Social Games: The Intersection of Established Reward Structures and Exercise for Older Rural Adults

Abstract A high percentage of older adults engages with games; however research about impacts of gaming on older adults is focused almost exclusively on games intended to strengthen cognitive health or slow age-related cognitive decline, very little relates gaming to exercise. Rural –dwelling older adults are underrepresented in this as in other health-related research. Nonetheless, recent developments that explore effectiveness of embedding positive health behaviors (including exercise) in established games such as Bingo hold great promise for addressing the endemic social isolation and chronically debilitating conditions often associated with rural aging. Using recent research with a challenging population group (rural Appalachian older adults) as an anchor for discussion, this paper describes the state of the art of such interventions and, through a multinational lens, finds that these suggest a new direction for gaming design that could enhance effectiveness of the use of gaming to improve health and happiness of rural adults. Part of a symposium sponsored by the Rural Aging Interest Group.


SUCCESSFUL ADAPTATION IN THE CONTEXT OF CARE ENVIRONMENTS: PROMISE AND CHALLENGE FROM A CAREER IN GEROPSYCHOLOGY Suzanne Meeks, University of Louisville, Louisville, Kentucky, United States
My first clinical exposure to older adults was in a psychiatric hospital, to people with life-long severe mental illnesses; I was drawn to their perseverance. The older people we see clinically interact with care environments that may or may not effectively use patients' personal histories. I have studied the affective experiences of older people in care environments-the mental health system and long-term care--to improve mental health care and well-being. Solutions seem obvious, and difficult. Theory and abundant empirical research tell us that environments can support adaptation through nurturing strengths, offering compensatory tools, and acknowledging losses. My work on depression is a simple example of how this can work in psychotherapy. Yet implementing simple solutions means overcoming barriers of training, resources, and institutional inertia. The promise is understanding age as the dynamic representation of a life span; the challenge is making this understanding work for older people. Joann Montepare, Lasell University, Newton, Massachusetts, United States At the core of behavioral and social scientists' work in the aging field is informing and supporting the well-being of individuals and their communities. With the shift in age demographics and the aging of our populations, broadening educational efforts are more important than ever. However, advancing knowledge about aging and creating age inclusive educational opportunities has been a challenge in higher education, reflecting its historical, age-segregated structure, among other things. The pioneering Age-Friendly University (AFU) initiative, recently endorsed by GSA's Academy for Gerontology in Higher Education (AGHE), offers a valuable set of guiding principles that institutions in higher education can use to assess the extent to which their programs and practices are age inclusive, as well as identify gaps and opportunities. This presentation will discuss how the time has come for scientists to help shape more age-friendly institutions, and what they can look like in the years to come. The meaning of aging in rural areas is not well explored in the literature. To address this gap each presenter in this multidisciplinary and international group of researchers will address different components of rural ageing. An exact definition of "rural" is essential to forming, implementing or evaluating policies and programs impacting rural populations; however there is no universal definition. Cohen introduces definitional issues, and underscores the heterogeneity and regional variability of "rurality" and how such factors drive rural-urban disparities. Pendergrast, an early career researcher, reports results of in-depth semi-structured interviews that examined institutional influences of social networks on health of rural older adults, with specific focus on support services. Leavey describes lessons learned from the activities of PLACE-EE, a transnational partnership of public health agencies, local authorities, academics and ICT experts dedicated to improving the quality of life for older people. He describes the impacts on relationships of a program of community engagement and intergenerational exchange between younger and older citizens that used an assets-based approach.

WHY AGE MATTERS IN HIGHER EDUCATION
Żurek explores the potential for reward structures that can be embedded in 'social games' to motivate older adults to exercise in the context of research conducted in the rural US (Appalachia) and urban Poland (Krakow), and suggests a new direction that can inform services intended to improve health and happiness of rural adults. Our discussant will reflect on the major themes that emerge from these multidisciplinary perspectives, especially the potential for intersection of rural community-based innovations and learning from different regions of the world. Rural Aging Interest Group Sponsored Symposium.

SOCIAL GAMES: THE INTERSECTION OF ESTABLISHED REWARD STRUCTURES AND EXERCISE FOR OLDER RURAL ADULTS Lyn Holley, University of Nebraska Omaha, Omaha, Nebraska, United States
A high percentage of older adults engages with games; however research about impacts of gaming on older adults is focused almost exclusively on games intended to strengthen GSA 2020 Annual Scientific Meeting Innovation in Aging, 2020, Vol. 4, No. S1 cognitive health or slow age-related cognitive decline, very little relates gaming to exercise. Rural -dwelling older adults are underrepresented in this as in other health-related research. Nonetheless, recent developments that explore effectiveness of embedding positive health behaviors (including exercise) in established games such as Bingo hold great promise for addressing the endemic social isolation and chronically debilitating conditions often associated with rural aging. Using recent research with a challenging population group (rural Appalachian older adults) as an anchor for discussion, this paper describes the state of the art of such interventions and, through a multinational lens, finds that these suggest a new direction for gaming design that could enhance effectiveness of the use of gaming to improve health and happiness of rural adults. Part of a symposium sponsored by the Rural Aging Interest Group.

University of Rhode Island, Kingston, Rhode Island, United States
There is no universal definition of rurality due to the heterogeneity in what makes a place "rural" or "urban". This study explored how elements of rurality are related to each other, and how the elements that define rurality vary by region. Data were abstracted for all 1948 non-metropolitan counties in the contiguous 48 states on rurality. K-means cluster analyses (k=4-8) were conducted to examine classification structures among component variables examining regional differences. In the South region, the majority (51.2%) were "Type 2" counties: low population size and density but higher urbanized population. The Midwest had a majority of "Type 3" counties (56.4%): intermediate for population size and density, but higher distances to metro areas. These exploratory findings underscore the heterogeneity and regional variability in rurality and how those measures are structurally related to each other, and essential to understanding those factors that truly drive rural-urban health disparities for older adults. Part of a symposium sponsored by the Rural Aging Interest Group.

HOW AREA AGENCIES ON AGING CONTRIBUTE TO SOCIAL CONNECTION FOR OLDER ADULTS IN RURAL AMERICA Claire Pendergrast, Syracuse University, Syracuse, New York, United States
Social ecological models of health identify intrapersonal, interpersonal, institutional, community, and policy-level contexts as social factors influencing individual and population health outcomes. However how institutions such as Area Agencies on Aging (AAA) shape rural older adults' social networks and influence health is little explored. This research examines institutional influences of social networks for rural older adults, particularly the social connections resulting from their AAA services and programs. AAAs are local social service organizations that coordinate home-and community-based supports. Our 2020 case study of a rural AAA in upstate New York involved in-depth semi-structured interviews with AAA staff, volunteers and participants included key themes related to older adults' social networks, social wellbeing, and physical and mental health. Our findings have both theoretical implications for rural community social structure as experienced by older adults, and practical implications to build AAA's capacity to address social isolation for rural older adults. Part of a symposium sponsored by the Rural Aging Interest Group.

SENSORY HEALTH AND SOCIAL WELL-BEING
Chair: Corinna Tanner Co-Chair: Jeremy Yorgason Discussant: Joshua Ehrlich Scientific inquiry into the psychological and social issues surrounding age-related sensory impairments has focused on ways in which the conditions are a catalyst for negative outcomes. However, investigating the patterns associated with negative life events can offer guidance on ways to circumvent or mitigate negative outcomes, and even to foster and facilitate the positive outcomes of growth and thriving. This symposium will present findings from individual studies that describe how social well-being among older adults with sensory impairments can be protected, by assessing social isolation as a point of intervention to maintain cognitive function and to promote post-traumatic growth, and by understanding the unique social considerations relevant to Hispanic older adults, and to improve the physical safety of older drivers with sensory and cognitive impairment by reducing exposure-adjusted motor vehicle crash risk. Authors will present both cross sectional and longitudinal, population based data, and will explore patterns and relationships between known variables associated with sensory impairments including depression, cognitive processing, cognitive functioning, social network, social isolation, driving patterns, and posttraumatic growth. Findings from the Longitudinal Research on Aging Drivers (LongROAD) study, the National Health and Aging Trends Study (NHATS), and data from a mixed methods study, underscore the reality that the negative outcomes associated with age related sensory impairments are not necessarily imminent and that there may be multiple intervention points to optimize the social well-being of older adults with sensory impairments. This mixed method study describes posttraumatic growth (PTG) accruing form experience with vision loss caused by severe age related macular degeneration (AMD) and explores relationships between depression, social support, and cognitive processing, on the path to PTG. Research describing the psychological and social issues surrounding AMD has focused on negative outcomes. However, learning from highly challenging experiences, such as vision loss, can offer