bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECT OF COMMUNITY HEALTHCHOICES ON PARTICIPANT SATISFACTION WITH HOME AND COMMUNITY-BASED SERVICES
Authors: Bear Todd 
Published: December 2022

Abstract
A stratified random sample of participants was interviewed in each region of Pennsylvania during each phase of the implementation using the Consumer Assessment of Health Providers Survey – Home and Community Based Services (CAHPS-HCBS) version. In addition, comparison groups were interviewed from the third implementation region. These data were combined with surveys conducted by the three Community HealthChoices managed care organizations (MCOs). Data were weighted to create geographically representative estimates of participant experience across a range of composite measures. We found that participant ratings of their personal care attendants declined on three out of four measures, however measures of medical and non-medical transportation improved as a result of the implementation of Community HealthChoices. There were notable differences between people of different racial and ethnic groups, with non-Hispanic whites consistently reporting lower levels of satisfaction with person care.
EMERITUS PROFESSORS' PERCEPTIONS: QUALITATIVE RESEARCH EXPLORING AGE-FRIENDLY UNIVERSITY PRINCIPLES
Authors: Melillo Karen Devereaux , Gautam Ramraj , Sritan Sarawut , Khumrungsee Montri 
Published: December 2022

Abstract
In 2020, the UML AFU campus launched the AFU Inventory and Climate Surveys (in partnership with UMass Boston). The results identified a need for campus improvement related to “involving retired faculty in University activities’ (Principle 9) and “promoting intergenerational learning to facilitate the reciprocal sharing of expertise between learners of all ages” (Principle 4). An IRB-approved follow-up survey invited respondents to participate in one-hour virtual qualitative interviews to explore the research question: What are the perceptions of Emeritus Professors regarding AFU Principles 4 and 9? Emeritus Professor interviews (n=19) were held in 2021. Four researchers completed the content analyses, which revealed six major themes: promoting intergenerational learning activities; considering emeritus group; being proactive; supporting continued UML relationships; meaning of emeritus and preferred engagement; actual and perceived benefits. The findings will be discussed as to how AFU principles can benefit both Emeritus Professors and students through understanding of this untapped resource.
AGE-FRIENDLY LOWELL: INTERGENERATIONAL CONNECTION THROUGH EXPERIENTIAL LEARNING OPPORTUNITIES
Authors: Townsend Michelly , Cornell David , Hostetler Andrew , Toof Robin , Melillo Karen Devereaux , Noel Sabrina 
Published: December 2022

Abstract
The rapid growth of the aging demographic requires students entering the workforce to be adept at engaging with older adults in a professional capacity. The Age Friendly Community (AFC) and Age Friendly University (AFU) initiatives present an opportunity for researchers and students to work alongside older residents to improve Age Friendly practices, policies, and infrastructure in their local communities. Age Friendly Lowell developed an Action Group (AG) of 25 Lowell residents aged 50y+, who provide feedback and guidance for 12 graduate students, as they develop measurement tools for a comprehensive community assessment. Students work with AG members to identify, pilot test, and adapt evaluation tools and learn innovative strategies for recruitment. This experiential learning structure is mutually beneficial, as residents lend their expertise, while students learn to echo those concerns throughout their work. This structure serves as a unique and effective model for other communities pursuing AFC and AFU designations.
INNOVATIVE APPROACHES TO EVALUATING THE LIFESPAN ASSOCIATIONS OF STRESS, HEALTH, AND WELL-BEING
Authors: Lee Lewina 
Published: December 2022

Abstract
Despite widespread agreement on the importance of stress in health and aging, the mechanisms by which psychosocial stressors influence emotional and physical health are not fully understood. Thorough operationalization of stressor exposure and stress response can contribute to a “common language of stress” (Epel et al., 2018) across disciplines, and a lifespan approach can inform the developmental timing of stress-health mechanisms. Guided by these considerations, this symposium presents five studies led by early-career researchers to delineate stress-health associations across the lifespan. Dr. Olivia Atherton will leverage father-offspring data over 25+ years to examine domains of early life stressors that are susceptible to intergenerational transmission and modifiers of such transmission. Drawing from daily diary bursts embedded within a longitudinal study, Dr. Emily Willroth will report on the role of affective reactivity to daily stressors as potential mediators of the association between childhood psychosocial stressors and all-cause mortality risk. Dr. Meaghan Barlow will present on a novel emotion construct – emotion globalizing – by considering the extent to which emotional response to daily stressors influences global assessment of well-being and age differences in these processes. Dr. Soomi Lee will consider job characteristics linked to 10-year stability and change in sleep health profiles in a national adult sample. Dr. Victoria Marino will illustrate a novel approach to assess the flexibility with which individuals select strategies for coping with stressors and describe its association with mortality. Altogether, this symposium contributes evidence on how psychosocial stressors may shape health and well-being across the lifespan.
TO WHAT EXTENT IS THERE INTERGENERATIONAL CONTINUITY IN EARLY-LIFE STRESSORS?
Authors: Atherton Olivia , Graham Eileen , Spiro Avron , Schulz Marc , Waldinger Robert , Mroczek Daniel , Lee Lewina 
Published: December 2022

Abstract
Prior work has investigated the correlates and consequences of early life stress within a person’s lifetime, but less is known about whether early life stressors are sustained across generations. Using multi-generational data from 1,312 offspring and their fathers (N = 518 families), we examined the extent to which there is intergenerational continuity in childhood social class, childhood home atmosphere, parent-child relationship quality, and childhood health, as well as whether person-level and family-level factors strengthen (or weaken) intergenerational continuity. Results suggest notable intergenerational continuity in childhood social class, but no continuity in childhood home atmosphere, parent-child relationship quality, or childhood health. Moreover, the intergenerational continuity of early life stressors was modified by father education level and education mobility, such that low education level conferred risks, and upward education mobility conferred benefits, for offspring adverse experiences. We discuss broader implications of the findings for future research, clinical interventions, and social policy.
EARLY-LIFE STRESSORS, ADULT AFFECTIVE REACTIVITY TO DAILY STRESSORS, AND MORTALITY RISK
Authors: Willroth Emily , Luo Jing , Graham Eileen , Antic Mina , Lopes Maria , Spiro Avron , Mroczek Daniel , Lee Lewina 
Published: December 2022

Abstract
Exposure to stressors in childhood is theorized to sensitize individuals to stressors experienced later in life. One way that stress sensitization might manifest is through greater affective reactivity to daily stressors. In turn, greater affective reactivity to daily stressors has been associated with poorer health and increased mortality risk. The present pre-registered investigation tested greater affective reactivity to daily stressors in later life as a potential mediator of the association between early life stressors and mortality risk in a sample of 144 men from the VA Normative Aging Study. Partially consistent with our hypotheses, greater early life psychosocial stressors were associated with greater positive (but not negative) affective reactivity to daily stressors in later life. However, neither early life psychosocial stressors nor affective reactivity to daily stressors were significant predictors of mortality risk. We will discuss implications of these findings for theories of stress experience across the lifespan.
COPING VARIABILITY AND ITS ASSOCIATION WITH ALL-CAUSE MORTALITY
Authors: Marino Victoria , Spiro Avron , Lee Lewina 
Published: December 2022

Abstract
Coping strategies – cognitive, behavioral, and emotional tactics used to manage stressors – are associated with morbidity and mortality. Between-strategy coping variability, defined as (un)evenness in usage across coping strategies, may reflect context-specific coping and account for additional variance in health outcomes beyond mean strategy use. This study examined prospective associations of mean coping strategy use and between-strategy coping variability with time to death in 823 men from the Normative Aging Study. In Cox proportional hazard models, 1-SD higher in mean usage of positive action, negative action, prayer, withdrawal, and substance use strategies was associated with 17-32% greater risk of all-cause mortality over 27 years, after adjusting for baseline demographics, health status, and depression. Contrary to prior research, mortality risk did not differ by coping variability. We will consider findings within the stress and coping framework and discuss implications for biobehavioral pathways linking coping to all-cause mortality.
M. POWELL LAWTON AWARD PRESENTATION AND LECTURE
Authors: Washington Tiffany 
Published: December 2022

Abstract
The M. Powell Lawton Award Lecture will feature an address by the 2021 recipient David L. Roth, PhD, FGSA, of Johns Hopkins University. This session will also include the presentation of the 2022 M. Powell Lawton Award to recipient Jon Pynoos, PhD, FGSA, FAGHE, of the University of Southern California. The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care. The Lawton Award is generously funded by the Polisher Research Institute of Abramson Senior Care.
ASSESSING CANCER SCREENING DISPARITIES USING SECONDARY SURVEYS: CHALLENGES AND OPPORTUNITIES
Authors: Zanwar Preeti 
Published: December 2022

Abstract
According to the WHO, cervical cancer is the fourth common cancer in women, with 90% each of the 604,000 new cases and 342,000 deaths in 2020 occurring in low-and middle-income countries. Cervical cancer can be cured if diagnosed early and treated promptly. Cervical cancer screenings by Pap-tests are evidence-based secondary prevention which are important in diagnosis and for receiving timely treatment for pre-cancerous lesions. I will present intersectional disparities in compliance with the U.S. Preventive Services Task Force guidelines for Pap testing in age-eligible women with disabilities by race/ethnicity using nationally representative Medical Expenditure Panel Survey. I find overall the proportion of women current with Pap testing is significantly lower among women with versus without disability. Additionally, I will provide example of other survey data such as the Behavioral Risk Factor Surveillance System that can be used for cancer screening and prevention and opportunities and challenges for using survey data.
THE ROLE OF A MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE DIAGNOSIS IN HEALTHCARE UTILIZATION
Authors: Castaneda-Avila Maira , Lapane Kate , Epstein Mara 
Published: December 2022

Abstract
Monoclonal Gammopathy of Undetermined Significance (MGUS) is an understudied precursor of multiple myeloma (MM), the second most prevalent hematologic malignancy in the US. MGUS is incidentally diagnosed, and its significance is unclear as only 1% per year transition to MM. MGUS is highly prevalent among adults aged ≥ 50 years. In this presentation, we will review mixed-method approaches. Using healthcare claims and electronic health records from patients in central Massachusetts, we applied group-based trajectory modeling and conditional Poisson regression. These analyses were complemented by a qualitative analysis of in-depth interviews with providers and MGUS patients. Together, these methodologies provided a comprehensive evaluation of the impact of MGUS on healthcare utilization in older adults. The qualitative analysis provided a better understanding of the patient and provider factors influencing healthcare utilization after an MGUS diagnosis. The presentation will highlight how the use of these methodologies provide different perspectives among understudied premalignant conditions.
NARROWING THE DISPARITIES GAP IN LTSS: POLICY AND PRACTICE
Authors: Choula Rita 
Published: December 2022

Abstract
Access to and the quality of long-term supports and services (LTSS) are not equitable for all older Americans. Disparities have been documented qualitatively and quantitatively for marginalized racial and ethnic communities and LGBTQI+ communities but the specific causes of gaps in equity differ by community, locality, and state. To be effective, policy solutions must be grounded in the lived experiences of Black, Latino, Asian American and Pacific Islander, and LGBTQI+ older adults in those communities. This symposium showcases how community-based research can be employed to understand the root causes of inequities in LTSS access and care affecting older adults of color and LTGBTQI+-identifying older adults and presents community-grounded policy solutions to remedy those inequities. Papers 1 and 2 use participatory research methods to understand barriers to equitable LTSS care access and quality and develop locally grounded solutions to those barriers. Caldera (Paper 1) shares results from a study of Cook County, IL nursing home residents and their caregivers focused on racial and ethnic disparities in access to and experiences with nursing home care. Hado (Paper 2) presents findings from research in Georgia and New York examining disparities in access to and experiences with HCBS for older racial and ethnic and LGBTQI+ communities. Fashaw-Walters (Paper 3) discusses the how systemic racism is at the root of inequities in LTSS access for communities of color and shares actionable recommendations aimed at ending racial and ethnic inequities in LTSS policies.
NARROWING RACIAL AND ETHNIC DISPARITIES IN HOME AND COMMUNITY-BASED SERVICES
Authors: Hado Edem 
Published: December 2022

Abstract
Older adults overwhelmingly prefer to age at home and in their community, yet research shows uneven access to quality home and community-based services (HCBS), especially among diverse racial and ethnic groups. Our research in Georgia and New York employs participatory research methods, including key informant interviews and focus groups conducted in 2021 and 2022, to identify root causes of disparities in access to, quality of, and experience with HCBS for older racial and ethnic and LGBTQI+ communities. Some root causes identified include: complexity in and lack of funding, tension between equal versus equitable service provision, and meaningful community outreach, particularly in Latino communities. We then identify scalable opportunities policy and programmatic interventions to improve care and service equity for older adults in those communities.
ADDRESSING SYSTEMIC RACISM ACROSS LONG-TERM SERVICES AND SUPPORTS
Authors: Fashaw-Walters Shekinah , Shippee Tetyana , Travers Jasmine 
Published: December 2022

Abstract
Long-term services and supports (LTSS) are some of the most racially segregated healthcare services in the U.S. today. Marginalized users (e.g., Black and Latino older adults) have disproportionate access to high-quality care and subsequently report poorer health outcomes when compared to White users. It is important to acknowledge racism as a fundamental cause of these inequities to LTSS access. As the U.S. works to expand LTSS, it is critical to diversify and strengthen the LTSS workforce, increase Medicaid reimbursements along with efforts to improve accountability and transparency, reconsider payment models and the use of public reporting, improve quality metrics, implement effective support systems for patients of color, expand access to care, and increase promotion of integrated care. Health equity researchers, Drs. Tetyana Shippee, Shekina Fashaw-Walters, and Jasmine Travers will share 7 actionable evidence-based recommendations for LTSS policy change aimed to dismantle racism and advance health equity.
RE-EXAMINING PATIENT-CENTERED CARE THROUGH DESIGN PROCESS
Authors: Mulhorn Kristine , Yoshinaga Shushi 
Published: December 2022

Abstract
Service design is the adoption of design process to healthcare and other service sectors. This was a transdisciplinary research project in which investigators were faculty members from Graphic Design and Health Administration. In addition, two student research assistants were recruited from undergraduate Graphic Design and Health Science majors. The objective of service design is to involve consumers, designers, and businesspeople in an integrative process, which can be applied to post-acute rehabilitation hospital settings focusing specifically on the experience of those who are 65 and older. The aim of this pilot study was to explore “designing with people rather than just for them”, an approach to improve the patient experience. Our first step involved on-site interviews. The patient narratives raised challenges and positive aspects of their interactions with the facility. On our initial site visit, we interviewed five members of clinicians and administrative staff. During the two follow-up visits, our student research assistants interviewed seven patients. Based on our staff member interview findings, we developed a revised set of questions for patients. The questionnaire was divided into three sections related to appointments: pre-arrival, during the visit, and after their appointments. Interview results were summarized in a visual data format and collaborative recommendations were made during the final presentation such as interior layout, wayfinding, online portal and their functionalities. Our findings also confirmed that the interior signage created confusion, promoting frequent questions to staff. These results will engage stakeholders and contribute to a co-designing process that will ultimately improve the patient journey.
GAINS AND LOSSES OF OLDER ADULTS LIVING IN SUBSIDIZED HOUSING DURING THE COVID-19 PANDEMIC
Authors: Blinka Marcela , Grieb Suzanne , Runge Katherine , Andes Laura , Latkin Carl , Boyd Cynthia , Cudjoe Thomas 
Published: December 2022

Abstract
Social isolation is prevalent among community dwelling older adults. Low income older adults living in subsidized housing may have increased risk for social isolation. To examine resident experiences and perspectives relating to their social connections during the COVID-19 pandemic, we conducted semi-structured interviews with 13 older adults (62+) who are English, Spanish, and Mandarin speaking recruited from a large non-profit affordable housing organization with communities in 22 states. Twelve housing communities were identified based on distributions of socio-demographic factors and prevalence of self-reported social isolation l in the housing community’s annual survey of residents in order to maximize site diversity. We used qualitative thematic analysis methods to examined participants’ views about their social connections before and during the COVID-19 pandemic, as well as their personal and the housing community’s strategies to mitigate experiences of social isolation. Emerging themes include loss of common facilities and opportunities to socialize with other residents due to COVID-19 restrictions, and increased use of technology to stay connected.
METHODOLOGICAL AND ETHICAL ISSUES OF RESEARCH WITH OLDER ADULTS IN PUERTO RICO DURING COVID-19
Authors: Cho Sunghwan , Camacho David , Buckley Thomas , Vazquez Julia , Carrasquillo-Sánchez Kiara 
Published: December 2022

Abstract
Engaging diverse groups of older adults is essential to addressing health disparities. In this presentation, we will describe how we used our research team’s networks and knowledge of the target population to engage key stakeholders in our KAP project. We will address our partnerships with clergy, NGO staff and administrators, housing authorities, colleagues at Puerto Rican universities, and older adults who serve as informal community and institutional gatekeepers. We will discuss how these partnerships facilitated our ability to identify and access study sites and participants; conduct telephone and in-person interviews; ensure data quality through training and monitoring; and, assure safety through adherence to COVID-19 protocols. Finally, we will describe key cultural and ethical issues of conducting research with older adults through community partnerships during a pandemic. The presentation has implications for developing beneficial partnerships with local community leaders and enhancing the representation of diverse groups of older adults in research.
KNOWLEDGE, ATTITUDES, AND PRACTICES TOWARD COVID-19 AMONG OLDER ADULTS IN PUERTO RICO
Authors: Becker Todd , Buckley Thomas , Burnette Denise 
Published: December 2022

Abstract
To better understand the dynamics of their health behaviors during the pandemic, we examined older adults’ COVID-related knowledge, attitudes, and practices (KAP). KAP theory postulates that individuals acquire knowledge about a health condition which influences their attitudes and beliefs and that these, in turn, lead to health practices. We used hierarchical regression to examine the influence of knowledge and attitudes (Step 1) on practices, controlling for health and relevant covariates (Step 2). The Step 1 association between increased knowledge and better practices (B = 0.14, p = .046) became nonsignificant in Step 2. Greater worry about contracting COVID-19 remained significant throughout (Step 2: B = 0.15, p = .043). We further explored subgroup differences within KAP measures via bivariate analyses. For instance, women had significantly higher overall knowledge (p = .013), while men had significantly better overall attitudes (p = .044). We will discuss implications of such subgroup differences for practice and policy interventions.
THE HEALTH OF THE DIRECT CARE WORKFORCE: EVIDENCE AND IMPLICATIONS ACROSS LONG-TERM CARE
Authors: Scales Kezia , Scales Kezia 
Published: December 2022

Abstract
Direct care workers play a key role in supporting the health and wellbeing of older adults and people with disabilities across care settings—yet their own health risks are largely overlooked. The four papers in this symposium address this critical knowledge gap. First, McCall and colleagues will present a comparative analysis of the health status, health insurance coverage, and healthcare experiences of direct care workers across long-term care using National Health Interview Survey data. Next, Lee et al. will present the trends and characteristics of occupational injuries and illnesses among California’s long-term care workers from 2019 to 2020 using California Workers’ Compensation data, assessing the impact of COVID-19 on their occupational health. Sterling will characterize the physical and mental health of the direct care workforce before and during COVID-19 using data from the CDC's Behavioral Risk Factor Surveillance Survey, as well as drawing on qualitative and survey-based studies of unionized, agency-employed home care workers in New York. Sterling will also present findings from a pilot feasibility study of an intervention aimed at improving home care workers’ well-being. Finally, Quinn et al. will synthesize findings on home care workers’ occupational hazards—including needlesticks, musculoskeletal strain, violence and infections—and examine how preventing these risks can improve safety for both workers and clients. The discussant will draw out themes and implications from across these complementary studies, highlighting the importance of safeguarding direct care workers’ health as a key step toward improving care quality and outcomes for older adults and people with disabilities.