bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE LONGITUDINAL RELATIONSHIPS BETWEEN SOCIAL ISOLATION AND HEALTH OUTCOMES: THE ROLE OF PHYSICAL FRAILTY
Authors: Mehrabi Fereshteh , Béland François 
Published: December 2022

Abstract
Social isolation is a public health issue that is linked to poor health outcomes. However, the mechanisms underlying this association remain unclear. The main objective of this study was to explore whether changes in frailty moderated the relationship between changes in social isolation and changes in health outcomes over two years. We examined the mediating role of changes in frailty when the moderation hypothesis was not supported. A series of latent growth models (LGMs) were used to test our objectives using data from three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and over. Missing data were handled by pattern mixture models with the assumption of missing not at random. We measured social isolation through social participation, social networks, and social support from different sources of social ties. We assessed frailty using the Fried frailty phenotype. Our moderation results revealed that high levels of changes in social participation, support from friends, nuclear, and extended family members, and social contacts with friends were associated with greater changes in cognitive and mental health among frail older adults with diminished physiological reserves compared to robust older adults. Additionally, changes in frailty mediated the effects of changes in social participation and social contacts and support from friends on changes in chronic conditions. This longitudinal study suggests that frailty moderated the relationships between social isolation and mental and cognitive health but not physical health. Overall, social support and strong friendship ties are key determinants of frail older adults’ health.
THE EFFECT OF COMMUNITY HEALTHCHOICES ON USE OF HOME AND COMMUNITY-BASED SERVICES
Authors: Kastner Keri 
Published: December 2022

Abstract
Medicaid claims data for the years 2013 to 2020 were analyzed to examine use of common categories of home and community-based services (HCBS) as well as the proportion of people living in nursing homes as opposed to receiving long-term services and supports in the community. There was a long-term trend prior to Community HealthChoices of a shift the locus of LTSS away from nursing homes. The implementation of managed care to deliver LTSS continued, but did not appear to accelerate this trend. However, MLTSS did appear to control to growth in hours of personal care per person both in the aggregate and longitudinally within the same individuals over time. There were decreases in the use of adult day services and home delivered meals. However, the decline in home delivered meals was more than offset by an increase in uptake of the supplementary nutritional assistance program (SNAP).
THE IMPACT OF COMMUNITY HEALTHCHOICES ON PERSON-CENTERED SERVICE PLANNING
Authors: Yauch John 
Published: December 2022

Abstract
Person-centered service planning (PCSP) is a required component of home and community-based services programs that operate under Medicaid waivers. CMS requires that states have processes in place to assure that participants and their family members (as desired and appropriate) are involved in decisions about their care. This mixed-method study combines interviews with participants and qualitative service coordinators regarding the PCSP process. Participant interviews using the Consumer Assessment of Health Providers Survey – Home and Community Based Services version found that the measure of “choice over services” improved slightly however, the “planning your care” measure was unchanged. Interviews with service coordinators found that the introduction of managed care had led to a system that was overly bureaucratic and focused on medical rather than social needs. This led to a perception that the service plans neglect aspects of daily living that are important for a good quality of life.
IMPLEMENTATION SCIENCE FOR THE SCALE-UP, SPREAD, AND SUSTAINABILITY OF ASSISTIVE TECHNOLOGIES FOR HEALTHY AGING
Authors: Freeman Shannon , Carroll Simon 
Published: December 2022

Abstract
In this symposium we present papers from four key stakeholders on a Michael Smith Foundation for Health Research (MSFHR) Implementation Science Team (IST) that is investigating the application of an emerging approach, the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework (Greenhalgh et al., 2017, 2018), to help predict and evaluate the success of technology-supported health and social care programs in British Columbia (BC). Specifically, our team’s intention is to apply the NASSS framework to answer the following research questions: 1) Can the NASSS framework be used to enhance the effectiveness and impact of innovative ATs through improving the equitable scale-up, spread, and sustainability of these technologies for older adults? 2) What are the most important factors in the technology development and implementation process that contribute to equitable scale-up, spread, and sustainability of ATs for older adults? And 3) How can we improve transdisciplinary and intersectoral collaborations to enhance and improve the equitable implementation of ATs for older adults? Based on discussions from team, advisory, and expert panel meetings, a Rapid Realist Review (RRR) of the literature, and an analysis of data collected to date, the speakers will respond to these questions.
AGE DIFFERENCES EMOTION GLOBALIZING: AN EXAMINATION OF BOUNDARY CONDITIONS
Authors: Barlow Meaghan , Willroth Emily , Wrosch Carsten , John Oliver , Mauss Iris 
Published: December 2022

Abstract
Emotion globalizing is an individual difference variable referring to the extent to which daily variations in an individual’s current emotions spillover into their evaluations of life satisfaction. The present research sought to: 1) extend the conception of emotion globalizing to stressor-related emotions, 2) examine age differences in these processes, and 3) differentiate associations with evaluations of life satisfaction and day satisfaction. To do so, we used daily diary data from two adult lifespan community samples [Study 1: N = 133 females, age range = 23-78; Study 2: N = 137, age range = 18-95]. Multilevel models revealed older (compared to younger) adults exhibited less negative (but not positive) emotion globalizing and stressor-related emotion globalizing. No age differences were revealed in the association between stressor-related emotions and day satisfaction. These findings support and extend assumptions underlying the mechanisms of emotion globalizing and inform theories of emotional aging.
MID-LIFE JOB STRESS AND SUPPORT PREDICT SLEEP HEALTH TRAJECTORIES THROUGHOUT ADULTHOOD
Authors: Lee Soomi , Smith Claire , Allen Tammy , Wallace Meredith , Almeida David , Buxton Orfeu , Patel Sanjay , Andel Ross 
Published: December 2022

Abstract
Good sleep is necessary for healthy aging, but it may be threatened by work stress. This study connected midlife job characteristics to trajectories of sleep health profiles (within-person configurations of key self-reported facets: duration, regularity, sleep onset latency or SOL, insomnia symptoms, feeling unrested, and napping) over one decade. A working adult sample (N=847, Mage=45) of the Midlife in the United States study provided data on sleep and job characteristics in 2004-2006 (T1) and 2013-2016 (T2). Four sleep profiles were consistently identified at both time points: (1) good sleepers, (2) irregular but sufficient, (3) short sleepers, and (4) long SOL/insomnia. Higher job demands at T1 predicted a transition from good or irregular/sufficient sleep at T1 to long SOL/insomnia at T2. Higher workplace social support at T1 predicted maintenance of good or irregular/sufficient sleep over time. Attention to job demands and workplace social support may help promote sleep health.
UNDERSTANDING RACIAL AND ETHNIC DISPARITIES IN NURSING HOME CARE IN COOK COUNTY, IL
Authors: Caldera Selena 
Published: December 2022

Abstract
Nursing facility data from the Illinois Department of Public Health reveals significant racial disparities in access to high quality nursing homes (NH) for older Black and Latino Illinoisans. While half of all Illinois NH residents live in a 1- or 2- star rated nursing home, 68% of Black NH residents live in such facilities. This study seeks to understand racial and ethnic disparities in access to, quality of, and experiences with care in Cook County, Illinois NHs and develop community-identified solutions to close quality, access, and equity gaps. We employ key informant interviews in a two-stage process that begins by developing a current state analysis of the experience with care through interviews with community stakeholders, including advocacy groups, policy and community leaders and public agencies. Those findings then guide interviews with older Black, Latino, and Chinese NH residents and their caregivers where we identify community-grounded solutions to closing equity gaps.
PHYSICAL AND MENTAL HEALTH OUTCOMES AMONG OLDER MILITARY VETERANS
Authors: Landes Scott , Wilmoth Janet 
Published: December 2022

Abstract
Older veterans are a unique health population, with physical and mental health outcomes impacted by the positive health aspects of military social capital as well as the negative aspects of military-related hazards. This symposium focuses on physical and mental health outcomes among older military veterans both before COVID-19, and during the COVID-19 pandemic. Three studies address veteran health outcomes pre-pandemic. Two of the pre-pandemic studies focus on veteran-only samples in order to determine whether aspects of marital quality predicted levels of loneliness, and risk factors for trauma re-engagement among those with medical illness. The third pre-pandemic study examines whether the increased mortality risk observed among older veterans compared to nonveterans varies by combat status. Two studies address veteran health outcomes during the COVID-19 pandemic. The first uses a sample of older veterans with PTSD who were surveyed pre-pandemic and during the pandemic in order to ascertain the mental and physical health impact of the pandemic. The second COVID-19 study uses data from a study of Veterans Affairs’ Home Based Primary Care (HBPC) providers to learn about the best practices discovered to ensure COVID-19 vaccination uptake by some of the most vulnerable older veterans. Results from each of these studies will shed light on policies and practices needed to ensure the best physical and mental health outcomes for older military veterans.
EXPLORING MULTIDIMENSIONAL RESILIENCE IN OLDER VETERANS WITH PTSD DURING THE PANDEMIC
Authors: Hall Katherine 
Published: December 2022

Abstract
The COVID-19 pandemic and restrictions for physical and social distancing has affected all older adults, but one segment that has unique needs and experiences is older veterans with PTSD. This presentation will explore how PTSD symptomology, and psychosocial functioning in this population have changed compared to pre-pandemic findings. The impact of the pandemic on daily life activities and functional impairment will also be explored. Participants recruited to a wellness clinical trial for older veterans with PTSD at two different timepoints (pre-pandemic, n=54; post-pandemic, n=28) completed PTSD and mental health assessments, and a physical performance battery testing strength, mobility, balance, and aerobic endurance. PTSD symptoms, specifically avoidance and hypervigilance were markedly lower in the post-pandemic sample. Higher levels of physical impairment were observed in the post-pandemic sample, suggesting a need for targeted outreach and health promotion programs among older adults with PTSD symptoms during the pandemic.
HEALTH LITERACY AMONG OLDER ADULTS IN SWITZERLAND: CROSS-SECTIONAL EVIDENCE
Authors: Meier Clément , Vilpert Sarah , Borrat-Besson Carmen , Borasio Gian Domenico , Jox Ralf J , Maurer Jürgen 
Published: December 2022

Abstract
Despite being widely regarded as a major cause of health inequalities, little is known regarding levels of health literacy among older adults in Switzerland. To fill this gap, this study assesses health literacy and its associations with individuals’ social, regional, and health characteristics in a nationally representative sample of adults aged 58 years and older in Switzerland. We use data of 1’625 respondents from a paper-and-pencil self-completion questionnaire that was administered as part of wave 8 (2019/2020) of SHARE in Switzerland. Health literacy is measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). We use multivariable regressions to explore how respondents' sociodemographic characteristics are independently associated with health literacy. Overall, 6,8% of the respondents had inadequate health literacy, 24,6% problematic health literacy, and 68,6% sufficient health literacy. There were significant associations between health literacy and individuals' gender, education, economic situation, and self-rated health. Women had higher levels of health literacy than men (p &lt; 0,001). Moreover, a higher education level (p &lt; 0,001), fewer financial difficulties (p&lt; 0.01), and higher self-rated health (p &lt; 0,001) were positively correlated with adequate/higher levels of health literacy. One-third of older citizens have difficulties managing health-related issues in Switzerland. These findings call for targeted interventions, such as using simplified health or eHealth information tools, improved patient-provider communication, and shared decision-making, promoting lifelong learnings activities and health literacy screening for older patients to increase low health literacy and mitigate its consequences, thereby alleviating remaining social health inequalities in the Swiss population.
LIFE LESSONS: THE EXPERIENCES OF OLDER ADULTS LIVING IN PUERTO RICO DURING COVID-19
Authors: Fabelo Humberto , Morgan Matthew , Vazquez Julia , Becker Todd 
Published: December 2022

Abstract
What life lessons emerge from a group of older Puerto Ricans concerning their experiences with COVID-19. We will review study participants’ reports of how they spent their time during the pandemic, what they found most difficult to cope with, and life lessons they learned as a result. We will use Erickson’s life course theory of psychosocial development to frame their responses to these questions, including the crises (and strengths) of generativity versus stagnation (care) and ego integrity versus despair (wisdom). We will report evidence of care and wisdom as core ego strengths resulting from their lived experience. We will also review how isolation, sense of community, and key mental and physical health factors seemed to influence how their responses suggest coping strengths. We will discuss our findings in the context of social and cultural norms of current cohorts of older Puerto Ricans, highlighting the salience of community and family relations. (150 words)
THE PHYSICAL AND MENTAL HEALTH OF HOME HEALTHCARE WORKERS: WHAT DO WE KNOW AND WHAT CAN WE DO ABOUT IT?
Authors: Sterling Madeline 
Published: December 2022

Abstract
This presentation will use data from the 2014-2018 CDC's Behavioral Risk Factor Surveillance Survey to characterize the physical and mental health of home health care workers compared to other similar frontline, low-wage worker groups, before the COVID-19 pandemic. Next, using primary survey data collected in partnership with the 1199SEIU Training and Employment Fund, the health of the workforce during the COVID-19 pandemic will be presented, as well as the workforces' needs. The survey includes data from over 250 home health care workers employed in New York, NY who provided care during the pandemic. Finally, data from a pilot feasibility study of an intervention aimed at improving home care workers' well-being will be presented.
CARING FOR HOMEBOUND VETERANS DURING COVID-19 IN THE US DEPARTMENT OF VETERANS AFFAIRS MEDICAL FOSTER HOME PROGRAM
Authors: Manheim Chelsea , Katz Maya , Haverhals Leah 
Published: December 2022

Abstract
The COVID-19 pandemic made older, homebound adults with multiple chronic conditions increasingly vulnerable to contracting the virus. The United States (US) Department of Veterans Affairs (VA) Medical Foster Home (MFH) program cares for such Veterans residing in private homes of non-VA caregivers. In this qualitative study, we assessed adaptations to delivering safe and effective healthcare during the early stages of the pandemic for Veterans living in rural MFHs, interviewing (n=37) VA MFH care providers at 19 MFH programs across the US. We identified themes reflecting adaptations to care provision, including care providers increasing communication and education to caregivers who prioritized Veteran safety. Caregivers coordinated increasing telehealth visits, applied creative strategies to mitigate social isolation of Veterans and themselves, and Veterans were prioritized for in-home COVID-19 vaccinations. Study findings illustrate the importance of clear, regular communication and intentional care coordination to ensure high quality care for vulnerable, homebound populations during crises.
FEELING YOUNG TODAY, FEELING GOOD TOMORROW? MICROLONGITUDINAL DYNAMICS IN SUBJECTIVE AGE
Authors: Rupprecht Fiona , Schmidt Laura , Sieverding Monika , Nikitin Jana , Wahl Hans-Werner 
Published: December 2022

Abstract
Insights into the short-term dynamics and micro-longitudinal consequences of subjective age can drive our understanding of its long-term mechanisms across adulthood. Using data from 80 newly retired individuals (aged 59 to 76 years; 59% women) collected on 21 days, we made use of a recent methodological advance—multilevel dynamic structural equation modeling. As possible same-day correlates and micro-longitudinal consequences of subjective age, we investigated physical activity, step number, sleep quality, affect, and stress, which were either assessed via wearables (FitBit Charge HR) or daily diaries. Analyses suggest a weak autoregression of subjective age, indicating that how old one feels is determined via daily rather than lasting experiences. Indeed, there were significant same-day relations to all suggested correlates. The one effect lasting across several days was from an older subjective age on subsequent negative affect—a potential short-term mechanism contributing to the detrimental long-term influence of an older subjective age.
DYADIC EFFECTS ON DEPRESSIVE SYMPTOMS OF SPOUSE CAREGIVERS AND THEIR CARE RECIPIENTS: EVIDENCE FROM CHINA
Authors: Liu Jinyu , Lou Yifan , Li Lydia , Xu Hongwei , Zhang Zhenmei 
Published: December 2022

Abstract

Objectives
The likelihood of providing care to a spouse in middle and older ages has increased as life expectancy increases, but knowledge about how the caregiver and care recipient influence each other’s mental health is limited. This study examined whether a partner’s physical, cognitive, and mental health in a spousal caregiving dyad are associated with the other partner’s depressive symptoms in China and whether the dyadic effects vary by gender.

Methods
This study used data from Wave 3 (2015) and Wave 4 (2018) follow-up surveys of the China Health and Retirement Longitudinal Study (CHARLS). The analytic sample featured 1,245 dyads of care recipients aged 45 or older and their spouse caregivers. The Actor-Partner Interdependence Model was used to test the dyadic effects among all couples in the analytic sample, couples with wife caregivers and couples with husband caregivers, respectively.

Results
We found that caregiver’s depressive symptoms at Wave 3 were significantly associated with care recipient’s depressive symptoms at Wave 4 in the full sample. Regardless of caregiver or care recipient roles, wives’ mental health was impacted by their husbands’ depressive symptoms, but not vice versa. Wife recipient’s cognitive impairment was associated with husband caregiver’s lower depressive symptoms. Discussion: This study sheds light on the mental health of couples in the context of caregiving in China. The findings indicate that interventions to support couples in a caregiving dyad need to consider the influence they have on each other, and the gender and health conditions of each in the dyad.
THE IMPACT OF CHILDHOOD ADVERSITY ON CAREGIVERS' HEALTH
Authors: Avent Elizabeth , Yonashiro-Cho Jeanine , Gassoumis Zach 
Published: December 2022

Abstract
Caregivers tend to report fair or poor health compared to non-caregivers. Adverse childhood experiences (ACEs), which are traumatic events experienced before age 18, have been associated with several health conditions and overall poor health in adulthood. The additive effect of early-life stressors and caregiving stressors may have a compounded impact on the health of caregivers, contributing additional stress and burden to their caregiving situation. Data from the 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) were used to analyze self-rated health (SRH) in the context of caregiving and ACEs, based on responses from Florida, Georgia, Tennessee, Virginia, and Utah (N= 41,334). Of the 8,368 caregivers, nearly 23% reported 4 or more ACEs, compared with 13% of non-caregivers. Nested regression models showed that caregivers have lower SRH (b=-0.04, p=0.0002); however, after including the combination of ACEs and being a caregiver, there was no significant impact of being a caregiver alone on SRH. The effect of ACEs alone on SRH persisted, with the strongest effect for individuals with 4 or more ACEs (b=-0.41, p&lt; 0001). The finding that caregivers’ childhood adversity accounts for SRH moreso than their caregiver status highlights the importance of a lifespan approach when considering caregiver health and, potentially, burden. This has implications for practice, suggesting that screening caregivers on their history of ACEs may be a valuable tool to identify caregivers at higher risk for poor health outcomes who may benefit from additional resources to support their health and well-being.
CHILDHOOD SES IS ASSOCIATED WITH FASTER WORSENING METABOLIC SYNDROME SEVERITY FOR BLACK RELATIVE TO WHITE WOMEN
Authors: Surachman Agus , Adler Nancy , Laraia Barbara , Epel Elissa 
Published: December 2022

Abstract
This analysis examined whether early life SES was associated with longitudinal changes in metabolic syndrome (MetS) severity among Black and white women. Data were from 531 women (non-Hispanic Black=263; non-Hispanic white=268, Mage=39) in the National Growth and Health Study (NGHS). Information about parental education was collected during the baseline survey when participants were 9. Information regarding MetS severity were collected during year-7 (Mage=16), year-10 (Mage=19), and year-30 (Mage = 39) follow-up studies. Controlling for baseline body mass index, smoking status, and marital status, Black participants showed a faster increase in MetS severity across two decades. Early life SES (b=.03, SE=.01, p&lt;.05), independent of current SES, was associated with faster worsening MetS severity among Black relative to white women. The socioeconomic context of early rearing is an important factor for racial disparities in accelerated aging among these early midlife Black and white women.