Adapting to Health Change: Aging Bias, Sensitivity, and Interprofessionalism in an Aging Sensitivity Training

Abstract Adapting to Health Change, a 2-hour aging sensitivity simulation to increase student sensitivity to age-related changes, was delivered to 148 health professions students in March 2020. Five small group stations (hearing loss, neuropathy and dexterity, vision loss and medication management, language and cognitive impairment, and mobility and balance) were facilitated by older adult volunteers and interdisciplinary faculty. Students completed (pre-post) Aging IQ Quiz, Aging Attitudes Assessment, Inter-professional Attitudes Scale (IPAS) Teamwork, Roles, and Responsibilities and Interprofessional Biases subscales, and an overall satisfaction rating. There was a statistically significant but small change in perceived knowledge of aging (mean Aging IQ score changed -0.025 points, p = 0.03). We also found a post-training increase in negative bias (mean Aging Attitudes Assessment score changed +2.68 points, p = 0.0001). While there was no change in attitudes about interprofessional education, this wasattributed to high baseline scores, suggesting students already valued interprofessional interactions. Multiple high satisfaction scores were encouraging. Ninety-four percent agreed that the simulation increased their understanding of age-related changes, while 97% indicated facilitators provided useful insights into the experiences of aging. A high majority (89%) felt they would be better health care providers for older patients than they would have been without the experience. This exercise to increase student empathy about age-related disabilities was well received, but did not achieve the usual intended aims. Simulation content should “re-aim” beyond empathy to teach new knowledge, highlight positive aspects of aging and professional care provision, and reinforce interprofessional roles toward wellness for older adults.


PRIMARY CARE PROVIDER ATTITUDES AND PERCEPTIONS OF ROUTINE COGNITIVE SCREENING IN OLDER ADULTS Giovanna Potenza, and Meghan Mattos, University of Virginia, Charlottesville, Virginia, United States
The 2011 Annual Wellness Visit (AWV) Medicare benefit includes a cognitive screening component intended to improve screening of older adults. However, available literature only presents physician perspectives on cognitive screening prior to 2011. The purpose of this study was to explore primary care provider (PCP) attitudes and perceptions of cognitive screening in older adults. An Internet-based survey link was sent to Virginia professional organizations and clinics to distribute to PCPs serving older adults. Likert scale, multiple choice, and free response questions were used to understand current attitudes, perceptions, and practices. The sample (N=39) was comprised of 26 nurse practitioners (NPs), 9 physicians, and four who did not disclose role. Most participants were aware of the AWV (n=31, 88.6%) and agreed that early detection "promotes earlier diagnosis and access to resources" (mean ± standard deviation,1.58±0.69). However, less than half of NPs screened annually (n=10/26, 38.5%) and even less conducted screening during an AWV (n=7/26, 26.9%). About half of MDs conducted cognitive screening during an AWV (n=5/9, 55.6%). Although NPs screened less, they more strongly agreed that screening should occur annually (1.92±1.15 vs. 2.67±1.23) and "additional training would improve [screening] ability" (2.04±1.0 vs. 3.22±1.20). Also, few NPs independently managed impairment (n=5/26, 19.2%) compared to MDs (n=5/9, 55.6%). Our findings demonstrate that NPs screen less and feel less prepared to conduct cognitive screenings. It is important to provide additional resources and training for all PCPs, but especially NPs who are rapidly entering primary care to help improve identification and management of cognitive impairment.

PSYCHOMETRIC PROPERTIES OF THE PHQ-9 AND CESD-R DEPRESSION MEASURES WITH OLDER ADULTS
Emma Katz, Rachael Spalding, and Barry Edelstein, West Virginia University, Morgantown, West Virginia, United States Our understanding of older adult depression has been impeded by the paucity of assessment instruments with validity evidence for older adults. Therefore, measures of depression that were initially developed for use with younger adults are commonly used with older adults as well, such as the Center for have strong psychometric support for their use with young adults, and are two frequently used depression measures. In light of age-related differences in the experience and presentation of depression (e.g., Balsamo, et al., 2015;Fiske, Wetherell, & Gatz, 2009;Hybels, Laderman, & Blazer, 2012;Wuthrich, Johnco & Wetherell, 2015), the present study examined the psychometric properties of these instruments with older adults. Two-hundred-and-seventy-seven older adults (ages 65 and older) completed an online survey including the PHQ-9, CESD-R, and instruments measuring several other constructs with anticipated relations to depression (anxiety, general depression, positive and negative affect, self-esteem, personality traits, and satisfaction with life). The relation between the two depression scales and measures of the other constructs were examined. Both the PHQ-9 and CESD-R evidenced good internal consistency reliability (a = .82 and .83, respectively) and strong correlations in anticipated directions with many of the related constructs. These results support the use of the CESD-R and PHQ-9 with community-dwelling older adults.

SESSION 10140 (LATE BREAKING POSTER)
Health Sciences Center, Reynolds Center for Geriatric Nursing Excellence, Oklahoma City, Oklahoma,United States,5. University of Oklahoma,Norman,Oklahoma,United States Adapting to Health Change, a 2-hour aging sensitivity simulation to increase student sensitivity to age-related changes, was delivered to 148 health professions students in March 2020. Five small group stations (hearing loss, neuropathy and dexterity, vision loss and medication management, language and cognitive impairment, and mobility and balance) were facilitated by older adult volunteers and interdisciplinary faculty. Students completed (pre-post) Aging IQ Quiz, Aging Attitudes Assessment, Inter-professional Attitudes Scale (IPAS) Teamwork, Roles, and Responsibilities and Interprofessional Biases subscales, and an overall satisfaction rating. There was a statistically significant but small change in perceived knowledge of aging (mean Aging IQ score changed -0.025 points, p = 0.03). We also found a post-training increase in negative bias (mean Aging Attitudes Assessment score changed +2.68 points, p = 0.0001). While there was no change in attitudes about interprofessional education, this wasattributed to high baseline scores, suggesting students already valued interprofessional interactions. Multiple high satisfaction scores were encouraging. Ninetyfour percent agreed that the simulation increased their understanding of age-related changes, while 97% indicated facilitators provided useful insights into the experiences of aging. A high majority (89%) felt they would be better health care providers for older patients than they would have been without the experience. This exercise to increase student empathy about age-related disabilities was well received, but did not achieve the usual intended aims. Simulation content should "re-aim" beyond empathy to teach new knowledge, highlight positive aspects of aging and professional care provision, and reinforce interprofessional roles toward wellness for older adults.

RELATIONSHIP WITH GRANDPARENTS AND YOUNG ADULTS' ATTITUDES ABOUT AGING AND FUTURE-ORIENTED TENDENCIES Tianyuan Li, and Pok Man Siu, Education University of Hong Kong, Hong Kong, China
It is important but always challenging to restrain from immediate temptations and behave conscientiously for long-term goals. Constructive interactions with older adults may promote young adults' positive attitudes about aging. With a brighter later adulthood in mind, young adults may then demonstrate a higher level of future-oriented tendency in their behaviors. The current study recruited 371 college students (Mage = 22.43, SDage = 2.88; 203 females) from Hong Kong. They completed an online survey about their interaction with the closest grandparent, attitudes about aging, and measures related to future-oriented tendencies (i.e., consideration of future consequences, healthy lifestyle, and impulsiveness). Parental intimacy and demographic information were assessed as potential covariates. Supporting the hypotheses, more interaction with grandparents was related to more positive attitudes about aging, β = .40, SE = .11, p < .001. More positive attitudes about aging was then related to more consideration of future consequences, β = .14, SE = .07, p = .03, healthier lifestyle, β = .16, SE = .06, p = .005, and less impulsivity, β = -.10, SE = .03, p < .001. Bootstrapping tests for the indirect effects from interaction with grandparents to the future-oriented outcomes through positive attitudes about aging were all significant as well. Although the current cross-sectional data could not confirm the causal links among the variables, the results provide some initial insight on how older adults can foster a long-term orientation in younger generations and contribute to the sustainable development of our societies through constructive intergenerational interactions.

SELF-PERCEPTIONS OF AGING, COGNITIVE FUNCTION, AND PHYSICAL ACTIVITY Caitlin Connelly, University of Massachusetts Boston, Boston, Massachusetts, United States
Stereotype embodiment theory suggests that internalized aging stereotypes will influence subsequent physical and cognitive health for older adults. This is proposed to occur through behavioral, physiological, and psychological pathways. Guided by stereotype embodiment theory, this study examined the how self-perceptions of aging are associated with cognitive function and the mediating role of physical activity as a behavioral pathway. The sample consists of 7,990 community-dwelling older adults age 65 from the Health and Retirement Study. Cross-sectional data analyses were conducted using bivariate and multivariate linear regression. Positive self-perceptions of aging were significantly associated with better cognitive function. Physical activity partially mediated the association between self-perceptions of aging and cognitive function. Findings suggest that self-perceptions of aging are important for cognitive function and physical activity may help to explain this relationship. Self-perceptions of aging may serve a possible intervention point to increase physical activity engagement and improve cognitive function.

SENIOR ADULTS: DOES BODY IMAGE MATTER?
Keri Larsen, 1 Myia Graves, 1 Ashley Bowers, 1 Valerie Saba, 2 and Lauren Himel, 3 1. Southeastern Louisiana University, Hammond,Louisiana,United States,2. Southeastern Louisiana University,Loranger,Louisiana,United States,3. Southeastern Louisiana University,Prairieville,Louisiana,United States Through the theoretical framework of the Social Comparison Theory, the current study will examine general attitudes and perceptions of body image in senior adults who are currently participating in organized recreational activities. Participants between the ages of 50 years of age and older participating in organized recreational programs in the Southeast will be administered the Sociocultural Attitudes Toward Appearance Scale (SATAQ) to measure participants' body image as influenced by general media, athletic and sport figures, as well as pressure to conform to the media ideal. The Figure Rating Scale will be administered, and is composed of nine drawings of bodies that progressively increase in size from very thin to overweight. Pearson product moment coefficient of correlation will be used to determine the association of scores between the SATAQ and Figure Rating Scale.