Life-Space Mobility, Transportation, and the Companionship Network of Members of a Hispanic Senior Center

OBJECTIVES

Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships.

METHODS

This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the likelihood of a companionship tie among senior center members (N = 42).

RESULTS

Members had an average of 2 companionships with one another (M = 2.2, SD = 2.7). Companionships were more likely for members with greater life-space mobility (p = .009), who attended the senior center more frequently (p = .004), with automobile ownership in their households (p = .034), and who were not transportation cost-burdened (i.e., spent less than 15% of their income on transportation, p = .005). Demographic characteristics, limitations on instrumental activities of daily living, and being at risk for depression were not significantly associated with the likelihood of companionships.

DISCUSSION

These findings extend previous knowledge of the role of life-space mobility and transportation in supporting general social participation for older adults to include the importance of transportation and mobility for having companions within a senior center.

A Semantic Approach to Describe Social and Economic Characteristics That Impact Health Outcomes (Social Determinants of Health): Ontology Development Study

BACKGROUND

Social determinants of health (SDoH) have been described by the World Health Organization as the conditions in which individuals are born, live, work, and age. These conditions can be grouped into 3 interrelated levels known as macrolevel (societal), mesolevel (community), and microlevel (individual) determinants. The scope of SDoH expands beyond the biomedical level, and there remains a need to connect other areas such as economics, public policy, and social factors.

OBJECTIVE

Providing a computable artifact that can link health data to concepts involving the different levels of determinants may improve our understanding of the impact SDoH have on human populations. Modeling SDoH may help to reduce existing gaps in the literature through explicit links between the determinants and biological factors. This in turn can allow researchers and clinicians to make better sense of data and discover new knowledge through the use of semantic links.

METHODS

An experimental ontology was developed to represent knowledge of the social and economic characteristics of SDoH. Information from 27 literature sources was analyzed to gather concepts and encoded using Web Ontology Language, version 2 (OWL2) and Protégé. Four evaluators independently reviewed the ontology axioms using natural language translation. The analyses from the evaluations and selected terminologies from the Basic Formal Ontology were used to create a revised ontology with a broad spectrum of knowledge concepts ranging from the macrolevel to the microlevel determinants.

RESULTS

The literature search identified several topics of discussion for each determinant level. Publications for the macrolevel determinants centered around health policy, income inequality, welfare, and the environment. Articles relating to the mesolevel determinants discussed work, work conditions, psychosocial factors, socioeconomic position, outcomes, food, poverty, housing, and crime. Finally, sources found for the microlevel determinants examined gender, ethnicity, race, and behavior. Concepts were gathered from the literature and used to produce an ontology consisting of 383 classes, 109 object properties, and 748 logical axioms. A reasoning test revealed no inconsistent axioms.

CONCLUSIONS

This ontology models heterogeneous social and economic concepts to represent aspects of SDoH. The scope of SDoH is expansive, and although the ontology is broad, it is still in its early stages. To our current understanding, this ontology represents the first attempt to concentrate on knowledge concepts that are currently not covered by existing ontologies. Future direction will include further expanding the ontology to link with other biomedical ontologies, including alignment for granular semantics.

The Risk for Loneliness and Major Depression among Solo Agers

Solo agers may be vulnerable to social isolation and mental health sequelae, particularly if they lack close family or friendship ties. This study examined associations among indicators of solo aging, frequency of loneliness, and Major Depressive Disorder among adults aged 60+. Depressed participants were diagnosed by a geriatric psychiatrist and control participants were not depressed. We hypothesized that older adults with more indicators of solo aging (i.e., living alone, being unmarried, not having family or friends nearby) would be more often lonely and more likely to be depressed. In multivariate analyses controlling for health comorbidities and financial difficulty, each additional solo aging indicator significantly increased the likelihood of frequent loneliness, 95% CI OR [1.50, 2.80], and having a depression diagnosis 95% CI OR [1.04, 2.07]. Solo agers may be vulnerable to loneliness and depression, reinforcing the need for assessment and intervention for social isolation among older adults.

Recruitment and Data Collection Challenges of Research Focused on Older Adults and Family Caregivers from Asian American Communities: A Case Study Series

OBJECTIVES

The purpose of this case study series was to present recruitment and data collection strategies used for Asian American ethnic groups by documenting challenges experienced by researchers in the field of aging.

SUMMARY

We compiled four case studies investigating Asian American older adults and/or family caregivers (i.e., Vietnamese, South Asians, Chinese, and Koreans). Each case study employed unique research methods to overcome experienced challenges associated with recruitment and data collection.

DISCUSSION

Three constructs were organized for effective recruitment and data collection strategies of this racial group and included (1) forming a bilingual and bicultural research team (research-centered); (2) establishing reciprocal partnerships between researchers and community partners (community-centered); and (3) understanding the historical and cultural backgrounds of targeted ethnic groups (participant-centered). Approaches taken to address the range of challenges and limitations identified in this case study series may also help increase the representation of Asian-American older adults and family caregivers in research.

CLINICAL IMPLICATIONS

Successfully including racial and ethnic minority groups in research, especially Asian Americans, may reduce existing racial disparities in mental and physical health. Any barriers and facilitators affecting the research regarding Asian American ethnic groups should continue to be discussed.

Community-clinic linkages for promoting HIV prevention: organizational networks for PrEP client referrals and collaborations

Community-clinic linkages may help communities increase HIV pre-exposure prophylaxis (PrEP) uptake. Referrals from community-based organizations may be particularly important for linking Black men who have sex with men (MSM) to PrEP. This study describes PrEP referral and HIV/STI prevention networks among organizations that serve MSM in Houston, TX (N = 40), and Chicago, IL (N = 28), and compares network positions of organizations based on percentage of Black/African American clients. A majority of organizations conducted PrEP awareness/promotion activities, but fewer made PrEP referrals, with little overlap between the collaboration and referral networks. The networks tended to have a densely connected core group of organizations and more a peripheral group of organizations linking into the core with relatively few times among themselves; this core/periphery structure is efficient, but vulnerable to disruptions. The percentage of Black/African American clients organizations served was not related to most measures of network centrality. However, in Houston's collaboration network, higher Black-serving organizations tended not to hold as influential positions for controlling communications or flows of resources. The findings indicate a potential to leverage collaborations into PrEP referral pathways to enhance PrEP promotion efforts and identify opportunities to address racial disparities in PrEP uptake.

Examining Racial and Ethnic Disparities Among Older Adults in Long-Term Care Facilities

BACKGROUND AND OBJECTIVES

The purpose of this project was to examine individual-level ethnic and racial differences and facility-level differences in types of complaints and rates of complaint resolution in a local long-term care ombudsman program.

RESEARCH DESIGN AND METHODS

We employed a mixed-methods sequential explanatory design. First, we analyzed secondary complaint data based on residents' race and ethnicity (n = 464) and facility characteristics (n = 101). We then conducted 2 focus groups with ombudsmen (n = 12) to provide context for our quantitative findings and to explore the ombudsmen's views on disparities in long-term care facilities.

RESULTS

Racial and ethnic minority residents were more likely to generate complaints related to residents' rights than nonminority residents. Assisted living facilities were more likely to have complaints related to residents' rights and outside agencies than nursing homes. The rate of complaint resolution increased among facilities with a higher proportion of minority residents, compared to facilities with a lower proportion of minority residents. However, an estimation of cross-level interaction revealed that non-Hispanic White residents in these facilities experienced faster complaint resolution than minority residents. Ombudsmen expressed concerns about communication barriers between minority residents and facility staff and discussed different complaint types and resolution rates according to facility types.

DISCUSSION AND IMPLICATIONS

Our findings highlight disparities across long-term care facilities as well as disparities in care minority residents experience. Long-term care ombudsman program complaint data should be disaggregated by race and ethnicity of the residents to advocate for policy change at facility, state, and federal levels.

Social Networks in an Assisted Living Community: Correlates of Acquaintance and Companionship Ties Among Residents

OBJECTIVES

Social relationships are important for older adults' well-being, including those who live in assisted living (AL) communities. This study explores coresident networks within an AL community and identifies factors associated with residents' social ties.

METHODS

Acquaintance and companionship networks within the community are described using cross-sectional survey data (N = 38). We use inferential network statistical methods to estimate parameters for factors associated with residents' acquaintance and companionship ties.

RESULTS

Residents reported an average of 10 acquaintances and almost 4 companionships with other residents in the sample. The likelihood a resident had an acquaintance was associated with higher levels of cognitive functioning (p < .05), higher levels of physical limitations (p < .01), living in the AL community for a longer time (p < .01), and less frequent contact with outside family and friends (p < .05). Acquaintances were more likely between residents who moved in around the same time as each other (p < .01), lived on the same floor (p < .001), or had similar levels of physical limitations (p < .05). Companionships were more likely to be reported by male residents (p < .05) and residents with higher levels of cognitive functioning (p < .05) or depressive symptoms (p < .05). Longtime residents were more popular as companions (p < .01). Companionships were more likely between residents who lived on the same floor (p < .001) or were similar in age (p < .01).

DISCUSSION

This research contributes to the literature of older adults' nonkin social relationships by providing detailed descriptions of the acquaintance and companionship networks within an AL community, quantifying correlates of residents' social ties, and distinguishing between acquaintances and companions.

Network Modeling of Assisted Living Facility Residents' Attendance at Programmed Group Activities: Proximity and Social Contextual Correlates of Attendance

BACKGROUND AND OBJECTIVES

Social engagement, including participation in group activities, supports older adults' mental and physical health. However, many residents of assisted living facilities do not participate in their facility's programmed group activities. Explaining residents' attendance at group activities is complex; attendance is associated with a confluence of individual-level and contextual factors. The aim of this study was to assess the effects of multilevel factors on attendance, including residents' proximity to activity location and the potential for one resident's attendance to depend on other residents' attendance.

RESEARCH DESIGN AND METHODS

We used bipartite exponential random graph models to examine the attendance of 35 residents at 563 programmed group activities. We simultaneously modeled the effects of the geospatial distance from a resident's apartment to the activity and the tendency for residents to attend activities with similar groups of other residents (i.e., shared attendance) on the likelihood of attendance, while controlling for individual-level factors (demographic and health indicators) and activity popularity.

RESULTS

Greater distance was associated with a reduced likelihood of attendance (p < .001) and residents tended to attend activities with similar subsets of other residents (p < .001).

DISCUSSION AND IMPLICATIONS

Findings suggest that greater distance to group activities may be a barrier to attendance. Implications include facility design, placement of activities and apartments, and mobility-related strategies to increase activity participation. It is also important to recognize that participation in activities is dependent on social context. We recommend that proximity to activities and social contextual factors be considered in future examinations of attendance at group activities.

Supports and gaps in federal policy for addressing racial and ethnic disparities among long-term care facility residents

Older adults from racial and ethnic minority groups are likely to face disparities in their health as well as care experiences in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. Policymakers in the United States face concerns around long-term services and supports to address the growing demands of a rapidly aging population through public and private sector initiatives. It is important to create inclusive and culturally responsive environments to meet the needs of diverse groups of older adults. In spite of federal policy that supports minority health and protects the well-being of long-term care facility residents, racial and ethnic disparities persist in long-term care facilities. This manuscript describes supports and gaps in the current United States' federal policy to reduce racial and ethnic disparities in long-term care facilities. Implications for social workers are discussed and recommendations include efforts to revise portions of the Patient Protection and Affordable Care Act of 2010, amending regulations regarding long-term care facilities' training and oversight, and tailoring the Long-Term Care Ombudsman Program's data collection, analysis, and reporting requirements to include racial and ethnic demographic data.

DISTANCE FROM APARTMENT TO ACTIVITY AS A BARRIER TO PARTICIPATION IN GROUP ACTIVITIES FOR ASSISTED LIVING RESIDENTS

Participating in group activities is potentially also beneficial for residents of assisted living facilities, who have decreased independence due to physical or cognitive limitations. However, their impaired abilities can make attending group activities difficult. One potential barrier is the physical distance from residents’ apartments to the activity location. This study analyzed resident (N=30) attendance at group activities in an assisted living facility. Attendance records for 822 group activities over the course of six months and the distance between residents’ apartments and activity location were analyzed. Exponential random graph models were used to estimate the effect of individual-level, activity-level, and social network factors on the likelihood that a resident attends an activity. On average, residents attended 128 events (SD = 151) during the six month study period. The average size of activities was 4.6 residents (SD = 2.9). The closest distance between a resident’s apartment and an activity was 7.7 feet; however, some residents had to travel up to 382 feet to attend an activity (M=153 ft.; SD=52). After controlling for individual-, activity-, and social network-level factors, distance to the activity was significantly and negatively associated with the likelihood a resident attended the activity. In spite of the fact that assisted living facilities offer supports and services to help residents overcome their physical limitations, it appears that distances within the building can be barriers to participation in group activities. This should be taken into account in designing facilities, locating group activities, and devising strategies to increase participation in group activities.

HEALTHCARE ACCESS AND SOCIAL ENGAGEMENT OF OLDER MINORITY ADULTS: EXPERIENCES NAVIGATING TRANSPORTATION BARRIERS

Transportation is vital in the daily lives of older adults and provides access to health care services and health enhancing activities, such as social engagement. Disparities in mobility exist for older African American and Hispanic adults compared to non-Hispanic Whites, including higher likelihood of driving cessation at an earlier age and having a higher risk for reduced life space. This poster presents findings from a qualitative analysis of data from the Using Geo-Ethnography to Explore the Spatial Accessibility of Health Services for Aging Minorities Study (GeoSAS), a mixed methods study of older minority adults in Houston, TX. Using interpretive phenomenological analysis, the transcripts of semistructured interviews with 23 older adults (13 African American and 10 Hispanic; 17 female; mean age = 71.3 yrs, SD = 6.3 years) were analyzed to address the research question: What are the mobility experiences and perceptions of minority older adults regarding healthcare access and social engagement? Based on an ecological systems theoretical framework, we found reciprocal influences of (1) healthcare systems and transportation utilization and (2) participants’ health and well-being, mobility, and social engagement. Support from family members and financial capacity were critical for participants’ mobility. Implications of this research include educating health care providers about patients’ transportation experiences and barriers, optimizing social support to increase mobility, and addressing systematic disparities in transportation access to enhance health and well-being for older minority adults.

FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

Turning Doctoral Students into Faculty in Gerontological Social Work: The AGESW Experience

Developing faculty interested in aging may help social work meet the needs of our growing aging population. However, doctoral students need a variety of supports to complete PhDs and become gerontological social work faculty. This study explored one program's role in supporting the development of social work doctoral students to faculty in gerontology. An e-mail invitation was sent to all former participants (2010-2016 cohorts) of the Association for Gerontology Education in Social Work (AGESW) Pre-Dissertation Fellows Program (PDFP). The 38-question online survey consisted of Likert-type scales, multiple answers, and one open-ended question per section about the program's impacts on their academic career development in teaching, research, mentoring, and support. Forty-five respondents, representing all six cohorts, completed the survey. More than half reported that the PDFP contributed to their ability to publish their research (64.4%, n = 29), grow their professional network (86.7%, n = 39, and teach (55.5%, n = 25). Doctoral programs provided different experiences than the PDFP, including mentoring, methodological training, professional development, networking, and peer support. Results suggest the PDFP provides content recipients value that supplements instruction received in their institutions. The program's ability to connect students to each other and to national leaders enhances their career development and socialization into academic roles.

What Can an Evaluation of the AGESW Predissertation Fellows Program Tell Us about the Mentoring Needs of Doctoral Students?

Good mentoring is a key variable for determining success in completing a doctoral program. The Association for Gerontology Education in Social Work (AGESW) provides leadership in the areas of gerontological social work education, research, and policy. In 2010, AGESW began offering the Pre-Dissertation Fellows Program (PDFP) to enhance social work doctoral students' professional development and skillset for academia. The purpose of this study was to examine student participants' perceptions of the PDFP in its role to providing mentorship and training for an academic position that encompasses research, teaching and professional service. This qualitative study examined eight cohorts (2010-2018) of the AGESW PDFP (N = 85). Participants identified a number of aspects of professional development gained, gratitude for the training, an appreciation for candid advice received, and areas of professional development they felt they were lacking within their doctoral training. Implications for doctoral education, doctoral mentorship programs, and the AGESW pre-dissertation program are discussed. Further, programs such as AGESW pre-dissertation fellowship program can serve as a model for other doctoral training initiatives to prepare students to work in academia.

Using Social Network Analysis to Assess Professional Network Development among AGESW Pre-Dissertation Fellowship Program Participants

Professional networks are important for the success of doctoral students and early career faculty members, yet there is little research about what types of experiences help emerging scholars develop these networks. Social network analysis may be an ideal method for studying the effectiveness of training programs in nurturing network development among emerging scholars. We describe one application of this method, which was used to examine the professional networks formed through participation in the Association of Gerontological Education in Social Work (AGESW)'s Pre-Dissertation Fellowship Program (PDFP). Alumni (n = 12) from the first three cohorts of the program (2010-2012) reported meeting an average of 20 scholars (SD = 13.2) through AGESW, which led to potential professional interactions and collaborations on conference presentations and manuscripts. Although challenges with missing data limited the conclusions that can be drawn, we find that this method holds promise for helping to identify key factors that facilitate professional network development in pre-dissertation training programs such as the PDFP.

Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men

BACKGROUND

This study explores the spatial accessibility of outpatient drug treatment facilities and the potential relationship with drug use-related outcomes among Mexican American heroin users.

METHODS

Secondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study in Houston, Texas. We used geographic information systems (GIS) to derive two spatial accessibility measures: distance from one's place of residence to the closest drug treatment facility (in minutes); and the number of facilities within a 10-minute driving distance from one's place of residence. Exploratory logistic regression analyses examined the association between the spatial accessibility of drug treatment facilities and several drug use-related outcomes: internal locus of control (LOC); perceived chances and worries of injecting in the next six months; treatment utilization; and location of last heroin purchase.

RESULTS

Participants with greater spatial access to treatment programs were more likely to report a higher chance of injecting in the near future. However, while current heroin users were more worried about injecting in the next six months, greater spatial access to treatment programs seemed to have a buffering effect. Finally, those who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood versus outside the neighborhood. Spatial accessibility was not associated with internal LOC or treatment utilization.

CONCLUSION

The findings showed that the presence of outpatient treatment facilities-particularly services in Spanish-may influence perceived risk of future heroin use and purchasing behaviors among Mexican American men. Implications for future spatially-informed drug use research and the planning of culturally and linguistically responsive drug treatment programs are discussed.

A new atmospherically relevant oxidant of sulphur dioxide

Atmospheric oxidation is a key phenomenon that connects atmospheric chemistry with globally challenging environmental issues, such as climate change, stratospheric ozone loss, acidification of soils and water, and health effects of air quality. Ozone, the hydroxyl radical and the nitrate radical are generally considered to be the dominant oxidants that initiate the removal of trace gases, including pollutants, from the atmosphere. Here we present atmospheric observations from a boreal forest region in Finland, supported by laboratory experiments and theoretical considerations, that allow us to identify another compound, probably a stabilized Criegee intermediate (a carbonyl oxide with two free-radical sites) or its derivative, which has a significant capacity to oxidize sulphur dioxide and potentially other trace gases. This compound probably enhances the reactivity of the atmosphere, particularly with regard to the production of sulphuric acid, and consequently atmospheric aerosol formation. Our findings suggest that this new atmospherically relevant oxidation route is important relative to oxidation by the hydroxyl radical, at least at moderate concentrations of that radical. We also find that the oxidation chemistry of this compound seems to be tightly linked to the presence of alkenes of biogenic origin.

Connection of sulfuric acid to atmospheric nucleation in boreal forest

Gas to particle conversion in the boundary layer occurs worldwide. Sulfuric acid is considered to be one of the key components in these new particle formation events. In this study we explore the connection between measured sulfuric acid and observed formation rate of both charged 2 nm as well as neutral clusters in a boreal forest environment A very short time delay of the order of ten minutes between these two parameters was detected. On average the event days were clearly associated with higher sulfuric acid concentrations and lower condensation sink (CS) values than the nonevent days. Although there was not a clear sharp boundary between the nucleation and no-nucleation days in sulfuric acid-CS plane, at our measurement site a typical threshold concentration of 3.10(5) molecules cm(-3) of sulfuric acid was needed to initiate the new particle formation. Two proposed nucleation mechanisms were tested. Our results are somewhat more in favor of activation type nucleation than of kinetic type nucleation, even though our data set is too limited to omit either of these two mechanisms. In line with earlier studies, the atmospheric nucleation seems to start from sizes very close to 2 nm.