bluuebunny/crossref_metadata_2025_split huggingface dataset:
INVESTIGATING THE BUILT ENVIRONMENT SURROUNDING NATURALLY OCCURRING RETIREMENT COMMUNITIES (NORCS) IN TORONTO
Authors: Fusca Laura , Rochon Paula , Huynh Tai , Hahn-Goldberg Shoshana , Matai Lavina , Fu Longdi , Savage Rachel 
Published: January 2025

Abstract
A positive built environment can improve the health of older adults and support aging in place by increasing access to amenities, physical activity, and social interaction. We investigated the walkability and amenity density surrounding Naturally Occurring Retirement Communities (NORCs) in Toronto, areas where many older adults live. This population-based descriptive study linked two built environment datasets with a provincial registry of high-rise NORC buildings in Ontario, Canada by postal code (PC). Mean (SD) walkability index scores and quartiles, as well as amenity density categories were compared for NORC and non-NORC PCs. Building and resident characteristics were also compared for NORC PCs in the least and most favourable categories for each outcome. Our analysis of walkability and amenity density included 49,295 (488 [9.9%] NORC) and 49,945 (489 [9.8%] NORC) Toronto PCs respectively. Walkability was significantly higher for NORC (mean 7.1 (SD 9.1)) versus non-NORC (4.9 (8.3)) PCs; although 57 (11.7%) NORC PCs were in low walkability neighbourhoods. NORC PCs were also more amenity dense, with 63.0% being classified as medium/high density compared to 50.5% of non-NORC PCs. Low walkability and amenity-poor NORCs tended to house older, immigrant, ethnically diverse and lower-income populations. Low walkability NORCs were also more likely to be apartments with supports and have residents without access to basic needs. Overall, our findings suggest that many NORCs are well-positioned to support aging in place given their walkability and amenity access, however action should be taken to support NORCs with suboptimal environment conditions.
LONG-TERM PATTERNS OF FAMILY AND PAID CAREGIVING BY CARE TYPES AND SOURCES
Authors: Shin Esther , Park Sojung , Park Soobin , Kim BoRin , Kwon Eunsun , Ahn Seoyeon 
Published: January 2025

Abstract
To support aging in place for community-dwelling older adults, sustainable long-term care and support are crucial. The existing literature often focuses on family caregiving, formal caregiving, or their relationship, such as whether they substitute for each other. This study aims to broaden the understanding of collaborative care by exploring the intersection of different care forms and caregiver sources, an area that is less studied. Using data from the National Health and Aging Trends Study (2011-2022), this research examines longitudinal patterns of caregiving, focusing on the types of services (ADL/IADL support) and their sources (unpaid informal, paid formal, and paid family caregivers). The study sample included individuals who received consistent caregiver support throughout the study period. Group-based multiple trajectory (GBMT) modeling identified four distinct care mix patterns: (1) consistently low care (72.2%), (2) increasing ADL informal care (18.3%), (3) increasing formal care (7.4%), and (4) decreasing formal care with increasing paid informal care (2.1%). Compared to the relatively healthy and less vulnerable “consistently low care” group, those receiving “increasing ADL informal care” were more likely to be married women, while those with “increasing formal care” tended to live alone, be male, and have dementia. Notably, individuals with “decreasing formal care but increasing paid family care” were often racial minorities, in poor health, and older, possibly utilizing consumer-directed care programs. These findings provide an initial empirical foundation for understanding care mix, highlighting the need for further research on gender-specific caregiving patterns and the impacts of these care trajectories on health outcomes.
MONTESSORI-BASED APPROACH FOR ALZHEIMER’S AND DEMENTIA: HANDBOOK FOR IMPLEMENTATION IN AN ADULT DAY CARE PROGRAM
Authors: Rodrigues Annette 
Published: January 2025

Abstract
Adult day care (ADC) programs serve as an intervention that offers a solution to the challenges faced by an increasing population of individuals living with dementia. Including activities for mental and physical stimulation such as games, exercises, and art, ADC offers dual benefits by providing community-based care for older adults and respite for caregivers. Studies indicate, however, that a lack of quality and standardization negatively impacts the quality of ADC programs, thereby reducing utilization. As program directors expand their services to address the needs of the current demographic, a Montessori approach to dementia care can serve as an effective method of delivering deliberate, evidence-based care. However, most existing applications focus on in-home and long-term care settings rather than ADCs. To address this gap, this project aimed to develop a handbook for implementation in an ADC setting. Montessori-Based Approach for Alzheimer’s and Dementia: Handbook for Implementation in an Adult Day Care Program was developed based on research, observations, and feedback from expert panelists. In the handbook, Montessori principles are presented, barriers and challenges are addressed, organizational strategies are offered, as well as recommendations for developing meaningful person-centered programs, preparing the environment, and addressing participants, staff, and family. By providing a comprehensive guide for an evidence-based standard of care, this handbook aims to advance the field of aging by combining existing research that supports Montessori-based dementia care and facilitating its implementation into an ADC program, with a goal of increasing utilization and improving quality of life.
NEIGHBORHOOD ENVIRONMENTAL CORRELATES OF FALLS AMONG OLDER ADULTS – IMPLICATIONS FOR FALLS PREVENTION PROGRAMS
Authors: Ackerson Leland , Procter-Gray Elizabeth , Le Qun , Kane Kevin , Li Wenjun 
Published: January 2025

Abstract
Neighborhood sociodemographic environmental factors may influence the risk of falling in older adults, which has important policy implications. We investigated the associations of neighborhood physical and social characteristics with rates of indoor and outdoor falls in a multi-racial cohort of 729 community-dwelling adults aged 65 to 99 residing in Massachusetts (2018-2024). Associations of Census tract-level sociodemographic and built environmental characteristics with fall rates were analyzed using negative binomial models. The overall rates of any, indoor and outdoor falls were 67.9 (95% CI: 63.9 – 72.2), 32.1 (95% CI: 29.4-35.1) and 35.6 (95% CI: 32.7-38.7) falls per 100 person-years, respectively. In crude analyses rates of any, indoor and outdoor falls were significantly associated with 12, 3 and 20 of the 80 neighborhood characteristics under analysis, respectively. After adjusting for individual age, sex, and race, 4, 7 and 6 remained statistically significant for any, indoor and outdoor falls, respectively (e.g., for outdoor falls % male, Hispanic population, % commuting 25-34 minutes, % of Black-occupied homes that are rented, % of Hispanic-occupied homes that are rented, and total number of Hispanic-occupied homes). After further adjustments for health-related risk factors, only a few neighborhood factors remained significant for either indoor or outdoor falls. In conclusion, neighborhood characteristics are more likely associated with outdoor falls than indoor falls. The observed associations likely result from compositional effects rather than contextual effects. When designing community-based falls prevention programs, the population compositional effects and geographic distribution of older adults with higher fall risks should be carefully considered.
NURSING HOME BARRIERS AND ENABLERS TO USING THE GOALS OF CARE VIDEO INTERVENTION
Authors: Chisholm Latarsha , Hickman Susan , Unroe Kathleen 
Published: January 2025

Abstract
Advance care planning (ACP) is a process that prepares individuals for communicating and making decisions about personal goals regarding medical care. Despite the benefits, ACP is limited across nursing homes (NHs) due to implementation challenges. It is essential to understand how to implement ACP, like Goals of Care (GOC) evidence-based intervention. The GOC video is intended to supplement ACP discussions to educate patients living with dementia and families. This study was performed to identify enablers and barriers to using the GOC video. We interviewed 12 staff from six Florida NHs. A pre-implementation guide was developed using constructs from the Consolidated Framework for Implementation Research 2.0. Enablers included: mission alignment (6 out of 6 NHs); physical space, use of information technology, and learning-centeredness (5 out of 6 NHs); and work infrastructure, communication, readiness, recipient-centeredness, and implementation facilitators (4 out of 6 NHs). Barriers included: design of the GOC video (6 out of 6 NHs; access to health education (5 out of 6 NHs); and patient readiness and culture as barriers (4 out of 6 NHs). NH staff reported various barriers and enablers to use the GOC video; however, some barriers and enablers were similar across NHs. Developing a standardized protocol that allows flexibility maybe helpful to nursing homes implementing the GOC video intervention.
ORGANIZATIONAL CULTURE AND SOCIAL ISOLATION IN NURSING HOMES
Authors: Martey Ebenezer , Morgan Jennifer , Skipper Antonius , Kemp Candace 
Published: January 2025

Abstract
Social isolation is a prevalent issue among nursing home residents, which can lead to various chronic diseases, such as depression, dementia, and chronic pain. Social integration refers to the active engagement in social ties, institutional connections, and participation in community-based activities. Organizational culture is a critical factor in providing person-centered care and fostering communication, teamwork, and quality improvement processes. Using a case study methodology, this study surveyed 49 nursing home staff and interviewed eight residents in one nursing center to understand the context of organizational culture and social integration among nursing home residents. Analysis of resident interview data indicated that communication challenges between staff and residents exist, as some residents report being uninformed, while others report great appreciation for staff responsiveness and personalized care. Social isolation was found to be a challenge for some residents due to a lack of meaningful engagement often exacerbated by health or mobility issues. Relationships between roommates often challenged resident well-being while supportive relationships among residents were essential to well-being. Residents noted that staff were very involved with encouraging residents to participate in activities and even take on specific responsibilities to foster a sense of community. The new availability of private rooms and bathrooms in this case study home was a big source of satisfaction for both residents and families. Private rooms appear to enhance satisfaction by enabling residents to exercise autonomy around daily schedules and promote dignity. Resident feedback on communication challenges revealed the need for organizations to practice greater transparency and consistent messaging.
PARTNERING WITH COMMUNITY ON A SUCCESSFUL FEDERAL FUNDING APPLICATION FOR MESOTHELIOMA CAREGIVERS
Authors: Woodward Amanda , Towe Maria , Hirsch Jen , White Julie 
Published: January 2025

Abstract
The Michigan State University School of Social Work (MSUSSW) and the Mesothelioma Applied Research Foundation (Meso Foundation) collaborated on a successful application for federal funding to develop and conduct feasibility testing of an online caregiver support intervention. The process of developing the proposal and the design of the four-year project follow key principles of the Community-Engaged Research Framework described by NORC at the University of Chicago. The research questions emerged from a survey the Meso Foundation administered to its community, thus aligned with a foundational component of community engaged research where the community drives the research focus. The team includes members with lived experiences whose time and expertise are incorporated through processes that promote shared decision making (e.g., co-principal investigators) and budgeted compensation for their work. Information about research processes, resources, and timelines are openly shared with all team members through password-protected cloud-based storage. Meeting schedules, modes of communication, workplans, and decision-making protocols are established collaboratively and revisited regularly throughout the work. The project itself engages patients, caregivers, those who have lost a loved one, and health professionals through in-depth interviews and focus groups to better understand the caregiver experience from diagnosis through end of life. Participant experiences and feedback will be used to develop and refine an online caregiver support intervention. The feasibility of the intervention will then be tested in an intervention-only design. This poster will describe the six key principles of community-engaged research and the ways we are implementing them in more detail.
PERSPECTIVES ON POLICIES TO IMPROVE EQUITY IN HOSPITAL AT HOME
Authors: Nnemnbeng Jeannys , Baim-Lance Abigail , Howard Brittni , Hart Julia , Leff Bruce , Levine David , Siu Albert , Gorbenko Ksenia 
Published: January 2025

Abstract
Hospital at Home (HaH) delivers acute hospital-level care at home as a substitute for traditional hospital care. Compared to traditional hospital care, HaH care demonstrates better patient satisfaction and care experience, lower readmission rates, and lower costs of care. There has been limited research on equity issues in HaH care delivery. We explored HaH program leaders’ views on the policy landscape and opportunities for equitable delivery of HaH across the US. We conducted a qualitative study using semi-structured interviews with healthcare leaders (1-4 leaders per program) at 18 HaH programs diverse by geography (region, rurality), size, and safety-net status. We conducted interviews via Zoom and used rapid template analysis and focused coding to identify key themes. We identified four areas supporting equitable HaH care delivery: (1) Technology access to promote more complete broadband coverage, particularly in rural areas; (2) Medicaid expansion to allow the enrollment of Medicaid beneficiaries, a frequent recommendation to increase lower-income individuals’ access to the program, including younger age groups that did not typically participate and would benefit; (3) Workforce role diversity to align with the needs of communities and therefore to include services like paramedicine familiar with delivering care at home; and (4) Sustainable and broadening of HaH funding including making the waiver permanent and expanding support for a package to connect patients with community-based care at discharge. HaH success in advancing equitable care delivery requires greater policy support to ensure equal access and solid funding mechanisms to support its ongoing growth.
PREPARING FUTURE HEALTH PROFESSIONALS FOR AGE, CULTURAL, AND TECHNOLOGY (ACT) FRIENDLY CARE IN HEALTH SCIENCES
Authors: Rayan-Gharra Nosaiba , Keisari Shoshi , Ring Lia , Engdau Shelly , Segel-Karpas Dikla , Zisberg Anna , Danial-Saad Alexandra 
Published: January 2025

Abstract
The aging population emphasizes the need for tailored training in welfare and health sciences, particularly for students who will work with culturally diverse older populations using advanced technological tools. This study examines how well the curriculum at the Faculty of Welfare and Health Sciences prepares students for Age, Cultural, and Technology (ACT) Friendly care. An online survey was conducted among 208 faculty lecturers, teaching mandatory undergraduate and/or graduate courses (BA only=65, MA only=82, both BA and MA=61). Respondents rated how extensively they address aging, multiculturalism, and technology in their courses. Only 15.4% had received training in aging studies, while 16.4% were involved in aging research. Aging-related topics were included in 31% of undergraduate and 27% of graduate courses. Multiculturalism was similarly integrated (28% for both programs), while technology was less addressed (13% for BA and 8% for MA courses). Only 17.3% of respondents extensively incorporated ACT topics in their teaching, and 65.7% did not address them at all. Multivariate analysis controlling for gender, seniority, and research area showed that involvement in aging, multiculturalism, or technology research predicted teaching these topics (p&lt; 0.05). The findings highlight a significant gap in preparing students for ACT-friendly care, particularly at the graduate level, and a lack of integration of the three domains. This study underscores the need for ongoing assessment and curriculum development to equip future health professionals for age-appropriate, culturally sensitive, and technologically integrated care. Faculty development initiatives are also recommended to enhance educators’ capacity to incorporate these critical areas into their teaching.
PROXIMITY, CARE VALUES, AND CAREGIVING STRAIN: EVIDENCE FROM THE 2020 NAC/AARP NATIONAL SURVEY
Authors: Jin Tingan 
Published: January 2025

Abstract
The concept of distant caregiving emerged as family caregivers can care for older adults in settings other than living with their parents. Previous studies have illustrated that differences in geographical distance could lead to different caregivers’ experiences in terms of physical, emotional, and financial strain. This study uses the most recent nationally representative data on caregivers in the US from the National Alliance for Caregiving and AARP to explore the characteristics and values of caregivers with varying distances to care recipients and test the effect of geographical distance on various aspects of caregiving strain. The preliminary analysis conducted in June 2024 suggests that caregivers providing care at a distance reported lower physical and financial strain levels regardless of proximity intervals. Long-distance carers, namely those who live more than one hour away from their parents, show more physical strain (b=-0.236, p&lt; 0.05) and financial strain (b =-0.228, p&lt; 0.05) than those who live with or close to their parents. Findings regarding emotional strain were against previous studies, and we found that while those who live close to their parents reported lower levels of emotional strain (b=-0.171, p&lt; 0.05), the pattern does not apply to long-distance caregivers with a positive, statistically insignificant relationship. Adding components regarding caregivers’ willingness and perceptions towards care provision, it is found that whether the respondents feel they had a choice to take care of their parents is a statistically significant predictor of physical (b=0.508, p&lt; 0.05), financial (b=0.446, p&lt; 0.05), and emotional strain (b=0.810, p&lt; 0.05).
REALITIES OF DIVERSITY, INCLUSION, AND BELONGING IN ASSISTED LIVING: SAFETY, CONNECTION, AND COMMUNITY
Authors: Kohon Jacklyn , Himes Dani , Dys Sarah 
Published: January 2025

Abstract
This study centers the voices and experiences of those working and living in assisted living, residential care, and memory care (AL/RC) settings in Oregon to understand how workplace diversity, equity, inclusion, accessibility, and belonging (DEIAB) can promote well-being. From January to April 2024, we conducted individual and focus group interviews with a total of 68 people, including 25 direct care staff, 9 former direct care staff, 9 administrators, 7 management representatives and 18 current residents from 23 AL/RC communities. We highlight six primary themes: 1) Care staff face discrimination, physical and verbal abuse from residents and colleagues; 2) those experiencing discrimination or not belonging were more likely to be from a minoritized group; 3) there is inconsistency in the existence, awareness, and currentness of diversity, equity, and inclusion policies, making implementation challenging; 4) company culture can support feelings of connection and belonging among staff; 5) care staff rely on peers and coworkers for support; and 6) workplaces need infrastructure that reflects language diversity of residents and care staff. Participants noted discrimination can happen overtly and subtly. In many instances, overt discrimination can be easier to address and handle, while subtle forms of discrimination happen daily and many times are invisible or look like unspoken norms. Recommendations include comprehensive DEIAB policies with clear implementation plans, DEIAB training programs for residents, investing in linguistic accessibility resources, and training administrators and managers in inclusive leadership practices.
RECIPROCAL RELATIONSHIP BETWEEN LONELINESS AND LIFE SATISFACTION IN HONG KONG OLDER ADULTS
Authors: Tang Foong Yee Vivien , Chou Kee Lee 
Published: January 2025

Abstract
Given the limited research on the reciprocal relationship between loneliness and life satisfaction in the Chinese community, this study examines this dynamic and explores the mediating effect of neighbourhood collective efficacy. Loneliness, a prevalent issue among the aging population, significantly impacts psychological well-being and overall quality of life. Conversely, life satisfaction reflects an individual’s overall contentment with life and is a crucial component of successful aging. Utilizing a two-wave secondary data from 1,696 Chinese older adults aged 60 and above (53.9% female), this study analyzed how changes in loneliness predict subsequent changes in life satisfaction, and vice versa. Participants were assessed on their levels of loneliness, life satisfaction, sociodemographic factors, health, social resources, and social support. The findings indicate a reciprocal relationship: loneliness was associated with lower life satisfaction two years later (B = -1.44, p = 0.014), and reduced life satisfaction led to increased loneliness (B = -1.106, p &lt; 0.001). Furthermore, neighbourhood collective efficacy was found to fully mediate the relationship between loneliness and life satisfaction (β = 0.18, p &lt; 0.001). These results underscore the importance of addressing loneliness and life satisfaction simultaneously. Maintaining strong neighbourhood collective efficacy may help mitigate the negative impact of loneliness on life satisfaction. This highlights the potential for targeted, community-based intervention programs designed to enhance life satisfaction and alleviate loneliness among older adults.