bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPMENT AND TESTING OF THE PC-MET (PERSON-CENTERED MEASURE EVALUATION TOOL)
Authors: Zimmerman Sheryl , Mast Benjamin , Port Cynthia , VanHaitsma Kimberly , Fazio Sam 
Published: December 2023

Abstract
Despite the importance of person-centered measurement -- and that numerous research instruments are now available to measure person-centeredness -- there are no tools to evaluate the extent to which existing research instruments themselves are developed consistent with principles of person-centeredness. The PC-MET (Person-Centered Measure Evaluation Tool) was developed to fill that gap. Based on literature and theory, the PC-MET assesses the process of instrument development and the content of the instrument itself based on six overarching criteria of person-centeredness: co-creation, accommodation, incorporation, biopsychosocial-cultural components, pragmatism, and systemic focus. The inter-rater reliability of the PC-MET was evaluated based on instruments recommended for use in relation to the Alzheimer’s Association 2018 Dementia Care Practice Recommendations (DCPR). Independent raters evaluated two measures within each DCPR area using the PC-MET. Agreement was excellent (kappas&gt;0.81) across all PC-MET criteria with the exception of the criteria assessing biopsychosocial-cultural components (where agreement was moderate; kappa=0.42) and pragmatism (where agreement was substantial; kappa=0.68). Raters provided feedback on the PC-MET and agreed or strongly agreed that the tool is easy to understand and score; the six PC-MET criteria are relevant and complete; and the PC-MET could improve the person-centeredness of dementia measurement instruments. The PC-MET has broad potential use, including to critique the extent to which existing instruments are person-centered, to promote efforts to make existing measures more person-centered, and to inform the development of new person-centered measures. This work was supported by the NIA through a grant to the Alzheimer’s Association and by the LINC-AD Research Steering Committee.
A POINT OF NO RETURN: A QUALITATIVE ANALYSIS ON RETURN MIGRATION AND AGING OF JAPANESE INDIVIDUALS LIVING IN NEW YORK
Authors: Toyama Itsuko , Nakashima Taeko 
Published: December 2023

Abstract
Our previous quantitative research studies have revealed that many older Japanese individuals living in overseas communities maintain hope of receiving culture-oriented care or harbor aspirations of returning to Japan to live out their final days. In this study, we analyzed the qualitative data of a free-answer question on anxieties about aging from a quantitative research study on older Japanese individuals living in Greater New York in 2018. We aimed to clarify the qualitative characteristics of anxieties among three groups: those who had decided to stay in the United States (“abiding”), those who had decided to return to Japan (“returning”), and those who had not yet decided (“undecided”). In the quantitative study, 2,057 questionnaires were distributed, with an overall return rate of 29.7%. The respondents were divided into three groups based on their answers regarding their intentions for the location of their final residence: the United States, Japan, or undecided. We performed the KJ method (affinity diagram) to visualize the differences and commonalities of their anxieties. The following is a summary of the findings: (1) Although most of the respondents are economically advantaged and healthy, “ambiguous“ anxieties about aging in New York arise in all three groups; (2) All three groups express uneasiness about supporting themselves after paying medical and nursing care costs; (3) Those in the “abiding” group express loneliness due to the societal relationship vulnerability in New York; (4) Those in the “returning” group worry about the additional burden of undergoing legal procedures and re-adjusting to the current Japanese society.
RACE/ETHNICITY DISPARITY FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA: DISABILITY, FINANCE, AND HEALTH AND WELL-BEING
Authors: Chen Lei 
Published: December 2023

Abstract
Older adults and people with disabilities have high needs for Long-Term Services and Supports (LTSS). Disability status, financial difficulties, and health and well-being are likely not uniformly experienced by all people with LTSS needs. Subgroups of older adults and people with disabilities, such as racial/ethnic minorities, may be at significant risk of experiencing financial difficulties and stress about making ends meet. This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships. Findings show that black/African American and Asian participants with LTSS needs were more likely to have cognitive impairments. Black/African American participants with LTSS needs were more likely to report difficulties in activities of daily living. Racial/ethnic minorities with LTSS needs experienced diverse and more financial difficulties on average than their white counterparts. Asian participants with LTSS needs reported worse psychological distress than other racial/ethnic groups. American Indians and Alaska Natives with cognitive impairments were more likely to have more financial difficulties, and those with difficulty in instrumental activities of daily living were more likely to report worse self-rated health. This study moves beyond the typical white/black disparities analyses and focuses on diverse racial/ethnic groups. We need to address the financial needs of various racial/ethnic groups of people with LTSS needs and target policies and service programs to meet their mental health needs.
RACIAL AND ETHNIC DISPARITIES IN NEIGHBORHOOD SOCIOECONOMIC CHARACTERISTICS ASSOCIATIONS WITH VISCERAL FAT
Authors: Follis Shawna , Shropshire Jeremey 
Published: December 2023

Abstract
Visceral adipose tissue (VAT) has a more significant role in the pathophysiology of cardiometabolic diseases than subcutaneous adipose tissue (SAT). Our previous findings suggest VAT represents an important pathway through which racial disparities in the social environment are biologically embodied. To understand the role of structural racism in this pathway, this paper investigated racial disparities in neighborhood socioeconomic status (NSES) and VAT. We hypothesized that NSES is inversely associated with VAT and VAT/SAT ratio over 6 years and associations differ by race and ethnicity. Abdominal VAT and SAT area (cm2) were measured at years 0, 3, and 6 using dual-energy X-ray absorptiometry in a subsample (n=11,020) of the Women’s Health Initiative (age 50-79). The NSES Z-scores were obtained from the US Census and American Community Survey based on participant’s census tract residence. We evaluate racial and ethnic disparities in the exposure and outcome using ANOVA, and associations between NSES with VAT using mixed effects models. We found that NSES and VAT area differed by race and ethnicity. American Indian and Alaska Native (AIAN), Black, and Latina groups were significantly (P&lt; 0.01) more likely to live in neighborhoods with NSES Z-scores below the population mean (Z-score=0) compared with White and Asian races. AIAN, Latina, and Black women had the highest VAT (220 cm2, 185 cm2, 177 cm2, respectively). Findings support the hypothesis that associations between NSES and VAT differ by race and ethnicity. Results from mixed effects models are expected to provide longitudinal evidence that structural determinants are associated with VAT.
ASSOCIATIONS BETWEEN REVERSED CHILDHOOD EXPERIENCE AND LATE-LIFE COGNITIVE IMPAIRMENT: THE CASE IN CHINA
Authors: Zhang Yalu 
Published: December 2023

Abstract
Exposure to violence, parental incarceration, household substance abuse and some other reversed childhood experience is associated with some negative impacts in one’s late life in some countries, such as difficulties in maintaining interpersonal relationships, being more likely to experience depressive symptoms, and performing certain physical functions. However, the impacts of reversed childhood experiences, such as starvation, unmet needs of healthcare services, and loss of parents, are still unknown. Using nationally representative data, China. Longitudinal Aging Social Survey, and the hierarchical cluster-based partial least squares regression, this study found a notably high prevalence of reversed childhood experience regarding childhood hunger and unmet healthcare needs. In China, 65% of the older adults aged 60 and above had experienced falling asleep with hunger, 83.1% think that their healthcare needs were not met in childhood, and 10.26% lost one or both parents before 10 years old. The regression analysis results show that compared to those who did not have experience falling asleep with hunger, those who had such experience were more likely to have a declined cognitive function by 33.8% (p&lt; 0.001). Additionally, the loss of parents also significantly caused poorer cognitive function by 44.2% (p&lt; 0.001). However, such a causality relationship was not detected among those who experienced unmet healthcare needs. These findings suggest that early prevention and interventions are needed among older adults with adverse childhood experience.
CREATING STRUCTURES FOR SUSTAINABILITY OF EVIDENCE-BASED DEMENTIA CAREGIVER PROGRAMS
Authors: Sherman Carey Wexler , Gaugler Joseph 
Published: December 2023

Abstract
Ensuring sustainable impact for broad-based evidence-based programs (EBPs) serving caregivers for persons living with dementia in the U.S. requires systemic maintenance of programmatic fidelity. This symposium aims to assist decision makers, aging and public health networks, and intervention developers to anticipate and deploy effective strategies and resources required to implement EBP interventions and sustain them. A series of four papers describes precursor studies and activities leading to the development of a structure aimed at ensuring that one such EBP, the Savvy Caregiver® (Savvy), can be faithfully sustained by sponsoring organizations. The first paper presents results from in-depth qualitative interviews of key staff (n=25) in nine organizations delivering Savvy. Findings highlight organizational, structural, and regional collaborations that contributed to sustained EBP implementation with fidelity. The second paper describes an online program to train Savvy interventionists. Informed by the first paper’s findings a fully asynchronous multi-media professional continuing educational interventionist training program was developed in collaboration with the educational design team at Emory’s School of Nursing. The third paper presents results of the online trainer program evaluation conducted among 76 interventionists from 32 organizations in eight states. High scores on content comprehension (95-99%) and participant feedback document benefits of self-paced learning, interactive materials and quizzes, and self-reflective exercises. The final paper describes a platform (Savvy Systems, LLC) created to ensure Savvy’s long-term dissemination, programmatic integrity and sustained use. The single platform provides for authorized content dissemination, leader training, enhanced referrals, and copyright compliance through licensing. Discussant will offer policy and practice implications. This is a collaborative symposium between the Alzheimer’s Disease and Related Dementias and Family Caregiving Interest Groups.
BUILDING AN ONLINE TRAINING PROGRAM FOR SAVVY FACILITATORS
Authors: Hepburn Kenneth , Sherman Carey Wexler , Hobday John , Char Adarsh , Reed Lai 
Published: December 2023

Abstract
Scaling evidence-based interventions to implementing organizations not linked to the development source poses difficulties in maintaining program fidelity. Program facilitator training must ensure consistency of training approach and content material across organizations. A training program must be able to certify that trainees can demonstrate a detailed understanding of the basic curriculum intent, learning objectives, core principles, mechanism of action, and operational details of the intervention. This presentation will describe the development of an online program to train interventionists to facilitate the Savvy Caregiver Program (SCP), a multi-session, group-based psychoeducational intervention grounded in Social Cognitive Theory that helps family caregivers develop the knowledge, skills, and sense of competency and confidence (mastery) important for effective caregiving. In collaboration with the educational design team at the Emory School of Nursing, we developed a prototype, fully asynchronous professional continuing educational interventionist training program. In seven components, the program employed embedded video, text, interactive interfaces, and short self-correcting quizzes to teach core principles, essential facilitator skills, and the dynamics of each of the six SCP sessions. At the end of each segment, learners were required to provide reflections on segment content; they were required to attain a score of at least 80% in order to advance to the next segment (retries were allowed). Based on feedback from the 35 interventionists who participated in the prototype training program, we added additional video assets to further illustrate methods for facilitating the program, further developed the internal quizzes and improved course navigation mechanisms.
STRATEGIES FOR MAINTAINING FIDELITY AND SUSTAINABILITY IN EVIDENCE-BASED PROGRAM DELIVERY
Authors: Gordon Kate , Sherman Carey Wexler , Hepburn Kenneth 
Published: December 2023

Abstract
Federal agencies and advisory councils emphasize the need to expand delivery of evidence-based programs (EBPs) to meet the needs of the increasing millions of family members and friends providing long-term, complex care to persons living with dementias in the U.S. (Alzheimer’s Association, 2022). Achieving lasting value and impact of such implementations requires systematic and replicable programmatic fidelity and sustainability to ensure caregivers’ broad access and positive outcomes, and the significant investments of providers, stakeholders, and funders are maintained. Unfortunately, a paucity of reported evidence on such strategies continues to limit the full benefit of most intervention efforts. (Hailemariam, M., Bustos, T., Montgomery, B. et al. 2019). To inform the larger RO1 effort described in the previous two papers, we recruited nine organizations from diverse regions that deliver Savvy Caregiver® to discern the key strategies employed to ensure program fidelity and sustainability. Semi-structured interviews were conducted with organization directors (n=9) and Savvy coordinators and group leaders (n=23). Thematic content analyses of transcribed transcripts yielded salient findings on fidelity best practices, including: Assuring EBP coherence with an organization’s mission; proactively integrating fidelity into interventionists’ training; and integration of fidelity monitoring strategies. Regarding structural practices supporting sustainability, findings included: Engaging leadership buy-in of Savvy as an anchor program; establishing succession plans for seamless program delivery; creation of local collaborative partnerships for long-term recruitment or in-kind contributions; establishment of infrastructure to secure ongoing state and federal financial support. Findings highlight effective, accessible, and achievable strategies for ensuring long-term benefits for all EBP implementation efforts.
NEW DIRECTIONS IN RESEARCH ON THE DYNAMICS OF PURPOSE IN LIFE AND COGNITIVE AGING
Authors: Sutin Angelina 
Published: December 2023

Abstract
Purpose in life is the feeling that one’s life is goal oriented and has direction. There is converging, replicated evidence that having a greater sense of purpose in life is associated with better cognitive aging outcomes, including less cognitive decline across middle and older adulthood and lower risk of incident dementia. Emerging evidence also suggests that cognitive function may likewise support purpose in life. This symposium highlights recent advances on the dynamics between purpose in life and cognition across varying time scales and populations. Kim will describe the association between purpose in life and the maintenance of better cognitive function across six years in older adulthood and moderators of this association. Nelson and Bergeman will describe how cognitive function supported purpose in life through the uncertainty of the Covid-19 pandemic and moderators of this association. Pfund and colleagues will report on the bidirectional associations between purpose and cognition in older adulthood across four longitudinal samples using a coordinated data analytic approach. Finally, Sutin and colleagues will report on an ecological momentary assessment study that found that in moments when participants felt more purposeful, they had faster processing speed. Collectively, these talks emphasize the dynamic and often bidirectional relation between purpose in life and cognitive function. This work will help stimulate research to better understand purpose and cognitive health and how to leverage purpose in life for healthier cognitive aging outcomes.
RECIPROCAL RELATIONSHIP BETWEEN SENSE OF PURPOSE AND COGNITIVE CHANGE IN OLDER ADULTHOOD: A COORDINATED ANALYSIS
Authors: Pfund Gabrielle , James Bryan , Hill Patrick , Hassenstab Jason , Rule Payton , Willroth Emily 
Published: December 2023

Abstract
Sense of purpose (i.e., the extent to which one has personally meaningful goals and directions guiding them through life) is a consistent promoter of healthy aging for older adults. Unfortunately, while individuals benefit from having a high sense of purpose as they age, many people’s sense of purpose declines during older adulthood. Some evidence suggests that these declines may in part be explained by health declines experienced later in life. With sense of purpose being a powerful predictor of cognitive functioning in older adulthood, the current project evaluates whether this relationship may be more reciprocal in nature. Using a coordinated data analytic approach, this work investigates how sense of purpose and cognitive functioning promote each other and change together as older adults age. Longitudinal data comes from the Health and Retirement Study (N=15,497; 4 waves over 12 years), Memory and Aging Project (N=1,700; up to 15 waves over 15 years), Minority Aging Research Study (N=950; up to 12 waves over 12 years), and Wisconsin Longitudinal Study (N=22,334; 3 waves over 18 years). Based on a series of random intercept cross-lagged panel models, initial results indicate that sense of purpose change precedes cognitive functioning change and vice versa, when accounting for between-person and concurrent within-person associations. Moreover, bivariate latent growth models show that longer-term change in sense of purpose co-occurs alongside changes in cognitive functioning. In this talk, we will discuss how promoting sense of purpose can support successful cognitive aging, and the repercussions of cognitive decline for sense of purpose.
OVERVIEW OF THE NEBRASKA GERIATRIC BEHAVIORAL HEALTH WORKFORCE SURVEY
Authors: Poon Cecilia 
Published: December 2023

Abstract
According to the US Census, more than 16% of Nebraska’s population is 65 and older. Many older Nebraskans reside in rural communities. Although clinicians in existing state-wide workforce surveys endorse working with older adults, it is unclear how frequently they are involved in geriatric mental health. To identify the needs of those who are providing mental health services to older Nebraskans, the Behavioral Health Education Center of Nebraska (BHECN) conducted an online survey of eligible licensed practitioners from August to December 2022. This presentation highlights the background characteristics of 193 respondents, nearly 40% of whom came from rural areas. Two-thirds identified either as licensed mental health therapists (38%), licensed clinical social workers (26%), or licensed psychologists (14%). More than a quarter did not provide direct clinical services to older adults. On average, respondents estimated devoting 18% of their time working with older adults. Respondents listed insurance restrictions, lower reimbursement rates, and limited specialized geriatric mental health training opportunities as major reasons that had kept them from serving older clients more frequently. These findings support BHECN’s ongoing efforts to further develop training and support, and advocate for potential policy changes to enhance the state’s geriatric behavioral and mental health workforce.
EXAMINING THE GERIATRIC SCHOLARS PROGRAM: IMPACT ON CLINICAL PRACTICE AMONG VA PSYCHOLOGISTS
Authors: Rodriguez Rachel , Mehta Priyanka , Gregg Jeffrey , Kramer Josea , Alfaro Ana , Gould Christine 
Published: December 2023

Abstract
Since 2014, the Geriatric Scholars Program – Psychology Track (GSP-P) has offered VA post-licensure psychologists with little-to-no prior geropsychology training an opportunity to enhance their knowledge and skills to better serve rural-dwelling older Veterans. This is achieved through an intensive course on geropsychology competencies, completion of a geriatric mental health focused quality improvement project and optional advanced learning components. A survey of GSP-P alumni was conducted to assess the long-term impact of participation on clinical practice with older Veterans and overall job satisfaction. Out of 148 alumni, 40 (27%) responded to the survey. Most alumni reported working within the home based primary care setting (45%), with the others working in a range of inpatient and outpatient settings. Utilizing a retrospective post-pre design, practice change was evaluated using a measure comprised of 12 items related to clinical practices/behaviors with older Veterans (e.g., “Incorporated a caregiver/family member in the assessment of an older Veteran.”) both before and after participating in the GSP-P. A paired samples t-test, t(29) = -2.91, p = .007, demonstrated a significant difference in clinical practice pre to post engagement with GSP-P, with participants reporting more frequent age-adapted clinical practices/behaviors post GSP-P participation. Sensitivity analyses showed a moderate effect size d = -.53 (95% CI: -.91, -.144). Qualitative responses reflected alumni growth in confidence and satisfaction in working with older Veterans, as well as more utilization of age-adapted evidenced based assessment and intervention. Overall, this evaluation shows that targeted training can improve psychologists’ clinical practice with older Veterans.