bluuebunny/crossref_metadata_2025_split huggingface dataset:
REVISITING THE TEACHING NURSING HOME: IMPACT ON NURSING STUDENTS’ PERCEPTIONS OF WORKING IN LONG-TERM CARE
Authors: Degenholtz Howard , Boltz Marie , Fick Donna , Hodgson Nancy , Strauch Kim , Kariuki Jacob , Cai Yurun , Pajerski Dawn 
Published: December 2022

Abstract
Revisiting the Teaching Nursing Home is a two-year pilot project to address the long-term care workforce shortage by introducing nursing students to geriatric nursing while improving quality of care within nursing homes. The initiative has multiple components: enhanced clinical rotations for nursing students with partner schools of nursing, implementation of the Institute for Healthcare Improvement Age-Friendly Health System “4M” quality improvement model, and an online learning network. Nursing students at three schools of nursing participated in the clinical rotations at regional nursing homes. The experience was limited to students in one specific course at each school of nursing. At the beginning and end of the spring 2022 semester, students rated their competence in: patient assessment, collaborating with the care team, gathering clinical information, medication review, eliciting resident values, and health promotion. Students also rated their preferences for working in long-term care and with older adults. Data from 85 responses at the start of semester and 64 responses to the end of semester survey were analyzed. Analysis of student responses found that students self-rated competencies improved in all areas except eliciting resident values. Prior to their clinical experience, students ranked working in long-term care and with older adults lower than other settings or populations. The rankings were unchanged after their clinical experiences. These initial findings suggest that although the Teaching Nursing Home Program is meeting the pedagogical goals, attitudinal shifts may require different strategies.
PRACTICE CHANGE OUTCOMES OF POST-GRADUATE TRAINING IN ADVANCED CLINICAL DEMENTIA PRACTICES
Authors: Kaplan Daniel , Chan Keith 
Published: December 2022

Abstract
Neurocognitive disorder is common among older adults with often progressive symptoms impacting multiple domains of life and with major implications and challenges for family involved in care. Clinical providers including doctors, nurses, and social workers play instrumental roles in addressing health and mental health vulnerabilities associated with neurocognitive disorder as skillful interventions can effectively improve wellness and quality of life for patients and care partners. Yet, providers report needing expanded knowledge to deliver appropriate clinical dementia care. An advanced clinical dementia practice certificate program at a major university in the U.S. offers a 45-hour training that covers 35 clinical practices identified by an interprofessional advisory group. This study aims to test the learning impacts of the educational program. Since 2017, 74 participants have completed this training. Their self-reported frequency of use of each clinical practice was measured before and after the training using a 5-item rating scale ranging from “Never” to “Several times per day”. Comparisons across two time periods demonstrate significant increases in overall use of clinical practices (mean difference: 0.45), with a large mean effect size (Cohen’s d = 0.8). These increases were statistically significant in 30 of 35 practices (p &lt; 0.05). The largest effects were observed for clinical practices emphasizing the teaching of practical care strategies and the application of person-centered interventions. Implications of this educational method for enhancing clinician practice behaviors and recommendations for quantitative evaluation of training outcomes will be presented.
CHANGING AGING MYTHS AND READINESS FOR INTERPROFESSIONAL EDUCATION IN FAMILY NURSE PRACTITIONER STUDENTS
Authors: Picella David , Woods Diana Lynn 
Published: December 2022

Abstract
The preparation of Family Nurse Practitioner (FNP) students caring for the older adult population is inadequate. The design was a quasi-experimental pilot study (N = 30) to assess change in myths about aging and readiness for interprofessional education (IPE) in FNP students near graduation. The Woolf Aging Quiz (WAQ) containing 24 true-false myths about older adults, and the Readiness for Interprofessional Learning Scale (RIPLS) containing 19 items rated on a 5-point Likert scale (high score indicates more readiness), were completed at baseline and post-intervention. The intervention consisted of 4-weeks of education on normal aging, agism, age friendly healthcare, and IPE using online weekly brief video presentations and peer discussion. Thirty FNP students, mean age 43.5 years, 80.6% (N = 25) female, 19.4% (N = 6) male. A paired t-test showed no significant pre-post difference in the WAQ (t = -1.388, p &lt; .05). McNemar crosstab analysis of the WAQ items indicated 14 aging myths where students chose the wrong answer pre and post intervention. In addition, the RIPLS showed no significant change (t = .793, p &lt; .05) from pre-intervention (mean = 35.87) to post-intervention (mean = 34.42). FNP students near graduation held strong ageist beliefs, reflected in the WAQ, and were unprepared for IPE. Both of these results were resistant to change. The data suggests that FNP programs need to address aging and IPE content earlier and provide students with exposure to older adults that addresses myths about aging affords both theoretical and practical opportunities for interprofessional learning.
HOW DOES THE INTERSECTION OF RACE AND GENDER AFFECT HOSPICE CARE AT THE END OF LIFE?
Authors: Suntai Zainab 
Published: December 2022

Abstract
Research in the palliative and end-of-life-care field has shown that hospice care in the final months of life can improve outcomes such as pain, emotional well-being, and physical comfort. Yet, researchers often find significant disparities in the ability to access hospice care, with Black individuals being less likely to have hospice care at the end of life. The theory of intersectionality suggests that the combination of multiple vulnerable identities may add to the number of hardships and stressors that an individual experiences across the lifespan. To test the theory, this study aimed to access whether gender moderated the relationship between race and the receipt of hospice care at the end of life. Data were derived from Round 3 to Round 10 of the National Health and Aging Trends Study, and two multivariate regression models were used to assess the relationship between the race/gender interaction and hospice care at the end of life (Model 1: main effects, Model 2: interaction term). Results showed that the effect of race on hospice care was indeed dependent on gender, with Black women being the least likely to have hospice care at the end of life. This points to the combined disadvantages resulting from membership in two vulnerable groups (i.e., being a woman and being Black), including fewer hospice facilities in Black-populated areas, race and gender discrimination in hospice referrals, and other factors that combine to reduce hospice access for Black women. Implications for research, practice, and policy are provided.
AN EXAMINATION OF ADVANCED CARE PLANNING IN BLACK AMERICANS: DIRECTION TO IMPROVE ENGAGEMENT
Authors: Bassett Rachel , Paulson Daniel , McClure Nicole Valdes 
Published: December 2022

Abstract
Past studies have found that older Black Americans are less likely to establish advance care directives (ACDs) than their White age peers, and medical distrust has been identified as one possible cause. Others have suggested the formulaic approach of ACD documentation which may conflict with the spiritual and cultural nature of these decisions. The Five Wishes ACD was developed partially to address this need. This study seeks to 1) replicate past findings regarding race and ACD adoption, and test the hypotheses that 2) Race will differentially predict Advanced Care Planning (ACP) engagement scores between conditions (Five Wishes vs State Directive), and 3) level of trust in physicians will relate to ACP engagement. The sample (N = 186) was recruited from Amazon Mechanical Turk and Prolific. Participants ranged from 50 to 77 years, were predominantly female (56.8%), White (51.61%), married (52.6%), and college-educated (70 .6%). ANCOVA results were a nonsignificant main effect of ACP engagement by race (F(1, 185) = 1.93, p = .166) and nonsignificant interaction of race by condition (F(1, 185) = 0.16, p &lt; .69). Trust in physician scale scores predicted ACP engagement (F(1, 185) = 16.15, p &lt; .001). The lack of an effect of race on ACP utilization may be explained by educational and SES characteristics of the sample by contrast to prior studies. The Five Wishes and State Directive ACD documents resulted in similar ACD engagement. These results suggest that trust in physicians is a primary barrier to ACP utilization.
THE ASSOCIATION BETWEEN FRAILTY AND PERCEIVED FATIGABILITY IN THE LONG LIFE FAMILY STUDY
Authors: Schumacher Benjamin , Kehler Dustin , Kulminski Alexander , Andersen Stacy , Gmelin Theresa , Christensen Kaare , Wojczynski Mary , Glynn Nancy 
Published: December 2022

Abstract
Higher levels of frailty, quantified by a frailty index (FI), may be linked to fatigue severity as tasks become more physically and mentally demanding. However, the association between frailty and fatigability—quantification of vulnerability to fatigue in relation to specific intensity and duration of activities—has not been assessed. Using cross-sectional data from the Long Life Family Study Visit 2 (2014–2017; n=2,524; mean age +/- standard deviation 71.4+/-11.2 years; 55% women; 99% White), we examined the association between a 79-item FI (ratio of number of health problems reported (numerator) out of the 79 (denominator); higher percentage=greater frailty) and perceived physical and mental fatigability using the Pittsburgh Fatigability Scale (PFS) (range 0–50; higher scores=greater fatigability). Mean+/-SD FI scores were 0.08+/-0.06 and mean+/-SD PFS Physical and Mental scores were 13.7+/-9.6 (39.5% more severe, &gt;=15) and 7.9+/-8.9 (22.8% more severe, &gt;=13), respectively. Both PFS subscale scores were higher for each 0.10 increment in FI. Mean PFS scores were 10.7 and 34.2 (Physical) and 5.7 and 28.8 (Mental) for FI scores of &lt; 0.10 (non-frail) and ≥0.30 (moderate-severely frail), respectively. In mixed effects models, a 0.03 higher FI score (accepted clinically meaningful increase in FI) was associated with 1.9-point higher PFS Physical (95% confidence interval (CI) 1.7–2.1) and 1.7-point higher PFS Mental (95% CI 1.5–1.9) scores after accounting for family structure and adjusting for age, sex, field center, body mass index, smoking status, education, and marital status. Individuals with higher FI scores may benefit from targeted interventions to mitigate further poor health outcomes.
DOES MOTIVATION PROMOTE PHYSICAL ACTIVITY IN OLDER ADULTS WITH CHRONIC MUSCULOSKELETAL PAIN?
Authors: Witonsky Kailyn , Zhu Xiaonan , Rosso Andrea , Rosano Caterina 
Published: December 2022

Abstract
Chronic musculoskeletal pain is common and limits physical activity in older adults. Understanding why some older adults remain physically active despite chronic musculoskeletal pain, “pain resiliency”, may offer insights to promote physical activity. We investigated the cross-sectional association of three indicators of motivation or mood with physical activity in adults over the age of 65 with chronic musculoskeletal pain from the Cardiovascular Health and Cognition Study. Of 2,703 participants with brain scans, 919 (34%) reported at least one month of either foot, knee, hip, or back pain and 47% of those with pain had moderate to high levels of self-reported physical activity, defined as “pain resilient”. Indicators of motivation included: (1) self-reported motivation: a composite score of perceived effort, difficulty getting going in the morning, and difficulty concentrating, (2) social network score from the Lubben Social Network scale, and (3) a composite depression scale. Separate multivariable linear models estimated the association between physical activity and each indicator, controlling for gender, race, BMI, age, gait speed, number of medications, number of pain sites, cognitive function, as measured by the digit substitution symbol test, and brain integrity, as measured by level of white matter hyperintensities. Higher self-reported motivation (β=-0.11, p=0.02) and larger social networks (β=0.03, p=0.01) were associated with higher levels of physical activity. Better mood was not associated with higher levels of physical activity (β=-0.017, p=0.34). Albeit based on cross-sectional self-reported measures, our research suggests the need for further research investigating psychosocial contributions to pain resilience.
A COMPARATIVE STUDY OF FALL RISK ASSESSMENT IN COMMUNITY DWELLING OLDER ADULTS IN INDIA
Authors: Kulkarni Snehal 
Published: December 2022

Abstract
Falls in older adults can be prevented with early identification. Recent research investigates the use of wearable sensors to provide quantitative data on mobility parameters to assess risk of fall. However, the efficiency of these new methods in comparison to conventional fall risk assessment tools is unknown. Therefore, the current study compares the sensor-based fall risk assessment with conventional fall risk measures. The study included 659 community-dwelling older adults (&gt;60 years) who were followed for 12 months after baseline. The American Geriatric Society Fall Risk Assessment tool was used to assess risk of fall conventionally and Kinesis QTUG was used to assess the fall risk using sensors. Receiver operating characteristics curve (ROC) was used to compare the sensor-based method and the conventional method of assessing fall risk. Out of the 659 community-dwelling older adults, 24% (163) of older adults reported a fall in 12 months. According to the sensor-based assessment, 23% of older adults had low risk, 50% had medium risk and 27% had high risk of fall and according to the conventional method 66.1% were in low risk, 27.1% were in medium risk and 6.8% were in high risk. The ROC analysis showed that the sensor-based methods (AUC-78%; sensitivity- 93.8% specificity – 56.3%) outperformed the conventional method (AUC – 61.2%; sensitivity – 82.8% and specificity - 67.2%) of identifying older adults at risk of fall. Therefore, use of simple wearable sensors can determine the risk of future falls.
BURDEN OF FALL-RISK INCREASING DRUGS IN OLDER ADULTS PRESENTING WITH FALLS TO THE EMERGENCY ROOM
Authors: Casey Martin , Niznik Joshua , Anton Greta , Meyer Michelle , Kelley Casey , Busby-Whitehead Jan , Davenport Kathleen , Roberts Ellen 
Published: December 2022

Abstract
Prescribing of fall-risk increasing drugs (FRIDs) may be an important driver of falls in older adults. Understanding the types and frequencies of FRIDs prescribed to older adults presenting with falls to an emergency department (ED) may help identify opportunities for deprescribing. We performed a cross sectional analysis of data collected from a pharmacist-led fall-prevention program focused on older adults presenting with a fall to an academic ED in the southeastern United States between August 2020 – December 2021. ED pharmacists identified older adults (≥65 years old) presenting with a chief complaint of ‘fall’ and then performed a medication reconciliations to verify and obtain data on outpatient prescription drug use. FRIDs were identified in accord with the 2019 American Geriatrics Society Beers Criteria and the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths, & Injuries (STEADI-Rx) list. The ED pharmacists performed medication reconciliations on 424 unique older adults presenting with a fall. The cohort had a mean age of 81.3 years and were mostly female (63.3%) and white (84.9%). Prescription use of FRIDs were identified in 45.8% (194/424) of older adults presenting with a fall. An estimated 25.5% (108/424) of the subjects were prescribed 2 or more FRIDs. The most common FRIDs identified were antidepressants (25.9%), anticonvulsants (18.6%), opioids (12.7%), benzodiazepines (8.5%), and antipyschotics (3.1%). . Prescription use of FRIDs, including use of 2 or more FRIDs, was common in older adults presenting with a fall to the ED.
ACCEPTABILITY DATA OF A TECHNOLOGY-ENABLED CARE COACHING SERVICE FOR CAREGIVERS OF INDIVIDUALS WITH DEMENTIA
Authors: Judge Katherine , Thomley Amelia , Stratton Lauren , Silver Emily , Finegan Kerry , Moreno Monica , Fazio Sam , Chung Joe 
Published: December 2022

Abstract
This poster presents acceptability data from the Kinto Care Coaching Intervention, an innovative technology-enabled care coaching service for caregivers of individuals with dementia. The 30-day program provides caregiver support and financial information through: 1) an initial one-on-one care coaching meeting; 2) interactive and on-going support and educational resources through an app; 3) access to support groups; and 4) if needed, additional meetings with their care coach. The solution is funded through the NIH’s Small Business Innovation and Research (SBIR) program, with the specific goals of developing mobile technology that is: 1) acceptable and usable for caregivers of all ages and 2) supports cost-effective deployment of the coaching intervention at scale. To assess program acceptability, participants completed a survey after their one-on-one care coaching meeting and after the 30-day program. On average, participants (n=32) were M=51.94 (SD=12.07) years old; 68.8% female; 71.9% White; 75% married; and 56.3% worked full-time. Using a 5-point Likert scale, nearly all participants (96.6%) indicated they ‘agreed’ or ‘strongly agreed’ that their care coach was: helpful in explaining the program; provided useful information; assisted with developing goals; and were supportive. Participants rated the program resources and technology as very helpful with mean ratings ranging from 4.41 to 4.69. When asked about the overall program acceptability, participants indicated they were extremely satisfied with the program (M=4.81; SD=.40), with 100% of participants ‘agreed’ or ‘strongly agreed’ that they were satisfied. Discussion will highlight key program components along with next steps in testing program efficacy.
THAT'S WHAT FRIENDS ARE FOR: SOCIAL CAPITAL, DEVELOPMENTAL DISABILITY, AND THE LIFE COURSE
Authors: Hoyle Jessica , Warren-Findlow Jan , Wallace Lauren , Laditka James , Laditka Sarah 
Published: December 2022

Abstract
Social capital, resources from reciprocal relationships, helps us get by as we age. People with developmental disability have service needs that persist across the life course, which social capital can help address. However, social structures, communication problems and smaller social networks limit social capital for some people with developmental disability. We studied how researchers conceptualize, measure, and apply social capital to developmental disability research throughout the life course, reviewing peer-reviewed articles across 5 disciplines, from 2000 through February 2022. Of 673 studies, 71 met criteria. Studies used a common definition of social capital but no common measures. Fourteen studies focused on parents or other caregivers. Few included older adults with developmental disability as research participants. Results indicate a need to better understand social capital in the lives of people with developmental disability and how social capital resources can support and improve lives of people with developmental disability as they age.
IDENTIFYING FACTORS ASSOCIATED WITH CAREGIVER NEGLECT IN OLDER PERSONS WITH DEMENTIA
Authors: Chang E-Shien , Czaja Sara , Rosen Tony , Moxley Jerad 
Published: December 2022

Abstract
Caregiver neglect is common among older persons with dementia and is associated with significant morbidity and mortality. Despite this, little empirical research exists examining factors that contribute or prevent neglect. Our goal was to identify caregiving factors that may be associated with caregiver neglect. Data were drawn from the baseline information of 240 caregivers enrolled in the Caring for the Caregiver Network study who provided care to a family member with dementia. Caregiver depression, burden, social support, perceived mutuality with care-recipients, positive aspects of caregiving, and self-perceived caregiving preparedness, were measured using validated scales. To maximize sensitivity in our measure of caregiver neglect, we operationalized caregiver neglect as consisting of: 1) caregivers’ failure to meet care-recipients’ needs, using 8-item instrumental activities of daily living (IADL) and 6-item ADL scales, and 2) caregivers not receiving additional formal services (e.g., visiting nurses; home care aides) to address care-recipients’ unmet needs. Selection of independent variables into multivariate regression models examining predictors of neglect was based on significance in bivariate analysis (p &lt; .10). Caregiver neglect was found in 29.2% of caregivers. The caregiver being male was significantly associated with greater risk of neglect. In the final adjusted model, only caregiver preparedness was found to be a significant risk factor for neglect (β = -.16 SE=.10, p &lt; .05). This analysis provides the first evidence of the association between caregiver preparedness and risk of caregiver neglect. Future research should examine possible psycho-social mechanism linking preparedness and neglect to inform neglect prevention and intervention programming.
CAREGIVING BURDENS OF TASK TIME AND TASK DIFFICULTY AMONG PAID AND UNPAID CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Smith Matthew , Kew Chung Lin , Han Gang , Wilson Lucas , Lee Shinduk , Fitch John , Ory Marcia 
Published: December 2022

Abstract
Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Cross-sectional baseline survey data were analyzed from 110 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling for contextual items related to the caregiver, care recipient, and caregiving logistics. Caregivers whose care recipients were female (B=-0.29, P=0.006), had more chronic conditions (B=0.31, P=0.011), and had lower Mini-Mental State Exam scores (B=-0.20, P=0.015) reported higher task time burdens. Caregivers whose care recipients had other paid caregivers (B=0.30, P=0.031) and spent more months/years caring for their care recipients (B=0.28, P=0.004) reported higher task time burdens. Caregivers’ task time burden was positively associated with their emotional stress level (B=0.30, P=0.020). Caregivers’ task difficulty burden was positively associated with their emotional stress (B=0.30, P=0.029) and depressive symptomatology (B=0.32, P=0.002). Results reinforce the relationship between caregiver burden and mental health. While the care recipient’s disease profile and needs were drivers of task time burden, which may also require coordination with other paid caregivers, task difficulty was emotionally driven. Findings highlight the importance of caregiver support services and programming for mental health.