bluuebunny/crossref_metadata_2025_split huggingface dataset:
CARE TRANSITIONS FROM HOSPITAL TO HOME: PERSPECTIVES FROM OLDER ADULTS, CAREGIVERS, AND HEALTHCARE PROFESSIONALS
Authors: Alotaibi Taghreed , Sixsmith Judith , cetnarskyj roseanne , Fang mei 
Published: January 2025

Abstract

Background
Saudi Arabia switched from hospital-focused to home-based care for older persons with long-term care needs due to a 25% increase in acute hospital bed occupancy for non-acute older adults. Healthcare professionals, older adults, and families are affected by the change in the care transition. Improvement in health outcomes depends on understanding all three groups.

Aim
This study aims to investigate the hospital-to-home transition of older adults with chronic conditions. The objective is to identify factors that facilitate or hinder the transition, with the aim of improving care during this critical phase.

Methods
The research employed a descriptive case study analysed with thematic analysis and an institutional ethnography. Pre- and post-discharge data were obtained from older adults, carers, and healthcare workers at King Saud Medical City using semi-structured interviews, focus groups, participatory observation, and documentary analysis.

Findings
The findings indicate that culture, family, and national healthcare policies play a crucial role. Older adults and their caregivers encounter obstacles during the transition process, including gender segregation causing difficulties with care coordination. The lack of standardised post-discharge follow-up and fragmented care provision further contribute to these hurdles.

Conclusion
The research recommends creating a unified administration system as a necessary foundation for solving the largest problems in the transition. This may help Saudi Arabia’s care policymakers and planners create a family-centred healthcare system. Future research should focus on targeted strategies to improve the care transition experiences of older adults and their caregivers.
CELEBRATING THE 100TH DAY OF SCHOOL: PILOTING AN AGEISM-REDUCING TOOLKIT FOR PREK TO SECOND GRADERS
Authors: Newsham Tina , Hancock Cynthia , Alston Daniel , Borrero Lisa , Nikzad-Terhune Katherina , Tesar Sarah , Fugate-Whitlock Elizabeth 
Published: January 2025

Abstract
Upon learning that some celebrations of the 100th day of school involve young children dressing up “like a 100-year-old,” our team questioned the ageist ideas this activity could reinforce. Children adopt beliefs about various social groups at an early age. They are inundated with ageist messages through books, TV, and other sources and internalize those ideas without questioning them. Those who hold negative views of aging live, on average, 7.5 fewer years than those who hold positive views. To prevent negative outcomes, children must be taught accurate and positive information about aging and older adulthood from an early age. The purpose of our research project is to provide teachers with evidence-based educational materials related to aging (centenarians in particular). We created a toolkit about aging and ageism to give PreK and elementary teachers options for celebrating the 100th day of school in a way that reinforces academic content while supporting age-inclusivity. The toolkit includes lesson plans celebrating centenarians. We used a mixed-method approach to pilot test the toolkit with 40 teachers and obtained a complete data set from 25 of them. Quantitative data were collected pre- and post-pilot using the 12-item Expectations Regarding Aging Survey. Qualitative data were collected through online pre-and post-pilot survey questions and post-pilot semi-structured interviews. We provide details on the toolkit and findings from the pilot study, which revealed a statistically significant improvement in expectations about aging (p&lt; 0.05) and strong qualitative support for the value of the toolkit.
COMBATING AGEISM: EVALUATING THE IMPACT OF AN AGE-POSITIVE TRAINING IN HEALTHCARE
Authors: Lester Barbara 
Published: January 2025

Abstract
Ageism among health and social service providers can have a negative impact on the services and outcomes for older adults navigating these systems. The U.S. population aged 65 and older is expected to nearly double by 2060, underscoring the need to address ageism in healthcare. To address this issue, this study explored the impact of “Building Momentum with Age Positive Teams,” an evidence-informed one-hour employee assistance training program designed to reduce ageism and foster an age-positive culture among healthcare employees. The program, adapted from the “Ending Ageism Together” workshop, was implemented from December 2023 to June 2024 at Intermountain Health, a health system with almost 70,000 employees. A total of 76 participants participated in the training and completed both the pre-test and immediate post-test, showing a significant improvement in the total score on the Expectations Regarding Ageing Scale (ERA-12) (p &lt; 0.0001). Furthermore, 38 participants also completed a third follow-up post-test administered 30 days after completing the program. Findings indicated that there were sustained significant improvements from pre-test to both immediate post-test and 30-day post-test (p &lt; 0.0001). The study’s findings highlight the potential effectiveness of targeted educational and workforce development interventions in reducing ageism, promoting more inclusive healthcare practices, and aligning with broader goals of reframing aging narratives. Additionally, findings demonstrated that although knowledge about aging improved, retention of this knowledge varied over time across participants. These results support the ongoing need for educational strategies that combat ageism and promote positive attitudes towards aging in healthcare.
COMMUNITY ENGAGEMENT, SOCIAL SUPPORT, AND RELATIONSHIP DYNAMICS AMONG OLDER ADULTS POST-COVID-19
Authors: Chen Limei , Yan Mengzhao , Rozario Philip 
Published: January 2025

Abstract
Social integration theory and social capital theory suggest the positive effect of community participation and the benefits of social connections gained in the community on health and wellbeing in later life. However, it is unclear whether these positive effects persist under the social restrictions imposed by the COVID-19 pandemic. To understand if the benefits of community participation can withstand such unprecedented disruptions, this study explores how community participation influences spousal/partner relationships, physical health, and mental health among older adults before and after COVID-19. Using linked data of the National Social Life, Health, and Aging Project (NSHAP) Round 3 and Covid-19 Study, we assess the impacts of volunteering, attending meetings, and religious activities using multinomial regrenssion models. Findings reveal that community participation, particularly volunteering and attending meetings, is strongly associated with improved relationship outcomes, even under stress from events related to the COVID-19 pandemic. Religious activities also support better relationships, especially when stressful events are present. While social support further enhances these positive effects, it can diminish the independent benefits of volunteering. For physical and mental health, community engagement serves as a protective factor, mitigating the adverse effects of stressful events. These results underscore the crucial role of active community involvement in promoting well-being and maintaining positive spousal/ partner relationship dynamics among older adults, highlighting its importance as a buffer against stressful events.
COPING WITH PERSISTENT NURSING HOME CHALLENGES: TEAM FUNCTIONING STRATEGIES TO EMPOWER DIRECT CARE WORKERS
Authors: Boakye Alfred , Morgan Jennifer 
Published: January 2025

Abstract
Nursing homes continue to experience staffing shortages, heavy workloads, poor quality indicators, and infection control challenges. Increasing levels of acuity and numbers of residents with challenging behaviors requires high-functioning teams in order for nursing homes to deliver high-quality person-centered care. Extant literature has described the benefits of developing and building teams to reduce staff conflict, reduce staff turnover and absenteeism, improve financial outcomes, and increase quality of care, motivation, and job satisfaction. Team functioning and improved communication can play a crucial role in delivering positive resident care outcomes. The aim of this study was to identify strategies that nursing homes can use to improve team functioning and communication in service of improved resident outcomes. Using a phenomenological qualitative approach with semi-structured interviews, twenty-five (25) nursing assistants were recruited from two high-quality nursing centers to understand team-related coping strategies adopted in order to combat persistent stressors. Interviews lasted 30-45 minutes. Interviewees were predominately Black (23), women (23), and had modal age range of 41-50 years old. Results of the analysis suggest that strategies such as formalizing team structures, dismantling cliques, encouraging the use of collaboration strategies, and tailoring check-in options for individual workers within teams (e.g., emails, phone calls and daily huddles) are critical to maximizing team functioning. These themes support our recommendation that nursing home leaders could profitably implement trauma-informed approaches to build more resilient teams. Trauma-informed principles such as safety, choice, collaboration, trustworthiness and empowerment offer values that can be infused into positive work cultures and support high-functioning teams.
DIFFERENCES IN HOME HEALTH SERVICES AND OUTCOMES FOR MEDICARE ADVANTAGE PLANS WITH EPISODIC VS. PER-VISIT PAYMENTS
Authors: Prusynski Rachel , D’Alonzo Anthony , Johnson Michael 
Published: January 2025

Abstract
For millions of older adults receiving home health (HH) services annually, those with Medicare Advantage (MA) plans receive fewer visits and have worse functional outcomes compared to similar patients with Traditional Medicare (MA) plans. However, the thousands of MA plans available to beneficiaries are not created equal. MA plans with episodic payments have fewer administrative restrictions for HH providers than MA plans that pay per visit. This study of 285,297 HH episodes from 2019-2022 used robust inverse probability of treatment weighting to detect differences in HH service provision and patient outcomes between TM, episodic MA, and per-visit MA plans. Patients with both MA plans had shorter HH episodes and fewer visits from nurses, physical, occupational, and speech therapists, and home health aides than TM. Compared to TM, patients with episodic MA were less likely to improve in mobility and self-care function (Odds ratio [OR] 0.92 and 0.94, respectively) but had lower rates of inpatient admissions during HH (OR=0.95). Patients with per-visit MA had higher rates of community discharge (OR=1.06) and inpatient admissions (OR=1.06) than TM. Per-visit MA plans had higher rates (OR=1.12) of inpatient admissions than episodic MA. While both MA plans provide fewer HH services than TM, outcomes for MA plans versus TM are mixed depending on the MA plan payment structure. However, when comparing MA plans, per-visit plans have higher rates of inpatient admissions than episodic plans, a negative patient outcome. HH providers negotiating with MA plans should prioritize episodic payments to maximize outcomes and reduce administrative burden.
EFFECTS OF DISCRIMINATION ACROSS THE LIFE COURSE: A CASE STUDY OF NARRATIVE METHOD ON TAIWANESE MOVIE BANANA PARADISE
Authors: HSU Sheng-Chin 
Published: January 2025

Abstract
The effects of discrimination across the life course are one of the products from the cumulations of diverse individuals and groups. This paper aims to present the results of effects of discrimination across the life course on Taiwan movie “Banana Paradise” through a narrative theory. “Banana Paradise” expressed the changes of main character in his life course, and showed diversity of his identity and discrimination via these changes during 1949 to 1989. The main objective is to offer an alternative to understand what effects of discrimination are constructed by the shifting across the life course and at the same time to show how effects of discrimination were embodied by interactions with others across one’s life course.
FINANCIAL FORTITUDE: IMPACT OF CAREGIVING ACROSS GENERATIONS
Authors: Vo Quynh , Bhurtel Shikha , Bell Janice , Martinez Pauline DeLange , Whitney Robin , Young Heather 
Published: January 2025

Abstract
There is growing evidence of the economic impact of unpaid family caregiving on physical, mental, social and financial wellbeing. The financial burden of caregiving has not however been fully examined nationally by generation. To address this gap, we examined relationships between generation and selected measures of financial fortitude among caregivers. This cross-sectional study used the 2020 Caregiving in the U.S. Survey to examine any reported impact of caregiving on savings, debt, and bills among adult caregivers who cared for an older adult. The primary independent variable was generation categorized as millennial, Gen X, and Baby Boomer. Survey-weighted logistic regression was used to model outcomes as functions of generation, controlling for socio-demographic and caregiving variables. Compared to Baby Boomers, millennials had higher odds of reporting impact on savings (OR=1.8; p=.006; 95%CI [1.17, 2.70]), debt (OR=2.2; p&lt; 0.01; 95%CI [1.45, 3.40]), and bills (OR=2.6; &lt; 0.01; 95%CI [1.69, 4.24]). Generation X also had higher odds of reporting impact on savings (OR=1.6; p=.006; 95%CI [1.15, 2.3]) and debt (OR=1.4; p=.03; 95%CI [1.02, 2.17]). Caregivers with higher incomes reported lower odds of impacts on all outcomes while those supporting more activities of daily living and caregiving for longer hours had higher odds. Additionally, caregivers with college degrees reported lower odds of impacts on bills. These findings highlight the role of generational status, socio-demographic and caregiving factors on financial outcomes, emphasizing the need for targeted interventions and policies that provide financial support to younger caregivers.
FROM POLICY TO PRACTICE: EVALUATING THE EFFECTIVENESS AND EXECUTION GAPS OF TLTCP 2.0 IN TAIWAN
Authors: Chou Yu-Ting , Yao Kaichen , Wang Hsiu-Jung , Chen Ya-Mei 
Published: January 2025

Abstract
Taiwan has implemented The Ten-Year Long-term Care Plan version 2.0 (TLTCP 2.0) for 7 years, focusing on integrated long-term care (LTC) services. Case managers at Community Integrated Service Center is the key and responsible for proposing managing service plan. However, gaps persist between policy and execution. To understand these gaps, related challenges, and outcomes, we conducted mixed-method study, including qualitative interviews with care managers and analysis of case managements outcomes using data from one a major center in northern Taiwan. Paired T-tests assessed differences between the Case Management Level (CML) scores at discharge and the first re-evaluation. Interviews revealed that the biggest gap and challenge is to become “one-stop shop.” TLTCP 2.0 users still face confusion due to multiple contacts during their service period. Case managers coordinated at least 140 cases monthly, yet the governments’ Care Services Management Information Platform is poorly designed to facilitate this coordination. Additionally, policy design flaws have led to service misuse, such as unclear requirement for range of motion services. Quantitative findings showed that while case mangers handle a higher caseload than in advanced countries, users demonstrate significant improvements in activities of daily living, primary caregivers’ burden, and CML scores after receiving integrated services. However, instrumental activities of daily living scores declined, likely due to reliance on service like house chores, leading to disuse these skills. Overall, the TLTCP 2.0 seems to be effective, but addressing policies and platform design and the issue of skill disuse is crucial for future improvement.
GERIATRICS EDUCATION MENTOR (GEM) PROGRAM: OUTCOMES FROM PAIRING STUDENTS AND OLDER ADULTS DURING MEDICAL SCHOOL
Authors: Griffin Hannah , Wihry David , Gugliucci Marilyn , Wehry Susan 
Published: January 2025

Abstract
Currently, only 15% of medical schools have mentor programs that educate students to work with older adults and their health. The University of New England College of Osteopathic Medicine Geriatrics Education Mentor (GEM) program is an experiential education component within the 1st and 2nd year curriculum whereby students and older adults are paired to conduct five “home-visit” GEM assignments. A pre/post survey design assessed students’ competence and confidence with older people (assigned GEMs). The survey was emailed to first-year medical students before they began GEMs and was sent again upon completion of the program at the end of their second year. This process was carried out through academic years 2020-2021 through 2023-2024 with an average of 174 first-year students per class, and this data was analyzed in RStudio. Results had a 26% response rate that included overall data (N= 133/Pre & N=138/ post), 24 responses were matched assessments. No significant change in students’ interest (p &gt; 0.4), perceived readiness and competence (p &gt; 0.07), or confidence in working with older adults (p &gt; 0.5) was revealed. However, perceived readiness and confidence increased from pre- to post-test, indicating that a larger sample size might reveal significance. Self-reported knowledge of older adult healthcare needs increased, pre- to post-test, with the paired subset showing a significant increase (p&lt; 0.015). Although a small sample, these findings provide a foundation for medical schools to consider implementing a mentor type program to augment medical student skill/knowledge in older adult health care to advance age-friendly health care.
HEALTHY DIETARY PRACTICE AND SELF-RATED HEALTH AMONG KOREAN OLDER ADULTS: THE MEDIATING ROLE OF PHYSICAL ACTIVITY
Authors: Chae Joosuk , Kim Hyunmi , Lim In-Taek 
Published: January 2025

Abstract
This study explored the relationship between healthy eating habits, physical activity, and self-rated health perception among older Korean adults, with a specific focus on whether physical activity level, as measured by the Global Physical Activity Questionnaire (GPAQ), serves as a mediating factor. We examined whether healthy eating habits influenced self-rated health perceptions through increased physical activity using Process Macro 4.3. The analysis included 1,468 older adults aged ≥65 years from the first year (2022) of the 9th Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative panel survey conducted in Korea from 2022 to 2024. The findings confirmed that healthy eating habits affected self-rated health perceptions via increased physical activity. This suggests that healthy eating habits positively help increase physical activity, which in turn enhances self-rated health status. These results highlight the importance of an integrated approach that incorporates healthy eating education and physical activity promotion when developing future care service plans for older adults in Korea. Based on these findings, more comprehensive guidelines can be established for social workers to design individualized programs within the older adults’ care service delivery system.
HOSPITAL AT HOME PROGRAMS: CAREGIVER INSIGHTS ON SUCCESSES AND ENHANCEMENTS
Authors: Hart Julia , Howard Brittni , Nnemnbeng Jeannys , Levine David , Gorbenko Ksenia , Leff Bruce , Siu Albert , Baim-Lance Abigail 
Published: January 2025

Abstract
Hospital at Home (HaH), an alternative to hospital-based care, continues to expand across the US. While the caregiver role is of great interest, little is known about their experiences. This is the first qualitative study, to our knowledge, examining caregiver experiences with HaH in a national sample. Beginning October 2023 (and ongoing), we conducted semi-structured interviews with caregivers via Zoom lasting 30-60 minutes, recruited through the HaH User’s Group, a national collaborative focused on implementation. This analysis uses rapid strategies including: systematic development of analysis templates, their synthesis to identify preliminary themes, and group consensus to ascertain meaning. To date, we completed 13 interviews with spouses, adult children, and grandchildren representing 5 programs (5 NE, 7 MW, 1 SE). 92% were female and 85% white. The mean age is 68 (range: 57-83). Program duration ranged from 3 days to 1 month. Overall, participants felt positive about HaH, reporting they would repeat the experience. Main benefits include: convenience, patient goal alignment, high quality care, and improved patient outcomes compared to brick and mortar experiences. Caregivers reported that providers were responsive, reliable and communicative. Yet, participants described lacking communication about caregiver roles and expectations, and desired additional information. Caregivers also reported needing more clarity about the timing of visits, tasks and procedures. They suggested that HaH may be more challenging to implement in contexts of greater caregiver strain or higher patient acuity. While caregivers generally reported positive HaH experiences, clearer and more explicit communication about the caregiver role could improve their experiences.
HOW DO KOREANS PERCEIVE THE EXPERIENCE OF CAREGIVING? A SYSTEMATIC REVIEW OF THE OUTCOMES OF INFORMAL CAREGIVING
Authors: Koh YoungBin , Ko Sunghyun , Lee Yeonjung 
Published: January 2025

Abstract
Globally, several research have been conducted to show the evidence of caregiving impact. In general, caregiving responsibilities have negative impacts on caregivers’ well-being, and further research has investigated the differences in the outcomes in terms of gender, race, and socioeconomic status. However, there exists not enough efforts to explain these differences at a macro level. For example, how countries differ in the extent to which they rely on informal care services and whether there are differences in caregiving impact among countries. These differences might be related to differences in cultural and policy background. Specifically, South Korea promotes formal long-term care through its national insurance. However, the support for informal caregivers is somewhat weaker compared to other countries, and there is limited research. The purpose of this study is to evaluate the research evidence in Korean contexts and summarize current findings on the outcomes of informal caregiving. A systematic review was performed with a structured literature search following PRISMA guidelines in five Korean databases. Our systematic search yielded 1,143 articles, of which 31 were included for synthesis. Findings show evidence of a negative impact of caregiving including caregivers’ deteriorating physical and mental health as well as reduced employability, especially for female caregivers. However, there are also some positive aspects such as having more satisfied relationship with caregiver recipient. The findings underscore the need for interventions to reduce the negative impact, particularly among female caregivers. We also suggest further research to investigate the cultural contexts to make caregiving experience positive.