bluuebunny/crossref_metadata_2025_split huggingface dataset:
EHEALTH LITERACY AMONG OLDER ADULTS: THE ROLE OF DIGITAL LITERACY AND SELF-EFFICACY
Authors: Göbl Linda , Jokisch Mario R , Wahl Hans-Werner , Leopold David , Doh Michael 
Published: January 2025

Abstract
Particularly for older adults with an increased risk of multimorbidity, digital health technologies can provide added value for health management. Successful use of these technologies requires appropriate skills. Key constructs are eHealth literacy and internet self-efficacy, which become particularly relevant in older age. This study investigated the relationship between these two multifactorial constructs in older adults, with eHealth literacy as a dependent variable, focusing on the mediating effect of digital literacy, and task-specific eHealth self-efficacy (i.e., contacting doctors via video communication and online health information seeking). A cross-sectional dataset with 327 internet-savvy German adults (mean age=71.75±6.06; 41% female) was analyzed using a structural equation model. After controlling for age, sex and subjective health, general internet self-efficacy showed a positive direct association on eHealth self-efficacy (β=.45, p&lt; 0.01). General internet self-efficacy showed no indirect association on eHealth literacy, mediated by digital literacy, but a positive direct association on digital literacy (β=.72, p&lt; 0.001). Digital literacy (β=.30, p&lt; 0.05) was the strongest predictor of eHealth literacy. The model fit the data good (CFI=0.980; RMSEA=0.044) and explained 22.9% of the variance of eHealth literacy and 69.7% of the variance of digital literacy. These results point to the need for programs improving eHealth literacy to also focus on the use of digital devices and the promotion of general and task-specific internet self-efficacy. Implications for public health strategies will be discussed in order to improve eHealth literacy among older adults in a targeted manner and enable the successful use of digital health technologies.
INTERGENERATIONAL DIFFERENCES: HPV KNOWLEDGE AND PERCEIVED HEALTH STATUS AT A MIDWESTERN UNIVERSITY, 2016–2022
Authors: Nesser Whitney , Snyder Scott 
Published: January 2025

Abstract
Studies of Human Papillomavirus (HPV) knowledge and health status have been conducted with university students, but typically exclude faculty and staff. The study aim was to assess HPV knowledge and perceived health status among students, staff, and faculty at a Midwestern university. Three cross-sectional surveys were conducted at a Midwestern university in 2016, 2019, and 2022 assessing HPV knowledge and perceived health status. A total of 2678 student, staff, and faculty responses were received. Perceived health status was measured using a standard health status question. Knowledge of HPV was measured as total score on a 15-item true/false test. There were 145 respondents 61 years or older. A factorial ANOVA revealed that HPV knowledge was significant for age group (p &lt;.001) but not cohort or interaction. Respondents 61 and older performed better than those aged 18-21 but lower than groups between ages 27-45. Main effects for minority status and age group (p &lt;.001) were found but no interaction (p =.655). No cohort effect was found for perceived health status. Chi-square analyses showed perceived health status relates to age group (p &lt;.01) with significantly more individuals 61 and older rating their health status as excellent than expected (SD = 2.6). Perceived health status for this age group was independent of cohort (p =.22). These findings highlight the need to increase HPV education to individuals under age 27, further investigate health status perceptions in individuals 61 and older, and explore perceived health status in minority respondents.
RESIDENTS’ PERSPECTIVES ON PROGRAM IMPACT OF A GROUP-BASED MIND–BODY INTERVENTION IN CCRCS
Authors: Mitchell Calli , Psenka Riley , Anctil Reid , Scully Madeleine , Laird Barrett , Park Elyse , Traeger Lara 
Published: January 2025

Abstract
Older adults in continuing care retirement communities (CCRCs) may experience critical stressors related to biological and social aging. Few interventions have been established to assist residents with managing life stressors, daily functioning, and sense of community. We conducted an analysis of exit feedback from intervention participants in a randomized trial of group-based stress management skills training (SMART-Relaxation Response Resiliency Program [SMART-3RP]; 9 weekly sessions delivered by a community clinician) versus waitlist control for independent living residents at nine CCRCs across the United States (N=288; 8/2022-1/2023). SMART-3RP is an evidence-based mind-body resiliency program that integrates relaxation response training with cognitive-behavioral and positive psychology principles. Intervention participants (n=148) completed a post-intervention questionnaire including 3 categorical items and open-text fields to evaluate program helpfulness with managing life stressors, daily functioning, and sense of community. Responses were evaluated using descriptive statistics and qualitative content analysis. 131/148 (88.5%) intervention participants provided feedback (77% female, M age=81 years [range=66-93 years], 91.5% White non-Hispanic). Most endorsed that the program helped manage life stressors (82.4%) and daily functioning (77.9%); participants further identified benefits of learning or strengthening skills for practicing gratitude, relaxation, emotion regulation, mindful awareness, self-compassion, and cognitive restructuring. Over half (56.9%) felt the program enhanced sense of community; residents reflected the value of connecting with group leaders and/or other group members and increasing motivation to engage in other community social and physical activities. Findings support that community residents valued participation in a group-based intervention to enhance skills for managing life stressors, daily functioning, and social connection.
AGE DIFFERENCES IN THE TEMPORAL PATTERNS OF SELF-CONTINUITY AND TEMPORAL DISCOUNTING
Authors: Lu Yi , Loeckenhoff Corinna 
Published: January 2025

Abstract
Self-continuity, the perceived connectedness with past and future selves, varies across the life span. Previous research found that both past and future self-continuity are positively associated with age and that such effects are more pronounced for more distant time intervals (Rutt & Löckenhoff, 2016). Questions remain about the appropriate mathematical modeling of such patterns and potential associations between age differences in self-continuity and temporal discounting, the tendency to devalue future outcomes. In response, the present study assessed both past and future self-continuity as well as temporal discounting across four temporal distances (0.5, 1, 5, 10 years) in a U.S. adult life-span sample (N=461, aged 18–96, M = 51.38, SD =19.54, 52% female, 65% Non-Hispanic White). When compared to linear and exponential models, hyperbolic models provided the best fit for both self-continuity and temporal discounting. Subsequent analyses therefore focused on hyperbolic slope parameters (k) derived for each participant. Chronological age was negatively associated with k for both self-continuity and temporal discounting, indicating that, with age, the perceived connectedness with past/future selves and the perceived value of delayed rewards show fewer decrements with increasing temporal distance. However, although k parameters for past/future self-continuity were significantly associated with each other, they were not significantly associated with temporal discounting. Moreover, age differences in temporal discounting remained significant after controlling for age differences in past/future self-continuity. The present study extends our understanding of previously reported age differences in self-continuity and temporal discounting but suggests that they cannot be traced to the same underlying mechanism.
CHINESE–WHITE DIFFERENCES IN SOCIAL ACTIVITY, SOCIAL SUPPORT, AND MENTAL HEALTH AMONG OLDER ADULTS
Authors: Chen Lingming , Procter-Gray Elizabeth , Le Qun , LoPilato Danielle , Ferretto Marianella , Zhang Meng , Kane Kevin , Li Wenjun 
Published: January 2025

Abstract
Studies on healthy aging of older Asian Americans, especially Chinese Americans, are rare. This study evaluated Chinese – Non-Hispanic White differences in social activity, social support and mental health. The study enrolled 554 community-dwelling older adults (434 Non-Hispanic White and 120 Chinese) aged 65-95 years old in central and northeastern Massachusetts (2018-2023). Social activity and social support were measured by the Lifestyle Questionnaire. Mental health includes depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale, anxiety symptoms assessed by the Beck Anxiety Inventory, perceived stress assessed by the Perceived Stress Scale, and resilience assessed by the modified Brief Resilience Scale. Chinese - White differences in these factors were analyzed using linear regression models adjusting for age, gender, self-rated health, physical activity, body pain, and living alone. Results showed that in both unadjusted and adjusted models, older Chinese had less social support, lower frequency of social activities, and lower level of resilience compared to Non-Hispanic Whites. In the unadjusted models, older Chinese had higher levels of perceived stress, anxiety, and depressive symptoms compared to Non-Hispanic Whites, but there were not differences in these three factors after adjusting for covariables. In conclusion, social activity, social support, and mental health were different between Chinese and Non-Hispanic Whites among older adults in the study population. The findings from this study can inform the design and implementation of health programs tailored to specific groups, thereby reducing health disparities and improving overall well-being for older adults.
EXPLORING CENTRAL SYMPTOMS OF SUBTHRESHOLD DEPRESSION IN OLDER ADULTS: A NETWORK ANALYSIS
Authors: He Rendong , Chen Li , Qiu Yiming , Li Junxin 
Published: January 2025

Abstract
Subthreshold depression (StD), a precursor to major depressive disorder, has not been well studied in older adults. Identifying central symptoms among various symptoms within the mental disorders enhances understanding of mental disorder structures and informs prevention strategies. We investigated the central symptoms of StD in community-dwelling older adults in China in a cross-sectional study. Depressive symptoms were assessed by prime care physicians during older adults’ well visits using the Hamilton Depression Scale-17 (HAMD-17). Those with StD (7≤ HAMD-17&lt; 17) were included in the study (n = 424). We also collected data on demographics, depressive symptoms, anxiety symptoms, and cognitive function. The network model was constructed using the “least absolute shrinkage and selection operator” technique with the tuning parameters minimizing the extended Bayesian information criterion. Node centrality was assessed using Expected Influence (EI). Network stability was examined with a case-dropping subset bootstrap featuring a correlation stability coefficient (CS). The sample consisted of 53.5% females who, on average, were 69.69 ± 6.80 years and with a HAMD-17 score of 10.46 ± 3.21. Among the 17 symptoms, the two most central symptoms were “Loss of interest in work or activities” (EI = 0.51) and “Depressed Mood” (EI = 0.41). The correlation between these two symptoms is the strongest (Edge weight = 0.26) among all symptoms. The estimated network has a good stability (CS = 0.44). Our findings suggest that “Loss of interest in work or activities” and “Depressed Mood” are potential intervention targets for StD in older adults.
TRANSFORMING TELEHEALTH ACCESS: INTEGRATING BEHAVIORAL HEALTH AND TECHNOLOGY COACHING
Authors: Carbajal-Madrid Pedro , Holben Rachel 
Published: January 2025

Abstract
Research indicates only 21% of older adults in the U.S. utilize telehealth services, with economic, linguistic or literacy challenges exacerbating barriers to accessing quality health care. The Insights Program at SCAN / Independence at Home is a behavioral health program that provides individual and group therapy for people aged 55 and over and their caregivers. Serving over 2,400 individuals in 2023, the Insights program offers no cost services to those who otherwise may not be able to access mental health treatment, with a reduction in symtoms of depression and anxiety over 50%. During the Covid-19 pandemic, transitioning from in-person to telehealth sessions highlighted clients’ struggles with technology as they were expected to engage with online platforms without prior training. This led to older adults avoiding scheduling appointments or missing scheduled visits due to a lack of understanding of technology. To meet this unmet need, Independence at Home launched the T.E.C (Technology, Education and Coaching) program in 2021. This program pairs trained Digital Coaches with Insights’ clients, providing individualized support to help them use virtual platforms for online therapy sessions and access other health and social services. Early outcomes show the T.E.C program significantly increased digital literacy (1.13 vs 2.94, p&lt;.0001 [eHealth Literacy Scale]) and technology engagement (.44 vs.75, p=.0014 [Program’s Technology Engagement Survey]) based on pre (n=22) and post (n=22) testing. These findings demonstrate the program’s positive impact on the clients’ understanding and proficiency in utilizing technology and navigating electronic health platforms.
USING AN MBSR MOBILE APP FOR MENTAL HEALTH: EXPERIENCES OF OLDER ADULTS IN UNDERSERVED COMMUNITIES
Authors: de Rosa Cristina , Chang Yu-Ping 
Published: January 2025

Abstract
Older adults living in underserved and racial/ethnic minority communities during the COVID-19 pandemic and beyond faced challenges regarding access to mental health care, compounded by additional vulnerability to disease. Technological solutions such as mobile applications provide great opportunities to address mental health concerns. This qualitative, descriptive analysis explores experiences of participating in an interactive and culturally-tailored mindfulness-based stress reduction (MBSR) mobile application intervention for mental health among older adults from an underserved, primarily African American community. Individual semi-structured interviews were conducted with participants who completed an 8-week MBSR mobile app intervention. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s reflexive thematic analysis. A total of 17 participants were included in the analysis. Participants were ages 60-84 (M = 65.76, SD = 6.02); 94.1% were female; 82.4% reported their race/ethnicity as Black or African American. Four themes were identified in our preliminary analysis: app technology facilitated an openness to mindfulness and deconstructed barriers to access, enabled participants to come into a greater awareness of self and surroundings, allowed on-demand practices particularly during prime opportunities and stressful situations, and encouraged personal habits for maintaining and revisiting calm and relaxing states. Findings suggest feasibility and acceptability of a mobile app-delivered MBSR intervention addressing mental health needs for older adults, as well as satisfaction with app content, delivery, and support. Innovative technologies such as mobile apps have immense potential to bridge gaps in care and should be further evaluated for effectiveness and possible implementation to ameliorate mental health symptoms in underserved communities.
A PRELIMINARY EXAMINATION OF SOCIAL MEDIA USE AMONG HISPANIC/LATINX DEMENTIA CAREGIVERS
Authors: Chana Sofia Mildrum , Alvarez Loreli , Azuero Andres , Crowe Michael , Puga Frank 
Published: January 2025

Abstract
Hispanic/Latinx (H&L) family caregivers of people living with dementia (PLWD) experience elevated stress levels that can negatively affect their mental health. Caregivers are also prone to loneliness and social isolation and may rely on technology and social media to enhance social ties, seek support or cope with stressors. However, no studies to date have examined social media use patterns in this population. Thus, this analysis presents a preliminary description of social media use habits among H&L caregivers of PLWD (n=45) employing data from the ongoing national-level, NIA-funded study entitled, “Nuestros Días (Our Days).” We examined bivariate associations between social media use, distress from behavioral symptoms of dementia, perceived general stress, and depressive symptoms. Participants (93.3% female, Mage=55.69, SDage=8.75) reported using social media an average of 158.18 minutes (SD=131.44) per day, with Facebook (31.55%) and Instagram (27.8%) being the most used platforms. Average time spent using social media was positively associated with behavioral symptom distress (r=.37, p=.04) and depressive symptoms (r=.41, p=.02). Passive social media use (i.e., consumption of social media content without active engagement, such as ‘doomscrolling’) was positively correlated with behavioral symptom distress (r=.49, p&lt;.001) as well as perceived stress (r=.33, p=.03) and depressive symptoms (r=.36, p=.02). But active social media use (i.e., engagement with content and deliberate interaction with other users) was not significantly correlated with any mental health outcomes. Findings highlight the different contributions of active versus passive social media use to mental health outcomes, with passive use being more closely linked to worsened mental health.
EXAMINING CHANGES IN CAREGIVING NETWORKS BY RACE AND ETHNICITY BETWEEN 2015 AND 2022
Authors: Bragg Alexa , Fabius Chanee 
Published: January 2025

Abstract
The growing heterogeneity of the aging population in the United States exists alongside an increasing demand for family and unpaid caregivers, particularly for those living with disability in the community. Caregivers often “role-share,” whereby multiple caregivers assist with the same tasks. Given well-documented differences in caregiving networks by race and ethnicity, it is important to assess the evolution of these arrangements over time. Leveraging the National Health and Aging Study (NHATS), a nationally representative study of Medicare beneficiaries, we compare sociodemographic and caregiving network characteristics of community-dwelling Non-Hispanic Black, Hispanic, and Non-Hispanic White groups living with disability in 2015 (n=1851) and 2022 (n=1475). Role-sharing was examined across four domains: medical, household, mobility, and self-care. While few older adult characteristics changed, Black and Hispanic older adults consistently experienced disparities in income, Medicaid-enrollment, and probable dementia. Fewer children were identified as caregivers in 2022 than in 2015 among older Black and White adults; this proportion remained stable among Hispanic older adults. More “other family” members were identified as helpers across all groups. The greatest amount of role-sharing was observed in household tasks; roughly 30% of Black, White, and Hispanic older adults experienced role-sharing in these activities in 2015 and 2022. Race differences in role-sharing patterns were evident across both time points. For instance, Hispanic older adults experienced greater role-sharing with self-care tasks than Black and White older adults in both years. Findings demonstrate reliance on alternative support structures and better inform caregiver policies for those caring for diverse groups of older adults.
LIFE EXPECTANCY AND COVID-19 MORTALITY DISPARITIES AMONG NATIVE AMERICAN OLDER ADULTS IN WYOMING
Authors: Siebecker Megan , Boateng Josephine , Fleet Alexa , Jansen Taylor , Dugan Elizabeth 
Published: January 2025

Abstract
Accumulated inequities contribute to health disparities. Striking evidence of this is found in Native older adults in Wyoming. The history of violence and racism against Native peoples in the US is a national shame. Documenting the health challenges experienced by Native older adults brings awareness and potential remedy to this racist history. American Indian and Alaska Native communities are a historically under-researched population and are at greater risk than non-Hispanic white older adults for many chronic conditions. The current study reports on results from the Wyoming Healthy Aging Data Reports (healthyagingdatareports.org). We compared community rates of life expectancy and COVID-19 mortality in Wyoming and in Fremont County (home to the largest proportion of older Native adults in WY). Data sources include US Census Bureau American Community Survey 2016-2020 (population characteristics), Robert Wood Johnson Foundation (community life expectancy), and the Wyoming Department of Health (COVID-19 infection and mortality rates). Small area estimation techniques were used to calculate rates, and ArcGIS software was used for mapping and geographic analyses. Results show an estimated 2,430 Native American older adults who are 55+ are living in Wyoming, and 56% of them reside in Fremont County. Life expectancy rates in Fremont County (73) are 5 years lower than the state average (78.1). There is also a 1.5x higher COVID mortality rate in Fremont County (513.7) as opposed to the state average (340.4). Communities that have experienced systematic discrimination and inadequate health care services have poor outcomes. Policy interventions to address such inequities are warranted.
MULTIMORBIDITY AND ADL DISABILITY AMONG MEXICAN AMERICAN OLDER ADULTS: SEX DIFFERENCES
Authors: Silveyra Eduardo , Snih Soham Al 
Published: January 2025

Abstract
Medical advancements in the 20th century allowed the development of treatments for many diseases, increasing people’s average life expectancy. We examined sex differences in the relationship between multimorbidity and disability among Mexican American older adults ages ≥75 years who were non-disabled at baseline over 12-years of follow up. Participants (N=999) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005-2016). Measures included socio-demographics, body mass index, pain, falls, depressive symptoms, cognitive and physical function, handgrip strength, multimorbidity and limitations in activities of daily living (≥ 1 ADL’s). Participants were divided into four groups according to the number of chronic conditions (CC): 0-1, 2, 3, and ≥ 4). Generalized Estimating Equation model were used to estimate the odds ratio and 95% Confidence Interval of ADL disability over time as a function of multimorbidity and number of chronic conditions controlling for all covariates. We found that female participants reporting 3 CC had greater odds of ADL disability (OR=1.60, 95% CI=1.08-2.38) over time than those with 0-1 CC after controlling for all covariates. Female and male participants reporting ≥4 CC had greater odds of ADL disability (OR=2.13, 95% CI=1.44-3.16 and OR=1.46, 95% CI=0.94-2.27, respectively) over time than those with 0-1 CC after controlling for all covariates. In conclusion, female participants were at increased risk for ADL disability when reporting ≥3 CC while the association was non-significant among males. Our findings indicate the need for evidence-based prevention and interventions targeting multimorbidity to prevent or delay ADL disability in this population.