bluuebunny/crossref_metadata_2025_split huggingface dataset:
AN UNEQUAL WORK ENVIRONMENT: NURSING HOME STAFF PERCEPTIONS OF UNIT ORGANIZATIONAL CONTEXT
Authors: Iaconi Alba , Tate Kaitlyn , Penconek Tatiana , Duan Yinfei , Saeidzadeh Seyedehtanaz , Cummings Greta , Norton Peter , Estabrooks Carole 
Published: December 2023

Abstract
The organizational context in nursing homes is associated with quality of care and residents’ quality of life. Our objective was to examine nursing home staff perceptions of unit organizational context. We conducted a secondary analysis of cross-sectional data. Participants were 3765 unregulated (health care aides (HCAs)) and 1130 regulated staff (managers, registered nurses, registered psychiatric nurses (RN/RPNs) and licensed practical nurses (LPNs)) from 91 nursing homes in Western Canada. We measured nursing home staff’s perceptions of organizational context via the Alberta Context Tool (ACT), comprised of ten concepts: leadership, culture, evaluation, social capital, formal interactions, informal interactions, organizational slack (staff, space, time). Differences between groups were examined via one-way ANOVA. Managers reported significantly higher organizational context scores compared to all other staff members in care homes, followed by RN/RPNs. LPNs and HCAs reported the lowest scores. Specifically, LPNs reported the lowest scores on all organizational context measures except for structural resources and organizational slack space, for which HCAs reported the lowest scores. HCAs reported higher scores than LPNs on unit leadership, culture, evaluation, social capital. When compared with managers and RN/RPNs in the nursing home, LPNs reported the lowest SF-8 mental health scores (49.30 (10.05)) and HCAs reported the lowest physical health scores (48.53 (8.16)). Our work demonstrates the need for improvement of staffing and time for staff in nursing homes. Specific attention is needed to focus on modifiable organizational unit context factors for LPNs and HCAs, who are responsible for providing the majority of the direct care for residents.
FACTORS ASSOCIATED WITH SERVICE UTILIZATION AMONG OLDER ADULTS WITH FUNCTIONAL OR COGNITIVE IMPAIRMENT
Authors: Choi Yeon Jin , Aranda Maria , Ailshire Jennifer 
Published: December 2023

Abstract
Social services (e.g., senior centers, adult day care centers) and home health services (e.g., in-home personal care, visiting nurses) have been found to provide numerous benefits, such as opportunities for social interaction, physical activity, cognitive stimulation, as well as personal care and regular medical check-ups for older adults. These services may have greater positive impacts among older adults with disabilities or impairments given their limited mobility and reduced capacities to perform daily tasks. However, as most previous studies have focused on the general population, our understanding of factors associated with service utilization among those with disabilities or impairments is limited. This study examined individual characteristics associated with social and home health service utilization among older adults with functional limitations or cognitive impairments using data from the Health and Retirement Study. Results from logistic regression models suggest that older age and being not married were positively associated with utilization of both social and home health services, while being foreign-born was negatively associated with the outcomes, adjusting for sociodemographic characteristics. Respondents with higher educational attainment tend to use social services more and are less likely to use home health services than those with less than a high school education. Rural residence was negatively associated with the utilization of social services, but not with home health services. Providing information on available services and enhancing access by increasing the number of service providers, transportation options, and financial assistance would promote utilization of supportive services among older adults with functional limitations and cognitive impairments.
IDENTIFYING EFFORTS AND CHALLENGES OF MARKETING THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL FOSTER HOME PROGRAM
Authors: Haverhals Leah , Manheim Chelsea , Nunnery Mary , Levy Cari 
Published: December 2023

Abstract
The United States (US) Department of Veterans Affairs (VA) Medical Foster Home (MFH) program is a long-term care (LTC) option for Veterans needing nursing home-level care. In the MFH program, Veterans live in the home of a community-based caregiver who has been recruited and screened by VA staff. Since 2016, VA Offices of Rural Health and Geriatrics and Extended Care has expanded the program, and by 2026 the VA plans to have programs at every VA Medical Center. To describe current efforts to market the MFH program, we conducted a national survey of MFH staff between Dec. 2, 2021-Jan. 6, 2022. We sent invitations via email, including a website link to the survey. N=94 completed the survey. Three team members analyzed open-ended data, using an inductive and deductive approach to thematic analysis. Findings revealed that external marketing strategies primarily focused on recruiting appropriate caregivers. Efforts included in-person presentations to community groups, utilizing local media outlets, manning booths at local health and job fairs, and providing written materials about the program. Internal marketing efforts included approaching many different VA departments including inpatient social workers, case managers, and discharge planners to identify Veterans for the program, and holding in-service presentations. Challenges included MFH coordinators having minimal time to market the program and receiving inconsistent support from the VA Public Affairs Office depending on location. Findings will inform expansion of the MFH program, which is paramount as the demand for LTC increases concurrently with the aging Veteran population.
PROMOTING CO-WORKER RELATIONSHIPS IN LONG-TERM CARE FACILITIES: A SYSTEMATIC REVIEW OF THE LITERATURE
Authors: Haunch Kirsty 
Published: December 2023

Abstract

Introduction
Co-worker relationships in long-term care settings are important. The work is physically and emotionally demanding. A largely unregistered workforce with variable preparation and training are expected to provide complex care to the most vulnerable members of society, with little external support. Often staff only have each other to rely on. Current evidence lacks insight into how co-worker relationships are established and what influences them. The aim of the review was to synthesise what is known about co-worker relationships more widely and its applicability to long-term care.

Methods
A systematic review identified, evaluated, and synthesised published evidence associated with co-worker relationships in health and social care settings. PRISMA guidelines were followed. The COM-B model was used to identify key behaviours and associated triggers of co-worker relationships.

Results
37 papers were included. The majority of studies were conducted in the US (n=23), used descriptive study designs (n=30) and were in a hospital setting (n=29). Interdependent organisational and individual factors suggest co-worker relationships occur when staff are ‘able’ (have the social skills), are ‘willing’ (have the right values) and are ‘supported’ (effective leadership).

Discussion
To date the focus has been on the ‘willingness’ of people and the ‘support’ they receive. Paying attention, the ‘ability’ (the social skills), which can be taught, is of equal, if not more importance. Social skills enable staff to navigate difficult and complex situations that arise, which preserves, and in some cases strengthens relationships. Social skills are particularly important when leadership is poor.
SEEKING ANSWERS FOR UNCERTAINTIES: GATHERING AND ORGANIZING CARE HOME UNCERTAINTIES: THE SEARCH U STUDY
Authors: Devi Reena , Haunch Kirsty , Graham Liz , Spilsbury Karen , Forster Anne , Griffiths Alys , Thompson Carl 
Published: December 2023

Abstract

Introduction and method
Staff providing care to residents must manage uncertainties whilst using their judgement and making decisions about care. Residents and their relatives may also have questions and ideas about how care could be improved. It is important to capture uncertainties/questions and work on addressing these. We gathered uncertainties/questions from residents, relatives and staff before, and during COVID-19 through interviews, analysis of a COVID-19 WhatsApp discussion group for long-term-care (LTC), and a systematic literature review.

Results
Questions and uncertainties gathered were categorised into 21 themes: 1. Direct care (personal care, sleep, care planning, medication management, nutrition) 2. Physical environment (safety, mobility, infection risk) 3. Mental health/well-being (relationships, socialising and meaningful activities, spirituality) 4. Resident individuality and dignity 5. End-of-life 6. Quality of work for care staff (reward and recognition, training and career opportunities, well-being, shift flexibility, workload) 7. Staff shortages 8. Promoting staff diversity 9. Care home interaction with wider healthcare services 10. Use of technology 11. Family engagement and communication with staff 12. COVID-19-related anxiety 13. Financial support with care home costs 14. Care homes and climate change and future sustainability 15. Valuing the contribution of care homes 16. Infection prevention control 17. Visiting care homes during COVID-19 18. COVID-19 safety for residents and staff 19. COVID-19 and the individual (symptoms and treatment) 20. Organisational impact of COVID-19 21. Information sharing and learning from COVID-19.

Discussion
With LTC staff, residents and relatives the identified uncertainties/questions will be shortlisted; the prioritised list will direct future research.
&gt;ADVOCATING FOR ENGINEERING SOLUTIONS TO IMPROVE OLDER ADULT DRIVING LONGEVITY
Authors: Dickerson Anne 
Published: December 2023

Abstract
To age-in-place, older adults need to access their community. As most older adults live in suburban/rural areas, driving is the primary and preferred means of mobility. While recent research has shown that drivers in the seventies have fewer crashes than middle-aged drivers, it is likely due to less exposure. However, it demonstrates that driving decisions need to be based on function, not age. Moreover, with the aging population and increase numbers of older adults with cognitive impairment and/or slowed processing speed, other strategies are needed to preserve and lengthen the driving lifetime. While efforts for developing alternative transportation options are working in some places, rural areas lack the infrastructure and potential for public transportation or volunteer programs beyond medical necessity. This presentation will present some roadway engineering proven countermeasures and community strategies that can protect and benefit aging drivers so they can drive longer while reducing crash risk. Stepping outside the typical gerontological community, this presenter became a contributing member of their state’s highway safety five-year plan. As an older driver advocate, I was successful in achieving older adults as an “emphasis” area in the present plan. For the next five-year plan, researching engineering solutions was deemed essential to advocate for specific strategies that protect both aging drivers and pedestrians. Since every state is required have a five-year plan for highway safety to receive federal funding, the presenter will outline successful strategies to participate in innovative ways for improving safety such as influencing engineering and department of motor vehicles partners.
PERSPECTIVES ON TECHNOLOGY ADOPTION AMONG SPANISH-SPEAKING HISPANIC ADULTS AGE 60+
Authors: Navarro Sheila Salinas , Lomeli Sindy , Estenson Lilly , Wilber Kathleen 
Published: December 2023

Abstract
By 2060, Hispanics aged 65+ are projected to be 21% (19.9 million) of the total US age 65+ population. Despite the benefits of technology use, such as facilitating social engagement and access to health services, few studies have explored attitudes of older Spanish-Speaking Hispanic adults toward technology adoption. In this secondary analysis of a larger diverse study of attitudes toward technology, we reviewed audio recordings and transcripts of Spanish-language interviews and focus groups with adults ages 63-89. Participants (n=21) self-identified as Hispanic, 67% had less than a high school education, and almost half (n=10) lived alone. Connecting with family members abroad was the primary motivator and a “necessity” for using technology; excess use of a device was negative. As one participant stated: “Technology brings you closer to those far away and pushes you away from those near you.” Those without relatives living with or near them reported greater difficulty using technology and identified living alone as a barrier to adoption. Finally, although the sample had low levels of English proficiency and low educational attainment, characteristics associated with lower use and knowledge of technology, findings challenge stereotypes that these older adults lack the capacity or interest to adopt the technology. Rather, the study identified multiple social factors that may hinder adoption. Understanding these cultural and linguistic barriers is important to promote digital inclusion; overcoming the digital divide will involve more than providing free tablets or classes. It will also require addressing barriers with adequate, culturally competent understanding, training and support.
A LIFESPAN DEVELOPMENTAL ANALYSIS OF RECIPROCAL RELATIONS BETWEEN HEAVY DRINKING AND SLEEP PROBLEMS
Authors: Bowlby Douglas 
Published: December 2023

Abstract
In recent years, numerous studies have begun to explore the ways in which problem drinking behavior is affected by different lifespan developmental changes. However, while there currently exists a plethora of research on adolescence and young adulthood, there is far less research with midlife and older adults examining lifespan developmental changes and problem drinking. As part of larger NIAAA-funded project investigating aging, health, and alcohol use, the current study investigated cross-sectional and longitudinal associations among heavy drinking and sleep problems in a sample of midlife and older adults. One particularly noteworthy analysis used path analysis in Mplus to test a longitudinal moderated mediation model involving sleep problems, sleep-related motives for drinking, and heavy drinking. Results showed an interaction between sleep problems and sleep-related drinking motives. Interestingly, sleep problems appear to significantly reduce the risk for heavy drinking among most participants. However, when combined with high sleep-related drinking motives, sleep problems appear to significantly increase risk for heavy drinking. This phenomenon may help explain the occasionally contradictory results found in previous studies examining the impact of sleep disturbances on drinking behavior and may prove to be an area worth investigating in future studies. From a lifespan-developmental perspective, these findings highlight how there are likely important differences across stages of adulthood in the most relevant factors that affect heavy drinking. Health-related factors including sleep problems, coupled with motives to use alcohol to cope with such problems, appear to be a pathway to heavy drinking that increases in importance across the adult lifespan.
ELDER ABUSE, ANXIETY, AND SOCIAL SUPPORT: DOES GENDER MATTER?
Authors: Yoon Sukyung 
Published: December 2023

Abstract
Elder abuse is a serious social justice violation and a public health concern that impacts victims’ mental and physical health worldwide. In the U.S., about 11.7% of older adults have reported elder abuse each year, but the rate is underestimated due to underreporting (Dong, 2015). To date, research on elder abuse has focused mostly on risk factors rather than protective factors (Storey, 2020). Some risk factors are beyond one’s control, such as physical and cognitive dysfunctions, but identifying both risk and protective factors will help healthcare professionals intervene more effectively (Yoon & Cummings, 2019). The research aims were to investigate 1) the impact of elder abuse on anxiety among community-dwelling older adults who experienced elder abuse, 2) the effects of social support on anxiety among older adults, and 3) the differences in the impact of elder abuse, anxiety, and social support between older men and women. This study used data from the Wisconsin Longitudinal Study (WLS), Wave 3. Structured equation modeling was used for the analysis. The independent variable was the experience of elder abuse, the dependent variable was anxiety, and the intervening variable was social support. The control variables were income, physical health, and marital status. The experience of elder abuse had a positive association with anxiety, however; social support had a negative association with anxiety. Multi-group analysis was conducted to investigate gender differences. Measurement invariance was examined by comparing unconstrained and fully constrained models. Both models were good fits. Gender differences were identified. Implications will be discussed.
INTERGENERATIONAL REMINISCENCE PROGRAM IN IMPROVING GENERATION CONNECTIONS: A RADAR ANALYSIS
Authors: Xu Ling , Raval Minjaal 
Published: December 2023

Abstract

Objectives
Intergenerational solidarity between grandparents and grandchildren has been highlighted in Asian Families and it is beneficial for the health of grandparents. An intergenerational reminiscence program was developed to improve the well-being of Asian American older adults as well as generational bonding. This paper qualitatively reported the weekly reflection from grandchild participants of this program.

Methods
Older grandparents received 6 sessions of life-review with their grandchildren remotely or in person for approximately 1 hour each week for 6 weeks. Each grandchild (n = 12) provided written reflection each week after talking with grandparent. The qualitative data were organized and analyzed using the five phases of the Rigorous and Accelerated Data Reduction (RADaR) technique.

Results
Results showed three categories with themes. Category 1: Positive experience. The grandchildren expressed: (1) more connection with grandparent, (2) learn more about grandparent’s past life experience, and (3) have more engagement. Category 2: Strategy to lead the discussion. The grandchildren thought the following good ways in facilitating their weekly conversation with grandparents: (1) taking notes, (2) using guiding question in the manual; (3) use translators, (4) spending time together. Category 3: Challenging experience. The grandchildren felt challenges regarding: (1) over explaining things, (2) language or vocabulary barriers, (3) broad topic.

Discussion
The reflection pages from grandchild participants showed that intergenerational reminiscence program is promising in bonding the grandparent-grandchild relationship and connection. They also gained knowledge and experienced challenges when talking with their grandparents during the program.
MEDICARE ADVANTAGE (MA) PLAN CHARACTERISTICS ON PHYSICAL AND MENTAL HEALTH OUTCOMES OF MA BENEFICIARIES
Authors: Basu Rashmita 
Published: December 2023

Abstract
With growing demands for better and cost-effective care delivery by Medicare Advantage (MA) plans, comparison of self-reported health outcomes is more important because those outcomes capture patients’ experiences and perspectives. The purpose of the study is to examine the characteristics of MA plans on Medicare beneficiaries’ physical and mental health status.
Methods: I used the Medicare Health Outcomes (HOS) survey, a random sample of Medicare beneficiaries surveyed from each MA plan with a minimum of 500 enrollees conducted by the CMS. The current study included 3 baseline cohorts from 2015 (n=195,800), 2016 (n=178,973), and 2017 (n=172,047). I used physical component summary (PCS) and mental component summary (MCS) scores as two outcomes which include various domains of physical (exercise, pain, activity limitation) and mental health (social functioning, emotional status, depression) status. Plan characteristics include plan ownership status (for-profit (FP) vs. not-for-profit (NFP), plan types (PPO vs. HMO/cost contract), and the number of plan members. I used the linear regression method with clustering at the plan contract level due to the correlation of multiple beneficiaries within the same plan.
Results: Adjusted for beneficiary level characteristics, beneficiaries in PPO plans experienced greater physical and mental health scores than HMO or cost contract plans. MA plan with less than 5k beneficiaries is associated with a lower physical health score than plans with more than 100k beneficiaries. For-profit ownership was significantly associated with lower mental health scores.
Discussion: The characteristics of MA plan insurers are important factors for beneficiaries’ enrollment decisions and quality improvement efforts.
RELATIONSHIP BETWEEN SOCIAL PROBLEM-SOLVING SKILLS AND CAREGIVER BURDEN AMONG DEMENTIA CARE PARTNERS
Authors: Kew Chung Lin (Novelle) , Smith Matthew , Han Gang , Wright Brittany , Holland Alexandra , Khera Alka , Wilmoth Kristin , Juengst Shannon 
Published: December 2023

Abstract

Background
This study examined the extent to which social problem-solving abilities, care situations, and depressive symptomatology were associated with caregiver burden among care partners of adults with Alzheimer’s Disease and Related Dementias (ADRD).

Methods
Baseline survey data were analyzed from care partners of ADRD who participated in a larger state-funded study. We used validated measures to assess social problem-solving abilities, care situation, positive aspects of caregiving, depressive symptomatology, and caregiver burden. Multivariate regression analysis with backward stepwise entry was used to identify factors associated with caregiver burden.

Results
Care partners were, on average, age 60.4 (±12.4) and most were female (82.5%) and lived with their care recipient (69.1%). Care partners who reported high caregiver burden were more likely to be male (p&lt; 0.0001) and have a positive problem-solving orientation (p=0.0002), but less likely to have a negative problem-solving orientation (p=0.0376). Higher caregiver burden was also associated with more resentment for caregiving role (p&lt; 0.0001), more anger towards care recipients (p&lt; 0.0001), more depressive symptomology (p&lt; 0.0001), and higher positive aspects of caregiving (p=0.0010). Care partners who reported high caregiver burden also reported less social support (p=0.0076) and less family conflict (p=0.0159).

Discussion
Findings suggest that factors thought to be protective against caregiver burden may not sufficiently reduce caregiver burden when considering their feelings of resentment and anger towards their care recipient, limited perceived social support, and high depressive symptomology. Interventions to reduce caregiver burden must consider care partners’ internal conflict as a caregiver and the relationship between the care partner and their care recipient.