bluuebunny/crossref_metadata_2025_split huggingface dataset:
RESPONDING TO THE HEALTH CARE ENVIRONMENT: DEVELOPMENT OF CBO NETWORKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH
Authors: Blair Beth , Kunkel Suzanne , Lackmeyer Abbe , Graham Robert , Scala-Foley Marisa 
Published: December 2023

Abstract
AAAs, with their wide array of community partnerships and ability to respond to local needs and context, are an important connection between social and health care. Recent research describes the impact of AAA services and partnerships on population health, and AAAs are increasingly contracting with health care systems and payers to provide a variety of supportive services that enable older adults to live at home and in the community. To better meet the needs of health care partners, and to maximize their service reach and impact, AAAs and other community-based organizations (CBOs) are increasingly forming networks to contract with health care entities. Data from the 2021 CBO-Health Care Contracting Survey shows that 44 percent of AAAs are part of a network that provides contracted services to health care entities, but little is known about how these networks are formed and sustained. Findings from a new qualitative study on CBO networks, which consisted of 23 semi-structured interviews with network leads (also known as community hubs) and member organizations, describe how AAAs and other CBOs are developing networks and contracting with health care entities. This session will share findings from the qualitative study to describe the opportunities and ongoing challenges of network participation. Networks allow CBOs to serve more people and contract with health care partners to provide integrated care, but ongoing challenges include lack of data infrastructure and financial viability for members that may have fewer clients to serve. This session will also discuss the policy implications of these findings.
FINANCIAL EXPLOITATION OF OLDER CLIENTS: EXPLORING FINANCIAL PROFESSIONALS’ ROLES AND EXPERIENCES
Authors: Cerino Lauren , Miller Julie , Balmuth Alexa , Felts Adam , Coughlin Joseph 
Published: December 2023

Abstract
Research shows that financial exploitation of older adults can be difficult to detect and underreported (Deane, 2018; Sullivan-Wilson & Jackson, 2014). Financial exploitation of older adults is both prevalent and costly, with estimated annual losses in the billions (Wood & Lichtenberg, 2017). Initiatives such as AARP’s BankSafe training program demonstrate that the financial services industry can prevent and address cases of financial exploitation (DeLiema & Deevy, 2016). But it is worth exploring how financial professionals perceive their own ability to support older adults in cases of financial exploitation. The MIT AgeLab conducted an exploratory study to examine financial professionals’ experiences with, and preparedness for, addressing financial exploitation against aging clients and their families. Data are inclusive of a sample (N=30) of financial professionals who completed an online questionnaire in April 2022. Participants’ encounters with financial exploitation in their work were wide-ranging in frequency and nature. Most participants reported that they felt well-prepared to support a client who was experiencing financial exploitation. Despite high levels of individual preparedness, participants often felt that the financial industry’s policies and services could better address elder financial exploitation. Results from this study suggest that, although financial professionals feel well-prepared as individuals to address financial exploitation, other entities—especially the financial services industry—could instill more confidence by increasing attention to the topic, implementing training, and providing resources. With additional knowledge, training, and resources, financial professionals may be able to more confidently address situations of financial exploitation.
RACIAL AND ETHNIC DISPARITIES IN THE EFFECTS OF COVID-19 ON EMPLOYMENT DISRUPTION AND FINANCIAL PRECARITY
Authors: Carr Dawn , Sonnega Amanda , Carpenter Rebekah , Cao Katy (Qiuchang) , Chen Qize 
Published: December 2023

Abstract
The COVID-19 pandemic disproportionately influenced minoritized individuals, with significantly higher rates of infection and death. One reason for this higher rate is hypothesized to relate to occupational environments of older minoritized populations had going into the pandemic, which also make them more likely to experience disruption in employment due to factors such as illness, and consequently, more financial consequences of the pandemic than their white counterparts. The current project evaluates race and ethnicity differences in disruptions in employment among older workers during the pandemic, and the extent to which those disruptions were related to the inability to pay monthly bills such as rent/mortgage, utilities, medical bills, food, or debt-related payments. Using data drawn from the Health and Retirement Study, including a COVID-19 survey collected in September 2021, this study evaluates older workers who were employed prior to the start of the pandemic to evaluate differences by race-ethnicity in whether and for what reasons they experienced job disruptions, and the extent to which these disruptions were associated with an inability to pay monthly bills. We further evaluate the extent to which being unable to pay monthly bills is moderated by pre-pandemic financial vulnerabilities. Results indicate that Black and Hispanic older people experience more significant financial consequences of job disruptions, and that pre-pandemic financial vulnerabilities significantly moderate the relationship between race-ethnicity and COVID-related financial consequences of job disruptions. To conclude, the policy-implications of these results will be discussed, particularly potential factors that may decrease financial vulnerability during retirement among minoritized populations.
ACCELERATED AGING IN MID LIFE: BEHAVIORAL, EMOTIONAL, AND PHYSIOLOGICAL MARKERS OF AGING
Authors: Agmon Maayan 
Published: December 2023

Abstract
The aging process starts at midlife and is multifactorial, involving behavioral, emotional, and biological pathways. Most studies to date have focused on either older ages, when age-related diseases already are present, or a single mechanism, thus missing the full scope of the aging process. The proposed symposium aims to fill this gap by highlighting the many-sided nature of aging among midlife adults, especially the contributions of behavioral, emotional, and biological markers. We will discuss how physical capacity, sensory modulation, and exposure to violence are associated with biological age, reflecting the true state of the body and the diversity of aging. Understanding these relationships can both illuminate early markers of the aging process and support the design of tailored interventions to reduce the prevalence of accelerated aging. The symposium will present the latest research on the combined markers to gain insight into normal and accelerated aging. Professor Agmon will give an overview of newly developed behavioral markers that quantify the aging process, such as the photogrammetry-based analysis of posture and physical capacity battery. Roy Tzemah-Shahar will discuss the relationships between physical capacity metrics and rate of aging, Merav Asher will explicate the association between one’s sensory profile and the rate of aging, and Khalil Iktilat will share how exposure to violence explains the accelerated aging of midlife Muslims. Finally, we will discuss the need for more research on midlife adults and the potential benefits of early interventions.
GREATER ADHERENCE TO DAILY HEALTH BEHAVIORS RELATE TO BETTER COGNITIVE FUNCTION
Authors: Hamada Fumiko , Lee Soomi 
Published: December 2023

Abstract
Healthy life habits cannot be formed overnight; therefore, adherence to optimal sleep, physical activity, and healthy eating behaviors is vital. This paper examined the relationship between the adherence rate of the three key health behaviors (i.e., sleep, physical activity, and healthy diet) and cognitive function in adulthood. Data were retrieved from Midlife in the United States third wave (MIDUS 3) Project 2, National Study of Daily Experiences (n=1,061). For eight consecutive days, participants reported nightly sleep duration, daily amount of physical activity, and daily consumption of fast food. Adherence rates of health behaviors were calculated by the sum of having optimal sleep (6 &lt; sleep hours ≤ 9), any intensity of physical activity (60 min.≤), and not eating fast food (yes/no) across the study period. Participants also completed a Brief Test of Adult Cognition by Telephone (BTACT). A series of general linear models examined the associations of the three adherence variables with the overall BTACT cognition score adjusting for sociodemographic and health covariates. Greater adherence rates of optimal sleep (𝛽=0.02; SE=0.01; p=0.01), physical activity (𝛽=0.03; SE=0.01; p&lt;0.01 ), and not eating fast food (𝛽=0.02; SE=0.01; p=0.02) were each and associated with higher BTACT score. Among the three adherence variables, adherence to physical activity was the most important for cognition independent of other health behaviors. Consistent associations were found for executive function, but not episodic memory. These findings suggest that adults with greater adherence to a healthy lifestyle have better cognitive function, and consistency of healthy behaviors is vital for cognitive health.
SPIRITUALITY AND RELIGIOSITY IN BRAZILIAN AND AMERICAN OLDER ADULTS, CHARACTERISTICS AND NURSING CARE APPROACH
Authors: Bós Angelo Jose , Gallagher Amelia 
Published: December 2023

Abstract
This symposium aims to understand two aspects of spirituality and religiosity: the importance of religiosity for older adults, in a population-based study, and a proposal approach for nursing care in cancer patients: Lift the Spirit approach. In the Brazilian study, we will show that religiosity is significantly associated with sex, race, level of education, perceived health status and non-transmittable chronic diseases, including cancer. The results evidence the important role of religious faith in the Brazilian older adult’s health. We concluded that religion and spiritual approaches should always be considered for older adults. In the American study, we will show that preliminary findings suggested Lift the Spirit was feasible, acceptable, and positively impacted knowledge, skills, and self-efficacy. The innovative combination of synchronous and asynchronous online delivery of the intervention and data collection methods has implications for research, education, and clinical practice. Lift the Spirit delivered on an entirely online format is widely accessible and convenient to researchers, educators, and practitioners, as well as participants and students. Equipping nurses to conduct spiritual histories through an intervention like Lift the Spirit is crucial to overcoming a significant barrier to providing spiritual care.
WHO CARES? RETENTION STRATEGIES FOR DIRECT CARE WORKERS
Authors: Applebaum Robert , Janssen Leah , Applebaum Robert 
Published: December 2023

Abstract
More than 30 years ago the Gerontological Society sponsored a congressional briefing about a growing problem; concerns about the adequacy and quality of the direct care workforce in long-term care. In 2002 the Robert Wood Johnson Foundation sponsored the Better Jobs, Better Care demonstration, in response to this continued challenge. Today recruiting and retaining high quality workers in the long-term services system has moved beyond a challenge to an all-out crisis. The initial paper of the symposium presents recent retention and work culture data highlighting todays’ hurdles, collected from more than 80% of long-term care facilities across Ohio. The second presentation provides a comprehensive review of state-level initiatives and innovations aimed at improving recruitment and retention for direct care workers (DCWs) in both facility-based long-term care and home and community-based long-term services across the country. A third paper focuses on retention-promoting factors from the perspective of providers and DCWs working in high-performing long-term care facilities in Ohio. In-depth interviews with 37 providers and DCWs revealed an overarching theme of the importance of work culture, highlighting the modifiable, intangible aspects for promoting DCW retention. The final paper introduces a tip sheet with practical strategies for providers who are seeking to retain direct care workers. Symposium findings will include both practical implications for long-term care providers and ideas for future studies. The direct care workforce crisis is the result of an array of challenges, which means that there will not be one solution, but rather many ideas will be needed.
RESIDENT RIGHTS: BALANCING SAFETY AND AUTONOMY IN LONG-TERM CARE
Authors: Perone Angela 
Published: December 2023

Abstract
Long-term care regulations require staff to keep residents safe while also respecting their autonomy. Building on street-level bureaucracy theory (Lipsky, 2010), which focuses on how front-line workers use discretion to implement ambiguous policies, this study examines how staff at various levels (floor staff, mid-managers, top management) balance these rights. This study employs a multi-method qualitative extended comparative case study of three levels of staff in two long-term care facilities (independent, corporate structure). Data includes in-depth semi-structured staff interviews (n=80), participant observation (n=8 months), and review of facility policy documents (n=376) and legal data (i.e., laws and regulations). Autonomy and safety presented conflicting rights for staff in three situations: fall prevention, food intake/refusal, and medication management. Staff exercised discretion via interpersonal conversations, documentation, and organizational lenses/resources and used interprofessional team approaches across staff hierarchies, especially among floor staff and mid-managers. Even when upper-managers sought external guidance (e.g., attorneys/risk managers), they deferred to the discretion of floor staff and mid-managers to communicate and implement decisions. Team approaches across staff hierarchy were less common when conflicting rights arose in medication management. Differences in organizational structure became relevant only when conflicting rights regarding autonomy and safety arose for food intake. This presentation will discuss the study’s strategies for employing coding teams and data software to analyze large datasets across diverse methodological approaches. It will also discuss ethical dilemmas with sharing large qualitative datasets as secondary data of populations deemed “vulnerable” by IRB.
BIOLOGICAL AND SOCIAL DETERMINANTS OF LATE-LIFE DISABILITY AND ITS IMPLICATIONS FOR AGING WORKFORCE
Authors: Zhang Yuan , Duchowny Kate 
Published: December 2023

Abstract
As the population continues to age, the number of people living with disability is increasing. Disability prevention is crucial for independent living and quality of life for older adults. Identifying biological, individual, and social factors that can delay the disablement process has significant policy and public health implications. This symposium comprises four papers examining critical determinants of old-age disability and the implications for the aging workforce. These papers use data from nationally representative biosocial surveys and cover a range of biological and social factors, including infection, immune aging, gender, social relationships, and work environment. First, Duchowny and Noppert will present findings on the association between advanced immune aging and physical disability in men and women. Their results suggest that immunosenescence may be a critical factor underlying gender differences in disability. Second, He will present her work on estimating the fraction of disability attributable to Cytomegalovirus (CMV) infection, highlighting the potential benefits of a vaccine for CMV in preventing disability. Third, Zhang will present results from a longitudinal study examining the pathways among various aspects of social relationships, physical limitations, and disability risk. Finally, Abrams will present educational disparities in health-induced work limitations and the importance of work characteristics in explaining such disparities. Together, the four studies presented in this symposium will enhance our understanding of determinants of the disablement process and provide valuable insights that can inform policies and interventions aimed at reducing disability and maintaining the productivity and well-being of older adults.
THE MAKING OF AFRICAN MADE: MEMORY AND DEMENTIA EDUCATION BY AND FOR THE AFRICAN IMMIGRANT COMMUNITY
Authors: Nkimbeng Manka , Aswani Truphosa , Russel Wynfred , Shippee Tetyana , Gaugler Joseph 
Published: December 2023

Abstract
African immigrants are a fast-growing segment of the U.S. Black population but dementia literacy and care needs of this population are not fully understood. A dementia care assessment in the community highlighted dementia education as a high priority need in the African immigrant community in Minnesota. This presentation will describe the collaborative process between the research team and a community project advisory board (PAB) to develop a culturally tailored dementia education program and booklet. Following several meetings and reviews, the PAB approved an interview guide that was used to conduct 10 key informant interviews (with leaders including priest, executive directors etc.) and three community conversations (30 participants). This data was used to identify important cultural dimensions for incorporation into the education program. Themes identified were need for respect, attitudes, beliefs and challenges related to dementia care. Identification and debunking of dementia and dementia care myths were also highlighted. The resulting educational content has been presented at 3 community events/organizations with many more scheduled in spring 2023. The African community in Minnesota is very receptive of the education program with many individuals noting that it truly captures African immigrant cultural norms and values. The collaborative process between the research team and the advisory board could serve as a model for creating culturally tailored dementia education programs in other communities. Additionally, successful implementation of this education program has implications for improving dementia care among African immigrants and reducing health disparities in this population.
DON’T STOP BELIEVING – MAKING AGE MATTER
Authors: Montepare Joann 
Published: December 2023

Abstract
As educators and scholars in the field of aging, many of us have seen how ageism operates in nuanced and powerful ways on many fronts and coming from different directions. In this presentation I will use examples from my personal experiences in higher education to describe how age biases can rear their heads and how they have guided me to respond. Beginning with my experiences as a junior faculty member in the 1980s when lifespan developmental approach was reshaping the traditional view of aging, I will share how attitudes about “age doesn’t matter” prevailed and warranted brave and creative responses. Reshaping courses from the inside out to integrate aging became my mission and passion. Whether it a traditional developmental psychology class, a core social psychology class, or a specialized class on face perception – aging could be shown to matter. Fast forward 40 years and much as come to fruition, as seen in the response to the Age-Friendly University (AFU) initiative that I have been helping to build with AGHE leaders, GSA colleagues, and AFU partners. However, there is much more work to be done as we see ourselves being the older adult in our courses about whom we have discussed and the older faculty member in an organizational structure built around people of a certain age. However, we know that if we “Don’t stop believin’, hold on to that feelin” we can continue to pave the way for age inclusivity in even more impactful ways.
IT’S OVERWHELMING FOR EVERYBODY: EXPERIENCES OF DEMENTIA CAREGIVERS WHO AREN’T CLOSE FAMILY
Authors: Lowers Jane , Datcher Ivree , Delk Michelle , Kavalieratos Dio , Perkins Molly , Hepburn Kenneth 
Published: December 2023

Abstract
One in three people with Alzheimer’s or other dementias lives alone, without a spouse/partner or nearby children (i.e., is aging solo). Friends, neighbors, and extended family often assist with tasks that preserve independence, but most dementia caregiving literature, and theory, to date focuses on spousal or parent/child dyads for whom reciprocity, indebtedness and self-interest are common motivators. This study seeks to address this knowledge gap. Design: Semi-structured interviews with caregivers of adults with cognitive impairment or dementia who were not the caregivers’ spouses or parents. Hybrid inductive/deductive thematic analysis incorporating social exchange and stress-coping theories.
Results: We interviewed 11 caregivers (100% female; age 54-85, mean 71; 91% white, 9% black; 27% friend; 27% church congregant; 27% sibling or in-law; 18% neighbor). Caregivers described altruism, empathy, and, in cases of extended family, duty as motivators to provide care for acquaintances with dementia. Caregivers who themselves lacked close family identified with their care recipient’s vulnerability and the possibility of needing similar care someday. Non-family caregivers described feeling unprepared and unqualified to make legal, financial, and guardianship decisions and looked to care recipients’ distant family, health care providers, and religious leaders to guide decisions that require balancing care recipients’ safety and autonomy, such as moving to a nursing home.
Conclusion: Dementia caregiving outside spouse or parent/child dyads can produce practical and emotional challenges for caregivers who are not immediate family. These caregivers may benefit from guidance about practical and ethical decisions in the absence of immediate family decision makers.
PREMATURE MORTALITY IN LGBT VERSUS NON-LGBT VETERANS: THE ROLE OF HEALTH RISK FACTORS AND SOCIAL DETERMINANTS OF HEALTH
Authors: Beaudreau Sherry , Lutz Julie , Otero Marcela , Warren Allison , Goulet Joseph 
Published: December 2023

Abstract
Lesbian, Gay, Bisexual, and Transgender (LGBT) adults experience substantially higher rates of mental health conditions and other health risk factors than non-LGBT adults, but there is limited reseach on how these conditions increase risk for premature mortality. The current study examined this issue among middle-aged and older Veterans ages 40-99 who used Veterans Administration healthcare services from 01OCT2009 to 30SEP2019 (N = 845,122). Earlier age of death by suicide, overdose, or all-causes was hypothesized for LGBT (n = 675,639 ) vs. non-LGBT (n = 675,639) Veterans, and health factors and social determinants of health were predicted as key risk factors of earlier age of mortality. As hypothesized, LGBT Veterans had significantly higher rates of death by suicide, overdose, and all-causes among younger age groups than non-LGBT Veterans. Adjusted risk ratios indicate a significant contribution of mental health conditions (e.g., anxiety/depression), medical comorbidity, pain, smoking history, and military sexual trauma accounting for differential mortality rates by age in LGBT and non-LGBT participants. Social determinants of health, such racial/ethnic minority status and housing instability, were also significant contributors. Findings suggest the need for Whole Health interventions for LGBT Veterans to manage multiple health risk factors contributing to increased mortality risk. Suicide prevention is critical for the many middle-aged and older adults who die from suicide each year, and for LGBT Veterans especially, beginning targeted suicide prevention efforts earlier in middle age may prevent suicide deaths in later life. Lastly, findings implicate subgroups of Veterans who may particularly benefit from outreach and services.