bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEASURING BARRIERS TO LONG-TERM CARE RESIDENT PREFERENCES: DEVELOPMENT AND CONTENT VALIDITY TESTING
Authors: Block Laura , Greenhalgh Ella , Roberts Tonya 
Published: December 2022

Abstract
Person-centered care (PCC), or delivery of care consistent with preferences, can improve outcomes for residents in long-term care (LTC). However, PCC has not been universally adopted. Few studies focus on measuring specific barriers to meeting resident preferences, hindering identification of actionable targets to improve PCC delivery. The purpose of this study was to develop and test the content validity of a survey that measures staff barriers to fulfilling resident preferences for daily care and activities. Item sets comprised of barriers and preferences were informed by a review of literature and a descriptive, qualitative study with 19 LTC staff. An expert panel (n=8) was convened to test content validity, and content validity indices (CVI) were calculated. The initial survey consisted of 12 item sets assessing whether knowledge gaps, resident characteristics (e.g. health needs), family, facility rules/policies, availability of options, or staffing/workload functioned as barriers to meeting resident preferences for daily care and activities (CVI = 0.76 barriers; CVI = 0.89 preferences). Revisions informed by expert feedback resulted in a total of 17 items sets. Second round testing with experts (n=10) revealed overall improved item sets (CVI = 0.77 barriers; CVI = 0.96 preferences). These findings indicate that the survey items have initial content validity in measuring staff barriers to meeting resident daily care and activity preferences. Further psychometric testing with LTC staff is needed prior to implementing the survey, which will represent the first tool of its kind for supporting measurement of staff-derived targets for PCC interventions and policy change.
AFFORDABILITY, PERCEIVED RACISM, AND HEALTHCARE SYSTEM DISTRUST AMONG AFRICAN AMERICAN WOMEN AGED 45 AND OVER
Authors: Wiltshire Jacqueline , Sampson Carla , Elder Keith , Musey Paul 
Published: December 2022

Abstract
Unaffordable healthcare costs—a major concern for Americans--disproportionately affect African Americans (AA), who are more likely to distrust the healthcare system due to past mistreatment and discrimination. However, the relationships between affordability, mistreatment, discrimination, and healthcare system distrust are unclear. Using cross-sectional survey data from a community-based sample of 313 African American women aged 45 and over, we assessed the relationships between the ability to get needed care due to costs, negative healthcare experiences, perceived racism, and healthcare system distrust. Linear regression and mediation analyses were conducted to assess relationships. Approximately 23% of women reported the inability to get needed care because of costs, and 44% had a negative experience with a healthcare provider. Healthcare system distrust was higher among women unable to get healthcare because of costs (β = 2.66; p = 0.005) or had a negative experience with a healthcare provider (β = 3.02; p &lt; 0.001). However, perceived racism in the healthcare system, a significant predictor of distrust (β = 0.81; p &lt; 0.001), attenuated the relationships between inability to get health care because of costs (β = 1.74; p = 0.051) and negative experience with a healthcare provider (β = 1.79; p = 0.013). Perceived racism explains 34% and 46%, respectively, of the relationships between affordability, negative experience with healthcare provider, and healthcare system distrust. These findings are important given the relevance of building trust and understanding needs to address health inequities. Future research should explore whether these findings hold for AA men and other minoritized groups.
NEITHER HERE NOR THERE, YOU BECOME A STRANGER FOR BOTH SIDES: SUCCESSFUL AGING IN CHINESE AMERICAN OLDER ADULTS
Authors: Khan Mushira , Li Chien-Ching , Kang Ezer 
Published: December 2022

Abstract
Previous studies have critiqued the inordinate emphasis on high physical and cognitive functioning and a relative absence of cultural factors in our understanding of the aging process. The multi-year Perceptions of Aging Well in Diverse Populations study explores (1) the meanings attached to aging well across cultures and (2) similarities and differences in these perceptions within diverse racial and/or ethnic groups. This presentation highlights findings from in-depth, semi-structured qualitative interviews with Chinese Americans 50 years and older (n=25; 10 male, 15 female; mean age 58.3 years). Thematic analysis of the data showed that generation status, age at arrival, density of social networks, and level of acculturation were key determinants of successful aging. Specifically, those who were born in the United States or had immigrated at an early age appeared to value their independence and were actively making retirement plans. Late-life immigrants were often lonely and more dependent on their adult children. Financial security and healthcare access were important considerations for mid-life immigrants. Several participants felt like an ‘outsider’ in the US but also felt like they were regarded as ‘foreigners’ in their country of origin, resulting in feelings of ambivalence and alienation. Many participants, particularly women, reported feeling less safe in their neighborhoods given the increasing prevalence of violence against Asian Americans in recent years and some were even contemplating moving to another country post-retirement. These findings provide insights into how aging is experienced among Chinese Americans and may help inform initiatives to support successful aging in this population sub-group.
ACTIVITY GOAL SETTING ON CHRONIC LOWER BACK PAIN FOR OLDER VETERANS RECEIVING CHIROPRACTIC CARE
Authors: Rogers Casey , Hackney Madeleine , Zubkoff Lisa , Echt Katharina 
Published: December 2022

Abstract
There is currently no literature addressing the impact that chiropractic services have on older adults achieving individualized specific goals throughout a course of care for chronic low back pain. This study aims to explore the impact of setting a self-determined, “what matters most” activity/goal of rehabilitation care with relevant activities as part of standard chiropractic care on the self-rated pain and disability of older Veterans. Participants were randomized into two groups. The first, an experimental group where participants identified a goal and received standard chiropractic care. The second, a control group that received standard chiropractic care only. Participants underwent six sessions of care. Outcome assessment tools were utilized at pre- and post-treatment for both groups as primary measures and an individualized goal setting measurement tool was utilized for those randomized to the experimental group. After treatment, all participants had self-reported improvement in their condition and all participants assigned to a “goal setting group” achieved their desired goal. Despite some outcome measures remaining unchanged, this self-reported improvement may be important in the future of chiropractic services for the older Veteran population suffering with chronic low back pain in achieving self-determined goals of importance.
THE RELATION BETWEEN PROVIDER RESPONSES AND PATIENT AND CARE PARTNER SELF-EFFICACY IN PALLIATIVE CARE APPOINTMENTS
Authors: Silverstein Hannah , McDarby Meghan , Carpenter Brian 
Published: December 2022

Abstract
Person-centered palliative care (PC) fosters patient and care partner participation during medical appointments. The current study used Bandura’s Social Cognitive Theory to examine whether the manner in which healthcare providers respond to patient and care partner questions during initial PC appointments is associated with their self-efficacy in question asking. We analyzed provider responses to direct and embedded questions during initial outpatient PC appointments at a large academic medical center. Provider responses were coded in terms of timeliness (number of dialogue exchanges between a question and a response) and completeness (how fully providers answered questions). Provider responses to direct questions were more timely (M = 1.91, SD = 3.55) compared to responses to embedded questions (M = 4.05, SD = 6.13), t(127) = -3.55, p &lt; 0.001, whereas completeness was similar for both direct (M = 1.43, SD = 0.71) and embedded questions (M = 1.59, SD = 0.96), t(127) = -1.59, p = 0.114. On average, receiving more timely responses was not significantly correlated with self-efficacy, r(49) = -0.038, p = 0.791, nor was receiving more complete responses ρ(49) = -0.178, p = 0.211. These findings suggest that timeliness and completeness of responses may not be factors that affect self-efficacy, thus future research should continue to explore other factors, such as empathy present in provider responses. These findings also suggest that future research should investigate the role and effectiveness of embedded questions as an information-seeking behavior in patients and care partners given that providers took longer to respond to them.
MUSCLE GROUP SPECIFIC SKELETAL MUSCLE AGING: A FIVE YEAR LONGITUDINAL STUDY IN SEPTUAGENARIANS
Authors: Naruse Masatoshi , Fountain William , Claiborne Alex , Finch Holmes , Trappe Scott , Trappe Todd 
Published: December 2022

Abstract
Most of the scientific literature on human skeletal muscle aging has focused on the quadriceps femoris, with the remaining few hundred skeletal muscles receiving limited specific investigation. This longitudinal investigation compared changes in skeletal muscle size via computed tomography of the quadriceps (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius), hamstrings (biceps femoris short and long heads, semitendinosus, semimembranosus), psoas, rectus abdominis, lateral abdominals (obliques and transversus abdominus), and paraspinal muscles (erector spinae and multifidi) of older individuals from the Health ABC study at baseline and 5.0±0.1 years later (n=469, 73±3y & 78±3y, 49% women, 33% black). Skeletal muscle size decreased (p &lt; 0.05) in quadriceps (-3.3%), hamstrings (-5.9%), psoas (-0.4%), and rectus abdominus (-7.0%). The hamstrings and rectus abdominus atrophied approximately twice as much as the quadriceps (p &lt; 0.05), while the quadriceps atrophied substantially more than the psoas (p &lt; 0.05). The paraspinals (+4.3%) and lateral abdominals (+5.9%) hypertrophied (p &lt; 0.05) to a similar degree (p&gt;0.05) over the 5 years. These data suggest that skeletal muscle mass in older individuals changes in a muscle group specific fashion in the eighth decade, a critical time period in the aging process. A broader understanding of muscle group specific skeletal muscle aging is needed to better guide exercise programs and other interventions that mitigate decrements in physical function with aging.
EVALUATING AGE-FRIENDLY COMMUNITY INITIATIVES FROM A SOCIAL NETWORK PERSPECTIVE
Authors: Greenfield Emily , Pestine-Stevens Althea 
Published: December 2022

Abstract
Age-friendly community initiatives (AFCIs) as community interventions systematically cultivate inter-organizational partnerships toward making policies, systems, and environments more supportive of healthy aging, aging in community, and aging equity. Building from a multi-year, university-community partnership to spur the development of AFCIs in New Jersey, we drew on social network theory and research methods to examine the networks of AFCI core teams and their key partners across diverse community settings. Data collection involved administering questionnaires to both AFC core teams and their key organizational partners. We report on the presence and strengths of dyadic relationships that comprise the networks, analyzed by sector, organizational function, and geographic service area of each network node. We discuss implications of the findings concerning policies and practices around sustainability planning for AFCIs as well as future directions for using network theory to understand AFC progress at various levels of geographic scope.
PARKINSON’S DISEASE AND STIGMA: A MULTIPLE CASE STUDY
Authors: Mastel-Smith Beth , Hermanns Melinda 
Published: December 2022

Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder caused by dopamine deficiency. PD affects emotional and physical health and causes people with PD and caregivers to experience stigma. Four types of stigma have been described: public, associated, self-, and structural. The aims of this study were to explore (a) how stigma is experienced by people with PD and caregivers, (b) whether stigma towards people with PD and caregivers is represented in the literature and social media and (c) examine whether findings support Stigma Theory and theoretical propositions. This was a multi-case qualitative study. Cases included a literature review, interviews with people with PD and caregivers, and examination of social media posts. A purposive sample included seven people with PD and five caregivers who were interviewed online using an interview guide. The study was approved by the University IRB and participants signed consent. Thematic analysis identified codes which aligned with conceptual definitions of Stigma Theory. Findings revealed that public stigma was presented in all four cases. Self- and structural stigma were represented in the literature and interviews with people with PD and caregivers. Associated stigma appeared in the literature and from caregivers’ descriptions. Three of six theoretical propositions were supported. Four types of stigma toward people with PD were prevalent and interrelationships between types of stigma noted. A multi-pronged approach to reducing stigma is needed at the individual, organizational and community levels. Research regarding stigma experienced by diverse populations and the health effects of stigma for people with PD is recommended.
CONTEMPLATING TEMPORAL LANDMARKS, SENSING TIME, AND PURSUING A MEANINGFUL LIFE IN ADULTHOOD
Authors: Kim DaEun , Liao Hsiao-Wen 
Published: December 2022

Abstract
Research has shown that experiencing and anticipating temporal landmarks affect one’s goal priorities and motivation. Particularly, milestone birthdays (MBD) remind people of where they stand in life timeline, prompting time experience that has consequences for pursuit of meaning. The current study examines this thesis in the context of adult development and aging. We tested whether (1) thinking about past and future MBDs (vs. a regular birthday) affects young, middle-aged, and older adults’ possession of and search for meaning in life and (2) sense of time, and (3) the association between contemplating MBDs and meaning in life is, at least in part, explained by sense of time. Participants (N = 239) were randomly assigned to one of the three conditions to verbally visualize a past MBD, a future MBD, or an upcoming regular birthday. They then completed a meaning in life questionnaire, which assessed presence of and search for meaning (Steger et al., 2016). Future time perspective (Lang & Carstensen, 1996) and time savoring (Carstensen et al. in prep) were also measured. We found that thinking about past and future MBDs (vs. regular birthdays) prompted people to search for meaning. Thinking about past MBDs (vs. regular birthdays) also elicited a sense that time left in life is limited. Mediation analysis indicated that perceived future time constraints helped explain the relation of recalling past MBDs to search for meaning. Results held when age effects were considered. We draw on motivation theories of temporal landmarks and socioemotional selectivity to discuss the findings.
CARING FOR CHILDREN WITH DISABILITIES, WORKING, AND SAVING FOR RETIREMENT OVER THE LIFE COURSE
Authors: Porterfield Shirley , Kwon Eunsun 
Published: December 2022

Abstract
In the US, financial security in retirement depends on having savings and other assets accumulated during the pre-retirement years. Pension savings accrue over the working life, in defined-benefit or defined-contribution retirement plans. Mothers with children with disabilities experience different life-course work trajectories than mothers without children with disabilities, though data used in previous studies primarily examine a single point in time or a short span of years. This paper draws longitudinal data from the nationally-representative 1979 National Longitudinal Survey of Youth for the years 1987 through 2018, using a life-course perspective and sequence analysis to identify long-term work patterns among women with children who do and do not have disabilities with an explicit focus on variations in occupational class and employment status. We found a distinctive pattern of long-term work history with five types: Full-time semi-professional to not working, Constantly not working, Semi-professional full time, Professional full time, and Not working to full time work. Results from regression analyses revealed variation in mothers’ household financial preparation for retirement at late mid-adulthood. Compared with mothers who held professional full-time jobs throughout their adulthood, mothers who started full time jobs in middle age and have children with disabilities were less likely to have pension plans. Mothers of children with disabilities who left the labor force in early middle age tended to have lower retirement savings. Policy interventions to address these mothers’ caregiving ability to stay engaged in the workforce and prepare for their retirement need to be explored.
THE RISE OF LONELINESS: TRENDS AMONG A LARGE MEDICARE ADVANTAGE COHORT OVER THE COVID-19 PANDEMIC
Authors: McNamara Kelsey , Rudy Ellen 
Published: December 2022

Abstract
Loneliness is an established risk factor for premature mortality, especially among older adults. National trends are indicating an increase in loneliness after the COVID-19 pandemic. We sought to explore annual trends in loneliness and quality of life among a large dataset of Medicare Advantage (MA) members. Papa Inc. is a national service that pairs older adults with “Papa Pals” who provide companionship and assistance with everyday tasks. Participants have free access if their health plan offers it. Analysis included members from MA plans that were active with Papa January 2020 through March 2022. Members (n=11,037) were assessed at enrollment screening (UCLA Three-Item Loneliness Scale, CDC’s Healthy Days Measure). Analysis used Chi-square tests, significance set at p &lt; 0.05. Among the sample, 81% were aged 65+, 14% were from a majority non-white community. Analysis revealed the following trends in annual prevalence rates (2020; 2021; 2022): lonely (43.2%; 39.3%; 40.9%), severely lonely (9.2%; 12.1%; 15.1%), 14+ physically unhealthy days (24.3%; 19.9%; 39.3%). In regression analysis, loneliness score increased by 0.05 (95CI: 0.02 - 0.07) per quarter over the 27 months. Our data mimics other sources highlighting a slow and steady increase in loneliness suggesting older adults’ hesitancy to engage in “normal activities.” Changes in unhealthy days follow COVID-19 trends with a significant increase during the height of the Omicron variant. The prolonged effects of isolation and loneliness are profound, thus greater emphasis should be placed on population level interventions, especially those connected to the healthcare system, to help address loneliness.
LONELINESS AMONG OLDER IMMIGRANTS LIVING IN SUBSIDIZED SENIOR HOUSING: DOES PERCEIVED SOCIAL COHESION MATTER?
Authors: Baek Jihye , Kim BoRin , Park Sojung , Ryu Byeongju 
Published: December 2022

Abstract
The study compared the level of loneliness among older immigrants living in subsidized senior housing to non-immigrant residents. Also, the role of perceived social cohesion on loneliness was investigated, focusing on the differential influence among older immigrants and non-immigrants. Residents of subsidized senior housing in St. Louis and the Chicago area were recruited, and 182 responses were used in the analysis (126 immigrants and 56 non-immigrants). Descriptive analysis examined the difference in loneliness between immigrants and non-immigrants. Also, multiple regression models estimated the association between 1) immigrant status and loneliness, 2) perceived social cohesion and loneliness, and 3) the moderating role of immigrant status. Linear regression model showed that there was no significant difference between loneliness levels between immigrants and non-immigrants. However, perceived social cohesion was negatively associated with loneliness (β=-.338, SE= .025, p &lt; .001). Additionally, immigration status moderated the relationship between perceived social cohesion and loneliness (β=-1.143, SE= .052, p &lt; .01), which implies that immigrants may benefit more from higher perceived social cohesion in terms of loneliness compared to their non-immigrant counterparts. High perceived social cohesion might be an important community-level protective factor against loneliness in old age, especially for low-income older adults living in subsidized senior housing. Creating socially cohesive environments, particularly for this subgroup, would be crucial for mitigating loneliness and facilitating aging-in-place.
COMPANION CARE ASSOCIATED WITH REDUCTION IN ADMISSIONS AND EMERGENCY DEPARTMENT USE AMONG OLDER ADULTS
Authors: McNamara Kelsey , Rudy Ellen , Armao Anne , Towsley Kerri , Lang Samantha , Perissinotto Carla 
Published: December 2022

Abstract
Older adults with unmet social needs, including social isolation and loneliness, have higher rates of hospital readmission and emergency department (ED) use. Our objective was to determine if Papa Inc., a nationwide service that pairs older adults with “Papa Pals” for companionship and assistance, was associated with reductions in readmissions and ED visits. SummaCare, a Medicare Advantage Organization in Ohio, partnered with Papa to offer free companion care to their members. We explored changes in inpatient admission rates and ED high-utilizers (defined as members with 4+ ED visits in a calendar year) from 2018 through 2021 using a claims-based analysis. Analysis included members who used 30+ minutes of Papa services in 2021 and had historical claims data from 2019 (n=1,420), matched 1:1 to a non-Papa comparison group (n=1,420) using a validated risk scoring model. Overall, average age was 78, 62% were female, 2% were ED high-utilizers in 2021. Increased enrollment in Papa occurred post hospitalization. The case-mix adjusted 30-day readmission rate in 2021 was 12.6% for Papa users (compared to 14.1% for non-Papa; and 14.5% for Papa users before enrollment), revealing a 1.5% to 2% decline in readmission rate after enrollment in Papa. Using case-mix adjusted relativities, Papa members had 0.89 readmissions for every 1.00 readmission for non-Papa users. Compared to the matched cohort, the Papa cohort had 34% fewer ED high-utilizers during the intervention year. Results provide preliminary evidence that a social companionship service may reduce readmissions and frequent ED use, and can inform future trials on companion-based interventions.