Smart Speaker and ICT Use in Relationship With Social Connectedness During the Pandemic: Loneliness and Social Isolation Found in Older Adults in Low-Income Housing

BACKGROUND AND OBJECTIVES

Social well-being of older adults living in low-income housing was disproportionately affected by the coronavirus disease 2019 pandemic. We explored low-income residents' experiences of social isolation and loneliness and strategies to remain socially connected during the pandemic.

RESEARCH DESIGN AND METHODS

As part of a larger, 3-phase user-centered design study, we conducted a qualitative study using focus groups to gain insights into social isolation experiences and the role of information and communication technologies (ICTs), including smart speakers, in social connectedness (N = 25, 76% African American). We also collected survey data to describe social isolation, loneliness, and current ICT use in the sample. Participants included both smart speaker users and nonusers.

RESULTS

Experiences of social isolation and loneliness varied by participants' sociodemographic characteristics and previous experiences with smart speakers. Qualitative analysis showed participants demonstrated coping strategies developed during the pandemic to adapt to new norms of connecting with others, including technology-enabled social interactions. Participants expressed a strong desire to build community together in their facilities and highlighted the potential role of smart speakers in making meaningful social connections, encompassing safety checks to have a means for emergencies, and providing a virtual companion. Access, digital literacy, training, security, and privacy issues were discussed as factors affecting their adoption of new ICT for enhanced social connectedness.

DISCUSSION AND IMPLICATIONS

This study highlights the importance of understanding the unique social isolation experience, demographics, and social determinants of health of low-income residents to develop ICT-based interventions for social connectedness.

Internalized ageism as a risk factor for suicidal ideation in later life

OBJECTIVES

We examined the influence of ageism on suicidal ideation using the framework of the Interpersonal Theory of Suicide among a sample of older adults in the United States.

METHOD

Using Research Match, volunteers 65 and older in the United States were recruited to participate in an online survey. Demographics, perceived burdensomeness, thwarted belongingness and self-directed ageism (internalized and relational ageism) were examined. Data were analyzed using hierarchical logistic regression analysis.

RESULTS

A total of 454 individuals from over 30 states participated in the study. Twelve percent of respondents reported that they had experienced suicidal ideation in the past month. Results from the logistic regression demonstrated that older adults with higher age and higher internalized ageism had a higher risk of suicidal ideation.

CONCLUSION

Findings present implications for understanding an association between ageism and suicidal ideation. Results speak to the importance of recognizing and understanding the impact of ageism. Examining the development clinical guidelines and policies that address ageism as a risk factor for suicide is warranted.

Generational Bias: Another Form of Ageism

Ageism includes discrimination toward both younger and older individuals. Discrimination based on generational cohorts can serve as a proxy for discrimination based on age and, therefore, can be argued as a form of ageism. This study examined the occurrence of generational ageism and its relationship to internalized and relational ageism. This cross-sectional study surveyed 913 individuals recruited through ResearchMatch. Analyses found that those in the Millennial and Gen Z groups reported experiencing the highest levels of discrimination based on generational cohort and reported feeling that their generational groups were viewed as less capable, more opinionated, and more selfish than other generations. Millennial and Gen Z groups also reported experiencing higher internalized and relational ageing anxiety levels than older cohorts. As our collective understanding of the manifestation and perpetuation of ageism grows, it is imperative to explore the impact and consequences of generational bias as a form of ageism.

Special Focus Facilities vs Special Focus Facility Candidates: What is the Difference?

OBJECTIVES

This study compares Special Focus Facilities (SFFs) and Special Focus Facility Candidate Facilities (SFFcs) on organizational traits and quality outcomes to evaluate the effectiveness of the SFF program as a quality improvement intervention and inform potential areas for program reform.

DESIGN

This is a retrospective analysis.

SETTINGS AND PARTICIPANTS

Using data from the Centers for Medicare and Medicaid Services archives for 2020, this retrospective study analyzed 247 nursing facilities (50 SFFs and 197 SFFcs).

METHODS

Variables of interest were staffing, profit status, facility size, certification status, number of residents, and complaint citations: t tests, χ2, Fisher's Exact test, and multivariate analysis of variance were used to compare the 2 groups.

RESULTS

From an organizational perspective, SFFs and SFFcs are minimally different. Both groups had similar facility size, profit status, hospital affiliation, continuing care retirement community status, and Medicare/Medicaid certification. Large and for-profit facilities were overrepresented in both groups. SFFs and SFFcs exhibited statistical differences in the number of complaint deficiencies. The groups had no significant difference in staffing levels, category, severity of complaints, or incident reports.

CONCLUSIONS AND IMPLICATION

The study's findings suggest that the SFF program, while resource-intensive, is minimally impactful. The similarities between SFFs and SFFcs raise questions about the program's effectiveness in improving nursing facility care. Previous adjustments to the program may not have successfully achieved the desired quality improvements. This research highlights the need to further evaluate the SFF program's effectiveness as a quality improvement intervention. It also underscores the importance of addressing biases and subjectivity in state survey agency processes, which affect the enrollment of nursing facilities. The study underscores the flaws within the nursing home monitoring system and the 5-star quality rating system, especially when comparing small samples between states.

The Next Critical Turn for Ageism Research: The Intersections of Ageism and Ableism

BACKGROUND AND OBJECTIVES

Aging includes multidimensional and multidirectional changes in biology, psychology, and social roles. With aging, individuals experience physiological changes that affect ability, stamina, and reserve capacity. Given the natural occurrence of physical decline accompanying aging, it is essential to understand if fear and prejudice toward disability (ableism) intersect and influence fear and anxiety about aging (ageism).

RESEARCH DESIGN AND METHODS

A cross-sectional survey study was conducted using ResearchMatch for study recruitment, 913 individuals responded to questions regarding 3 types of ageism, including affinity for older people, internalized ageism, and relational ageism, as well as internalized and relational ableism.

RESULTS

Internalized ageism was significantly associated with relational ageism, fear of physical disability, fear of cognitive disability, and affinity for older people. Relational ageism was associated with internalized ageism, relational ableism, fear of physical disability, fear of sensory disability, fear of cognitive disability, and affinity for older people.

DISCUSSION AND IMPLICATIONS

Examining the intersection of ageism and ableism represents the next pivotal juncture to developing effective anti-ageism interventions that address the root anxieties influencing negative attitudes about aging and fears of growing older. Public policy initiatives to address community-level interventions and targeted training to inform discourse that addresses the intersection between ageism and ableism are critical to addressing these issues and promoting age and ability inclusivity.

Cultivating Relationships as a Community-Based Recruitment Strategy in Transdisciplinary Aging Research: Lessons From an Academic-Community Partnership

Participation of Black American older adults in community-engaged research remains challenging in health sciences. The objectives of this study were to describe the specific efforts, successes, and challenges in recruiting Black American older adults in research led by the Health and Wellness in Aging Across the Lifespan core, part of the Virginia Commonwealth University Institute for Inclusion, Inquiry, and Innovation (iCubed). We conducted a cross-case analysis of 6 community-engaged research projects using the community-engaged research continuum model. Successful recruitment strategies comprised a multifaceted approach to community-based collaboration, including a wellness program with a long standing relationship with the community, engaging key stakeholders and a community advisory board, and building a community-based coalition of stakeholders. Posting flyers and modest monetary compensation remain standard recruitment strategies. The cross-case analysis offered critical lessons on the community's nature and level of engagement in research. Relationship building based on trust and respect is essential to solving complex aging issues in the community.

Anti-Ageism for Gerontologists

We argue that gerontologists are products of our ageist culture and that we both perpetuate ageism and suffer from internalized ageism ourselves. We make ageist comments, deny our own age, fail to teach students to recognize and confront ageism, and use language that authorizes and categorizes older people. Gerontologists are in ideal positions to confront ageism through our scholarly work, teaching, and community engagement. However, we suggest that, despite our deep gerontological knowledge, we do not have enough awareness, knowledge, and skills for taking anti-ageism actions in these arenas of our professional lives. We offer some suggestions for confronting ageism, including self-study, increasing content on ageism in the classroom and beyond, pointing out ageist language and behaviors to colleagues and students, working with diversity, equity and inclusion offices on campus, and giving careful consideration to our research approaches and academic writing. To go forward, we must increase awareness about ageism and gain skills in promoting anti-ageism.

"I like being young, active, alive": first-year medical students' attitudes to their own aging

BACKGROUND AND OBJECTIVES

Senior Mentoring programs have been developed to expose students to older adults, increase knowledge of geriatrics, and prepare them to provide patient-centered care. However, even while participating in a senior mentoring program, health professions students demonstrate discriminatory language toward older adults and the aging process. In fact, research suggests ageist practices occur, intentionally or not, among all health professionals and within all healthcare settings. Senior mentoring programs have primarily focused on improving attitudes about older people. The current study evaluated a different approach to anti-ageism by examining medical students' perceptions of their own aging.

RESEARCH DESIGN AND METHODS

This qualitative, descriptive study explored medical students' beliefs about their own aging at the beginning of their medical education using an open-ended prompt immediately before beginning a Senior Mentoring program.

RESULTS

Thematic analysis identified six themes: Biological, Psychological, Social, Spiritual, Neutrality and Ageism. Responses suggest that students enter medical school with a complex view of aging that goes beyond biological considerations.

DISCUSSION AND IMPLICATIONS

Understanding that students enter medical school with a multi-faceted view of aging provides an opportunity for future work to explore senior mentoring programs as a way to tap into this complex view of aging by changing the way students think not just about older patients but about aging more broadly, and specifically about themselves as aging individuals.

STAFFING DIFFERENCES IN NURSING HOME SPECIAL FOCUS FACILITIES AND SPECIAL FOCUS FACILITY CANDIDATES

Introduction

Centers for Medicare and Medicaid Services designates “Special Focus Facilities” (SFF), which are nursing homes receiving special oversight for persistent quality problems. “Special Focus Facility Candidates” (SFFc) are nursing homes with quality problems that are designated as candidates to be future SFFs. Recent academic literature has not examined if SFF and SFFc have significant differences in staffing hours per resident day (HPRD).

Methods

Nursing homes that were SFF or SFFc in 2020 were matched to 5-star nursing homes. Monthly staffing averages were aggregated, and two-way ANOVAs with Tukey Post Hoc were conducted to detect level differences in HPRD across the three facility groups. Gross and Case-Mix staffing HPRD were analyzed, along with daily resident census.

Results

The final sample was n=197 SFFc, and n= 50 SFF, which were matched with n=247 5-star nursing homes for a total sample of Nf494. Over 2020, daily census for 5-star nursing homes was lower (M=72.36, SD=52.5) than SFFc (M=93.77, SD=68.34) or SFFs (M=97.88, SD=44.06). There was a significant difference between SFF and SFFc HPRD in Case-Mix Aide F(2, 5748)=187.6, p= < .005, and Registered Nurse (RN), F(2,5748)=323,p=.003 care. There were no significant differences between SFF and SFFc in HPRD Aide F(2,5748)=380,p=.63, Practical Nurse F(2,5748)=1.1, p=.211, Case-Mix Practical Nurse F(2,5748)=19.57,p=.39, Case-Mix RN F(2,5748)=9.51,p=.91 or Total HPRD F(2,5748)=472.6,p=.16, care. Discussion: There is only a significant difference in staffing levels observed between SFF and SFFc for Aide staffing and RN staffing. This information supports researchers and policymakers in delineating the differences and similarities between SFF and SFFcs.

ENGAGING LOW-INCOME SENIORS IN PARTICIPATORY DESIGN OF SMART SPEAKER APPLICATIONS FOR WELLNESS

Low-income senior housing (LISH) residents are at a high risk of unmanaged health conditions, loneliness, and limited healthcare access. Smart speakers have the potential to improve wellness in LISH settings. We conducted a user-centered process with primarily African American, LISH residents (N=25) to develop prototypes of smart speaker applications for wellness and social connections. Five focus groups were conducted to elicit feedback about challenges with maintaining wellness and attitudes towards smart speakers. Participants expressed their desires for using the technology for safety and health. Through design workshops, they identified several smart speaker functionalities perceived as necessary for improving wellness and social connectedness. Then, seven low-fidelity prototypes and scenarios were developed in the following categories: wellness check-ins, befriending the virtual agent, community involvement, and mood detection. We demonstrate how smart speakers can provide a tool for their wellness and increase access to applications that provide a virtual space for social engagement.

EXPLORING FRONTLINE PERSONNELS’ PERCEPTIONS OF SUPPORT, KNOWLEDGE, AND RESOURCES FOR ELDER ABUSE

In Virginia, the number of both reported and substantiated cases of abuse in later life have grown steadily over the last several years (DARS, 2021; O’Connor, 2019). Unfortunately, the resources provided to combat elder abuse have not maintained the same steady increase; in many cases, funding to agencies that work to prevent abuse in later life has even been reduced (DARS, 2021). To better understand the gap that exists between need and available resources in Virginia, we conducted an exploratory sequential mixed methods study [QUAL → quan] (Creswell & Plano Clark, 2018). In the qualitative strand, we conducted a series of interviews and focus groups with professionals who often are called upon to respond/intervene when elder abuse is suspected: aging and victim services (n = 9), healthcare providers (n = 7), law enforcement (n = 8). Three themes emerged from the qualitative data: increasing capacity, prevention/coordination, and ageism. Findings from the qualitative strand were then used to guide implementation of the quantitative strand. These participants (N = 2,891) worked in a variety of frontline settings with older adults or in aging services, mostly in health care, law enforcement, social services. Project findings point to a need for increased resources for and training on elder abuse, a shift from reaction to prevention of abuse, improved care coordination and case management, and a need to reduce harmful ageist beliefs. Moreover, our findings highlight the effect structural and societal ageism at the policy level perpetuates the prevalence of abuse in later life.

Ageism Interventions: The Need for An Ecological Perspective

Ageism is a dynamic force of oppression that presents systemically within all levels of Bronfenbrenner's ecological system framework (microsystem, exosystem, mesosystem and macrosystem). Although ageism is a well-documented phenomenon with wide-reaching negative impacts, interventions to mitigate ageism's effects remain understudied. This internal evaluation conducted a deductive content analysis of 208 resources on an anti-ageism resource clearinghouse, OldSchool.info. Resources were organized using two coding schemes; to determine focal points based on the ecological systems theory and to ascertain the mechanisms of the intervention (e.g., active or passive approach). Results indicate the majority of ageism interventions are passive-oriented societal-level macrosystem approaches. Findings indicate active-oriented interventions at the personal and relational levels are lacking. Since ageism is embedded within all of the interacting levels of the ecological system, meaningful change in policy and practice will require multiple approaches to developing positive change toward building an age-inclusive society. An ecological approach to ageism can provide critical insights toward the development of policy and law to reduce or eliminate ageism, including promoting positive behaviors and attitudes at the individual level and raising awareness of anti-discrimination and human rights laws at the macrosystem level.

Socioeconomic Effects on Psychosocial Factors Among Low-Income Older Adults

Objectives: Older adults have been disproportionately affected by COVID-19. The primary goal of this study is to determine the socioeconomic effects on psychosocial factors among low-income independent-living older adults, in an urban setting, during the COVID-pandemic. Methods: Participants were recruited through Virginia Commonwealth University’s Richmond Health and Wellness Program. Telephone surveys (n=100) were conducted using the Epidemic – Pandemic Impacts Inventory Geriatric with the Racial/Ethnic Discrimination addendum. Responses were analyzed for income and education effects across seven domains: home life, social activities/isolation, economic, emotional health-wellbeing, physical health, COVID-infection history, and positive change behaviors/experiences. Results: The sample population was between 51 and 87 years of age, 88% were Black, 57% reported incomes of $10,000/year or less, and 60% reported a high-school education or less. There were income effects for social activities/isolation (f = 3.69, p<.05) and positive change (f = 8.40, p<.01), and education effects for COVID History (f = 4.20, p <.04). Discussion: Overall results highlight the social patterns for a diverse sample of low-income urban older adults; education and income are identified as risk factors for social losses, COVID-infection experiences, racial/ethnic discrimination during the COVID-pandemic, and positive change behaviors.

COVID in Context: The Lived Experience of Richmond’s Low-Income Older Adults

Taking a phenomenological approach, this qualitative study describes the lived experiences of low-income older adults during the COVID-19 pandemic. A socio-ecological model was used to organize the five identified themes describing the lived experience: socio-economic context, Black Lives Matter and the politics of race, COVID and polarized views of COVID, interpersonal context (social connections), and individual context (feelings, beliefs, and behaviors). Study findings illustrate the intersectionality of contextual influences on the experience of low-income older adults. Study participants demonstrated remarkable resilience and coping strategies developed in response to the challenges they experienced throughout their lifetime which benefited them when faced with the pandemic, social unrest, and political events that took place in 2020. This study highlights the importance of understanding the larger context of COVID-19 which has significant implications for policy makers and public health leaders.

Anti-Ageism Interventions: An Ecological Approach

Ageism, discrimination based on age, is a systemic problem that occurs at multiple levels of the ecological system – meaning that ageism manifests at the individual, dyadic, institutional and societal levels. The expression of ageism within the levels of the ecological system makes ageism a continually shifting and dynamic force of oppression. Although ageism is a well-documented phenomenon with wide-reaching negative impacts, interventions to mitigate ageism’s effects remain understudied. Little is known about the taxonomy of interventions available addressing ageism at the individual, dyadic, subcultural, institutional and societal levels. The current study conducted a deductive content analysis of an anti-ageism resource clearinghouse, OldSchool.info, to evaluate ageism interventions using an ecological framework. Results indicate the majority of ageism interventions are passive-oriented societal-level macrosystem approaches. A gap analysis will be discussed that indicated more active-oriented interventions with engageable content to address ageism at the personal and relational levels are needed.

Bringing Transdisciplinary Aging Research From Theory to Practice

There is a growing emphasis to use a transdisciplinary team approach to accelerate innovations in science to solve complex conditions associated with aging. However, the optimal organizational structure and process for how to accomplish transdisciplinary team science are unclear. In this study, we illustrate our team’s experience using transdisciplinary approaches to solve challenging and persistent problems for older adults living in urban communities. We describe our challenges and successes using the National Institutes of Health four-phase model of transdisciplinary team-based research. Using a de-identified survey, the team conducted an internal evaluation to identify features that created challenges including structural incongruities, interprofessional blind spots, group function, and group dynamics. The team then identified responses to address the features that created challenges and determined indicators for success. Indicators for success were identified by the team as a place for continued evaluation of the teams’ collaborative effectiveness, transdisciplinary integration, and impact on the university and aging community. This work resulted in the creation of the team’s Transdisciplinary Conceptual Model. This model became essential to understanding the complex interplay between societal factors, community partners, and academic partners. Conducting internal evaluations of transdisciplinary team processes is integral for teams to move beyond the multi- and interdisciplinary niche and to reach true transdisciplinary success. More research is needed to develop measures that assess team transdisciplinary integration. Once the process of transdisciplinary integration can be reliably assessed, the next step would be to determine the impact of transdisciplinary team science initiatives on aging communities.

The Effect of Testing Turnaround Time on COVID-19 Outbreak Severity Within U.S. Nursing Homes

COVID-19 has brought renewed attention to infectious diseases in U.S. nursing homes (NHs). The Testing turnaround time (TAT) of SARS-CoV-2 is vital information, supporting staff ability to make decisions regarding resource allocation. Methods: Using data obtained from the National Healthcare Safety Network’s COVID-19 nursing home data set, we analyzed the TAT of laboratory polymerase chain reaction (PCR) testing on outbreak severity (number of people infected) for residents and staff. A MANOVA was performed on NHs submitting data over 26 weeks (May-November 2020). The independent variable was the average TAT for the two weeks prior (&lt;24 hours, 1-2 days, 3-7 days, or 7+ days). Results: N = 15,363 NHs. The TAT for the combined dependent variables of staff and resident COVID-19 cases. F(10,781,354) = 3161.265, Pillai’s trace = .078, p&lt;.0005, partial η2=.4. The average outbreak severity for staff was 13.93 cases when TAT was &lt; 24 hours, compared to 15.29 cases at 1-2 days. For residents, the difference was less pronounced but still significant. The average outbreak severity for residents was 17.07 cases when TAT was&lt;24 hours, compared to 18.61 cases when the TAT was 1-2 days. Tukey post-hoc tests found significance for all levels of testing for residents and staff at p&lt;.0005. Discussion: Time differences to receive PCR test results from a laboratory are significant in outbreak severity for staff and residents. The most meaningful result positively impacting the ultimate spread and severity of gross cases is when the TAT for PCR results is &lt; 1 day.

Elderhood as an Anti-Ageism Intervention

Ageism is a complex, multi-layered phenomenon impacting feelings, thoughts and behaviors toward self and others. Due to the complexity of ageism, evidence-based anti-ageism interventions have proved challenging and costly. To date, using the concept of elderhood as a mechanism to mitigate the negative impacts of ageism has not been explored. As an anti-ageism strategy, elderhood reframes later life as a stage that encompasses growth and development and expected loss and decline. The current study evaluated a brief video intervention among first-year medical students before participating in a year-long senior mentoring program. First-year medical students (N = 585) from 2018-2021 responded to open-ended questions after viewing the video. Thematic analysis revelated four themes: neutrality, elderhood as development, reframing stigma and elderhood as othering. Findings suggest that elderhood may be a viable and productive anti-ageism strategy.

Alumni survey of a combined doctor of pharmacy/graduate certificate in aging studies program

INTRODUCTION

The Certificate in Aging Studies at Virginia Commonwealth University allows students to study gerontology while completing their doctor of pharmacy (PharmD) or graduate pharmaceutical sciences degree concurrently. The objective of the study was to evaluate alumni satisfaction with the Certificate in Aging Studies program, its application, and its perceived usefulness.

METHODS

Alumni of the program (n = 49) were emailed an anonymous electronic survey about their perceptions of the program. The survey was emailed three times. Responses to eight multiple choice questions were summarized using descriptive statistics. Two free response questions were qualitatively analyzed for themes by two investigators.

RESULTS

The response rate to the survey was 59.2% (n = 29). Most respondents practice in hospital settings (24.1%) and did not undertake additional postgraduate clinical training (44.8%) or earn additional geriatric certifications (69%). The majority (65.5%) reported using the dual program in their career and would recommend the Certificate in Aging Studies to others (96.6%). Most (59%) alumni indicated that the best part of the program was the interprofessional interaction, and 69% suggested no further areas of improvement for the program.

CONCLUSIONS

A PharmD-Gerontology dual program is one way to enhance the workforce to care for the growing older population. This partnership approach should be considered by schools of pharmacy that also offer degree programs in gerontology.

The efficacy of a video-based intervention to reduce ageism among long-term services and supports staff

Research has shown that ageism can act as a barrier to both quality of life and quality of care delivery within the continuum of residential care settings. Anti-ageism interventions have the hefty task of improving attitudes and behaviors toward aging and older adults. The purpose of this study was to examine whether a one-hour video-based intervention designed to address ageism could decrease self-reported ageist attitudes and behaviors among staff members of long-term service and support settings. This cross-sectional study used data collected from 265 staff members of aging services organizations. The study examined ageist attitudes and behaviors at pre-intervention, and at two follow-up points: immediately after the intervention and three-month post-intervention. Results demonstrated that internalized aging anxiety significantly decreased from pre-intervention to the immediate follow-up and stayed stable at the 2^nd follow-up. Results showed that ageist behaviors significantly decreased over the three-month study period and that participants were able to identify specific actions they had taken as a result of the video intervention. The study suggests that a low-cost, short video-based intervention on ageism can improve ageism-related attitudes and behaviors among staff in long-term services and supports settings.

Introduction to the JPIC issue, Aging in older adulthood: Community-level intervention programming and partnerships providing older adults with community health promotion opportunities

Community-level health promotion programs offer opportunities to improve the lives of older adults and improve the cultural narrative about aging. However, age-discrimination, ageism, and negative attitudes about aging, across the systematic ecological community levels have undermined older adult health. While the longevity of a society is a marker for success worldwide, age-discrimination and ageism, seen through limited community-level health advancement opportunities, have thwarted progress toward societal elderhood, even in the most developed and advanced nations. As a society, we need to continue to push for community-level prevention and intervention across the older age spectrum, to continue human advancement through late life.

GPS Tracking Technologies to Measure Mobility-Related Behaviors in Community-Dwelling Older Adults: A Systematic Review

Global positioning system (GPS) technology has been increasingly used in aging research as a tool for reliably capturing the level and patterns of mobility among older adults. This article aims to systematically review the current state of GPS-based mobility research with community-dwelling older adults. Twenty-nine studies from 2008 to 2019 are included. Included studies examined various forms of temporal and spatial mobility measures. This review provides a synthesis of the current evidence on the risk factors or correlates of GPS-driven mobility limitations, such as demographic, cognitive, physical, psychological, and environmental factors. There is variability in types of GPS technology and GPS-derived mobility measures, GPS recording methods, data processing, and correlates of mobility limitation across studies. Future research should focus on identifying meaningful GPS-derived mobility measures and developing standardized protocols for GPS administration and data analytics for comparison across studies.

Bringing Transdisciplinary Aging Research from Theory to Practice

There is a growing emphasis to use a transdisciplinary team approach to accelerate innovations in science to solve complex conditions associated with aging. However, the optimal organizational structure and process for how to accomplish transdisciplinary team science is unclear. In this forum, we illustrate our team's experience using transdisciplinary approaches to solve challenging and persistent problems for older adults living in urban communities. We describe our challenges and successes using the National Institutes of Health four-phase model of transdisciplinary team-based research. Using a de-identified survey, the team conducted an internal evaluation to identify features that created challenges including structural incongruities, inter-professional blind spots, group function, and group dynamics. This work resulted in the creation of the team's Transdisciplinary Conceptual Model. This model became essential to understanding the complex interplay between societal factors, community partners, and academic partners. Conducting internal evaluations of transdisciplinary team processes are integral for teams to move beyond the multi- and interdisciplinary niche and to reach true transdisciplinary success. More research is needed to develop measures that assess team transdisciplinary integration. Once the process of transdisciplinary integration can be reliably assessed, the next step would be to determine the impact of transdisciplinary team-science initiatives on aging communities.

Job Satisfaction in the Long-Term Care Workforce: How Ageism Plays a Role

Prior research has demonstrated that ageism, specifically negative attitudes and behaviors about growing old, can be barriers to delivering high-quality long-term care (LTC), but little is known about how ageism may be related to job satisfaction – an important driver of workforce retention in LTC. Hence, the purpose of this study was to examine the role of ageism in job satisfaction in LTC. Our cross-sectional study used data collected from 265 staff members of aging services organizations (e.g. nursing homes, assisted living) representing the continuum of job types in LTC. The study examined the relationship between ageist attitudes (i.e. internalized and relational aging anxiety; affinity for older persons) and ageist behaviors, and job satisfaction when controlling for socio-demographic (i.e. age; gender; ethnicity) and employment-related variables (i.e. years of employment; advanced training in gerontology; direct care vs. managerial position). Results of a regression analysis showed that lower internalized aging anxiety and higher affinity for older people were significantly associated with higher levels of job satisfaction. Findings suggest addressing ageism to improve job satisfaction in LTC and provide some evidence for incorporating ageism screening and training into recruitment and onboarding of staff to enhance job satisfaction and to mitigate turnover.

Approaches to Anti-Ageism Interventions

Ageism, a multidimensional construct, is also understood as a relational process whereby perceptions and behaviors toward older individuals by younger individuals not only damage the self-esteem of elders, but also create a hostile environment for their own future social interactions and their own future self-development as elders. Anti-ageism interventions have the hefty task of improving attitudes and behaviors toward aging within all of these contexts. This presentation will discuss findings from two different anti-ageism interventions both designed to mitigate the negative impacts of ageism. Results from a study on an intergenerational arts-based program found that after participation students demonstrated a positive change in their attitudes toward older adults. Findings from a video-based ageism intervention among a sample of 265 staff members in 15 senior living communities demonstrated decreased internalized aging anxiety as well as decreased ageist behaviors directly after the training and at three month post follow-up. Given the complex and systemic nature of ageism, diversity is necessary in scope and type of intervention in order to reach the broadest audience.

A Theoretical Framework for the Development of Views of One’s Own Aging

Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among all health professions and within assisted living and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). There is reason to believe that how we feel about other older adults is a reflection of how we feel about ourselves as aging individuals. As part of an evaluation of a Senior Mentoring program, we found that students’ attitudes towards older adults were not significantly improved (t (92) = .38, p = .70). To further explore this, we collected subsequent qualitative data. Specifically, we asked students to respond to the open-ended prompt before and after completing their senior mentoring program: How do you feel about your own aging? Our findings have revealed just how complex students’ views towards aging and elderhood are, pointing to a need to develop a theoretical framework for how these views are formed. Thus, the results of this qualitative grounded theory study illustrate the stages of development medical students’ progress through as they come to accept themselves as aging humans.

My Heart Has Always Been Set on Pediatrics, and Other Insights From First-Year Medical Students

Senior mentoring programs provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase their knowledge of topics in geriatrics and aging, and increase the likelihood that students will pursue geriatric specialties. Though research findings show that senior mentoring programs have the potential to increase medical students’ attitudes towards older adults (Samra et al., 2013) and their willingness to consider working with older patients in the future (McManus et al., 2017), a critical shortage of doctors who specialize in geriatrics still exists. Moreover, the demand for geriatrically-trained physicians is expected to continue to increase (American Geriatrics Society, 2018). In order to develop avenues for successfully fostering interest in and pursuit of geriatrics specialties, we need to fully understand students’ perceptions of working with older adults. The purpose of this qualitative content analysis was to explore first-year medical students’ (n = 216) perceptions of working with older adults. We asked students to respond to the following reflection at the beginning and end of their Senior Mentoring program: How do you feel about working with older patients after you complete your training? Our findings suggest that while students feel more comfortable with and open to caring for older adults, they do not feel compelled to pursue geriatrics. Themes and sub-categories emerging from the data provide insight into why students continue to dismiss pursuing geriatrics.

KNOWLEDGE OF AGEISM AND ATTITUDES ABOUT AGING AS A CORE COMPETENCY FOR HEALTH PROFESSIONALS

Senior mentoring programs have been established that provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase knowledge of geriatrics, and prepare them to care for an aging population. However, even while participating in a senior mentoring program, health professions students still demonstrate some discriminatory language towards older adults (e.g., Gendron, Inker, & Welleford, 2018). In fact, research suggests ageist practices occur, intentionally or not, among health professions in disciplines such as medicine, nursing, and social work and even within assisted and long-term care facilities (e.g., Bowling, 1999; Dobbs et al., 2008; Kane & Kane, 2005). We evaluated a senior mentoring program to gauge the impact of a new pedagogical approach and to gain a deeper understanding of the learning gained in relation to ageism and elderhood. This qualitative content analysis explored first-year medical students’ opinions of their own aging and attitudes towards caring for older adults. Students (n = 216) participating in a brief curriculum model of a senior mentoring program responded to the following open-ended prompts before and after the program: 1) How do you feel about your own aging?; 2) How do you feel about working with older adult patients after you complete your medical training? Responses suggest that students’ views of their own aging and views towards towards working with older patients are positively impacted by their experiences in the senior mentoring program.

ADVANCING OUR UNDERSTANDING OF ELDERHOOD: A NARRATIVE REVIEW

There are relatively few explorations of later life in the peer reviewed gerontological literature that holistically embrace the duality of potential and decline. This is in striking contrast to a growing body of non-scholarly literature, frequently authored by elders, displaying deep interest in the phenomenon of elderhood, i.e. the holistic, lived experience of later life. We conducted a narrative review with the aim of describing the state of the science with regard to the bio-psycho-social-spiritual experience of elderhood. Following a search of multiple databases for English language, peer reviewed articles published from 2000-2017, we identified 24 articles in the disciplines of gerontology, anthropology, psychology, the humanities, and spirituality studies, reflecting elderhood in Eastern and Western cultures. While the articles offered no shared operational definition of elderhood, nor applied any unifying conceptual or theoretical structures, several common themes emerged. These included the description of elderhood as both inward facing (inner development) and outward facing (social contributions of elders). Numerous articles also recognized that ageism socially mediates the experience of elderhood, resulting in a failure of social systems and structures to recognize or provide opportunities for lifelong growth in later years, including a lack of mentors and role models for individuals transitioning into elderhood. This review demonstrates that there is a compelling need for the discipline of gerontology to strengthen our understanding of the phenomenon of elderhood by leading on the development and implementation of theoretically driven empirical research into the subject of the holistic, lived experience of later life.

Development of the Relational Ageism Scale: Confirmatory Test on Survey Data

The objective of the study is to test a refined measure of attitudes about aging as a multidimensional construct reflective of a relational process that includes personal identity (i.e., beliefs about oneself), social identity (i.e., self-conception based on group membership), and collective identity (i.e., self-conception based on comparison of groups) as well as capturing awareness of ageism and its impact. Researchers refined the Aging Anxiety Scale and recruited a convenience sample of 329 participants via a social media platform. A principal component factor analysis revealed the specification of three latent factors: personal, relational, and collective aging anxiety. Awareness of ageism as a problem in society was lower than awareness of other forms of discrimination, and awareness of the negative impacts of ageism was low. The findings support the incorporation of this new measure of relational aging anxiety as a by-product of social identity and construction in future ageism studies.

2018 American Society of Consultant Pharmacists Annual Meeting & Exhibition

Poster abstracts are evaluated based on the following criteria: significance of the problem to healthy aging or medication management; innovativeness of ideas, methods, and/or approach; methodological rigor of methods and approach; presentation of finding; implications identified for future research, practice, and/or policy; and clarity of writing. Submissions are not evaluated through the peer-reviewed process used by The Consultant Pharmacist. Industry support is indicated, where applicable. Presenting author is in italics. The poster abstract presentation is supported by the ASCP Foundation.

Who Is Likely to Commit to a Career With Older Adults?

Gerontology, as an academic discipline, provides professionals with the conceptual knowledge and the skills necessary to address the complexities of working with a diverse aging population. We know little about what attracts professionals to the aging field and what maintains commitment to these careers. The aim of this study was to investigate the roles of career motivation, job satisfaction, anxiety about aging, and professional identity in relation to career commitment among those working with older adults. Participants (N = 756) were recruited through organizations and institutions serving older adults and responded to an online survey. Participants' motivation for working with older adults, level of job satisfaction, and exposure to formal gerontological education significantly predicted career commitment. In addition, aging anxiety mediated the relationship between job satisfaction and career commitment. This study sheds lights on perspectives of professionals working with older adults and highlights areas for future gerontological research and training.

Perceived Benefits of Mobile Learning Devices for Doctoral Students in a School of Allied Health Professions

Graduate students increasingly use personal electronic devices for learning but little is known about how they evaluate their benefits as mobile learning devices (MLDs). This study surveyed students in a hybrid distance education doctoral (PhD) program about their perceptions of the benefits of MLDs. Overall, the study found a range of opinions about the value of MLDs with about one-half of respondents finding benefits. Respondents emphasized that the MLDs improved motivation and productivity and that they were helpful in reviewing course-casts of on-campus sessions. Continued research is needed on doctoral education in general and the increasing use of innovations such as MLDs.

Evaluation of glutathione-sensitive fluorescent dyes in cortical culture

The sensitivity of six fluorophores to glutathione (GSH) was evaluated in living rat cortical neuronal/glial mixed cultures during the first 23 days in vitro (DIV). Four of the dyes require glutathione-S-transferase (GST) to form a fluorescent conjugate, potentially conferring specificity for GSH: these included t-butoxycarbonyl-Leu-Met-7-amino-4-chloromethylcoumarin (CMAC), 7-amino-4-chloromethylcoumarin (CMAC-blue), monochlorobimane (MCB), and 5-chloromethylfluorescein diacetate (CMFDA). The final two dyes examined, 2,3-naphthalenedicarboxaldehyde (NDA) and o-phthaldehyde (OPD), do not require GST for adduct formation with GSH. To examine the specificity of the dyes for GSH, cultures grown less than 6 DIV were pretreated with diethyl maleate or DL-buthionine-(S, R)-sulfoximine to deplete endogenous GSH. This resulted in a substantial loss of staining by CMAC, CMAC-blue, and MCB and partial loss of staining by OPD, indicating specificity for GSH, while staining by CMFDA or NDA was not altered, indicating a lack of specificity for GSH. Neurons experienced a dramatic decline in GSH levels relative to astrocytes between 5-6 DIV, as shown by a loss of neuronal staining with CMAC, CMAC-blue and MCB. This decrease in staining was not due to a decrease in GST activity, as neurons stained with the GST-insensitive OPD also exhibited a decline in GSH-sensitive staining. Immunolabeling experiments demonstrated that CMAC staining co-localized with GFAP-positive astrocytes, but not with MAP-2-positive neurons, in 18 DIV cultures. Finally, CMAC was exploited as a specific morphological marker of astrocytes in cultures aged >5 DIV. CMAC staining was employed to monitor astrocyte proliferation and to resolve astrocytes in living mixed cultures co-loaded with the Ca(2+)-sensitive dye, calcium green 5N-AM. GLIA 30:329-341, 2000. Published 2000 Wiley-Liss, Inc.

Quality of life and pain in patients with recurrent breast and gynecologic cancer

Pain is a central factor affecting quality of life for the cancer patient. This descriptive study was designed to explore the relationship between pain and several factors affecting quality of life. The factors explored included physical and social functioning, emotional health, and spiritual commitment in women with recurrent breast or gynecologic cancer. Pain frequency, amount, and interference with activities were found to correlate more strongly with objective measures of quality of life (i.e., physical and social functioning) than subjective measures (i.e., psychological or spiritual dimensions).