bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISABILITY STATUS OF ASIAN OLDER ADULTS IN THE UNITED STATES: FINDINGS FROM THE 2017–2021 AMERICAN COMMUNITY SURVEY
Authors: Miyawaki Christina , Nguyen Hoang , Markides Kyriakos 
Published: January 2025

Abstract
Little information is available on the disability status of the diverse Asian population in the United States (U.S.). In this study we estimate the prevalence of six types of disability in older adults for six major Asian subgroups using the recently released data from the 2017-2021 American Community Survey. The survey contains a sample of 11,737 Vietnamese; 32,388 Chinese; 24,625 Filipino; 12,125 Japanese; 10,231 Koreans; 16,759 Indians; and 2,412,999 non-Hispanic Whites. All analyses use survey weights for population estimates and the jackknife method for standard errors. We find higher prevalence of disability in independent living for Vietnamese, Chinese, Filipino, Japanese, and Indian compared to non-Hispanic White. For self-care disability, Vietnamese, Chinese, Filipino and Indian have higher prevalence. Cognitive disability is more prevalent in Vietnamese, Filipino, and Japanese. Only Vietnamese older adults have higher prevalence of mobility disability and vision disability. Surprisingly, all Asian subgroups in the study have lower prevalence of hearing disability than the non-Hispanic White group. Overall, the results show Vietnamese older adults have the worst disability profile, whereas Korean older adults have the best profile. Future research is needed to understand the role of fortitude in addressing disability status, especially in the areas of independent living, self-care, and cognition, which are more prevalent in most Asian groups.
HOW OLDER ADULT PATIENTS PERCEIVE THE IMPORTANCE OF AMBULATION DURING HOSPITALIZATION
Authors: King Barbara , Steege Linsey 
Published: January 2025

Abstract

Background
Older adults commonly experience loss of walking independence during a hospital stay. Loss of functional mobility is the greatest threat to independent living post discharge and quality of life. Limited ambulation during hospitalization is the most predictable and preventable cause of loss of functional mobility. There is an abundance of data on frequency of patient ambulation and the number of steps taken exists, but little information on how older adult patients perceive ambulation during hospitalization. The purpose of this study was to understand how older adult patients perceive ambulation when admitted to a hospital setting. Method: A qualitative study using inductive content analysis was conducted. Fifteen (n = 15) older adults participated in one-on-one in-depth interviews three months post discharge. Interviews were audio recorded and transcribed verbatim. Analysis consisted of open coding to identify main and supporting categories that describe the patient’s experience.

Results
Value of Ambulation was identified as the main category which consisted of four supporting categories, Maintaining Health, Filling Time, Getting Ready and Being Connected. Older adults perceived walking during a hospital stay as critical for managing their acute and chronic illness, connecting with other patients and unit staff and limiting social isolation, helping fill their time to reduce boredom, and served to determine if they felt ready to go home.

Conclusion
Ambulation during a hospital stay is highly valued and matters to older adults. Additional research on the patient experience with ambulation is needed to develop person-centered care to improve functional outcomes for older persons.
TOWARD AN UNDERSTANDING OF IN-HOSPITAL INACTIVITY
Authors: Pedersen Mette Merete , Hansen Maria , Bandholm Thomas , Kirk Jeanette 
Published: January 2025

Abstract
Lack of mobility during hospitalization is a common problem in older adults (+65) and is associated with an elevated risk of hospital-associated disability. In a recent study, we have shown that there is unclarity among health professionals on priorities and responsibilities concerning mobility, and barriers to the promotion of mobility are present. Also, in recent years, it has become clear that in-hospital inactivity is rooted in the hospital culture and that multi-dimensional and multi-professional interventions are required to incorporate and implement mobility into clinical practice. However, important factors for such interventions to succeed are patient and caregiver engagement and interaction. Therefore, for future interventions to be successful in routine care it is important to know what characterizes clinical practice and communication around physical activity and what influences current levels of activity. We will present data from clinical studies on older adults (65+) in a geriatric and an orthopedic ward in which we have investigated 1) current and previous levels of physical activity during acute hospitalization; 2) clinical practice about mobility and physical activity - how local culture mediates care routines; and 3) if and how a technological artifact can mediate increased physical activity. Also, we will include the perspective of patients and ward staff on what influences mobility and levels of physical activity among patients hospitalized following hip fractures and for geriatric conditions.
LIVE DISCHARGE FROM HOSPICE AS A CRITICAL CARE TRANSITION: MEASUREMENT, EXPERIENCES, AND SOLUTIONS
Authors: Wallace Cara , Hunt Lauren 
Published: January 2025

Abstract
Hospice care has been shown to improve end-of-life outcomes for adults with chronic illness, yet with eligibility limited to a six-month prognosis, the hospice system is not structured to meet longer-term needs. Many adult patients stabilize, or have a change in terminal prognosis, leading to a ‘live discharge.’ In 2021, 17.2% of all Medicare discharges were patients discharged alive, with 6.3% of these due to decertification (patient stabilization). This symposium examines live discharge as a critical care transition, including potential measures of quality and continuity, how hospice care coordination or caregivers’ social contexts impact experiences of the transition, and a potential intervention to improve the overall process. The first presentation considers utility of the Care Transition Measure (CTM-15) and the Patient-Perceived Continuity of Care from Multiple Clinicians Measure in live discharge from hospice, highlighting the positive and statistically significant relationship between relational continuity—how well a patient feels known and understood by their primary hospice clinician and overall team—and the quality of the care transition. Next, using scores from the CTM-15 to classify participants’ experiences as “positive” or “negative,” presenters will provide information about the important role of hospice care coordination in the overall experience of the transition off hospice. Third, presenters will showcase the social context among ADRD caregivers, including the way support systems help caregivers during and following a discharge. Last, presenters will demonstrate the development and preliminary usage of a Live Discharge Protocol that hospices can use for a standardized approach to improving this care transition.
THE ROLE OF HOSPICE CARE COORDINATION IN THE EXPERIENCE OF LIVE DISCHARGE TRANSITIONS
Authors: Wallace Cara , Wladkowski Stephanie , Juboori Ruaa Al , Becker Todd , Trinitas Joseph , Hinyard Leslie , Hendricks-Ferguson Verna 
Published: January 2025

Abstract
Hospice care improves end-of-life outcomes for patients, while a live discharge results in lost access to supportive services and resources. The quality of this transition is critical for ensuring that a caregiver and patient are prepared for the termination of hospice services, and to avoid negative outcomes, such as a hospitalization or a burdensome transition. This study interviewed 32 caregivers of patients across diagnoses who experienced a discharge from hospice due to decertification—when a patient is removed from hospice due to a stabilized condition. Participants were placed in a priori groups (16 in each group) depending on whether their care transition was more positive (designated by a score of 66.67 or higher on the CTM-15) or more negative (scores of 66.66 or below). There were no statistically significant differences between groups based on demographics. However, qualitative codes relating to care coordination differed based on these a priori groupings. Specifically, the positive transition group was more likely than the negative transition group to report hospice action related to the discharge in the following areas: awareness and information, communication between providers, medication, and receiving support from hospice after the discharge. Alternatively, those in the negative transition group were more likely to report hospice inaction related to awareness and information, communication about the discharge, communication between providers, and lack of help generally. Differences in access to healthcare service and availability of social support and how this impacted quality of life also differed across groups. Research, clinical, and policy implications will be discussed.
AN EXPLICIT LIVE DISCHARGE PROTOCOL (LDP) TO IMPROVE CARE TRANSITIONS
Authors: Wladkowski Stephanie , Enguidanos Susan , Schroepfer Tracy 
Published: January 2025

Abstract
Discharge planning for care transitions is required in hospitals, skilled nursing facilities, and home health agencies within the United States under Medicare guidelines. Yet, no required discharge planning or clear guidelines are available to guide practitioners in transitioning patients and their caregivers out of hospice care. A live discharge from hospice can occur when a patient stabilized under hospice care no longer meets the life expectancy hospice eligibility criteria. For these individuals and their caregivers, the result is a disruption of care continuity. Further, an increased burden is placed on primary caregivers who may be unprepared for this transition. Presenters have developed a live discharge protocol (LDP), to standardize the live discharge process and assess for psychosocial support needs for patients and their caregivers post-discharge. This presentation will describe the development of the LDP through several steps: first, with an advisory committee made up of research experts, clinicians, and caregivers. Next, through focus groups to gain a deeper understanding of current approaches and accompanying challenges of a discharge protocol. Finally, the LDP was drafted and reviewed by practicing social workers and nurses for usability. Further, this presentation will report on how each step provided valuable feedback and informed the final LDP currently being used by hospice agencies and the complexities of conducting a live discharge, the uniqueness of each hospice agency, and the need for more research to support a standardized and reimbursable discharge process.
CENTER FOR SCIENTIFIC REVIEW: YOUR APPLICATION’S JOURNEY BEGINS WITH THE DIVISION OF RECEIPT AND REFERRAL
Authors: Boulay Marc 
Published: January 2025

Abstract
The first stop for your application is at the Division of Receipt and Referral (DRR), the central receiving point for all competing grant applications submitted to the NIH. Here, your application will receive: (a) an initial check for its compliance with both NIH policy and the specific requirements of the Notice of Funding Opportunity used for the submission, (b) an assignment to a funding Institute, and (c) an assignment to the most appropriate study section for review. Attendees will become acquainted with the process used by DRR and will receive some tips to help them avoid common errors with their submission. This session will also highlight tools that applicants may use to inform their application’s review assignments and will be introduced to the ENQUIRE process (Evaluating Panel Quality in Review), ongoing evaluations of CSR’s study sections to ensure that the scientific scope of the study sections align with the current state of the science. By the end of the presentation, attendees should have a greater understanding of the factors they should consider when preparing their NIH submissions.
AFTER REVIEW AND TIPS FROM NIH STAFF
Authors: Nguyen Emerald 
Published: January 2025

Abstract
After the review meeting, the SRO prepares the summary statement, which is the primary outcome of peer review. Program staff and advisory councils at the institutes use this official document to make recommendations about which applications to fund. How can you best prepare for the next steps for your application? Understand the qualities of a competitive NIH application, talk to program staff, and take advantage of the opportunity to become a peer reviewer yourself. From the field, apply the tips shared by applicants and reviewers about what they do and what they look for in a well-written application. Receiving the summary statement can be daunting and discouraging; but by de-mystifying the process and getting involved, you can help position your application towards maximum success.
IMPLEMENTATION OF THE PAIN MANAGEMENT CLINICAL PRACTICE GUIDELINE USING THE EVIDENCE INTEGRATION TRIANGLE
Authors: Galik Elizabeth 
Published: January 2025

Abstract
To optimally implement the Pain Management CPG and change behavior among residents and staff in nursing homes we developed a theoretically based approach that incorporates the Social Ecological Model, Social Cognitive Theory and was guided by the Evidence Integration Triangle. The PAIN-CPG-EIT was implemented by a research nurse facilitator 10 hours per week for two months and then 4 hours per week for an additional four months to provide four components: Component I: Establishing and working with a stakeholder team monthly; Component II: Education; Component III: Mentoring and motivating the staff; and Component IV: Ongoing monitoring of pain assessment, diagnosis and management for residents. The first stakeholder team meeting included information about the Pain Management CPG and a brainstorming session to develop community goals. The ongoing role of the stakeholder team was to provide positive reinforcement for the staff caring for residents and support the champions. As per Component II, the research nurse facilitator provided education to staff based on the Pain Management CPG. Component III included reviewing pain related issues among residents with the staff and brainstorming about solutions, implementing treatments and adjusting care plans. In addition, contests were held to have staff share innovative approaches to addressing pain among residents. Weekly pain management tidbits were provided via email to all stakeholder members to share with staff. Component IV included the ongoing re-evaluation of pain among residents and monitoring of pain related interventions to determine if these were effective, still needed or if changes in care plans were necessary.
FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF IMPLEMENTATION OF THE PAIN-CPG-EIT
Authors: McPherson Rachel 
Published: January 2025

Abstract
The primary aim of this pilot study, testing the implementation of the Pain-CPG-EIT, was to evaluate feasibility (delivery and enactment) and preliminary effectiveness. Delivery was based on the intervention being provided as intended and enactment was based on expected behaviors being performed. It was hypothesized that: (1) all components of the intervention would be delivered; and (2) the goals established by each community would be achieved as expected or greater than expected, there would be an increase in nonpharmacologic interventions, and a decrease in unnecessary pharmacologic medications. Effectiveness was based on evidence that residents would have a: (1) pain assessment completed, diagnosis for the pain, and an individualized pain management care plan developed; (2) decrease in pain; and (3) evaluation of appropriate use of opioids. This was a pragmatic trial and no identifiable data was obtained on residents. Participants had a mean age of 70 (SD=8), over half were male (N=25, 51%), and the majority were Black residents (N=33, 67%), Non-Hispanic (N=48, 98%), not married (N=45,92%) and had at least a high school education (N=37, 76%). The mean score on the BIMS was 6 (SD=4) they had 4 (SD=1) comorbidities. The intervention components were delivered as intended and goals achieved. There was significant improvement in the appropriate pain assessments, no change in diagnosis of pain, an increase in the percentage of residents with pain addressed in their care plan, some improvement in assessment for appropriate opioid use, and a decrease in the percentage of residents on opioids.
SEX/GENDER DIFFERENCES IN DIAGNOSIS OF PAIN AMONG OLDER MEDICARE BENEFICIARIES
Authors: Milani Sadaf , Shan Yong , Kuo Yong-Fang , Raji Mukaila 
Published: January 2025

Abstract
Pain is often underdiagnosed among women, especially Black women, but the extent of underdiagnosis is unknown. Cognitive status can also complicate pain reporting and diagnosis. Our objective was to assess the odds of having a pain diagnosis, by sex/gender, while considering race/ethnicity and cognitive status. We used data from the 2018 Health and Retirement Study linked to Medicare claims. We included individuals with complete 2018 Part A and B enrollment and complete information on covariates, excluding those with HMO. Our outcome combined self-reported frequent pain and diagnosis of chronic pain: no pain, self-report only, and diagnosed (both diagnosed only and diagnosed + self-report). Our exposure was sex/gender. We used multinomial logistic regression models to assess the odds of pain diagnosis, by sex/gender, controlling for age, education, race/ethnicity, rurality, cognitive status, and Elixhauser comorbidity index. Among our participants (n=3,523), 12.0% had no pain, 4.6% had undiagnosed pain, and 83.4% had diagnosed pain. Compared to men, women had higher odds of diagnosed pain. The interaction between gender and race/ethnicity was significant (p=0.02). When stratified by sex/gender, non-Hispanic (NH) Black women had lower odds of diagnosed pain, compared to NH White women. Compared to NH Black and Hispanic men, NH White men had lower odds of any type of pain (both diagnosed and self-reported). The main effect of cognitive status and interaction with gender was not significant. Contrary to our hypothesis, women had higher odds of diagnosed pain than men. Within racial/ethnic group differences exist in men and women and warrant future studies.
RURALITY MATTERS: UNDERSTANDING THE CRITICAL AND NUANCED ROLE OF PLACE-BASED FACTORS IN RURAL AGING
Authors: Cassidy Jessica , Cohen Steven , Jensen Leif 
Published: January 2025

Abstract
Although only 15% of all Americans live in rural communities, 22% of U.S. older adults live in rural areas. Despite the prevalence of rural older adults, there are significant gaps in the gerontological literature regarding this vulnerable sub-population and furthermore, the multidimensional factors that characterize rurality and influence their healthy aging. To highlight the impact of place-based factors on the breadth of needs and outcomes found in rural aging populations, this symposium will host five research projects spanning the social and health sciences. The first study applies multi-level models to estimate the spatial distribution of aging and disability service organizations by sociodemographic and sociocultural characteristics in U.S. rural counties. The second uses multiple methods to contrast challenges facing older adults aging in place in rural areas with assets and opportunities for supporting healthy aging in rural older adults. The third examines rural-urban differences in health outcomes and the lived experiences of informal caregivers to suggest culturally appropriate intervention strategies, tailored to the needs of rural caregivers. The fourth analysis compares differences in rural health disparities among diverse aging populations living in rural Wyoming and Mississippi. The fifth investigates benefits of examining claims versus survey data when comparing rural and urban areas to better understand access to healthcare services. Our discussant will lead conversation to emphasize the important nuances of healthy aging in rural communities and to increase awareness on research and policy strategies that may support the needs of older adults and caregivers living in rural communities.
SOCIO-SPATIAL DETERMINANTS OF COMMUNITY-BASED LONG-TERM CARE AVAILABILITY IN RURAL COUNTIES
Authors: Pendergrast Claire 
Published: January 2025

Abstract
Community-based long-term care services are critical resources to support aging in place in communities across the country. These services may be especially important to rural older adults’ health and independence, as declining numbers of working-age adults in rural communities may reduce access to informal family supports. This study examines the spatial distribution of two forms of community-based long-term care in rural U.S. counties: aging and disability services organizations and home health agencies. Using data from the American Community Survey (ACS) and the National Neighborhood Data Archive (NaNDA) for 1708 rural counties, multi-level mixed-effects negative binomial models were estimated to examine the association between the availability of both forms of community-based long-term care services with county sociodemographic and sociocultural characteristics. Findings suggest significantly lower availability of aging and disability services per capita in rural counties with higher crime rates. Greater availability of these services was observed in more Republican counties, those with higher voter turnout, poverty rates, and shares of residents aged 65 and older, as well as shares of Black and Hispanic residents. Home health agency availability per capita was significantly greater in rural counties with higher crime rates, poverty rates, and shares of residents aged 65 and older. State-level factors explained 17.7% of the variation in rural counties’ aging and disability services availability and 4.5% of the variation in home health agency availability. Further investigation is needed to understand place-based factors driving inequalities in community-based long-term care access in rural areas.
SUPPORTING RURAL OLDER ADULTS AGING IN PLACE: IMPLICATIONS FOR RESEARCH
Authors: Henning-Smith Carrie 
Published: January 2025

Abstract
Most older adults, including those living in rural areas, want to age in place; that is, remain in their home and community as they age. Rural areas have many strengths related to aging in place, including generally high levels of social cohesion and strong community ties. However, rural areas also have unique challenges related to aging in place, including more limited housing, transportation, and health care infrastructure and residents with poorer health outcomes and fewer financial resources. Rural areas are older, on average, than urban areas, making them especially important to glean lessons from related to supporting aging in place. This presentation will synthesize recent research on rural aging in place – including new, unpublished results – using a combination of national survey data (the National Health Aging Trends Study and National Health Interview Survey) and qualitative interview data from subject matter experts. Results from this research show that rural older adults are more likely to be aging in place (as measured by longer duration in their current homes and communities) and face specific challenges, including homes that are less physically accessible for people with mobility limitations, poorer health outcomes, and poorer access to care. However, results from this research also show that rural older adults aging in place demonstrate strong social connectedness and key informant interviews illuminated several assets and opportunities inherent to supporting older adults aging in place in rural areas. This session will share key results from this research, as well as implications for rural aging research.