bluuebunny/crossref_metadata_2025_split huggingface dataset:
CULTURAL COMPETENCE TRAINING AND EVALUATION AMONG NURSING HOME STAFF
Authors: Okolie Tochukwu , Sandri Tina , Booker Staja , Ekoh Prince , Udeh Kingsley 
Published: January 2025

Abstract
The dynamics of cultural and ethnic identity in healthcare has become more salient in the United States due to the growing population diversity. In particular, significant number of nursing home staff are from diverse sociocultural groups, which necessitates cultural competency in nursing homes in order to provide quality care to older adults. Cultural competency in nursing homes is usually analyzed in terms of the interplay between staff members and the older adults, but this study investigated the relational cultural competency between staff members in the workplace. First, cultural competency training on promoting inclusion and respecting diversity, and communication/teamwork was provided to staff members working in a nursing home in Washington, D.C. To evaluate the level of cultural competency post-training, a semi-structured in-depth interview was conducted with 16 nursing home staff. Participants were purposefully selected to capture variation in cultural identity and ethnicity, national origin, work experience and position at the organization. The interviews were conducted individually and audio-recorded after consent was obtained. The audio files were transcribed verbatim and analyzed with the aid of Nvivo12. Findings show that the training was positively perceived as having impacted their outlook of culture and identity in the workplace. Most of the participants were comfortable with working with individuals from different cultures and identified techniques used in communicating when there are language barriers, including utilizing interpreters and translation tools. Participants recommended that organization’s leadership should create more opportunities for intercultural exchange among staff members through potlucks, and recognizing national holidays of staff members.
DIGITAL HEALTH AND OLDER ADULT WELL-BEING: THE MEDIATING ROLE OF SOCIAL TECHNOLOGY USE
Authors: Power Shannon 
Published: January 2025

Abstract
Older adults engage in digital health use (DHU) and social technology use (STU) to connect with health care providers and loved ones. DHU has expanded as an accessible health care option, though its effects on well-being are underexplored. Meanwhile, STU is known to improve quality of life for older adults. This study investigates the association between DHU and well-being and determines whether STU mediates this association. Data from the 2022 National Health and Aging Trends Study were analyzed, with a sample of 5,773 U.S. Medicare beneficiaries, ages 65 and older. The sample was primarily White (64%), female (58%), 65-79-years-old (52%), and urban-living (84%). Structural equation modeling captured the complex relationships of the latent constructs of DHU (e.g., telehealth visit, sending portal messages), STU (e.g., video chat, texting, social media), and well-being (e.g., belief in one’s life purpose, self-determination, confidence). Confirmatory factor analyses with sufficient fit indices established validity of the measurement models. In the full model, DHU was negatively associated with well-being (β=-0.22, p&lt;.001); however, a mediation analysis revealed a strong partial mediation (β=0.32 (CI 0.24-0.46), SE=0.055, z=6.163, p&lt;.001) with acceptable model fit. Adding STU as a mediator reversed the direction and increased the magnitude of the association between DHU and well-being. The significant negative path between DHU and well-being may indicate that DHU is not a preferred option for older adults, but the partial mediation suggests that STU offers familiarity with communication technology that strengthens the association towards well-being. Future research should clarify the reasons underlying these significant associations.
ENHANCING SOCIAL CAPITAL IN OLDER ADULTS: STRATEGIES IN THE ASIAN CONTEXT
Authors: Chan On Fung , Lum Terry , Lu Shiyu , Chui Hiu-kwan 
Published: January 2025

Abstract
Research on enhancing social capital among older adults in East Asia often neglects the aspects of trust, norms, and reciprocity, focusing primarily on social participation. Moreover, it frequently overlooks the capacity of older adults for collective action within society. This study addresses these gaps by exploring strategies that enable older adults in Hong Kong to shift from being passive service recipients to active participants in community and collective action. Using a qualitative research design. We conducted focus groups with 43 participants over 60, who were committee members of various socially beneficial groups, including self-initiated and NGO-led groups. These groups engaged in activities such as promoting age-friendliness, ageing in place and ecological conservation. Data were collected through semi-structured interviews and analyzed using deductive and inductive thematic analysis based on Nahapiet and Ghoshal’s framework. The findings identified five key strategies to enhance social capital among older adults: establishing connections with trusted intermediaries, transforming individuals to share collective goals, providing stable platforms for trust-building, facilitating informal interactions to enhance cohesion, and leveraging influential figures to reinforce group norms. These strategies empower older adults and integrate them into the broader social fabric, thereby contributing to collective action. The study provides actionable insights for policymakers and social workers to develop interventions that enhance social capital among older adults, thereby leveraging their potential as active societal contributors.
EXPLORING RELUCTANCE: HEALTH PROFESSIONS STUDENTS AND GERIATRIC CARE
Authors: Zheng Mingyang , Frasier Pamela , Philippi Jr. H George 
Published: January 2025

Abstract
The aging population in the United States is growing rapidly, yet a shortage of healthcare workers persists, with health profession students showing limited interest in geriatric care. It is urgent to understand the reluctance of working with older adults among health profession students to develop interventions to address the workforce shortage issue. This study aims to understand the factors influencing these students’ intentions to work with older adults using the Theory of Planned Behavior. Using a cross-sectional survey design, the study surveyed 244 health profession students at a mid-sized public comprehensive university in the Southeast. Structural equation modeling demonstrated a good fit (χ² = 625.981, df = 340, p &lt; 0.001, CFI = 0.918, RMSEA = 0.059, SRMR = 0.064, TLI = 0.908). The results indicated that attitudes (β = 0.930, p &lt; 0.001) and subjective norms (β = 0.864, p &lt; 0.001) play critical roles in shaping health profession students’ intention toward geriatric care, while perceived behavioral control (β = 0.169, p = 0.118) and self-efficacy (β = 0.008, p = 0.976) were not significant predictors. These findings suggest that educational interventions should focus on improving attitudes toward older adults and leveraging social influences to enhance the desirability of geriatric careers. Future research should explore longitudinal changes in health profession students’ attitudes and evaluate targeted interventions on students’ career intentions. Addressing biases and enhancing the educational curriculum are crucial steps toward mitigating the workforce shortage in geriatric care.
FACTORS ASSOCIATED WITH HOME HEALTH CARE VERSUS SKILLED NURSING FACILITY REFERRAL FOLLOWING HOSPITAL DISCHARGE
Authors: Turner Natalie , Sabbatini Amber 
Published: January 2025

Abstract
Among post-acute services, home health care has markedly increased following hospitalization. Home health care is less expensive compared to other post-acute services, namely skilled nursing facilities, and is more aligned with older adults’ desire to remain at home. The objective of this study was to identify individual, hospital, and community factors associated with home health care referral among Medicare beneficiaries. Multivariate logistic regressions with hospital-level fixed effects were used to estimate the patient, hospital and community-level factors associated with home health care referral among Medicare beneficiaries at hospital discharge. Older age, being female, and dual enrolled beneficiary status were associated with decreased odds of home health care referral. Beneficiaries living in rural compared to urban settings had higher odds of home health care referral. Communities with a higher proportion of people of color had a lower odds of home health referral, while having a greater percentage of residents living in poverty was associated with higher odds. The decision to refer to home health care was largely driven by patient-level factors. However, the racial and ethnic composition of a community as well its economic status and rurality may affect the odds of a home health care referral beyond both the patient characteristics and the specific hospital in which they were treated. Ensuring equitable access to home health care necessitates increased investment in care infrastructure and policies that dismantle structural barriers to preferred post-acute care settings.
HEALTH AND WELL-BEING OUTCOMES OF MEALS ON WHEELS: A SYSTEMATIC REVIEW FOR A COMPLEX INTERVENTION
Authors: Wright Bernadette , Owens Victoria , Wilson Sanjaya 
Published: January 2025

Abstract
Meals on Wheels programs deliver nutritious meals to older adults’ homes, providing the opportunity to address social and safety needs that affect health. To make informed decisions on programs and policies, decision-makers need to understand which Meals on Wheels services lead to specific impacts, identifying the affected populations, locations, and mechanisms involved. We investigated these questions through a systematic review of studies demonstrating Meals on Wheels’ effects on older adults’ health and health-related outcomes. Forty-eight publications met inclusion criteria, representing 47 studies and 105 outcome analyses. Outcomes frequently examined included diet quality (20), nursing home use/living independently (17), food insecurity (12), healthcare utilization (11), social connection (10), falls/home safety (6), nutrition (5), and other outcomes (24). Study designs included single group quasi-experiments (13), analyses of perceived outcomes (12), comparison group quasi-experiments (9), single-group pre-post studies (8), and randomized experiments (5). Majorities of studies were from the U.S. (38), in peer-reviewed publications (35), and published in the past 10 years (27). Risks of bias included unaccounted-for variables (11) and underpowered samples (9). Eighty-eight analyses (45 studies) found evidence of beneficial effect. Studies attributed success in part to meeting participant preferences and nutritional needs, serving those with greatest need, offering more meals/food, and ensuring opportunity for social connection. Seventeen analyses (9 studies) did not find positive effects, most frequently explained by methodological issues or participants not receiving enough services. These findings suggest that Meals on Wheels services that meet participants’ preferences and needs can reduce barriers to health and aging in place.
HEALTH OUTCOMES AND RISK FOR MORTALITY IN OLDER ADULTS WITH ATTENTION DEFICIT/HYPERACTIVITY DISORDER SYMPTOMS
Authors: Cooper Tara , Piccinin Andrea 
Published: January 2025

Abstract
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that persists into older adulthood with important implications for healthy ageing. Previous research documents significant disparities for children and adolescents with ADHD compared to their neurotypical peers on various social determinants of health. Critically, previous research reports a significantly higher risk for mortality in adults with ADHD followed since childhood. The literature on health outcomes of older adults with ADHD is sparse. Therefore, the purpose of this research was to examine social determinants of health and risk for mortality associated with ADHD symptoms in a sample of older adults. Participants from the Longitudinal Aging Study Amsterdam (n= 986) were screened for childhood and current ADHD symptoms in 2008/2009 and followed until death or most recent assessment (August, 2021). Based on symptoms reported currently and evidence of childhood onset, participants were assigned to either an ADHD symptom (ADHD-sx) group (n= 147) or a non-ADHD group (n= 839). Survival analysis revealed no significant risk for mortality associated with ADHD-sx (HR:.90, 95% CI [.63, 1.29], p=.58). Furthermore, although older adults with ADHD-sx reported more chronic health conditions (p &lt;.001), group differences were not observed in terms of income (p=.49), education (p=.95), social participation (p=.63) or occupational attainment (p=.94). These results suggest that selection and survival bias are important considerations when studying older adults with neurodevelopmental disorders. Future directions for research on ADHD in healthy ageing are presented.
HEALTH, SOCIAL ISOLATION, AND 12-YEAR MORTALITY ACROSS DIFFERENT COMMUNITY-BASED SENIOR HOUSING TYPES
Authors: Ahn Seoyeon , Park Sojung , Kwon Eunsun , Kim BoRin 
Published: January 2025

Abstract
The literature on subsidized senior housing for low-income older adults primarily focuses on affordability and health outcomes like mortality. In contrast, research on other senior housing models often emphasizes the social environment, creating a disconnect that may lead to misunderstandings about factors influencing health and well-being across different housing types. This study examines the influence of socio-economic status, health conditions, and social isolation on 12-year mortality across various community-based senior housing types. Data were drawn from twelve waves of the National Health and Aging Trend Study (2011-2022), involving 6,534 community-dwelling adults (obs=29,929) aged 70 or older who died during the study period. Housing types were categorized into five groups: 1) subsidized senior housing (SSH), 2) senior housing with low-income status and housing cost burden (HCB), 3) senior housing without low-income status and non-HCB, 4) traditional homes with low-income status or HCB, and 5) traditional homes without low-income status and non-HCB. A hierarchical discrete-time event history model using logistic regression was employed to assess the influence of health conditions, social isolation, and housing type on mortality risk. We found that (1) low income or HCB significantly increased mortality risk across all housing types; (2) chronic health conditions and severe social isolation were strong predictors of higher mortality; and (3) socially isolated individuals had a lower mortality risk when living in senior housing compared to traditional homes. These findings highlight the importance of housing affordability policies and suggest that congregate senior housing offers protective benefits for socially vulnerable older adults.
HEARING LOSS AND COGNITIVE DECLINE: POLICY RECOMMENDATIONS
Authors: Hemrajani Girish , Dobbs Debra 
Published: January 2025

Abstract

Hearing loss is the third most common health condition in older age after arthritis and heart disease. With a rapidly increasing older adult population, hearing loss cases are expected to grow from 38 million to 73 million by 2060. Hearing loss in midlife has been estimated to account for 9% of cases of dementia, a huge – but potentially reversible – disease burden given that dementia affects 47 million people worldwide.

Methods
The systematic literature review was included from the Ageline database, containing articles published in English from January 2013 to June 2024. The search terms ‘hearing loss,’ ‘cognitive decline’ and ‘older adults’ produced 161 results and out of these 18 relevant articles were chosen for the review.

Results
In eight articles, hearing interventions were found to reduce cognitive decline in cognitively healthy older adults with hearing loss and slow down the progression of cognitive decline. One article found the provision of hearing aids would have a 48% protective effect on cognitive changes compared to the control over three years. The other articles were equally divided as “not sure” and “need further investigations”. Implications: The review highlights the importance of addressing hearing loss as a preventative measure and suggests policy measures and prevention strategies to maximize cognitive well-being in older adults. Age related sensorineural hearing loss is widely treatable with hearing aids and targeted intervention for hearing loss may play a fundamental role in dementia prevention. Key words: hearing loss, cognitive decline, hearing aid.
HIGH CONFIDENCE IN MANAGING COMMON GERIATRIC PROBLEMS AMONG RURAL FRONTLINE CLINICIANS
Authors: Stone Alison , Dryden Eileen , Moo Lauren , Hung William , Kennedy Meaghan , Pimentel Camilla , Riley Jessica , Caprio Thomas 
Published: January 2025

Abstract

Background
Older rural Veterans often have less access to specialty care services, including geriatrics. The Veterans Health Administration’s (VHA) GRECC Connect is a national program that provides virtual geriatric services for patients and geriatric education for rural clinicians through a case conference series focused on the 5Ms (Mind, Mobility, Medications, Multicomplexity, and Matters Most), a hallmark of high-quality geriatric care. We aimed to measure rural frontline clinicians’ confidence in managing common geriatric problems to inform future education efforts.

Methods
We conducted an electronic survey-based needs assessment during three case conferences in Spring, 2024. The survey included a brief demographic section and 16 questions on respondents’ confidence addressing clinical issues within the 5Ms (e.g., polypharmacy, falls prevention, goals of care).

Results
Forty nine percent (211/430) of conference participants completed the survey, including social workers, pharmacists, nurses, and physicians. On average, 69% of respondents reported being ‘confident’ or ‘very confident’ (range 53%-84%) across the 16 questions. Highest confidence levels were in the ‘Matters Most’ domain. Topics rated lower included managing depression, deprescribing, and managing behaviors in patients with dementia. Confidence varied according to health professions and the responsibilities associated with each role. Providers who serve a higher percentage of rural Veterans reported feeling more confident than their urban colleagues across all questions.

Conclusion
The high level of confidence aligns with findings in the literature that report high self-efficacy ratings in the 5Ms domains among other VA providers and may be related to the VHA’s focus on Age Friendly Health Systems.
IMPACT OF PROVIDING IPADS TO OLDER ADULTS: LESSONS CALIFORNIA FUNDED PROGRAM
Authors: Navarro Sheila Salinas , Yan Mengzhao , Lomeli Sindy , Roman Carly , Wilber Kathleen 
Published: January 2025

Abstract
The California Department of Aging innovative Connections, Health, Aging, & Technology (CHAT) program has bridged the digital divide by providing free iPads with internet access to older adults aged 60 and over. This initiative sought to enhance mental and physical well-being through increased community engagement, information, and access to services. Our research employed a mixed-method approach to understand participants’ usage and motivations. We used Stata 18 to analyze data from 980 participants who completed a pre and post-test. Most used their iPads more than once a day (n=454; 46%) or once a day (n=211; 22%); 62 participants (6%) did not use the iPad. In a qualitative analysis conducted with Dedoose using grounded theory, we identified key themes for using the iPad, including the role of pre-test expectations and motivators identified in the post-test. Initially, participants anticipated using their iPads for communication, learning, well-being, technology, and simplifying life. However, post-test results revealed a fascinating shift in motivations, now centered on technology, education, entertainment, communication, and health. This shift underscores the profound impact of the CHAT program on the participants’ attitudes and behaviors. Understanding what motivates users is crucial for tailoring programs that support older adults in mastering advanced features and enhancing their connection to loved ones, information, the community, and healthcare providers. Our findings suggest that older adults are not only interested in but also actively engaged with technology for a variety of activities.
IMPROVING STUDENT CONFIDENCE IN APPLYING GERIATRICS BEST PRACTICES USING THE 4MS FRAMEWORK
Authors: DeGennaro Jennifer , Powell Leonard , White Christian , Overbeck Kevin 
Published: January 2025

Abstract
Recognized by the Institute for Healthcare Improvement as a Level II Age-Friendly Health System, the Rowan-Virtua School of Osteopathic Medicine (RVSOM) Department of Geriatrics and Gerontology is committed to infusing the 4Ms framework (What Matters, Medication, Mentation, Mobility) into all education initiatives as well as clinical practice. RVSOM medical students are exposed to the 4Ms in the second year of undergraduate courses and the framework is further emphasized during the required 4-week clerkship. To standardize content delivered to students rotating at a host of rotation sites and to augment the assigned self-study modules, a new initiative was introduced at the beginning of academic year (AY) 2024-2025. Students now participate in a full day of in-person didactics designed to teach them to use evidence-based screening tools and employ best practices when caring for older patients. A post-clerkship survey on the 4Ms approach was administered in AY 2023-2024 which allows an examination of differences between cohorts of students who received the in-person didactics and those who did not. Analysis of the data indicates that students benefit from the focused didactics as significant differences emerged on nearly half of the survey items [e.g., sufficient knowledge to perform a Geriatric Assessment [t(109) = 2.45, p =.016, d =.47] and confidence in initiating a conversation about Advance Care Planning [t(109) = -2.69, p =.008, d = -.51]). Findings indicate that enhanced training and exposure to Geriatrics best practices bolsters students’ confidence in understanding geriatrics issues and assessing older patients.
INTERGENERATIONAL CARE PROVISION AND THE CARE PLANNING OF SANDWICHED AGEING CARERS
Authors: Bai Xue , Liu Mengyu 
Published: January 2025

Abstract
An increasing number of people in their 50s and 60s are sandwiched between surviving parents and children. However, there is a research gap on the relationship between upward and downward care provision of sandwiched ageing carers and the impacts of intergenerational care provision on their care planning. Integrating theories on intergenerational transfer, resource depletion, and proactive coming, this study aims to answer two questions in Hong Kong’s context: (a) How do sandwiched ageing carers provide care across multiple generations? (b) Does intergenerational care provision influence sandwiched ageing carers’ care planning? Using data from the Survey on Sandwiched Ageing Carers in Hong Kong (N = 1500), we find that overall levels of upward and downward care provision of sandwiched ageing carers are positively correlated. However, the high care intensity attenuates such a positive relationship. When the percentage of household income spent for upward and downward care exceeds 12.2%, the association turns to negative. Moreover, the sandwiched ageing carers who provide more upward and downward care are less prepared for their future care. These findings deepen the understanding of intergenerational care provision and care planning experiences among ageing families in Hong Kong and enhance professionals’ and service providers’ awareness of care planning in multi-generational family contexts.