, or other behaviors (e.g., pacing). eINTERACT behaviors were defined as any general agitation or verbal or physical aggression. 96% of NHs used eINTERACT forms for at least half of their residents. On average, 14.8% (SD 35.6) of residents with a qualifying assessment in a given month had an MDS-documented behavior, and 2.4% (SD 15.2) had an eINTERACT-documented behavior. 1.4% (SD 11.7) had behaviors documented only on the eINTERACT form representing about a 10% increase in detectable behaviors in a given month over MDS alone. Results were robust to stratification by NH-level prevalence of MDS behaviors. Using the eINTERACT forms in addition to the MDS behavioral items increased in detection among long-stay residents with ADRD. There is some indication that greater use of eINTERACT is associated with greater increases in behavior identification.
THE UNEVEN LATER WORK COURSE: INTERSECTIONAL GENDER, AGE, RACE, AND CLASS DISPARITIES
Authors: Moen Phyllis , Flood Sarah , Wang Janet 
Published: December 2023

Abstract
We document patterned continuity and change in monthly work attachments and analyze the intersecting effects of age, gender, education, and race/ethnicity. We utilize 16-month panel data from Current Population Survey (2008-2016) to code monthly states: working full-time, long hours, part-time; being self-employed or unemployed; not working due to disability or family care, or retired. Analyses of 346,488 American women and men aged 50–75 years reveal patterned elasticity in the timing and nature of work attachments in the form of six distinctive pathways. Analyses illustrate divergences and disparities: advantages for educated White men, disadvantages for low-educated Black men and women through their early 60s, and intersecting effects of gender, education, and race/ethnicity during the later work course across age groups. We find convergence across social markers by the 70s. This research highlights the importance of intersectional analysis, recasting the gendered work course in later adulthood to reflect its complexities.
EARLY-LIFE WAR EXPOSURE AND LATER-LIFE FRAILTY AMONG OLDER ADULTS IN VIETNAM: DOES WAR HASTEN AGING?
Authors: Zimmer Zachary , Korinek Kim , Young Yvette , Teerawichitchainan Bussarawan , Toan Tran Khanh 
Published: December 2023

Abstract
We aimed to assess the nature and degree of association between exposure to potentially traumatic wartime experiences in early life and later-life frailty. The Vietnam Health and Aging Study included war survivors in Vietnam, age 60+. Latent class analysis (LCA) is used to construct classes exposed to similar numbers and types of wartime experiences. Frailty is measured using a deficit accumulation approach that approximates biological aging. LCA yields 9 unique wartime exposure classes, ranging from extreme exposure to non-exposed. Higher frailty levels among those with heavy/severe exposures certain combinations of experiences, including intense bombing, witnessing death firsthand, having experienced sleep disruptions during wartime, and having feared for one’s life during war. The difference in frailty-associated aging between the most and least affected individuals is more than 18 years. War trauma hastens aging and warrants greater attention toward long-term implications of war on health among vast post-conflict populations across the globe.
ACTIVITIES OF DAILY LIVING (ADL) NEGLECT IN INDIVIDUALS WITH DEMENTIA
Authors: Hancock David , Czaja Sara 
Published: December 2023

Abstract
Caregiver (CG) neglect, a form of elder mistreatment, is often measured by examining unmet care needs. A common way to measure unmet needs is to examine if a care recipient has needs for Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL) care needs, and if so, whether those needs are being met. The current study, using data from the Caring for the Caregiver Network Study, describes unmet ADL care needs among persons with dementia. Specifically, we examine how many needs there are, which needs are most common, how bothersome the caregiver finds attending to those needs, and how often those needs go unmet by the caregiver or other family members or friends. Overall, 1 in 10 care recipients experienced neglect as defined by unmet ADL needs. On average, caregivers (n=244) indicated care recipients needed help with 4 ADL care needs (range 0-7). The most common ADL need was needed help bathing, followed by getting dressed, and toileting. Moreover, the CGs generally found these tasks to bother or upset them between “not at all” and “a little.” Toileting and bathing were ranked as the most bothersome tasks. Additionally, 10% of the caregivers identified ADL needs which were not being met by either themselves or other family members or friends. The most common unmet need was help with bathing, followed by toileting. Needs were most bothersome and most likely unmet for intimate acts such as bathing and toileting, suggesting possible targets for skill-based intervention development.
DEVELOPING A SCALE TO MEASURE NEGLECT SEVERITY: THE HEALTH-RELATED SEVERITY IN ELDER NEGLECT SCALE
Authors: Rosen Tony , Pillemer Karl , Burnes David , Fulmer Terry , Teresi Jeanne , Safford Monika , Czaja Sara , Lachs Mark 
Published: December 2023

Abstract
Caregiver neglect in older persons can vary dramatically in severity, with differential impact on an older adult’s health. Assessing severity is critical for research and clinical practice but has received focus until recently. To address this gap, we developed a scale to describe the health-related severity of elder neglect using an expert consensus method. In development, the experts conceptualized severity as: (1) the level of risk that neglectful behaviors would cause morbidity or mortality and (2) related timeframe. Additionally, the experts recommended that the scale identify risk for future neglect. The scale was designed iteratively, and, after finalization, we assessed face and construct validity. The final scale was found to have validity. It has 5 levels: not present, not present / potential risk, present / mild, present / moderate, present / severe. Each level has a description to guide assessment. For example, present / mild is described as: “caregiving behaviors not optimal, with potential to create morbidity, but low concern for immediate danger,” present / moderate is: “caregiving behaviors with significant potential to create morbidity within the next 4 weeks,” and present / severe is “caregiving behaviors creating immediate danger of morbidity or mortality -- insufficient access to shelter, food, medication – with alternative living situation or ED visit / hospitalization recommended.” The description of not present / potential risk is: “though neglect not currently occurring, factors present that raise concern for future neglect risk.” Assessing neglect severity using this scale may improve understanding of the phenomenon and inform intervention.
DEMENTIA DIAGNOSES PREDICT CAREGIVER EDUCATION DISCREPANCIES IN HOSPITAL SETTING
Authors: Medlin Austin , Still Catherine , Werner Nicole , Fields Beth 
Published: December 2023

Abstract
Many family caregivers report feeling unprepared to provide care for persons living with dementia (PLWD) after their hospital stay. Consequently, PLWD may experience poorer health outcomes and higher service utilization rates. Health systems can provide education to patients and their family caregivers, increasing preparedness, but these practices are less understood. This retrospective data analysis of electronic health records examines the role of diagnostic billing codes in predicting amount of education received by patients and their family caregivers. Our dataset includes 419 unique encounters of hospitalized older adult patients with a documented dementia diagnosis and a listed family caregiver between 1/1/2019 and 8/1/2022. Dementia-related ICD-10 billing codes determined unique patient diagnoses. Encounters were given designations of receiving more vs. less education if the amount of education received was above or below the sample median. Logistic regressions then determined the relationship between diagnostic billing codes and education received while controlling for demographic and contextual characteristics. We found that encounters with diagnostic codes “other degenerative disease of nervous system” and “Alzheimer’s disease” were 2.8 and 3.3 times as likely to receive more education, respectively (95% confidence interval = [1.051, 7.347], p = .0394; [1.175, 9.461], p = .0236). Conversely, encounters with the code “other frontotemporal dementia” were 3.3 times as likely to receive less education ([1.150, 9.684], p = .0266). Findings demonstrate certain dementia-related diagnoses predict differences in how likely caregivers are to receive education. Health systems should evaluate for these differences and incorporate new methods to increase caregiving preparedness.
DEVELOPING A CONCEPTUAL MODEL TO ASSESS ACTIVE ENGAGEMENT WITHIN A DEMENTIA CAREGIVER INTERVENTION
Authors: Neller Sarah , Cajavilca Moroni Fernandez , Johnson Julene , Ellington Lee , Eaton Jacqueline 
Published: December 2023

Abstract
Active engagement is identified as an effective component of psychoeducational interventions for caregivers of persons living with dementia. There are many approaches to active engagement; however, limited assessment of this component within interventions reduces optimization and standardization. To fill this gap and increase transparency, we aimed to strengthen active engagement by developing Enhancing Active Caregiver Training (EnACT), an arts-based intervention designed to help caregivers address the behavioral symptoms of dementia. The intervention uses multi-sensory activities, including interacting with caregiver-informed vignettes, to foster engagement and process caregiving experiences. We partnered with caregivers of persons living with dementia (n=9) to iteratively refine EnACT through six focus groups. The purpose of this presentation is to report the process we took to identify how intervention participants actively engaged with EnACT. Focus group data were analyzed using process coding to identify the patterns of participant engagement with 17 intervention activities. The process codes were mapped to create a diagram of participant engagement for each activity. These diagrams were used to develop the EnACT Cycle of Engagement, a conceptual model illustrating how participants engaged with the intervention. The three-step model illustrates that: 1) antecedents (personal and intervention) contribute to 2) interaction with EnACT through participation, contribution, and application, which leads to 3) EnACT’s hypothesized proximal outcomes (capacity to adapt and appraisal of caregiving demands) and distal outcomes (perceived stress and caregiver well-being). The EnACT engagement model will be tested in the forthcoming randomized control trial assessing feasibility and acceptability.
INFLUENCE OF PERSON AND ENVIRONMENTAL FACTORS ON OLDER ADULT ENGAGEMENT IN VIDEO TELEHEALTH
Authors: Gately Megan , Waller Dylan , Maynard Matthew , Moo Lauren 
Published: December 2023

Abstract
Rural patients at Veterans Health Administration (VHA) are older and have more complex chronic conditions than Veterans receiving care outside VHA. Rural patients face challenges accessing care, particularly specialty services which are often in urban areas. Though video telehealth can increase access to care by older patients, video was underutilized by this group even during the rapid increase in use of video in response to COVID. The unequal uptake of video telehealth by older patients during a time when there were limited options suggests a gap in our understanding of the factors involved with older adults’ utilization of video telehealth. To explore these factors, we interviewed occupational therapy practitioners who were high users of video telehealth (N=27) about their experiences with video telehealth. According to interviews, successful utilization of video telehealth involves consideration of complex factors operating at the person (i.e., patient and clinician) and environmental levels. Person-level factors for the patient and/or family caregiver include technological literacy, sensory impairments, and stress tolerance. Clinician person-level factors include confidence with technology, attitudes towards video (including perceived benefits for clinical care), and specific skills like communication and flexibility. Environmental level factors include the physical setting (e.g., whether the patient/clinician are in a private space), availability of technical assistance for patients and clinicians, caregiver assistance on the patient side, and presence of a device and adequate broadband for patients. Elucidating the network of factors involved with video telehealth may enable sustained integration of video telehealth by rural patients most in need of care.
UNTANGLING THE MODEL MINORITY STEREOTYPE: PROMOTING HEALTH EQUITY AMONG ASIAN AMERICAN OLDER ADULTS
Authors: Wu Bei , Jang Yuri 
Published: December 2023

Abstract
The “model minority” stereotype portrays Asian Americans (AAs) as a monolithic group with common traits, e.g., high levels of education and income, and better health status. Five studies in this symposium used multiple data sources and provided rich information to untangling this stereotype. The first study highlighted racial/ethnic disparities in help-seeking behaviors among Americans with subjective cognitive decline, revealing that AAPIs exhibit the lowest likelihood of seeking help for cognitive problems. The second study examined the degree to which socioeconomic disparity contributes to functional impairment among older AAs relative to other racial/ethnic groups, revealing that AAs fare worst in the burden of functional impairment due to education disparity. The third paper explored the cultural adaptation of the NYUCI for Chinese and Korean dementia caregivers, showing that cultural beliefs have a profound effect on caregivers’ views of dementia and caregiving, their use of social and family support, and their understanding of self-care and counseling services. The fourth study assessed factors linked to depressive symptoms among older Southeast AAs, revealing that Vietnamese Americans have significantly more depressive symptoms than Indonesian and Filipino Americans. Resilience and age are negatively related to depressive symptoms, while greater family conflict and inability to speak English fluently are positively associated with depressive symptoms. The fifth study used a large longitudinal survey on older Chinese Americans and demonstrated that higher acculturation levels are associated with a more rapid decline in depression and a slower decline in activities of daily living but are not related to long-term cognitive changes.
CLIMATE CHANGE AND AGING: FROM VULNERABILITY TO ACTION
Authors: Ayalon Liat , Pillemer Karl 
Published: December 2023

Abstract
Older people are particularly susceptible to extreme climate change events. This is attributable to physiological susceptibility, but also to factors such as social isolation, digital exclusion, ageism, and living arrangement. Unfortunately, older people are often not considered in mitigation and adaptation climate change policies contributing to their heightened susceptibility in the face of extreme climate events. Compounding this challenge, it is younger people who are seen as the face of the climate change movement, at times, blaming older people for their (in)action, which has contributed to the current climate situation. Nevertheless, research has shown that older people engage in pro-environmental behaviors and can highly benefit from taking part in climate change activism. The present symposium aims to tackle this topic by discussing the challenges pertaining to older populations occasioned by climate change, and how older populations can engage in being part of mitigation solutions.. The first presentation by Carr and colleagues addresses global population aging and heat exposure with a particular focus on implications for wellbeing and social policy. Delving into the country level, Cherry and colleagues discuss findings concerning long term mental health effects of exposure to a single versus two extreme weather events. Moving to possibly mitigation and adaptation measures, Nikitin and Rupprecht address opportunities associated with exposure to nature, whereas Kohon and colleagues discuss the role that aging and old age capture in climate change policies. The symposium concludes with a theoretical conceptualization by Diehl which reframes aging in the context of climate change. This is a Climate Change and Aging Interest Group Sponsored Symposium.
CLIMATE CHANGE POLICIES AND OLDER ADULTS: AN ANALYSIS OF STATES’ CLIMATE ADAPTATION PLANS
Authors: Kohon Jacklyn , Carlson Bryant , Carder Paula , Himes Dani , Toda Eiji , Tanaka Katsuya 
Published: December 2023

Abstract
As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states’ climate adaptation plans to assess the methods through which they address the impact of climate change on older adults. This study uses content analysis to analyze available climate change adaptation plans for all U.S. states for strategies designed to increase resilience of older adults to impacts of climate change. Nineteen states have climate adaptation plans, of which 18 describe older adults as a population group with specific health impacts and risks factors. Four categories of adaptation strategies for older adults include communications, transportation, housing and emergency services. State plans vary in terms of the risk factors and adaptation strategies included. To varying degrees, states’ climate change adaptation planning address health, social and economic risks specific to older adults, as well as strategies for mitigating those risks. As global warming continues, collaborations between public and private sectors and across regions will be needed to prevent negative outcomes such as forced relocation and other social and economic disruptions as well as disparate morbidity and mortality.