bluuebunny/crossref_metadata_2025_split huggingface dataset:
STAFFING LEVELS AND INJURY-RELATED EMERGENCY DEPARTMENT VISITS IN OHIO
Authors: Hua Cassandra , Nelson Matt , Cornell Portia , White Elizabeth , Thomas Kali 
Published: December 2023

Abstract
Assisted living (AL) residents with dementia are at increased risk of injuries compared to residents without dementia. Nursing home research indicates that changes in staffing levels are related to quality, including rate of injuries among residents. We leveraged novel data from a survey administered to AL communities in Ohio from 2007-2015 linked to administrative claims of Medicare beneficiaries with dementia to explore the relationship between staffing levels and injuries among AL residents with dementia. We examined the relationship between changes in each type of staffing level (RN, LPN, and aide hours per resident day [HPRD]) and injury-related emergency department use among AL residents with dementia. We adjusted for demographic characteristics, AL characteristics, and fixed effects for year and AL. Our sample included 13,929 fee-for-service Medicare beneficiaries with dementia (141,749 person-months) from 472 AL communities. Staffing levels increased slightly over time; median aide HPRD were 0.93 in 2007 and 1.10 in 2015. Median RN HPRD were 0.00 in 2007 and 0.04 in 2015. Median LPN HPRD increased from 0.29 to 0.41. Using linear regression modeling, we did not detect a statistically significant relationship between staffing levels (RN, LPN, or aide) and injury-related emergency department visits among AL residents with dementia. Within-AL changes in staffing levels may have no effect on rates of ED visits. However, it is possible that we did not observe enough within-AL variation to detect an association, or that unobserved differences in resident acuity associated with staffing levels biased our finding toward the null.
THE ASSOCIATION BETWEEN RESIDENT ENGAGEMENT AND QUALITY OF CARE INTERACTION AMONG ACUTE CARE PATIENTS WITH DEMENTIA
Authors: McPherson Rachel 
Published: December 2023

Abstract
Care interactions are essential to patients with dementia. The purpose of the study was to describe the quality of staff-patient care interactions among acute care (AC) patients with dementia and to test whether the quality of staff-patient care interactions varied by resident level of engagement in the interaction. Specifically, it was hypothesized that controlling for age, cognition, pain, behavior, and function, actively engaged patients would have more positive care interactions with staff compared with passively engaged patients. This secondary data analysis used baseline data from the Function Focused Care for Acute Care (FFC-AC- EIT), an ongoing intervention study. The sample included 286 patients. Descriptive statistics and a multiple linear regression were conducted. The majority of interactions that occurred were positive care (n = 225, 79%). Actively engaged patients had significantly more positive interactions compared to passively engaged patients (b = 1.49, p &lt; .001). Patients with more pain (b = -0.26, p &lt; .001) and behavioral symptoms (b = -0.12, p &lt; .05) had significantly poorer care interactions. Passively engaged patients or patients with pain and behavioral symptoms may be at risk to receive poor quality care interactions. Findings from this study will inform future interventions and training for AC staff to promote positive care interactions among patients with dementia. Managing pain, managing behavior, and supporting resident engagement in care will likely help increase the frequency of positive care interactions in future work.
INCREASING ACTIVITY-STIMULATING BEHAVIOR IN DUTCH HOME CARE: FEASIBILITY OF THE SELF-PROGRAM
Authors: Metzelthin Silke , Hermens Lotte , De Waal Getty Huisman - , Vluggen Stan , van Ginkel Janneke Man - , Zwakhalen Sandra 
Published: December 2023

Abstract
The concept of aging-in-place has become increasingly popular worldwide, including the Netherlands. However, as individuals age, their ability to perform activities of daily living often declines leading towards a need for homecare. Unfortunately, staff often unnecessarily take over care tasks and thereby potentially accelerate older adults’ functional decline. SELF is an interactive, tailored, holistic and theory-grounded training program consisting of 7 sessions spread over a period of 14 weeks, which aims to change staffs’ behavior towards more activity stimulating behavior. The program was evaluated in a cluster-randomized trial in Dutch nursing homes. However, its feasibility in the homecare setting was not yet known. Therefore, a feasibility study in one Dutch homecare team was conducted using a mixed-methods approach combining quantitative (i.e. checklist, logbooks, attendance forms and questionnaires) and qualitative data (i.e. focus group interviews) among program participants, team manager, coaches and trainers. Data was collected based on the three main pillars of the MRC framework: implementation, mechanisms of impact and contextual factors. In total, 24 staff members participated in the study, who delivered care to 145 clients. The SELF-program was largely implemented as intended, resulting in positive changes in staff knowledge, self-efficacy, and skills. However, contextual factors influenced the implementation of activity stimulating behaviour in practice. While reporting in electronic patient records and manager support were identified as facilitators, resistance from clients, bad expectation management by hospitals and GPs and time constraints acted as barriers. Overall, the SELF-program was feasible in Dutch homecare and only small program modifications are needed.
THE NIH STAGE MODEL AND STUDY EXAMPLES OF EARLY STAGES IN DEMENTIA CARE INTERVENTION DEVELOPMENT RESEARCH
Authors: Dobbs Debra , Meng Hongdao 
Published: December 2023

Abstract
The NIH’s Stage Model provides a common language to facilitate discussion of intervention development research. According to NIH Stage Model (2022), “an examination of the mechanisms of behavior change or the principles underlying an intervention is encouraged by the NIH Stage Model in every Stage of behavioral intervention development.” The five papers in this symposium focus on early-stage intervention development by refinement, adaptation and pilot testing (Stage 1) related to dementia and palliative care (PC) clinical trials. The first paper is a cluster trial of a PC education program for nurses (N=23) in 10 assisted living communities that tested the mechanism of staff self-efficacy in increases in advance care planning discussions with family members of residents living with dementia. The second paper is a clinical trial that tested the feasibility of Companion Robots in live-alone Korean-American older adults (N=30) to determine which features help improve health behaviors (e.g. medication adherence, daily exercises). The third paper is a single-site clinical trial pilot study developed with stakeholders which tested the feasibility of a palliative care community health worker support program for hospitalized minoritized persons living with dementia and their caregivers. The fourth paper adapts an evidence-based e-PainSupport intervention for use with dementia caregivers to report patient pain and administration of analgesics. The fifth paper is a protocol to test the feasibility and acceptability of a culturally sensitive caregiver peer support program (Pair2Care) in current (n=15) and trained former (n=15) African-American dementia caregivers. The discussant will highlight ways to improve clinical trial mechanisms.
CO-DESIGNING A STAGE 1B FEASIBILITY STUDY OF INPATIENT PALLIATIVE COMMUNITY HEALTH WORKER SUPPORT
Authors: Kwak Jung , Kvale Elizabeth , Mills Sarah , Patel Snehal 
Published: December 2023

Abstract
Persons living with dementia (PLWD) are 2-3 times more likely than their non-dementia peers to be hospitalized annually and experience burdensome care transitions and treatments at the late stage of dementia. Minoritized PLWDs are significantly more likely to be hospitalized and experience frequent transitions between care settings, and also less likely to access palliative care. There is a pressing need to develop better models of care transition support for PLWDs and their family caregivers. Proactive palliative care can reduce unnecessary hospitalization and improve outcomes for PLWDs and family caregivers. Community health workers (CHW) can effectively bridge cultural gaps between vulnerable patients/families and formal care systems, and provide care navigation and coaching support. We are currently conducting a single-site randomized controlled pilot trial study to co-design with key stakeholders (Stage 1a), implement and assess (Stage 1b) the acceptability and feasibility of a palliative CHW support for hospitalized PLWDs and caregivers. To date, we have conducted a needs assessment with 34 PLWD/caregiver dyads, key informant interviews with 4 palliative care providers and 2 CHW and social care experts, and multiple stakeholder meetings with hospital frontline providers and CHW groups to develop intervention components and research implementation plans that address language and cultural barriers and healthcare provider and system level barriers experienced by PLWD and caregivers from minoritized and financially vulnerable backgrounds. In this presentation, we will describe stakeholder engagement and co-design process outcomes and preliminary findings on intervention fidelity, participant recruitment and retention, and PLWD/caregiver outcomes.
EMPOWERING PEOPLE OF ALL AGES BY PROMOTING POSITIVE VIEWS OF AGING AMONG PK-12 STUDENTS
Authors: Newsham Tina , Borrero Lisa 
Published: December 2023

Abstract
Beliefs about aging and older adults form early in life and persist. People who hold positive views of aging rather than internalized ageism live, on average, 7.5 years longer. Communities where older adults retain meaningful engagement and are respected experience greater longevity and better social and physical well-being among people of all ages. Having positive interactions with older adults increases likelihood of pursuing careers working with older people. Promoting positive, accurate views of aging benefits individuals (of all ages) but is most effective when implemented early in life. Children, however, are rarely intentionally taught about aging and learn primarily negative stereotypes through media such as cartoons, books, and fairy tales. In this symposium, presenters will share projects aimed at disrupting the perpetuation of ageist stereotypes through intentional work with young children to promote positive views of aging. Laura Donorfio will present an aging education project developed for the Connecticut school system via an Administration on Aging grant. Next, Elizabeth Bergman will present two intergenerational case study projects involving elementary school-aged children, college students, and elders. Edward Miller will then the describe and sharing findings from an ongoing intergenerational tutoring intervention, begun during the early stages of the COVID-19 pandemic, wherein older adults provide free, online evidence-based tutoring to bi-lingual kindergartners. Finally, Tina Newsham and Cynthia Hancock will share research on a toolkit developed for preschool-2nd grade teachers to introduce information about aging and centenarians as a way to celebrate the 100th day of school. Lisa Borrero will serve as discussant. This is an Intergenerational Learning, Research, and Community Engagement Interest Group Sponsored Symposium.
EXPLORING NEW WAYS TO IMAGINE OUR FUTURE THROUGH INTERGENERATIONAL CASE STUDY PROJECTS IN ELEMENTARY SCHOOL
Authors: Bergman Elizabeth 
Published: December 2023

Abstract
Aging education is largely absent from the PK-12 curriculum. When students do encounter messages about aging and older adults it is generally through such activities as dressing “like a 100-year-old” to celebrate the 100th day of school which promotes the internalization of ageist stereotypes starting at a young age. Motivated by a desire to push back against these ageist messages in school, the presenter partnered with elementary school educators and school administrators to develop and deliver two intergenerational case study projects involving elementary school-aged children, undergraduate students, and older adults. The presenter will highlight objectives, activities, and outcomes of the Let’s Dream Together and Ages & Stages in Our Community projects and provide suggestions for aging educators interested in similar initiatives.
“I DON’T KNOW WHO GETS MORE OUT OF IT”: OLDER ADULTS’ EXPERIENCES WITH THE ONLINE INTERGENERATIONAL TUTORING PROGRAM
Authors: Miller Edward , Hoffman Jessica , Hermelbracht James , Burr Jeffrey , Mutchler Jan 
Published: December 2023

Abstract
Due to pandemic-related academic and social stressors experienced by children and social isolation and loneliness experienced by older adults, a team of school psychologists and gerontologists collaborated with older adults to develop the Online Intergenerational Tutoring Program. Conceived in fall 2020, the program is now in its third year of implementation. The program addresses a service delivery gap in schools because older adult volunteers expand schools’ capacity to implement reading instruction with students in need of support. Older adults share their time and talents with young children and children benefit from the care, attention, and instruction from older adults. Tutors meet with students after school 3-4 times per week over a 6–8-week period over Zoom; each of the 24 sessions last 30 minutes. Evaluation data show the program is socially valid, tutors deliver instruction with accuracy, students have high engagement, and there are literacy gains among students.
PROMISES AND CHALLENGES OF IMPLEMENTING TELEHEALTH IN LTC FACILITIES: LESSONS FROM A MULTISITE PILOT PROJECT
Authors: Yan Mengzhao , Zhu Yujun , Wilber Kathleen 
Published: December 2023

Abstract
In response to the COVID-19 pandemic, the demand for telehealth implementation has expanded in long-term care (LTC) facilities. To better understand the promises and challenges of implementing telehealth, we evaluated a pilot project in which five LTC facilities in California implemented telehealth from September 2021 to May 2022. Employing a mix-method approach, we used a diverse set of evaluation tools (i.e., documenting 37 telehealth visits, holding 8 monthly learning sessions, conducting 36 check-in interviews, and tracking monthly COVID-19 cases) to examine how telehealth was adopted, used, and perceived among residents, administrators, and health practitioners. From a descriptive analysis of quantitative data and a thematic analysis of qualitative data, we found that telehealth demonstrated the capability to treat a variety of conditions; prevented nearly 20% of transfers to emergency departments; residents indicated a high degree of comfort with telehealth; and healthcare practitioners perceived that telehealth could improve care delivery. In addition to benefits, several barriers were identified including initial concerns about the quality of visits, required upfront costs, time constraints, difficulties in coordinating different platforms in the healthcare system, uncertainty about payment parity with in-person care, and reduced staffing related to COVID-19. Based on our evaluation, we propose six strategies to help implement telehealth in LTC facilities: recognize sources of resistance to change; recognize the need for initial investment; understand and address contextual issues; prepare and pave the way for staff buy-in; identify a champion; and ensure sufficient and ongoing training and support.
THE LANDSCAPE AND OUTLOOK FOR CONTINUED WORK LATER IN LIFE IN THE 2020S
Authors: Cahill Kevin , Shaw Benjamin , Beach Brian 
Published: December 2023

Abstract
For the first time in more than three decades, older workers’ labor force participation rates are no longer increasing. Even more remarkable is that this trend contrasts with changes among younger workers, who have experienced increases in labor force participation in the wake of the Covid-19 pandemic. A narrative that has existed for more than two decades—that older workers have been the exception to reductions in labor force participation generally—may be coming to an end. A question then is, in the 2020s, will older workers who exited the labor force during the pandemic return? This symposium explores the new landscape that older workers face. The first paper addresses work-related trade-offs and the extent to which older workers assess the benefits and costs of continued work later in life. The second paper explores how pension eligibility triggers a new stage of the life course, in which older workers can leverage their newfound financial gains to improve work conditions or, alternatively, to exit the labor force. The third paper explores, specifically, how the Covid pandemic changed the workplace for older workers. The fourth paper rounds out the symposium by exploring the relationship between income and health in recent years in both the United States and in China. The flexibility of the U.S. labor force enables fairly abrupt shifts in workforce dynamics in response to macroeconomic changes and other events. The Covid-19 pandemic was one such shift. This symposium provides insight into the post-pandemic labor market for older workers. This is an Economics of Aging Interest Group Sponsored Symposium.
EFFECTS OF COVID-19 PANDEMIC ON OLDER WORKERS’ LABOR MARKET AND RETIREMENT DECISIONS
Authors: Radpour Siavash 
Published: December 2023

Abstract
Several studies have documented the increase in retirement since the onset of the Covid-19 pandemic. I contribute to this literature by answering two key questions that show the pandemic excess retirement is caused primarily by demand-side factors: first, using the monthly Current Population Survey (CPS) data on employment and retirement of older workers and CPS’s panel structure, I explore if older workers left their jobs and the labor force voluntarily as a part of “the great resignation”. I find that very few workers quit their jobs voluntarily, and most retirements were preceded by involuntary job loss and unemployment. Second, using the Health and Retirement Study (HRS) with its rich data on wealth, employment, and the special Covid-19 related questions included in 2020 HRS (Wave 15), I examine if older workers who experienced job loss during the pandemic retired because they were financially prepared for retirement. I find that among the small group of older workers who quit their jobs because of the pandemic, the majority did not have adequate retirement assets and their decision is more likely to be based on their health status and vulnerability during the pandemic.
THE EFFECTIVENESS OF A VIRTUAL INTERGENERATIONAL ACTIVITY FOR REDUCING YOUNGER AND OLDER ADULTS’ AGEISM
Authors: Fassi Janelle 
Published: December 2023

Abstract
This presentation will discuss results from a study that examined whether a virtual intergenerational activity was feasible and effective for reducing ageism among older (OA) and younger adults (YA) during the COVID-19 pandemic. OA (n = 16) and YA (n = 15) completed a virtual intergenerational activity, and analysis was conducted for a subsample (n = 5 OA, n = 10 YA) who completed pretest-posttest ageism surveys. Paired samples t-tests showed no significant ageism change in attitudes toward OA. OAs’ ageist attitudes toward YA (p = .012) were significantly reduced. Open-ended responses revealed several themes (e.g., challenging ageist stereotypes), which contrasted with statistical findings among the YA sample. Preliminary evidence demonstrated the feasibility of this activity. Further, OA and YA gained greater respect and understanding for each other as indicated by the open-ended responses. However, a larger sample size is needed to better determine efficacy. Nonetheless, the key takeaways from this presentation will help educators and program organizers alike explore when and how a virtual intergenerational activity can bridge gaps between older and younger adults.
TECHNOLOGY AND OLDER ADULTS: BEST PRACTICES FOR ENHANCING USABILITY, ENGAGEMENT, AND COMMUNICATION
Authors: Falzarano Francesca 
Published: December 2023

Abstract
The massive growth in population aging has coincided with a time of continued fast-paced innovations in technology. Technology can be leveraged to support health, well-being, and quality of life in older adults with health, mobility, and cognitive issues and is a means of maintaining social engagement in later life. However, for technology to achieve its intended purpose, older adults must have access to and recognize the value of such products. Despite the sheer size of the older adult population, the field of Information Communications Technology (ICT), has long overlooked the perspectives of older adults with regard the design of ICT applications. ICT systems that fail to consider the diverse capabilities and attitudes of older adult users are likely to alienate a significant, growing segment of the population and will likely be underutilized. This presentation will review best practices to enhance older adults’ usability and engagement with technology, with an emphasis on user-centered design principles as well as innovative tools facilitating virtual ICT support and training (e.g., TeamViewer software) to provide older adults who have limited to no technology proficiency with the skills needed to navigate its use. Key takeaways from this presentation will include a greater understanding of the importance of design principles to enhance usability and adoption of ICT systems among older adults; means of increasing access and adoption of ICT applications; and how user feedback can be leveraged to inform adaptions to enhance the efficacy and acceptability of technology applications, and ultimately foster psychosocial well-being in older adults.
PHYSICAL ACTIVITY AND DEMENTIA IN THE NATIONAL HEALTH AND AGING TRENDS STUDY (NHATS)
Authors: Davoudi Anis , Donahue Patrick , Carlson Michelle , Dougherty Ryan , Wanigatunga Amal , Freedman Vicki , Schrack Jennifer 
Published: December 2023

Abstract
Individuals living with dementia exhibit disrupted sleep/wake rhythms; however, whether daily physical activity volume and patterns are worse among those living with dementia is not well established. We examined the cross-sectional association between dementia classification and accelerometry-derived patterns of daily physical activity in NHATS. Wrist-worn accelerometry was collected using the Actigraph Centrepoint Insight Watch in a subset of Round 11 (2021) participants. Dementia status, including possible and probable dementia, was determined using the NHATS dementia algorithm. We characterized daily physical activity patterns using: most active 10-hours/day (M10), time of M10, least active 5-hours/day (L5), time of L5, relative amplitude (RA), intra-daily variability (IV), inter-daily stability (IS), and activity fragmentation using the active-to-sedentary transition probability (ASTP). We used separate linear regression models to study the association between dementia and each actigraphy feature, adjusting for relevant demographic features including age, gender, race, BMI, and education. 721 participants had ≥3 days of valid accelerometry data, dementia status, and complete covariate data (40% aged ≥80 years, 54% women). Compared to cognitively normal participants, those living with dementia averaged fewer activity counts/day (beta: -382K counts/day p&lt;0.0001), lower M10 (beta: -261K counts, p&lt;0.0001), lower IS (beta: -0.04; p= 0.0066), and higher ASTP (beta: 7.1%; p&lt;0.0001). Participants with and without dementia did not differ in terms of IV, L5, or RA (p&gt;0.05 for all). These results suggest important differences in volume and patterns of daily movement by dementia status. Future studies should investigate whether similar differences exist in earlier stages of cognitive impairment to enhance preventative efforts.