Tele-Healthcare in Research and Education: Age Differences in Access and Utilization of Healthcare Resources

Abstract Societal needs highlighted during the pandemic have led to significant changes in healthcare, including the rapid development and implementation of tele-care consumer options. This study examined video-based, virtual healthcare access and utilization before and during the pandemic. Participants included traditional college-aged students, middle-aged adults, and retirement-aged persons (n = 685); measures included access to physical and mental health services, consumer satisfaction with type of services accessed, and anticipated use of virtual healthcare following the pandemic. Results showed that approximately half of participants (49.2%) had experience with virtual healthcare, with most of these cases during the pandemic. Virtual healthcare was more often used for physical compared to mental healthcare services, with college-aged participants more likely to use mental healthcare services than adult and retirement-aged participants. Laptop computers were most widely used to access services, with smartphone use proportionally lower in retirement-aged participants (31.4%). Overall satisfaction with virtual services was high (Mdn = 5 on a 6-point Likert scale), but college-aged participants trended toward a lower satisfaction (Mdn = 4.25) than other age categories. These results support that virtual healthcare service development and access experienced significant growth during the pandemic. Age differences in the types of services, types of devices, and satisfaction with virtual services all suggest a similar theme for age-related considerations of life stage, life responsibilities, and comfort and familiarity with technology that must be addressed for virtual healthcare to reach its full potential and reach equitably across the lifespan.

predicted pro-Trump and anti-Biden stances and ultimately voting intentions for Trump.Taken together, these results suggest examining relevant categories of stereotypes associated with candidates and voting stances provides a fuller picture of voting behavior toward multiple candidates vying for office in addition to political ideology and voting intentions.

SYSTEMATIC REVIEW OF PSYCHOLOGICAL AGING RESEARCH IN NEPAL
Kezang Tshering, 1 Srijana Shrestha, 2 and Barbara Kamholz, 3 1.Wheaton College,Wheaton College,Massachusetts,United States,2. Wheaton College,Norton,Massachusetts,United States,3. UCSF,UCSF,California,United States Nepal faces unprecedented levels of aging similar to trends in many less well-resourced countries.It has limited capacity to address the medical, social and psychological needs of older persons.Difficult choices regarding allocation of resources will be needed.In this review, we hope to clarify what is already known in aging research in Nepal.The databases APA PsychINFO and PubMed were searched.The inclusion criteria were peer-reviewed articles on i) psychological constructs and mental illnesses, ii) use of original data, iii) inclusion of senior participants and iv) studies conducted in Nepal.Studies that included mixed age group and cross-country comparisons were excluded from this review.The initial search resulted in 76 articles from APA PsychINFO and 590 articles from PubMed.Articles were reviewed independently for inclusion and exclusion criteria.A total of 49 articles were included in the final list.Preliminary results showed that the largest share of articles focused on depression (32.1%), followed by quality of life/life satisfaction or loneliness(18.9%).A large number of studies also examined prevalence rates of psychiatric and neurocognitive disorders (22.6%).Common conditions, like dementia and delirium were studied only in 1.9% and 3.8% of published studies respectively.All of the studies were cohort-based and none focused on evaluations of psychosocial/medical interventions.Robust intervention studies are needed to help improve the lives of seniors in Nepal.To our knowledge this is the first comprehensive review of published articles on psychological construct in aging populations in Nepal.

TELE-HEALTHCARE IN RESEARCH AND EDUCATION: AGE DIFFERENCES IN ACCESS AND UTILIZATION OF HEALTHCARE RESOURCES
William Hills, 1 Matthew Murphy, 1 and Karen Hills, 2 1.

Coastal Carolina University, Conway, South Carolina, United States, 2. Beaufort Jasper Hampton Comprehensive Health Services, Conway, South Carolina, United States
Societal needs highlighted during the pandemic have led to significant changes in healthcare, including the rapid development and implementation of tele-care consumer options.This study examined video-based, virtual healthcare access and utilization before and during the pandemic.Participants included traditional college-aged students, middle-aged adults, and retirement-aged persons (n = 685); measures included access to physical and mental health services, consumer satisfaction with type of services accessed, and anticipated use of virtual healthcare following the pandemic.Results showed that approximately half of participants (49.2%) had experience with virtual healthcare, with most of these cases during the pandemic.Virtual healthcare was more often used for physical compared to mental healthcare services, with college-aged participants more likely to use mental healthcare services than adult and retirement-aged participants.Laptop computers were most widely used to access services, with smartphone use proportionally lower in retirement-aged participants (31.4%).Overall satisfaction with virtual services was high (Mdn = 5 on a 6-point Likert scale), but college-aged participants trended toward a lower satisfaction (Mdn = 4.25) than other age categories.These results support that virtual healthcare service development and access experienced significant growth during the pandemic.Age differences in the types of services, types of devices, and satisfaction with virtual services all suggest a similar theme for age-related considerations of life stage, life responsibilities, and comfort and familiarity with technology that must be addressed for virtual healthcare to reach its full potential and reach equitably across the lifespan.

THE EFFECT OF A VIRTUAL REALITY DELIVERED PHYSICAL ACTIVITY INTERVENTION ON THE PHYSICAL FUNCTION OF OLDER ADULTS
Kyle Kershner, 1 Jason Fanning, 2 Joy Furlipa, 2 Peter Brubaker, 2 Amber Brooks, 3 Lindsey Page, 1 and Diane Ehlers, 1 1.University of Nebraska Medical Center, Omaha, Nebraska, United States, 2. Wake Forest University, Winston-Salem, North Carolina, United States, 3. Department of Anesthesiology, Wake Forest School of Medicine, North Carolina, United States COVID-19 public health recommendations have prohibited many older adults from attending in-person physical activity (PA) programs that improve physical function and promote functional independence.Most PA programs have shifted towards a video conference (VC) format, but this modality has been noted to "flatten" the social experience which is fundamental for lasting behavior change.Virtual reality (VR) is now designed for immersion and placepresence and may be better suited for instilling a feeling of social connection, which will likely improve physical function.The purpose of this study was to evaluate differences in physical function after a 4-week in-home VR or VC based PA intervention.Low-active adults (66.8±4.8 years) were randomized to VR (n=5) or VC (n=4) based PA counselling and instructed to find activities that were intrinsically motivating.VR participants were asked to select pre-approved available active games in addition to enjoyable real-world activities.ANCOVA models were used to explore group differences in six-minute walk distances across time.Results are reported using η^2 effect sizes based on the small sample size.After controlling for baseline values, the ANCOVA models revealed a moderate-to-large magnitude effect for distance traveled during the six-minute walk test (η^2=.10).Additionally, the VR group participants walked 42.63 meters further, which approaches a clinically meaningful difference.These promising early findings suggest there is value to exploring the impact of VR-delivered, group-mediated activity promotion on physical functioning in older adults.Future research should investigate aspects of VR that promote increased social connection and physical function in the older adult population.

THE HERITABILITY OF COGNITIVE AGING: A SYSTEMATIC REVIEW OF LONGITUDINAL TWIN STUDIES
Alice Kim, 1 Alyssa Kam, 1 Maxwell Kofman, 2 and Christopher Beam, 1 1.University of Southern California, University of Southern California, California, United States, 2. University of Southern California, Los Angeles, California, United States Heritability of cognitive ability changes across late adulthood, although whether genetic variance increases or decreases in importance is not understood well.We performed a systematic review of the heritability of cognitive ability derived from longitudinal twin studies of middle-aged and older adult twins.Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were identified in APA PsycINFO and Clarivate Web of Science electronic databases.Identified articles were screened by title and abstract; remaining full-text articles were then fully evaluated.Reference sections served as an additional method for identification of relevant articles.In total, 3,106 articles were identified and screened, 28 of which were included and were based on data from 10 longitudinal twin studies published from 1994-2021.There are large genetic influences on an initial level of cognitive performance across domains whereas there are small to moderate genetic influences on change in performance with age.Evidence was less definitive about whether the same or different genetic factors contribute to both level and change.Non-shared environmental influences appeared to drive individual changes in cognitive performance.Heritability tended to either be stable or decline after 65 years, possibly because of the increasing importance of non-shared environmental influences on cognitive ability.Recent studies report increases in heritability across specific subtests and domains.Shared environmental variance accounted for little variance in cognitive ability.Emerging research questions and future directions for understanding genetic and environment influences in the context of gene-environment interplay are highlighted in this review.

THE IMPACT OF AGE ON MOBILE TECHNOLOGY USE DURING THE COVID-19 PANDEMIC Yi Lin, and Graham Rowles, University of Kentucky, Lexington, Kentucky, United States
The COVID-19 pandemic led to quarantines and mandatory spatial distancing; people of all ages were encouraged to use technologies instead of actual human contact as part of COVID-19 prevention.The promotion of mobile applications (apps) during the pandemic influenced mobile technology use behavior.This study explored age differences in mobile technology use during the COVID-19 pandemic.A pilot-tested survey was distributed using online survey software.Persons surveyed were 35 years of age or older, currently living in the United States of America with experience using mobile technology.Survey questions pertained to mobile technology use frequency and factors influencing the decision to use mobile technology.The nationwide response included 1212 individuals.The average age of participants is 56.12±12.26years old (female: male = 1.24:1).Responses were categorized participants into three age groups, 35 to 49, 50 to 64, and 65 or older.Daily mobile technology use frequency increased significantly (p<0.01) for all groups