Brian D. Carpenter

Background and Objectives: There is substantial literature documenting the pervasiveness and harmfulness of ageism to older adults and society. Anti-ageism interventions are being developed and evaluated. However, most interventions target younger people and service providers, not older adults themselves. In this study, we aim to build knowledge about how older people understand, experience and react to ageism with the goal of advancing anti-ageism interventions. Research Design and Methods: We conducted nine focus groups with 58 people who were 60 years of age or older. Participants were 64% female, 64% Caucasian, and 33% African American. The modal age group was 75-79 years. A thematic content analysis was used to identify themes and representative quotes. Results: Five themes emerged. Not all older people are familiar with the concept of ageism, and some report they have not experienced it. Once primed, most participants could identify experiences of interpersonal ageism in employment, health care, media, families, and community settings, like stores and restaurants. Internalized ageism was less familiar to participants. Reaction to these experiences depended on the circumstances, and reactions ranged from doing nothing to making complaints. Participants generated suggestions for potential interventions. Discussion and Implications: Focus group participants recognized experiences of interpersonal ageism and had ideas about how to confront it. They had a harder time understanding and giving examples of internalized ageism. Increasing awareness and building skills to respond to interpersonal and internalized ageism emerged as a priority in intervention development. Innovation and Translational Significance: Interventions to empower older adults themselves to address ageism in daily life are needed. Through focus groups with older people, we learned that older people experienced interpersonal ageism in employment, health care, the family, and community settings; and how they reacted to an ageist incident depended on the circumstances. The concept of internalized ageism was less familiar to focus group participants. We learned that increasing awareness and developing skills are necessary first steps for older adults to confront interpersonal and internalized ageism.

There is growing attention to anti-ageism interventions, and evidence is mounting that education and contact with older people can reduce ageism. Yet outcomes in these interventions focus mainly on younger people and service providers, although older people are essential ingredients in the interventions. We argue that the lack of attention to older adults is a missed opportunity to improve older participants’ attitudes toward younger people and perhaps attain other benefits from intergenerational engagement. We repurposed the systematic review of Apriceno and Levy that focused on interventions to reduce ageism toward older people, and we studied the roles and outcomes experienced by the older participants in these interventions. Systematic attention to older participants is lacking, and their experiences and outcomes are not usually considered. In the small number of studies that assessed older participants, the results are promising. However, weaknesses in theoretical and empirical approaches abound in this literature. We urge scholars to elevate attention to older participants in anti-ageism interventions, develop programs with clear theoretical foundations as to outcomes expected for older as well as younger participants, and strengthen research designs and measurement, with the goal of promoting a more collaborative and inclusive society across all age groups.

Background/Objectives: Resiliency is critical in coping with stressors associated with chronic health diseases. Sickle cell disease (SCD) is a chronic blood disorder in which familial psychosocial functioning impacts disease outcomes. We hypothesized that caregiver perceived stress and resiliency are related to the resiliency of children with SCD and may influence SCD clinical outcomes. Methods: Child–caregiver dyads completed the Perceived Stress Scale (PSS-10), Connor Davidson-Resilience Scale (CD-RISC), and used a 1–5 Likert scale to rate the frequency of stressors they experience, including the COVID-19 pandemic. Results: Of the 55 child participants, 36% reported a history of stroke, 7% a bone marrow transplant, and 25% frequent (≥3) emergency room visits within last year. Dyad median resiliency scores (68.5 vs. 75.8) and stress scores (16.1 vs. 15.3) were similar and consistent with population studies. Child resiliency was not associated with child (r = −0.21, p = 0.12) or caregiver (r = −0.16, p = 0.26) perceived stress. Caregiver and child resiliencies had a significant positive correlation (r = 0.38, p = 0.0046) but no relationship across dyads with perceived stress scores. Children with one to two hospitalizations within the last year had significantly lower median resiliency scores compared with those who had experienced no hospitalizations (median 65 vs. 76, p = 0.0386), but displayed no relationship with genotype, history of stroke, or stem cell transplant. During the COVID-19 pandemic, both groups rated “worry about my/my child’s sickle cell disease” as the most frequent psychosocial stressor. Conclusions: In a cross-sectional cohort study that explored the relationship between caregiver resiliency and child resiliency in SCD, we found that caregiver resiliency and child resiliency were strongly correlated, while child resiliency showed no significant association with perceived stress. Higher child resiliency scores were associated with fewer hospitalizations. The results indicate the need for interventions to increase both child and caregiver resiliency in SCD, as it may contribute to health outcomes in SCD. Further research is needed to explore cofounding factors influencing resiliency in children with SCD.

Background and Objectives: This study examined the impact of receiving foundational information about aging on continuing education (CE) interests, preferences, and behaviors of mental health providers. Research Design and Methods: Participants were practicing licensed professional counselors (N = 120) recruited from a random sampling of a state registry. The study employed a 3-group randomized controlled design with participants assigned to 1 of 3 conditions: an aging-specific reading, an opioid use disorder-specific reading, and a CE requirement-specific reading. As outcomes, participants rated their interest in aging-specific CE and selected to receive an aging-specific CE or Motivational Interviewing-specific CE program. Results: Perceived competence for working with older adults, assessed before the experimental manipulation, predicted choice and degree of interest in the aging-specific CE across conditions. Participants in the Aging-Reading condition rated a higher interest in aging-specific CE and were marginally more likely to select the aging-specific CE option than those in the other 2 conditions. Those in the Aging-Reading condition were also more likely to register for and complete an actual CE program focused on any topic. Discussion and Implications: Foundational knowledge about aging may increase practitioners’ interest and behaviors toward gaining competency for working with older adults, supporting the Positive Education about Aging and Contact Experiences model (Levy, S. R. (2018). Toward reducing ageism: PEACE (positive education about aging and contact experiences) model. Gerontologist, 58(2), 226–232. https://doi.org/10.1093/geront/gnw116) of reducing ageism.

Blood-based biomarker (BBB) tests to assess risk for developing Alzheimer disease (AD) have recently been approved for clinical use. Little is known about people’s interest and concerns about these new tests, although the relative simplicity of the tests may help reduce disparities in early diagnosis for AD in historically marginalized groups, such as African Americans. The current report uses data from a national survey of adults in the United States (N = 1,274) conducted in 2022, oversampling African Americans. In addition to demographic questions, respondents rated the importance of different factors they would weigh when deciding whether to take a BBB test and their trust with the healthcare system. The sample was diverse in age (M = 48.6, SD = 17.6, range = 18-91), balanced in gender (55.3% female) and race (48.1% African American), and ranging in education (41.1% < BA). A higher percentage of respondents rated the accuracy (69.2%) and usefulness (64.5%) of the test as very important to their decision, compared to cost (40.8%) and convenience (38.0%). However, African Americans rated cost, convenience, confidentiality, and the potential for learning about other medical problems as more important than White respondents (chi-square p’s < .01). Contrary to hypotheses, trust in the healthcare system was not significantly related to decisional factors. Results from this study have implications for how to tailor culturally sensitive messages about new tests for the early detection of dementia risk.

Background and Objectives: Palliative care (PC) is a specialty medical service that aims to address the bio-psycho-social–spiritual needs of patients with serious illnesses and their care partners. Despite the value of PC, its expansion in Sub-Saharan Africa has been uneven and particularly underdeveloped in Senegal due to variability in access to training resources and funding. This study sought to understand the current landscape of PC services in Senegal and the barriers and opportunities in its growth. Research Design and Methods: Semistructured interviews were conducted with six PC clinicians, four caregivers of people with serious illnesses, one driver for a PC service, and one public health professor, all native to Senegal. Questions addressed their experience delivering or receiving PC, perceptions of barriers to implementation and access, and recommendations for additional resources and initiatives. Interviews were translated and transcribed from French into English. Transcripts were qualitatively coded for concepts during open and focused coding to identify themes. Results: Five themes were identified: (1) the current landscape of PC, (2) barriers to implementing PC, (3) strategies and philosophies in care, (4) unique features of Senegalese culture, and (5) the future of PC. Discussion and Implications: Our findings demonstrate that PC in Senegal remains an underresourced and underutilized specialty medical service, but work is being done by personally committed clinicians. Results can inform PC expansion by highlighting important cultural factors influencing care in Senegal, as well as the need to expand training opportunities for clinicians, increase education of other medical providers and the public about the nature of PC, integrate PC into the healthcare system, and expand research to evaluate the impact of these resources. PC has the potential to be an important force for improving the quality of life for Senegalese patients and their care partners.

Objectives: Several U.S. health surveillance surveys contain items related to self- and proxy reports of dementia and subjective memory complaints (SMC). Despite their similar content, these items differ in terminology, item specificity, and time frame. The goal of this study was to analyze whether item features might influence endorsement rates for dementia and SMC. Methods: We calculated design-appropriate estimates for the endorsement of dementia and SMC across U.S.-based national surveys and employed pairwise comparisons to evaluate endorsement rates across surveys. We also examined item characteristics to explore possible effects on endorsement rates. Results: Endorsement rates were wide-ranging for dementia (ranging from 2.7% to 9.9%) and SMC (5.6% to 46.6%). Pairwise comparisons revealed statistically significant differences on most dementia-related items (76%), and all SMC comparisons (100%). Items varied substantially in the terminology used to assess dementia and SMC (e.g., “dementia” vs “Alzheimer’s disease”) and used different time frames (e.g., “past month” vs “5 years”). Discussion: National survey data on reported dementia and SMC can have important research, training, and policy implications, yet endorsement rates vary widely across surveys. That variability could emerge from subtle but influential item characteristics, and our findings highlight the need for item harmonization, in even their most basic characteristics. Standardizing items across national surveillance surveys facilitates comparison across surveys so that we can better understand the true burden of these conditions to inform public health initiatives.

Trainees may be interested in careers in aging but unfamiliar with career options, leading to a shortage in the geriatric workforce. In response to needs identified at a national geropsychology training conference, a multisite faculty group developed a six-session webinar series about careers in geropsychology, detailing career options in six unique settings. Each webinar session featured a moderated discussion with a panel of four professionals currently employed in the career of interest. The webinar was advertised to clinical and counseling psychology trainees with a potential interest in age-related careers, with evaluation of the series primarily including trainees from graduate programs, clinical internships, and postdoctoral fellowships. Participants rated their attitudes and beliefs about each career option at pre- and post-discussion. On average, each webinar session was attended by 48 individuals (SD = 12, range = 33-60). At baseline, attendees reported significantly more interest in careers in clinical practice compared to other careers, and interest in university settings increased from pre- to post-discussion. Across all six sessions, participants reported increased understanding of training experiences that would be helpful in pursuing that specific career. Findings point to the feasibility and utility of webinars for enhancing interest and confidence in pursuing careers in aging.