CHILDHOOD TRAUMA AMONG US VETERANS AND THEIR NEGATIVE HEALTH AND RISKY BEHAVIORS IN LATER LIFE

Abstract Background Behavioral and health outcomes of childhood traumas are public health issues. Research on adverse childhood experiences (ACEs) have been explored among the general population; however, ACEs among persons with history of military service remains unknown. Methods Current study used secondary dataset obtained from CDC Behavioral Risk Factor Surveillance System (BRFSS) 2011. Study’s total sample size was 7,112. Data was weighted to account for the complex sampling design and nonresponse. Logistic regression was used to explore ACEs among US Veterans, and how early trauma correlates to long-term health problems, while controlling for their socioeconomic status. Results Our analyses suggested that compared to participants with 0 ACEs, those who reported 1 ACE (OR=1.38; CI=1.10-1.73), 2 ACEs (OR=2.30; CI=1.80-2.95), 3 ACEs (OR=2.81; CI=2.11-3.73), and 4+ ACEs (OR=4.04; CI=3.20-5.09) were more likely to report depression. Participants who reported for having 4+ ACEs were 4.16 times more likely to report in risky sexual behaviors (OR=4.16; CI= 1.83-9.46). Individuals with 4+ ACEs scores were 30% more likely to report binge drinking (OR=1.30; CI=1.02-1.67), 94% at risk for being a smoker (OR=1.94; CI=1.54-2.45) and had higher odds of developing poor health status (OR=1.67; CI=1.32-2.10). Conclusion Our research suggests that more ACEs score associates to a higher risk of developing health issues in later life. Research on ACEs has traditionally focused on health outcomes using secondary datasets among the general population. More research should be explored in longitudinal studies on ACEs, particularly with persons who have served in the military.


ASSOCIATION BETWEEN EXERCISE AND UNCONTROLLED BLOOD PRESSURE IN HYPERTENSIVE PATIENTS Sinwoo Hwang, and Eunhee Cho, Yonsei University College of Nursing, Seoul, Republic of Korea
Hypertension is closely associated with cerebrovascular and cardiovascular diseases, the most frequent causes of death in Korean adults.Despite its continuously improving treatment rate, it is necessary to consider patients whose blood pressure remains uncontrolled.Walking exercises are strongly recommended to lower blood pressure.This study aimed to examine the level of walking in hypertensive patients and factors that deterred walking.This cross-sectional study was conducted through secondary data analysis using data collected from the Korea National Health and Nutrition Evaluation Survey from 2016 to 2020.Participants included 1,800 hypertensive patients over the age of 19 years, whose blood pressure was not under control despite medication.Walking was defined as exercise lasting for at least 30 minutes more than five times a week.Multiple logistic regression analysis was conducted to evaluate factors that deterred walking as an exercise in hypertensive patients.Of the total sample, 63.8% patients (n=1,149) were not exercising (walking).Job and obesity were two significant factors associated with walking less.Patients who were employed or obese were more likely to not walk, compared to those unemployed (OR, 1.31; 95% CI, 1.04-1.65)or those with normal weight (OR, 1.43; 95% CI, 1.03-1.98).Patients with uncontrolled blood pressure despite medication need lifestyle modifications as well.High medication adherence should not be the reason to overlook the management of hypertensive patients.In fact, detailed management is required to identify vulnerable groups, particularly those who do not engage in even walking exercises regularly, which is a simple treatment of hypertension.

BARRIERS TO HEPATITIS C TREATMENT AMONG US BABY BOOMERS: PROVIDER PERSPECTIVES Elaine Wethington, Cornell University, Ithaca, New York, United States
Chronic Hepatitis C (HCV) is a major health problem in the US for the baby boomer cohort (born 1945-65), affecting 1.8 million persons; 75% acquired it through injection drug use in earlier life.About 20% develop cirrhosis, often leading to end stage liver disease.HCV is curable and treatment has become more affordable and available.However, uptake of treatment has lagged.This paper reports on a semi-structured interview study of 36 health providers from 2 states (NY, AL) with experience treating/referring HCV+ patients, part of a mixed-methods study of providers and patients.Interviews were coded using thematic analysis.Providers reported that baby boomers, especially racial/ethnic minority and low income, experience barriers to HCV care, because of the complexity of the treatment cascade (testing, linkage to qualified providers, prescribing treatment, insurance delays, and successful completion of therapy).Low provider awareness of need to test for and treat HCV, limited access to specialists (the primary prescribers of HCV medications until recently), variable effectiveness of health systems in assuring successful treatment, and insurer initial reluctance to support treating all infected persons, have also contributed to disparities in care.Perceived stigma and discrimination are barriers to treatment even among the majority of newly diagnosed HCV+ baby boomers who no longer use injection drugs.Providers report that patients fear that families and workplaces will avoid or isolate them if their past drug use becomes known.Moreover, patients who have yet to experience serious health impact may delay treatment, given fears about discrimination against drug users.
Background: Behavioral and health outcomes of childhood traumas are public health issues.Research on adverse childhood experiences (ACEs) have been explored among the general population; however, ACEs among persons with history of military service remains unknown.Methods: Current study used secondary dataset obtained from CDC Behavioral Risk Factor Surveillance System (BRFSS) 2011.Study's total sample size was 7,112.Data was weighted to account for the complex sampling design and nonresponse.Logistic regression was used to explore ACEs among US Veterans, and how early trauma correlates to long-term health problems, while controlling for their socioeconomic status.Results: Our analyses suggested that compared to participants with 0 ACEs, those who reported 1 ACE (OR=1.38;CI=1.10-1.73), 2 ACEs (OR=2.30;CI=1.80-2.95), 3 ACEs (OR=2.81;CI=2.11-3.73),and 4+ ACEs (OR=4.04;CI=3.20-5.09)were more likely to report depression.Participants who reported for having 4+ ACEs were 4.16 times more likely to report in risky sexual behaviors (OR=4.16;CI= 1.83-9.46).Individuals with 4+ ACEs scores were 30% more likely to report binge drinking (OR=1.30;CI=1.02-1.67),94% at risk for being a smoker (OR=1.94;CI=1.54-2.45)and had higher odds of developing poor health status (OR=1.67;CI=1.32-2.10).Conclusion: Our research suggests that more ACEs score associates to a higher risk of developing health issues in later life.Research on ACEs has traditionally focused on health outcomes using secondary datasets among the general population.More research should be explored in longitudinal studies on ACEs, particularly with persons who have served in the military.

CULTIVATING AN ATTITUDE OF GRATITUDE: A BRIEF GRATITUDE INTERVENTION FOR OLDER ADULTS WITH CHRONIC PAIN
Shelley Condon 1 , Brian Cox 2 , and Patricia Parmelee 1 , 1.The University of Alabama, Tuscaloosa, Alabama, United States, 2. Alabama Research Institute on Aging, Tuscaloosa, Alabama, United States Gratitude interventions have emerged as a promising approach to ameliorate the negative impact of pain and enhance quality of life.Despite the high prevalence of older adults with chronic pain, there are very few gratitude intervention studies in this population.The current study examined the feasibility and effectiveness of a two-week daily gratitude journaling intervention in a sample of 38 older adults (M=67.53years) with chronic knee or hip pain.Participants were randomly assigned to the gratitude group (n=21), who wrote down three things they were grateful for every day, or the attention-matched control group, who did not journal.All participants completed pre-and post-intervention interviews and received 14 nightly phone calls, allowing for "global" (pre/post interviews) and "daily" (nightly calls) analyses of the study aims.Aim 1 examined the effects of gratitude on well-being using regression and multilevel model analyses, while Aim 2 examined the effects of the intervention on changes in well-being using repeated measures analyses of variance and multilevel model analyses.In Aim 1, significant associations were found between trait and state gratitude and well-being, supporting previous research and a multifaceted conceptualization and measurement of gratitude.In Aim 2, significant main effects for time emerged, suggesting that participants' well-being improved regardless of their treatment group.Income level was also a consistent predictor of well-being, demonstrating disparities in chronic pain.The impact of small sample size, COVID-19, and methodological limitations will be discussed.Future research plans and recommendations will also be provided.Diabetes risk and rates increase across age with prevalence rates of diagnosed diabetes of 24% and estimated pre-diabetes rates of 49% in adults 65 or older (2017-2020;CDC, 2020) underscoring the importance of understanding diabetes risk factors and lifestyle behaviors in older adults.Senior centers offer a unique opportunity to reach older adults to deliver health promotion interventions.The study purpose was to examine diabetes/pre-diabetes occurrence, risk factors, lifestyle behaviors, and preferences for promoting healthy lifestyles to reduce diabetes risk in older adults (>60).An anonymous cross-sectional self-report survey was administered in senior centers.It included questions regarding occurrence of diabetes, diabetes risk factors, and hypertension; self-reported health status; lifestyle behavior patterns; cognitive function; and social engagement.Open-ended questions obtained information on diabetes risk awareness and preferences for healthy lifestyle interventions delivered in senior centers.The sample included 159 adults: average age of 76 years (range: 60-96), 77% female, 83% White, and 14% African American.Reported health related patterns include: 89% rated health as goodexcellent; 74% were at high risk for pre-diabetes; 64% had hypertension; and 20% were told by provider of diabetes and 32% pre-diabetes.Reported lifestyle patterns included: 73% get regular physical activity, 53% eat 5 daily fruits/ vegetables, 7% smoke, and average 7 hours of sleep/night.The large proportion at high risk for pre-diabetes underscores the importance of focusing on diabetes prevention in older adults and potential for delivering healthy lifestyle interventions in senior centers.Presentation will describe the quantitative and qualitative results and implications for lifestyle interventions.

DIFFERENCES IN HOSPICE AND NONHOSPICE NURSES' PERSONAL AND PROFESSIONAL CHARACTERISTICS
Janie Taylor, and Renee' Zucchero, Xavier University, Cincinnati, Ohio, United States The overextension of nurses due to an aging population, increase in chronic conditions, and the COVID-19 pandemic, places them at risk of negative outcomes.However, less is known about how hospice nurses compare to nurses in other subfields in terms of professional quality of life or factors that may potentially protect against adverse consequences of caregiving.Therefore, this study investigated