bluuebunny/crossref_metadata_2025_split huggingface dataset:
FUTURE SELF, PERCEIVED CONTROL, AND AGING PREPARATION BEFORE AND AFTER THE PANDEMIC: MODERATED MEDIATION EFFECT
Authors: Hu Yue , Lin Zhixuan , Fung Helene 
Published: December 2022

Abstract
Aging preparation, which can be seen as an adaptation to age-related challenges, is always oriented toward the future. The present study aims to explore how thinking about the future self and aging preparation are related. Domain-specific aging preparation was assessed in a longitudinal sample including 359 Hong Kong adults aged from 20 to 98 yrs. In both the pre- (2018) and during pandemic (2020) waves, perceived control fully mediated the positive relationship between thinking clarity on the near future self and aging preparation in the financial domain. However, the mediation effect of perceived control on aging preparation was moderated by age in the pre-pandemic wave, with a higher effect for older adults than for younger adults. Yet, these age differences were no longer significant during the pandemic. The present findings suggested the critical role of perceived control in preparation for the age-related changes and the age-equating effect of COVID-19 pandemic outbreak.
WHO PLANS FOR LATER LIFE? AN EXAMINATION OF MIDDLE-AGED AND OLDER FLORIDIANS
Authors: Barrett Anne , Mimbs Hope , Michael Cherish , Noblitt Jessica 
Published: December 2022

Abstract
The extension of life expectancy highlights the importance of understanding how people conceptualize – and plan for – their later years. We address this issue using data from an online survey of over 3,400 Floridians aged 50 and older that was conducted between December 2020 and March 2021 and funded by the Florida Department of Transportation. We examine five types of planning: for health care needs, financial well-being, living arrangements, driving retirement, and end-of-life care. We find that the likelihood of planning varies considerably across these types. Only 23 percent of respondents reported planning “some” or “a lot” for driving retirement, compared with 74 percent for health care needs, 76 percent for end-of-life care, 77 percent for living arrangements, and 83 percent for financial well-being. Likelihood of planning varied by age, gender, socioeconomic status, health, and race or ethnicity. Across all types of planning, older adults and those with at least a college degree and higher income were more likely to have planned. Women were more likely than men to plan for their financial future, living arrangements, driving retirement, and end-of-life care. Those in better health were more likely to plan for their financial future and end-of-life care. The effects of race or ethnicity were less consistent across the types of planning. White respondents were more likely than other race or ethnic groups to report planning for their living arrangements and end-of-life care, while Hispanic respondents were more likely than other groups to plan for driving retirement.
INVESTIGATION INTO THE PREDICTORS OF HELP-SEEKING BEHAVIOR IN OLDER ADULTS
Authors: Kann Michael , Chapman Silvia , Azar Martina , Joyce Jillian , Waltrip Leah , Shagalow Shaina , Rizer Sandra , Cosentino Stephanie 
Published: December 2022

Abstract
Early help seeking (HS) among patients with emerging Alzheimer’s disease and related dementias (AD/ADRD) can have considerable implications for treatment course, access to clinical trials, lifestyle, and future quality of life. Previous studies in older adults suggest cognitive impairment itself does not lead people to seek help; rather, HS appears to be driven by Subjective Cognitive Decline (SCD), personality, and mood. It is possible, however, that tests used to measure objective cognition were not sensitive to detect subtle cognitive impairments that may influence HS behavior. In this study of 142 cognitively healthy older adults, we examined if utilizing cognitive tasks sensitive to preclinical AD (i.e., short term memory binding, associative memory, and susceptibility to semantic interference) revealed an independent association between objective cognition and HS, or if SCD continued to be a primary driver. Participants were assessed for HS, SCD severity, personality traits (conscientiousness and neuroticism), depressive symptoms, and demographics (age, gender, education). Partially and fully adjusted regression models were conducted to examine the association between cognitive tests and HS whilst adjusting for demographics, personality, depressive symptoms, and SCD. Associative memory was the only cognitive marker significantly worse in those who help seek (B=- 0.07, SE=0.03, p=.031); however, it did not withstand adjustment for SCD. Only increased SCD (B=0.06, SE=0.02, p=.005) and educational attainment (B=0.42, SE=0.15, p=.005) had independent associations with HS. Ongoing work is establishing possible moderators of these associations to unravel the multifaceted influences on HS and to guide strategies to increase HS in older adults with SCD.
EARLY-LIFE EDUCATIONAL EXPERIENCES, TOXIC STRESS, AND RISK OF NEUROCOGNITIVE IMPAIRMENT AMONG US ADULTS OVER AGE 50
Authors: Nkwata Allan 
Published: December 2022

Abstract
Increasing evidence suggests that the risk of cognitive impairment in later life in the US has been declining in recent years. However, factors associated with this decline are not fully understood. This study aims to examine whether educational history, including college attainment and adverse childhood experiences (ACEs) are associated with neurocognitive impairment (NI) among midlife and older US adults. We will use data from the Health and Retirement Study (HRS) along with information on respondents' early educational experiences collected in the 2015 and 2017 HRS Life History Mail Survey to examine whether school context, educational content, academic ability, and ACEs are associated with NI. We will farther explore ACEs as potential modifiers/ mediators of the relationship between educational history and NI in our sample. Multivariable logistic regression models will estimate odds ratios (ORs) and 95% confidence intervals (CI) with adjustment for demographic factors, socio-economic status (SES) and lifestyle factors.
A VIRTUAL STAFF TRAINING TO IMPROVE COMMUNICATION FOR OLDER ADULTS DURING MASK WEARING
Authors: Mamo Sara , Garrity Katherine , Wheeler Kara 
Published: December 2022

Abstract
The need for masking protocols in care centers for older adults exacerbated communication challenges in an already difficult environment. The purpose of this study was to alleviate the burden of communicating while wearing masks by providing a virtual staff training that introduced a headset amplifier and communication tips. The training was delivered via Zoom to small groups of staff at three Programs for All-inclusive Care for the Elderly (PACE®) organizations. The training included education about the impact of age-related hearing loss, instructions for using a headset amplifier, and communication tips. Staff were encouraged to use the amplifier with as many participants as possible to ease communication while wearing masks—rather than targeting participants based on hearing status. A pre/post quasi-experimental approach was undertaken. Fifty-one staff members completed the training and immediate pre/post questionnaires to measure knowledge gain. Follow-up questionnaires (including open-ended responses) were collected at 2- (n = 29), 4- (n = 23), and 6-months (n = 23) post-training. In addition, we completed one focus group (n = 5) and one in-depth interview regarding the feasibility of participation in the research project and brainstorming to increase use of the amplifiers. By integrating quantitative and qualitative findings, we highlight communication improvements when using the amplifiers and tips for integrating amplifiers into group care programs. The findings from this study will contribute to the development of a large-scale intervention to address hearing loss and support communication for older adults in group care settings.
AN INNOVATIVE APPROACH TO ENHANCING COPD CARE AND MANAGEMENT IN A RURAL NORTHERN COMMUNITY
Authors: Freeman Shannon , Meyer Anthon , Skinner Kelly , Peach Laura 
Published: December 2022

Abstract

Background
COPD is the third leading cause of death worldwide. Rural communities often face challenges to provide high quality chronic disease care for aging populations. Despite these longstanding challenges, there was an intention to improve the care setting by developing and fostering a shared vision for quality care, as evidenced by enhancing COPD screening and care. To ensure consistent and longitudinal patient access to high quality of care as well and ongoing physician recruitment and retention a new rural program was developed. Objective-In this presentation we will describe a new rural community based COPD program from conceptualization and development through to current functioning highlighting areas of innovation. Methods-A process evaluation guided by Moore et al.’s framework to assess program implementation, mechanisms of impact, and context was conducted. Qualitative thematic analysis was undertaken of stakeholder interviews conducted in 2021 (n=11) and document review (n=60;~500 pages) of key clinic documents dated back to pre-program development.

Results
We describe five phases of program development: Survive; Reorganize and Stabilize; Assess and Respond; Build and Refine; and Sustain and Share. Outreach and localizing resources improved access to the program. Acquiring secured physician compensation, capturing quality data, and improving patient and provider self-efficacy built the capacity of the system and stakeholders within it. Finally, relationships were forged through building an integrated facility, collaborative networking, and patient engagement. The key elements of program implementation were the resources required to ensure its operation, categorized as hardware, software, organizational, and human.
AN INTERPROFESSIONAL APPROACH TO DEPRESCRIBING: A CURRICULAR FRAMEWORK
Authors: Sun Winnie , Sadowski Cheryl , Farrell Barb 
Published: December 2022

Abstract
Deprescribing is an important approach for managing polypharmacy and reducing harm from potentially inappropriate medications. Healthcare professionals identify barriers to deprescribing, including lack of knowledge and skill. This is not surprising as pre-licensure education does not consistently incorporate components of deprescribing into curricula. As such, there is a clear need to consider how to promote deprescribing competencies, teach related knowledge and skills and assess learning outcomes. The Canadian Deprescribing Network (CaDeN) Health Care Professional Committee undertook a consensus process to develop a proposed competency framework that describes essential knowledge, teaching strategies, and assessment protocols to promote deprescribing skills and advocate for consistent education about deprescribing principles and practices. The framework is informed by the deprescribing process, which includes gathering and interpreting patients’ medication history and clinical information within their context, using tools that help identify potentially inappropriate medications, weighing potential benefit and harm of continuing or deprescribing medications, using shared decision-making to make decisions about deprescribing, communicating deprescribing and monitoring plans, and monitoring progress and outcomes. The competency framework considers interprofessional learning and how to involve patients and care partners in deprescribing decisions. Integrating deprescribing competencies in healthcare curricula requires an intentional and structured approach across all years of the program, focusing on interprofessional collaboration. Learning activities should be active and practical, progressing from early to advanced learner skills and include integration of deprescribing during experiential education. This framework includes a review of the competencies, learning outcomes, and assessment strategies, with a discussion of strategies to incorporate interprofessional learning activities.
HIGH-RISK ELDERLY SCREENING IN MEDICAL INTENSIVE CARE UNIT
Authors: Gnanasekaran Gowrishankar , Alappan Narendrakumar 
Published: December 2022

Abstract
Geriatrics care in medical intensive care units (MICU) establishes a unique opportunity in early screening of High Risk Elderly (HRE) patients admitted for critical care. Many MICUs do not have a standard protocol to screen for HRE patients as part of their daily huddle. Our program is a quality improvement initiative to improve early identification of HRE patients in the MICU. HRE patients were identified based on nursing specific screening triggers at one of the Regional Hospitals of a large teaching hospital in Northeast Ohio.The program was designed as a part of geriatrics care expansion at regional hospital sites. Identified patients were discussed in daily huddles to determine unique geriatric needs in caring for these patients. A geriatrics co-management team was engaged in comprehensive geriatric assessments and care transition when it was needed. Geriatrics care in MICU demonstrates a unique opportunity in early identification of HRE patients. This helps to support a patient -centered approach in caring for critically ill elderly patients. The program would lay foundations in early screening for risk factors and optimizing elderly care in MICU.
DELIVERING FOOD RESOURCES AND KITCHEN SKILLS TO OLDER ADULTS WITH FOOD INSECURITY AND HYPERTENSION
Authors: Rivera Rebecca , Holden Richard , Adams Mariah , Dawkins Emily , Tu Wanzhu , Clark Daniel 
Published: December 2022

Abstract
Non-Hispanic Black adults experience higher rates of food insecurity, poor diet quality, and hypertension compared with their non-Hispanic White counterparts. Delivering Food Resources and Kitchen Skills (FoRKS) is an integrated intervention that concurrently addresses food insecurity, nutrition literacy, and chronic disease self-management among older patients at a Federally Qualified Health Center. Two clinical dietitians led virtual hypertension self-management, cooking skills, and nutrition education classes twice per week for 16 weeks. Participants registered for classes, ordered free meal ingredients, and received encouragement from the dietitians through the FoRKS mobile technology application. This study presents diet quality descriptive results from the FoRKS pilot intervention conducted at Eskenazi Health from September 2021 to January 2022 in Indianapolis, Indiana. Participants (n=13) with hypertension (systolic blood pressure ≥120 mm Hg) and who identified as food insecure per the 18-item US Household Food Security Survey Module completed the 2018-version of the National Cancer Institute’s Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool at baseline and post-intervention assessments. Healthy Eating Index (HEI)-2015 scores range from 0-100 and were calculated from ASA24 data. Participants were non-Hispanic Black (n=12) or non-Hispanic White (n=1) with mean age 58 years (range 53-65 years). Mean±SD HEI-2015 scores improved from 51.5±11.9 at baseline to 55.2±12.5 after the intervention. This preliminary data supports further investigation into the efficacy of integrated lifestyle interventions, i.e., FoRKS, using a randomized controlled study design. Addressing food and culinary skills can lead to improvements in diet quality that may translate to improved disease management among diverse older adults.
PSYCHONEUROLOGICAL SYMPTOMS IN CANCER SURVIVORS AND THEIR CAREGIVERS: A LONGITUDINAL PILOT STUDY
Authors: Litzelman Kristin , Stevens Jen , Berghoff Ashley , Balubaid Afnan , Kwekkeboom Kristine 
Published: December 2022

Abstract
In cancer patients, stress is associated with a psychoneurologic symptom cluster of depressed mood, anxiety, pain, fatigue, and sleep disturbance. The stress of caregiving may trigger similar symptoms among caregivers and warrants investigation. The purpose of this analysis was to characterize correlates of psychoneurologic symptoms in cancer caregivers. Cancer survivor-caregiver dyads (n=29) provided eight weekly symptom reports using a web-based assessment system. Symptom burden was calculated as the sum of symptom severity (mean=7.5, SD=8.1, range=0-41). Primary and secondary stressors of caregiving were also assessed. Mixed modeling was used, accounting for repeated measures. Models controlled for person-mean of time varying covariates, as well as sociodemographic, clinical, and care-related covariates. A secondary analysis assessed interdependence in survivor and caregiver symptoms using Actor-Partner Interdependence Models. In descriptive analyses, caregivers most frequently reported feeling anxious (44% on average across timepoints), sleep problems (31%), fatigue (25%), depressed mood (24%), and feeling irritable/angry (24%). Within caregivers, greater hours of care (beta=0.11, p&lt;.01) and more patient symptoms (beta=0.10, p&lt;.01) were associated with greater symptom burden. Between caregivers, higher baseline perceived stress was associated with greater symptom burden (beta=0.38, p=.04) and coresidence with the survivor was associated with lower symptom burden (beta=-12.8, p&lt;.01). Caregivers experienced higher symptoms when patients specifically reported anxiety, lack of appetite, or pain (beta=1.4, 2,4, and 3.0, p&lt;.05). Cross-lagged Actor-Partner Interdependence Models indicated interdependence among survivor and caregiver symptom burden. The findings provide preliminary evidence of the interrelationship of psychoneurologic symptoms in survivors and patients, with implications for symptom management and supportive care practice.
DEVELOPMENT OF A BRIEF MEASURE OF COMMUNICATION QUALITY: THE 5- AND 10-ITEM FAMILY INPATIENT COMMUNICATION SURVEYS
Authors: Burke Emily , Slaven James , Taylor Tracy , Monahan Patrick , Sachs Greg , Torke Alexia 
Published: December 2022

Abstract
Communication quality between clinical care teams and families impacts important outcomes like satisfaction, depression, and anxiety. Assessment tools must be efficient and reliable to be useful in the clinical environment. We report the development of 5 and 10-item versions of the validated 30-item Family Inpatient Communication Survey (FICS). Data were from 364 surrogate decision makers (SDMs) for incapacitated older adults in the ICU. Most SDMs were adult children (66.8%). SDMs were 70.9% female, 68.9% white, with a mean age of 58.3. Exploratory factor analysis revealed high internal reliability for the single-factor FICS5 (α= .88) and two-factor FICS10 (α= .93). The FICS10 reliably measures two subscales: information (α= .91) and emotional support (α=.81). Good discriminant and predictive validity were demonstrated when comparing total scores to outcomes at 6-8 weeks after hospital discharge, including anxiety (correlation coefficient (ρ)= -.13; p=.0234 ), depression (ρ =-.15; p=.0076), decision regret (ρ =--.15; p=.0066), and satisfaction (ρ =-..48; p&lt;.0001). Repeating analysis with a new sample (n=188) revealed similar results with Cronbach’s alpha ranging from .81 to .93. The FICS5 revealed significant associations (p&lt;.05) at 6-8 weeks after discharge with distress (-.22), while the FICS10 demonstrated significant associations with distress (-.28), anxiety (-.20), depression (-.19) and decision regret (-.27). Confirmatory factor analysis indicated adequate fit (CFI: FICS5= .994, FICS10= .994; RMSEA: FICS5= .093, FICS10= .103). The FICS provides clinicians and interventionists with a reliable, low burden tool to evaluate communication quality and respond quickly, which could impact satisfaction and other important outcomes for patients and families.
CARING FOR INDIVIDUALS WITH DEMENTIA AND COGNITIVE IMPAIRMENT IN LOS ANGELES: A CAREGIVER PROFILE
Authors: Thomas Ariane , Barragan Noel , Reyes Mariana , Kuo Tony 
Published: December 2022

Abstract
In 2020, the Los Angeles County Department of Public Health launched Healthy Brain LA (HBLA). HBLA is a multi-pronged project designed to promote cognitive health, reduce the risk of dementia, and help develop a dementia-focused strategic plan for Los Angeles County (LAC) that prioritizes the needs of those impacted by dementia and cognitive impairment and their caregivers. To support this effort, the HBLA team analyzed weighted data from the 2019 and 2020 California Health Interview Survey (CHIS) to better understand the profile of adult caregivers of individuals with dementia and cognitive impairment. CHIS is a publicly available, population-based, web and telephone survey that asks California residents about a wide range of health topics, yielding representative data on all 58 counties in the state. In 2019-2020, an estimated 1.6 million adults provided care to individuals aged 18 years or older in LAC. About 322,880 of those caregivers provided care for individuals with dementia and cognitive impairment, representing 2% of LAC’s adult population. Many of these caregivers were female (59%), Latino/Hispanic (44%), and between 50-64 years of age (32%). Most of them experienced challenges, such as financial stress (61%), physical/mental health problems (18%), or a change in job status (27%), due to caregiving. These data provide the first local estimate of dementia and cognitive impairment caregiving in nearly 15 years. Results offer critical information about this population that will be used by the HBLA team and its partners to guide efforts to effectively meet the needs of caregivers in LAC.
FORMAL CAREGIVER BURDEN IN NURSING ASSISTANTS IN NURSING HOMES: A FEASIBILITY STUDY
Authors: Kunkle Rachel , Chaperon Claudia , Berger Ann 
Published: December 2022

Abstract
Formal caregivers are the direct care workforce that aid residents in nursing homes. Providing care to residents is hazardous and physically demanding. Formal caregiver burden encompasses five attributes – perceived stress, caring for another, dependency of the older adult, responsibility, and competence. Exploring the five attributes of formal caregiver burden using a mixed-methods approach will determine if the attributes are present and how the nursing home setting contributes to formal caregiver burden. The purpose of this feasibility study is to describe formal caregiver burden of nursing assistants who provide direct care to residents in a nursing home setting in the Midwest United States. Study site one was only able to enroll three participants; therefore, results were limited. However, study site two was able to recruit and enroll the desired sample size (N=9). Interviews and self-report measures (Background/COVID-19 Questionnaire, Perceived Stress Scale, Caring Behaviors Inventory, and Nursing Home Staff Competency Assessment) were completed, and the PI compared integrated mixed methods results. Results suggest all the attributes of formal caregiver burden were present, and no additional attributes were identified. The feasibility of virtual recruitment, enrollment, and data collection procedures were confirmed. Multiple challenges played a role in the unsuccessful recruitment of this feasibility study at site one; however, virtual recruitment was successful at site two. Further exploration will inform identification and measurement of formal caregiver burden to ensure support for nursing assistants, continue the vitality of the nursing assistant workforce in nursing homes/long-term care, and improve the lives of nursing assistants.