bluuebunny/crossref_metadata_2025_split huggingface dataset:
EDUCATION, ADULT LITERACY SKILLS, AND JOB AUTOMATION RISK IN THE OLDER US WORKFORCE
Authors: Narine Donnette , Yamashita Takashi , Chidebe Runcie , Cummins Phyllis , Kramer Jenna , Karam Rita 
Published: December 2023

Abstract
Despite the overall benefits of technological advancement, ongoing job automation has disrupted the U.S. workforce. Of particular concern is that increasing levels of job replacement—driven by job automation—is likely to be a risk factor for economic uncertainty, both for workers and the labor market. Older workers with lower educational attainment and basic adult literacy are known to face challenges in learning new knowledge and skills, which are currently required to be competitive in a technology-driven labor market. Thus, this study aimed to examine the relationship between educational attainment, literacy proficiency, and previously published job automation risk by occupations. Using the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC) data, we analyzed a nationally representative sample of middle-aged and older workers (age 45-74 years; n = 1,484). The results of the linear regression indicated that higher educational attainment (college or higher vs. less than high school: b = -14.11, p &lt; 0.05) and greater literacy proficiency (score 0-500 points: b = -0.06, p &lt; 0.05) were associated with lower job automation risks (0-100 % replacement in the next decades) among middle-aged and older U.S. workers, accounting for the covariates (R-squared = 0.18). In alignment with the federal Workforce Innovation and Opportunity Act, these findings offer empirical support for policies and interventions that are purposefully designed to boost the human capital (i.e., knowledge and skills) of middle-aged and older workers through adult education and literacy training to lower their job automation risk, thereby increasing their level of job security.
INTENTION TO USE HOSPICE CARE FOR FAMILY AMONG OLDER RURAL BLACK AMERICANS IN ALABAMA
Authors: Csikai Ellen , Lee Hee Yun 
Published: December 2023

Abstract
Hospice usage overall continues to rise however, remains low among people of color, including by Black/African Americans. In 2020, 50.8% of White Medicare decedents and only 35.5% of Black decedents used hospice (NHPCO, 2022). Often reasons are connected to poor knowledge of and access to hospice resources that provide holistic support to those near end of life and their caregivers (Adrien, 2017). Little is known about the intention of older rural Black Americans’ to use hospice when caring for family members at home. In this study, older African Americans in Black Belt communities in Alabama were recruited to participate in a survey that addressed health literacy of problems with high prevalence in this rural area (diabetes, cardiovascular disease, stroke and cancer) (CDC Interactive Atlas, 2022). Guided by the Andersen’s Behavioral Model of Health Services Use, regression analysis was conducted to identify predisposing, enabling, and need factors influential in older rural African Americans’ intention to use hospice for family members. Among non-caregivers, who had heard of hospice (n=118 of 180), education, gathering with friends and social club participation, and PHQ-9 were found influential in predicting intention to use hospice for family members. However, among caregivers (n=107), female gender, education, health literacy, gathering with friends, social club participation, and PHQ-9 were influential. Results point to interventions to bolster health literacy regarding hospice among older rural Black Americans and that social clubs and other gathering places could be targeted with educational programs to increase intention to use hospice care for family members.
EMPOWERING ADULTS SEEKING RECOVERY FROM SUBSTANCE AND OPIOID USE DISORDER IN THE DEEP SOUTH
Authors: Buxton Michael , Allen Rebecca , Jacobs M Lindsey , Cox Brian , Holditch Sarah 
Published: December 2023

Abstract
Substance and opioid use disorder may be missed due to lack of consideration of physical, social, and emotional changes in midlife and later adulthood. This presentation uses data from a Graduate Psychology Education grant to examine predictors of alcohol use and misuse among treatment-seeking and primary care patients. Across three sites, 237 individuals completed behavioral health assessments; a rural (n = 54) and an urban federally qualified health center (n = 59), and a state-certified residential rehabilitation facility (n = 124). Participants ranged from 18 to 70 years of age (M = 40.05, SD = 1.75). Approximately 49.4% were female and 72.2% were non-Hispanic White, 23.3% African American, and 4.6% other. More than 28% of individuals had less than a high school education, and 38.4% reported a high school education or GED. Using the TAPS-II, 34.2% of participants reported alcohol use, and 13.5% reported prescription opioid misuse. Logistic regression analyses revealed that older age, prescription opioid misuse, and depression were significantly associated with alcohol use, χ2 (7) = 18.04, p = 0.12, while gender, report of adverse childhood experiences, and anxiety were not. Holding age, gender, and experiences constant, prescription opioid misuse had a significant effect on the probability of alcohol use, B = 1.092, SE = .429; Wald = 6.496, p = 0.01. The odds of alcohol use increased by a factor of 2.98 for individuals misusing prescription opioids. Treatment for problematic alcohol use must consider contextual influences including age, prescription opioids, and depression to implement effective evidence-based treatment.
IMPROVED NALOXONE PRESCRIBING IN RURAL PRIMARY CARE FOLLOWING ACADEMIC DETAILING FOR OPIOID OVERDOSE PREVENTION
Authors: Tobey Leah , Breckling Meghan , Ali Mohab , McAtee Robin 
Published: December 2023

Abstract
Performing opioid misuse screenings for older adults (OA) and reviewing high-risk medications are reliable screenings in preventing harm, especially accidental overdose. As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system (ARcare) to reduce the likelihood of patient’s accidental overdose by co-prescribing Naloxone, when indicated. An Academic Detailing (AD) team of a PT, PharmD and MD, led this interactive training. AD is clinician-to-clinician support customized with the purpose to connect primary care providers to the best available evidence and most up-to-date clinical practice guidelines. A conversational needs assessment was stimulated where the provider shared their perspectives, knowledge deficits, and needs surrounding the AD topic of Naloxone. These AD interactions encouraged safer prescribing of high-risk medications while considering the use of hard reduction resources for patients, such as prescribing Naloxone. ARcare providers (n=22) attended AD on Preventing Opioid Overdose with Naloxone over 11 months. Of those, 9 had previously prescribed Naloxone 40 times pre-training then 107 times post-training; five providers had never prescribed Naloxone but prescribed it 46 times post-training. Eight providers, made no change, some of whom work in schools. Post-training data gathered from the 14 Naloxone prescribing providers showed a total of 153 Naloxone prescriptions after AD, a 283% increase. For primary care settings, age-friendly medication practices are critically important for OA safety, aging in place, and for OA and their caregivers to understand and utilize Naloxone if accidental overdose is suspected.
CULTURAL FACTORS PREDICT POSITIVE CAREGIVING APPRAISAL AMONG DIVERSE DEMENTIA FAMILY CAREGIVERS
Authors: McCarthy Michael , Remiker Mark , Garcia Y Evie , Williamson Heather , Baldwin Julie 
Published: December 2023

Abstract

Background and Objectives
Positive caregiving appraisal is strongly linked to health among caregivers of persons with Alzheimer’s Disease and Related Dementias (ADRD). Few studies have identified predictors of positive caregiving appraisal, although research suggests that cultural factors may play a role. This study hypothesized that self-identified race and ethnicity, as well as more nuanced cultural factors such as language spoken at home, culture-based values surrounding caregiving, and perceptions of provider cultural competence would predict positive caregiving appraisal.

Research Design and Methods
A cross-sectional survey was administered to 156 diverse, community dwelling ADRD caregivers. Data were analyzed according to a modified Sociocultural Model of Coping using sequential regression.

Results
In the final model, self-identified race and ethnicity did not predict positive appraisal. However, culture-based values around caregiving and provider cultural competence contributed significant variance to positive appraisal, after controlling for other factors in the model. Caregiving burden and perceptions that help was available were also linked to positive appraisal. Discussion and Implications: This study is among the first to identify cultural factors that contribute to positive appraisal in a diverse sample of ADRD caregivers, beyond race and ethnicity. Findings reinforce the need to assess and incorporate culture-based values in interventions for ADRD caregivers, as well as the importance of provider cultural competence when working with diverse ADRD family caregivers.
HEALTH INFORMATION–SEEKING BEHAVIORS, CONFIDENCE, AND CHALLENGES AMONG FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Chung Jane , Davidsson Rebecca 
Published: December 2023

Abstract
Family caregivers play a significant role in providing care for their loved ones with dementia, including communication with healthcare providers (HCP), treatment decision-making, and care coordination. These tasks require family caregivers’ ability to seek, manage, and interpret health information they have found or received during and outside clinical encounters. This study examined which sources family caregivers use for seeking dementia care information, how trustworthy and reliable they find these sources, and information seeking confidence and challenges. A survey designed to understand family caregivers’ information seeking was completed by 36 participants who provided at least 10 hours of dementia care weekly (mean age 63.4; 83% female). About 80% reported using the Internet to look for dementia information, and less than 20% used a smartphone app to exchange their loved one’s medical information with HCP through a protected portal. While family caregivers entrusted HCP, pharmacists, and dementia-related organizations as sources of dementia information, they were skeptical of radio and TV as sources of credible information. Other information sources were identified, including Alzheimer’s Association, support groups, books/documentaries, and research journals. Approximately 50% reported concerns about the quality of dementia-related information; 45% experienced difficulties accessing the information they needed; 44% sensed frustration while searching for dementia-related information; and 40% had difficulty understanding the information found. There should be efforts to develop strategies that help dementia caregivers better identify credible information sources to increase confidence and reduce the stress and burden of acquiring reliable information necessary to care for their loved ones.
ASSOCIATIONS BETWEEN FRAILTY AND SLEEP IN OLDER ADULTS WITH CANCER TREATED WITH CHEMOTHERAPY
Authors: Hoogland Aasha , Crowder Sylvia , Extermann Martine , Li Daneng , Carpenter Kristen , Fischer Stacy , Kinney Anita , Jim Heather 
Published: December 2023

Abstract
Little is known about the association between frailty and sleep after starting chemotherapy. The goal of this study was to examine frailty and sleep in older adults (65+ years old) with cancer. Patients newly diagnosed with cancer and starting chemotherapy were recruited to a multi-site study. Participants completed questionnaires before chemotherapy (i.e., baseline) and 5 days after their first infusion. A pre-treatment frailty score was derived using a 59-item deficit accumulation index and dichotomized (frail vs. robust). Sleep was assessed with the PROMIS Sleep Disturbance 8a (difficulty sleeping) and Sleep Impairment 8a (daytime sleepiness). Repeated measures ANOVAs adjusted for age, sex, cancer stage, and cancer type evaluated change in sleep over time. Participants were 402 older adults with cancer (M age=72, SD=5). Most were female (65%), non-Hispanic (96%), and married (67%). Difficulty sleeping was higher in frail participants (26%) than robust participants at baseline (p&lt; 0.001). Over time, difficulty sleeping decreased in frail participants but increased in robust participants (p=0.02). Difficulty sleeping remained higher in frail participants post-infusion (p=0.01). Daytime sleepiness at baseline did not differ by frailty status (p=0.86) and was higher than population norms. Frail participants reported smaller reductions in daytime sleepiness over time (p&lt; 0.01), and more daytime sleepiness after infusion (p&lt; 0.0001) than robust participants. Despite improvements in sleep from pre-treatment to 5 days after infusion, frail participants reported more difficulty sleeping and daytime sleepiness than robust participants after infusion. Additional research is needed to better understand the association of frailty with health outcomes in older adults with cancer.
CLINICAL VERSUS SUBJECTIVE PREDICTORS OF DISTRESS AND HEALTH SATISFACTION AND THE MODERATING ROLE OF PERCEIVED CONTROL
Authors: Seckin Gul 
Published: December 2023

Abstract
Coping with cancer in old age and a general decline in physical health may result in a lack of control over health. Cancer diagnosis tends to be associated with fear, uncertainty, and loss. It also challenges one’s assumptions about the sense of the self and bodily image. This paper explores health perceptions (distress with somatic symptoms, treatment side effects, and satisfaction with health status) in a sample (N=350) of older individuals who reported being treated with cancer (M age=50.23, S.D. =10.91). Three models of hierarchical multiple regressions were performed to estimate the impact of sociodemographic, medical, and psychosocial variables and perceived control over health on subjective health indicators. The results indicated that lower income was associated with greater distress with physical symptoms (Slope = -.12; B= -.17, p =.002), older age was associated with less distress with cancer treatment side effects (Slope = -.01; B= -.12, p =.019) and gender (female) were negatively associated with satisfaction with health status (Slope = -.36; B= -.15, p =.002). Even though the higher stage of cancer was a significant covariate for greater distress with somatic symptoms (Slope = .12; B= .17, p =.001), it was not a significant covariate for distress with treatment side effects and satisfaction with health status. Perceived control over health significantly moderated the association between research covariates and satisfaction with health. These findings suggest that assessing differential aspects of self-rated health may provide health professionals with important information to supplement their diagnosis to understand the patient’s illness experience better.
FACTORS ASSOCIATED WITH LOW-DOSE COMPUTED TOMOGRAPHY LUNG CANCER SCREENING IN THE UNITED STATES
Authors: Tseng Tung-Sung , Li Chien-Ching , Lin Hui-Yi , Chiu Yu-wen 
Published: December 2023

Abstract
Low-dose computed tomography (LDCT) screening is recommended for high-risk smokers to decrease lung cancer-related mortality. In the US, the uptake of LDCT screening among eligible smokers is suboptimal. The impacts of social-environmental and individual factors on LDCT screening uptake are not clear. The current study investigated multi-level factors associated with the utilization of LDCT screening using national data. Methods: The 2017-2021 Behavioral Risk Factor Surveillance System (BRFSS) data and other state-level variables (Medicaid expansion status and the number of screening facilities) were applied. Our study outcome is the utilization of LDCT screening among study participants who met the US Preventive Services Task Force guidelines for lung cancer screening. The final study sample consisted of 15640 respondents from 29 states. All analyses were weighted to account for the complex sampling design applied in BRFSS. Results: The overall utilization rate of LDCT screening is only 18.4%. The LDCT utilization rate varied by state (6.2 -31.1%). Among the respondents, individuals who were employed, never married, had good health status, didn’t have personal physician, experienced cost problems, never had routine checkups, and did not experience certain chronic conditions (cancer, asthma, COPD) had a lower utilization rate of LDCT screening compare with their counterpart. Conclusion: Utilization of LDCT screening among eligible smokers remains low. Risk factors associated with LDCT screening identified from this study can be used to guide future lung cancer screening programs or revise the LDCT screening guidelines to meet the needs of high-risk smokers.
FAITH AND HEALTH: THE INTRICATE INTERPLAY OF MARITAL QUALITY, RELIGIOSITY, AND DIABETES
Authors: Case Rebekah , Yorgason Jeremy 
Published: December 2023

Abstract
Although chronic illness in later life can negatively affect marital quality and life satisfaction through increased stress and burden, religiosity and spirituality are known robust protective factors in relational and psychological outcomes. Stress theory suggests that religious behaviors can help moderate this negative relationship by providing patients with a sense of meaning in illness, external social support, and healthy coping mechanisms. Using data from the Life and Family Legacies Study, we analyzed cross-sectional data from 1,210 married participants around age 70 in 2016. Using an OLS linear regression model, we found main effects which showed that type 2 diabetes among older adults was predictive of lower positive marital quality and lower life satisfaction. When religious behaviors were included in the model as a moderator, religious behaviors interacted significantly with diabetes such that individuals with type 2 diabetes who reported high religiosity had high positive marital quality, while those with low religiosity reported significantly lower positive marital quality. Findings suggest that when persons with type 2 diabetes participate regularly in church services, prayer, and scripture study they experience more positive marital quality. This indicates that religiosity may be a significant protective factor and coping tool for marital quality when chronic illness is present.
PAIN INTENSITY AND PAIN CATASTROPHIZING ARE RELATED TO PHYSICAL PERFORMANCE IN OLDER ADULTS WITH BACK PAIN
Authors: Simon Corey , Knox Patrick , Goode Adam , Lentz Trevor , George Steven , Hicks Gregory , Colón-Emeric Cathleen , Keefe Francis 
Published: December 2023

Abstract
Back pain is highly prevalent in older adults and a risk factor for poor/declining physical performance. Back pain intensity and pain catastrophizing are two factors known to be associated with physical performance in younger adults; though a paucity of similar research exists in older adults. Thirty-nine older adults with back pain completed a battery of four standardized physical performance tests: 30-second chair rise, repetitive seated trunk rotation, repetitive standing functional reaching, and six-minute walk. Test scores were z-transformed and summated for a standardized physical performance score. We measured resting pain intensity and dispositional pain catastrophizing before the battery and movement-evoked pain intensity and situational pain catastrophizing during/after the battery. After accounting for age and biological sex, resting and movement-evoked pain intensity explained 14% and 39% unique variance in physical performance. In multivariable models, movement-evoked pain was the stronger factor. Similar modeling showed dispositional and situational pain catastrophizing explained 14% and 28% unique variance in physical performance. In multivariable models, situational pain catastrophizing was the stronger factor. Finally, path modeling showed situational pain catastrophizing mediated the total effect of movement-evoked pain on physical performance (21%). Findings suggest: 1) Factors with movement (i.e., movement-evoked pain, situational pain catastrophizing) are more strongly associated with physical performance than factors measured independent of movement (i.e., resting pain, dispositional pain catastrophizing); and 2) The impact of pain on physical performance is mediated by psychological distress. Importantly, neither movement-evoked pain nor situational pain catastrophizing are part of current standard of care for older adults with back pain.
PATTERNS OF USE, RISK FACTORS, AND ATTITUDES OF OLDER ADULT CANNABIS USERS
Authors: Anquillare Elizabeth , Gallegos Adrianna , Thayer Rachel 
Published: December 2023

Abstract
While cannabis use continues to increase among older adults (OA), research within this population is limited. This study aimed to describe OA patterns of use, risk factors, and subjective effects of cannabis use. OA cannabis users ages 60-79 (N=17, Mage=68.29, SD=5.61) were 94% White and 59% women, with an average education of 15.94 years (SD=2.38). Participants completed online questionnaires and semi-structured interviews regarding medical and mental health, subjective cognitive functioning, and cannabis use patterns and attitudes. Participants reported M=33.41 years of cannabis use (SD=20.15) with an average age of first use of 20.11 years (SD=10.40). Current use was reported as 4.29 days/week (SD=3.14). Current reasons for use were recreational (n=6), medical (n=2), or both (n=8). The most common medical conditions for which participants reported using cannabis were arthritis/joint pain (n=4) and disordered sleep (n=4). The most commonly reported benefits of cannabis use were relaxation (n=8), improved sleep (n=6), improved mood/anxiety (n=6), cognitive enhancement (n=5), and pain management (n=4). Common drawbacks included subjective cognitive decline (n=7), social hindrance (n=6), and health complications (n=5), whereas 5 participants reported no drawbacks. Most participants (76%) reported discussing cannabis use with their physician, although only 38% of those reported that discussion was helpful. Disconnect between OA cannabis users and their physicians could result in cannabis use that is contraindicated by preexisting medical conditions or medications. Emphasis should be placed on individualized psychoeducation regarding the potential risks/benefits of cannabis use as well as continuing education for physicians regarding cannabis use in OA.