National Representative Sample Research Articles

FACTORS ASSOCIATED WITH ELECTRONIC HEALTH RECORD ADOPTION AMONG ADULT DAY SERVICES IN THE US

Abstract Successful adoption of Electronic Health Records (EHR) is becoming increasingly important for Adult Day Service Centers (ADSC) to function effectively and competently, particularly in care coordination with other healthcare providers. Therefore, in the present study, we assessed the EHR adoption among ADSC and its associated organizational characteristics using the 2018 National Study of Long-Term Care Providers (NPALS). The sample included 4,035 ADSC from a national representative sample. Directors or managers of ADSC completed the survey that included questions on organization characteristics, staffing, practice procedures, services, technology use, etc. Findings reveal that the adoption rate of EHR among ADSC was less than thirty percent and less than twenty percent of ADSC used EHR for health information exchange with either physicians or pharmacists. In addition, we found that an ADSC located near other healthcare providers, with Medicaid authorization and a higher percentage of Medicaid patients, and various computer capabilities such as recording participants’ demographic information, clinical notes, medications, service plans, and lab results were related to a higher likelihood of EHR use and EHR exchange. However, possibly due to privacy concerns, the capabilities to record participant problems and view lab results, negatively predict EHR exchange with physicians or pharmacists. The findings are discussed in terms of challenges and strategies to promote EHR adoption in ADSC.

HOSPICE USE AND END-OF-LIFE EXPERIENCE BY RACE AND GEOGRAPHY: A LATENT CLASS ANALYSIS

Abstract Long existing inequalities near the end-of-life (EOL), including the death experience, have been uncovered because of increased attention during the COVID-19 pandemic. Hospice may be an avenue to equalize EOL experiences. This study aimed to 1) understand the profiles of hospice use and EOL experience in a national representative sample of decedents and 2) uncover how race and/or geographic location predict class membership. We conducted a latent class analysis with covariates using Waves 9-11 (n=1050) from the last month of life interview in the National Health and Aging Trends Study. Based on fit statistics, response probabilities, class separation, interpretability, and fit with theory, a four-class model was ultimately selected. The four latent classes were: well-rounded hospice care; no hospice, goal concordant care; no hospice, poor overall care; and complex hospice care. We found that geographic location was not a significant predictor of latent class membership but being non-White was significantly associated (p < .001) with 8.79 times higher odds of being in the no hospice, poor overall care group and 1.85 times higher odds of being in the no hospice, complex care group compared to the reference class (well-rounded hospice care). The current study’s findings paint a complex picture of hospice use and EOL experience in a nationally representative sample. Hospice use alone does not make a “good death” experience, particularly for people of color. Rather, there are unique profiles of hospice use and experiences at EOL. Future research should explore the impact of geographic location on the death experience.

POPULATION ATTRIBUTABLE FRACTIONS FOR THE CONTRIBUTION OF HEARING LOSS ON DEMENTIA RISK ACROSS COHORT STUDIES

Abstract Estimates range from 2-8% of dementia cases in the US are attributable to hearing loss. Here, we investigate measurement considerations in quantifying the population attributable fraction (PAF) of dementia from hearing loss to highlight how differences in methodology can underestimate the PAF. We use two cohort studies of older adults in the US: the National Health and Aging Trends Study (NHATS), a nationally-representative sample of older Medicare beneficiaries; and the Atherosclerosis Risk in Communities (ARIC) Study, a large, community-based cohort study with longitudinal follow-up. Each study collects reference-standard hearing measures on participants. We have two specific aims. First, we compare two valid, formula-based approaches to quantifying the PAF. The advantages of quantifying a PAF using a well-characterized, biracial, community-based sample with a longitudinal design are weighed against those of using a nationally-representative sample with a cross-sectional design (moderate or greater hearing loss: PAF in NHATS, 16.9% [95% CI: 4.1-28.7%]; PAF in ARIC, 13.2% [95% CI: 2.2-20.9%]), highlighting the need for longitudinal designs in studies of the PAF from hearing loss. Second, we describe the impact of subjective versus objective measures of hearing loss on the PAF. In ARIC, subjective hearing loss was not associated with incident dementia (hazard ratio <1.0). PAFs of dementia from objective hearing loss were 6- to 8-fold greater than PAFs previously quantified using self-reported hearing measures in population-based studies. Our findings have broad implications for the inclusion of hearing loss as a potentially modifiable risk factor in clinical and public health initiative for dementia prevention.

BLACK/WHITE DIFFERENCES IN LENGTH OF STAY IN HOSPICE AMONG MIDDLE-AGED AND OLDER ADULTS IN THE UNITED STATES

Abstract Objectives Hospice length of stay (LOS) is a crucial measure of hospice care. This topic is understudied within a nationally-representative sample across different races/ethnicities, especially among non-White decedents. Methods The study used negative binomial regression to analyze three waves (2014, 2016, and 2018) from HRS (n=1,991). Results African Americans were found to stay longer in hospice than their White counterparts when controlling for all other variables in the model. Not married, having Medicare insurance, cancer, chronic lung disease, and dementia significantly influence length of hospice stay when holding all other variables constant in the model. Discussion The significant Black/White differences in hospice length of stay demonstrate the potential decrease in cumulative inequality in the delivery of appropriate and needed hospice services across the two racial groups. Future research is recommended to explore the potential consequences of longer hospice stays as well as the health and health care mechanisms related to the different disease profiles that lead individuals to hospice care, especially among African Americans.

THE IMPACT OF HOME-BASED CARE SERVICES ON ADULT CHILDREN AS CAREGIVERS OF OLDER ADULTS IN CHINA

Abstract The family has always been the primary resource for elder care support in China, and adult children are the main caregivers of older parents. In the background of rapid development of home-based care services for older adults, this study aims to explore the impacts of the home-based care services on the adult children as caregivers for their older parents. Based on a national representative sample of aged 60 years or older (N=8674) from the China Longitudinal Aging Social Survey (CLASS) in 2018 and 2020, this study used propensity score matching difference-in-differences method to analyze the data. Firstly, we found that home-based care services for older adults could reduce the care burden of family caregivers by sharing part of the instrumental support effectively for the elderly. Secondly, this substitution effect is more significant among the families with more dependable and vulnerable older adults. Finally, the use of home-based care services appeared not to affect the intergenerational relationships between older parents and their adult children caregivers. Home-based care services may relieve the burden of family caregivers by providing instrumental care support for older adults. Therefore, it is very necessary to accelerate the implementation of an elder care programs in community to benefit the older and younger generations in Chinese family.

SOCIAL CONNECTEDNESS ACROSS THE LIFE COURSE: CORE NETWORKS AND EVERYDAY SOCIAL INTERACTIONS OF AMERICAN ADULTS

Abstract Scholars have been monitoring the signs of social isolation and weakening of family ties among Americans. This paper asks: (1) Do Americans socially disengage from society as they age? (2) Are family ties replaced by work or friends as Americans grow out of their original family? Using a state representative sample of egocentric network data (Person to Person Study: P2P) and a national representative sample of time dairy data (American Time Use Survey: ATUS) during 2018-2021, we found that although people spent less social time with others as they age, they maintained a stable sized core network of confidants for discussing important and health matters. This refutes the view that old age has a universal negative influence on social connectedness. We found little evidence that family ties are replaced by non-kins at any age in both core network and daily social contact. By combining core network and time dairy data, we found that although people spent substantial time with coworkers daily when they enter the workforce, they rarely included even a single coworker into their core network. This suggests that people’s core network is less influenced by current daily social interactions than many theories on social contact would predict. We speculate that people may organize their core network based on cumulative time they spend with a particular person over the life course rather than current time. The roles of life events and age in shaping changes in daily interactions and core network over the life course are further discussed.

ASSOCIATION BETWEEN LATE LIFE EDUCATION AND COGNITIVE FUNCTION AMONG U.S. OLDER ADULTS

Abstract This study assessed whether late-life education (LLE) was associated with better cognitive function and whether the benefits of LLE on cognitive decline differed by gender, race/ethnicity, and education level in a nationally-representative sample of U.S. older adults. We conducted a retrospective cohort study using six waves of data from the Health and Retirement Study ([HRS] 2008-2018) that included adults aged ≥ 65 with no baseline diagnosis of Alzheimer’s disease and related dementias (ADRD). Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7’s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range=0-35). LLE was measured at every wave and was categorized as “once a month or more,” and “not in the last month [or never].” Covariates included participants’ demographic background, socioeconomic status, psychosocial and behavioral factors, and health-related factors. Of 12,099 participants (median age 71 [IQR=10]), engaging in LLE at least once a month or more was associated with better cognitive function and was equivalent to a 2-4 year delay in cognitive decline than non-participation in LLE. The association was only partially attenuated after adjusting for a wide range of covariates. In addition, the benefits of LLE on cognitive function did not significantly differ by gender, race/ethnicity, or prior educational attainment. This study provides new insights into the protective role of LLE on cognitive function and underscores the importance of continued learning among older adults.

POPULATION ATTRIBUTABLE FRACTION OF POOR ORAL HEALTH FOR THE INCIDENCE OF DEMENTIA: A POPULATION-BASED COHORT STUDY

Abstract Emerging evidence indicates a positive association between suboptimal oral health and increased risks of dementia. Despite the preventable and treatable nature of many oral health problems, oral health has not been considered in the risk factors for dementia that shape public health policy and research priorities. We aimed to quantify and compare the fractions of incident dementia attributable to poor oral health and other modifiable risk factors. The research included a nationally-representative sample of 15,474 cognitively intact adults aged≥50 from the Health and Retirement Study, with the outcome of incident dementia between 2006 to 2016. We estimated the multivariate-adjusted hazard ratio (HR) and population attributable fraction (PAF) of edentulism and nine risk additional dementia factors. Additional analyses were conducted on 1,239 individuals who completed the “Dental Health Module” in 2008, examining oral health problems as an exposure. Edentulism was associated with a higher risk of dementia for both men (HR,1.38; 95%CI, 1.15-1.66) and women (HR, 1.32; 95%CI, 1.16-1.51). The PAF of edentulism for dementia was 4.64%, which exceeded that of hearing impairment (3.58%) and hypertension (2.90%). Oral health problems were also a significant factor for men (HR, 2.01; 95%CI, 1.49-3.39) and women (HR, 1.15; 95% CI, 1.02-1.30), with a PAF of 11.84% among men, the second-largest following less education (22.60%). The substantial estimated proportion of dementia attributed to poor oral health in the aging population, particularly in men, warrants more attention. Dental care should be an integral component of a comprehensive approach to promoting cognitive health.

SOCIAL ISOLATION AND HOSPITALIZATION IN A NATIONAL SAMPLE OF COMMUNITY-DWELLING OLDER ADULTS BY DEMENTIA STATUS

Abstract Social isolation poses risks for poor health, yet its impact on hospitalization for persons with dementia is unknown. Dementia may result in reduced social contact that increases the risk of hospitalization. This observational cohort study examined longitudinal associations between social isolation and hospitalization among a nationally-representative sample of community-dwelling older adults with and without dementia. Using the National Health and Aging Trends Study, we conducted multivariable analyses for 5,533 Medicare beneficiaries. Social isolation was measured using a multi-domain 4-item typology. Logistic regression tested associations between social isolation in 2015 and self-reported hospitalization over the next twelve months, stratifying by dementia status. Covariates included sociodemographics and health characteristics. About 21.5% of older adults were socially isolated, with a much higher proportion of social isolation among those with dementia (38.0%) versus without (20.7%) (p < .001). Overall, the odds of hospitalization were not significantly associated with social isolation (OR 1.13; p = .184). While there was no association between social isolation and hospitalization among those without dementia (OR 1.09; p = .394), social isolation was significantly associated with hospitalization among older adults with dementia (OR 2.07; p = .001). Among older adults with dementia, social isolation increased the predicted probability of hospitalization by about 14.1% over one year (p = 0.030). In this population-based study, social isolation was common among community-dwelling older adults with dementia and significantly associated with increased odds of hospitalization over twelve months. Efforts to reduce hospitalization should explore ways to bolster social relationships for older adults with dementia.

(How) do self-concept, interest, and conscientiousness function together in academic motivation? A typological approach developed and replicated in two large-scale samples

BackgroundFollowing a call for integrative attempts to study academic motivation, we apply a typological approach. AimTo identify and replicate naturally existing combinations of general academic self-concept, school interest, and conscientiousness. SampleTwo national representative samples of Luxembourgish 9th grade students (N > 12,000). MethodLatent profile analysis (LPA) to identify motivation profiles, as well as BCH method and R3STEP approach to relate profiles to academic adjustment and background variables. ResultsLPA's revealed six robust motivation profiles, three of which mainly reflect differences in students' general motivation level (i.e., “Highly motivated”, “Lowly motivated”, and “Amotivated” students). In line with the assumption of synergistic motivation processes in expectancy and value, these differences in motivation strength were reflected uniformly in different indicators of academic adjustment (e.g., standardized test scores and school anxiety). However, we also replicated three profiles whose nature and relation to academic adjustment point to compensatory and interference processes of motivation. While “Self-confident” students, who are characterized by a high general academic self-concept only, showed a better academic achievement as would have been expected by their motivation level, “Unconfident” students showed a rather poor academic adjustment, despite a relatively high interest in schooling and a high conscientiousness. In addition, we found some evidence that for “Conscientiously motivated” students, being highly conscientious may compensate for relatively low interest, seemingly at the cost of relatively high school anxiety. ConclusionOur typological approach complements previous variable- and person-oriented research on the interplay between expectancy beliefs, value beliefs, and conscientiousness.

‘Ageing well’: Discursive constructions of ageing and health in the public reach of a national longitudinal study on ageing

Established in 2006, the Irish Longitudinal Study on Ageing (TILDA) investigates the health, economic and social circumstances of a nationally-representative sample of people aged fifty years and older in a series of biennial data collection waves. Irish newspapers have been reporting the results of TILDA for over a decade and a half, and their texts represent reports of scientific research distilled through the pen of journalists. In their totality, their texts constitute a public discourse on ageing and health. Using critical discourse analysis, we examined the discourse within the texts of a purposive sample of two national daily newspapers. As sites of public discourse, newspapers reflect social life and are influential in forming and legitimating public attitudes. Like other sites of discourse, their language-in-use is contextually located, is rarely neutral and may employ strategies to discursively construct, sustain and privilege particular social identities, including ageing identities.Discursively constructed as ‘ageing well’, our analysis of newspaper texts revealed a discernible meta-discourse on ageing and health in which ageing was framed as a life course stage that may be cultivated, diligently self-nurtured and exploited for its positive aspects. When considered in light of literature on health and social inequalities, the consequences of this broadly positive ageing discourse can, somewhat perversely, frame older adults in unintended negative ways, including homogenising them and attributing to them capacities for ageing well that they may not possess. Discursively constructing older adults as a social and economic resource can also impose unrealistic expectations on them and may legitimise exploitation and demonstrate how normative ideologies of ageism and ableism are conveyed through legitimising language. Despite these potentially unintended consequences, the available media resources associated with TILDA may represent one of the most important contributions of the study, in terms of informing positive public attitudes towards ageing.

Peer Victimization Trajectory and Psychosocial Maladjustment in Early Taiwanese Adolescents: A Longitudinal Study.

This study examined the peer victimization trajectory and maladjustment outcomes among early Taiwanese adolescents. Data were extracted from a large-scale longitudinal study with a national representative sample. A total of 1691 school students in 4th, 6th, and 8th grade were analyzed. Using latent profile analysis, students were classified into four trajectories, chronic victims, late onset victims, desisters, and non-victims, based on their self-reported physical and verbal victimization at three time points. Maladjustment, including psychological distress, reduced school attachment, internet addiction, and suicidal ideation in 8th grade, were assessed. The results showed significant differences in adjustment among students in the four trajectories. Chronic victims had the poorest outcomes on most variables, followed by late onset victims and desisters, while non-victims had the least maladjustment. The findings highlight the need for future interventions that would consider students' victim status over time and pay particular attention to those who suffer constant bullying and abuse.

Young People and Social Networks: News Consumption Habits and Credibility of the News

Social networks have become extremely effective platforms for the dissemination of up-to-the-minute news among ever wider sectors of the population, particularly among young people, for whom these channels are a preferred means of socialization and of understanding their environment. The main objective of this study is to analyze the news consumption of the Spanish population aged between 15 and 24 years on social networks, with the intention of understanding how they access news, what interactions take place, and what factors engender trust, as per an online questionnaire administered to a national sample representative of the population under study (n=1,067) and five focus groups (n=97). The findings reflect a high daily exposure to the networks, which are the most common means of news consumption for young people, who show little inclination to fact-check. They receive most news items incidentally; usually, they simply read them or, at most, share them with their contacts, and they tend to attribute very little trustworthiness to them. However, the analysis of sociodemographic factors shows that variables such as age, educational level, and ideological positioning influence the credibility that young people give to the current affairs content that the networks disseminate and to the sources from which they come.

Financial Hardship on Food Security in Ageing Populations.

Objective: This study investigated the prevalence of food security, and the association of food security with financial hardship and socio-demographic characteristics among the ageing population in Thailand. Methods: The study extracted data on 1,197 persons age 60years or older from a nationally-representative sample survey of Thai households. The food security data were collected using the Food Insecurity Experience Scale (FIES), developed by the Food and Agriculture Organization. Multiple regression analysis was used to investigate the association between financial hardship, socio-demographic characteristics, and food security. Results: Of the total sample, 71% had food security. The least probability of having food security was observed in the respondents who sometimes and often had income problems (p < 0.001), and felt dissatisfied with their financial situation (p < 0.001). The respondents who were female, at oldest-old age, with lower than primary school education and in the Northeast were less likely to have food security. Conclusion: These findings suggest the need for government assistance for those who are experiencing financial hardship to help them manage their finances and food security more effectively, taking into account different socio-demographic characteristics.

Age, sex and race distribution of accelerometer-derived sleep variability in US school-aged children and adults

Sleep variability (e.g. intra-individual variabilities in sleep duration or sleep timing, social jetlag, and catch-up sleep) is an important factor impacting health and mortality. However, limited information is available on the distribution of these sleep parameters across the human life span. We aimed to provide distribution of sleep variability related parameters across lifespan by sex and race in a national representative sample from the U.S. population. The study included 9981 participants 6 years and older from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, who had 4–7 days of valid 24-h accelerometer recording with at least one day obtained during weekend (Friday or Saturday night). Of the study participants, 43% showed ≥ 60 min sleep duration standard deviation (SD), 51% experienced ≥ 60 min catch-up sleep, 20% showed ≥ 60 min sleep midpoint SD, and 43% experienced ≥ 60 min social jetlag. American youth and young adults averaged greater sleep variability compared to other age groups. Non-Hispanic Blacks showed greater sleep variability in all parameters compared to other racial groups. There was a main effect of sex on sleep midpoint SD and social jetlag with males averaging slightly more than females. Our study provides important observations on sleep variability parameters of residents of the United States by using objectively measured sleep patterns and will provide unique insights for personalized advice on sleep hygiene.

Stability of social jetlag and sleep timing into the second year of the Covid-19 pandemic: Results from a longitudinal study of a nationally representative adult sample in Ireland

ABSTRACT The early phase of the COVID-19 pandemic has previously been associated with marked changes in sleep/wake timing arising from the imposition of society-wide infection mitigation measures. Such observations are considered of broader significance as they reveal the social pressures that sleep timing normally operates under. In order to assess how persistent such changes were as the COVID-19 pandemic developed, we assessed sleep timing and quality in a longitudinal study of a nationally-representative sample of Irish adults with data collected at two time-points (December 2021 and March 2021). Data on social jetlag and chronotype was derived from the micro Munich Chronotype Questionnaire from 830 and 843 participants who provided data in December 2020 and March 2021 respectively, of which 338 contributed data to both timepoints. Demographics and measures of insomnia symptoms, anxiety, depression and loneliness were also collected, and data was analysed both within-subjects and cross-sectionally within data waves. Social jetlag (the mismatch between sleep timing on “work” and “free” days) and other measures of sleep timing were stable across the two time-points, although insomnia symptoms improved slightly from December 2020 to March 2021. The mean social jetlag at both timepoints was ~ 30 minutes, considerably lesser than reported pre-pandemic levels in similar populations. Multiple regression analysis of cross-sectional data reveals that the timing of midsleep on “free” days was only a weak-to-moderate predictor of social jetlag, whilst hours worked per week was the strongest predictor of social jetlag. Requirement for “face-to-face” contact with the public at work and urban location of residence also emerged as predictors of social jetlag, although insomnia, anxiety and depression symptoms and loneliness rating did not. We conclude that sleep timing changes that occurred during the initial phase of the COVID-19 pandemic persisted into the second year of the pandemic, and these results further illustrate the key roles working practices and other social factors have in shaping social jetlag.

Height-for-age and weight-for-age growth charts for Pakistani infants under six months: derived from a novel case selection method using multiple indicator cluster survey data

BackgroundIn the past two decades, there has been a growing recognition of the need to establish indigenous standards or reference growth charts, particularly following the WHO multicenter growth study in 2006. The availability of accurate and reliable growth charts is crucial for monitoring child health. The choice of an appropriate model for constructing growth charts depends on various data characteristics, including the distribution’s tails and peak. While Pakistan has reported some reference growth charts, there is a notable absence of indigenous charts for children under two years of age, especially for infants aged 0–6 months who are exclusively breastfed. Additionally, acquiring data poses a significant challenge, particularly for low-income countries, as it demands substantial resources such as finances, time, and expertise. The Multiple Indicator Cluster Survey (MICS) constitutes a large-scale national survey conducted periodically in low-income countries under the auspices of UNICEF. In this study, we propose methods for generating selection variables utilizing the “Novel Case Selection Method,“ as previously published. Further our approach enables to select and fit appropriate model to the MICS data, selected, and to develop the standard growth charts.MethodsOut of the 11,478 children under 6 months of age included in MICS-6 (Pakistan), 3,655 children (1,831 males and 1,824 females) met the specified criteria and were selected using the “Novel Case Selection Method”. The sample was distributed across provinces as follows: 841 (23.0%) from KPK, 1,464 (40.1%) from Punjab, 819 (22.4%) from Sindh, and 531 (14.5%) from Balochistan. This sample encompassed both rural (76.4%) and urban (23.6%) populations. Following data cleaning and outlier removal, a total of 3,540 records for weight (1,768 males and 1,772 females) and 3,515 records for height (1,759 males and 1,756 females) were ultimately available for the development of standard charts. The Bayesian Information Criterion (BIC) was employed to determine the optimal degrees of freedom for L, M, and S using RefCurv_0.4.2. Three families within the gamlss class—namely, Box Cox Cole and Green (BCCG), Box Cox T (BCT), and Box Cox Power Exponential (BCPE)—were applied, each with three smoothing techniques: penalized splines (ps), cubic splines (cs), and polynomial splines (poly). The best-fitted model was selected from these nine combinations based on the Akaike Information Criteria.ResultsThe Novel Case Selection Method yielded 3655 cases as per criteria. After cleaning the data, this method lead to selection of 3540 children for “weight for age” (W/A) and 3515 children for “height for age” (H/A). The “BCPE” family and “ps” as smoothing method proved to be best on AIC for all four curves, i.e. the W/A male, W/A female, H/A male, and H/A female. The optimum selected degrees of freedom for the curve “W/A”, for both genders were (M = 1, L = 0, S = 0). The optimum degrees of freedom for H/A male were again (M = 1, L = 0, S = 0), but for females the selected degrees of freedom were (M = 1, L = 1, S = 1). The indigenous fitted standard curves for Pakistan were on lower trajectory in comparison to WHO standards.ConclusionThis study uses the Novel Case Selection Method with introduced algorithms to construct tailored growth charts for lower and middle-income countries. Leveraging extensive MICS data, the methodology ensures representative national samples. The resulting charts hold practical value and await validation from established data sources, offering valuable tools for policy makers and clinicians in diverse global contexts.

Child sexual abuse by different classes and types of perpetrator: Prevalence and trends from an Australian national survey

BackgroundLittle evidence exists about the prevalence of child sexual abuse (CSA) inflicted by different relational classes of perpetrators (e.g., parents; institutional adults; adolescents), and by individual types of perpetrators (e.g., fathers and male relatives; male teachers and male clergy; known and unknown adolescents). ObjectiveTo generate evidence of the prevalence of CSA by different perpetrators, and trends by victim gender and age group. Participants and settingThe Australian Child Maltreatment Study collected information about CSA victimisation from a nationally-representative sample of 8503 individuals aged 16 and over. MethodsWe analysed data about 42 perpetrator types, collapsed into eight classes. We generated national prevalence estimates of CSA inflicted by each perpetrator class and individual perpetrator type, and compared results by victim gender and age group. ResultsAustralian CSA prevalence was 28.5%, with the following prevalence by perpetrator classes: other known adolescents (non-romantic): 10.0%; parents/caregivers in the home: 7.8%; other known adults: 7.5%; unknown adults: 4.9%; adolescents (current/former romantic partners): 2.5%; institutional caregivers: 2.0%; siblings: 1.6%; unknown adolescents: 1.4%. Women experienced more CSA by all perpetrator classes except institutional caregivers. Age group comparison showed significant declines in CSA by parents/caregivers, and other known adults; and increases in CSA by adolescents (current/former romantic partners). Individual perpetrator type comparison showed declines in CSA by fathers, male relatives living in the home, non-resident male relatives, and other known male adults; and increases in CSA by known male adolescents, current boyfriends, and former boyfriends. ConclusionsCSA by adults has declined, indicating positive impacts of prevention efforts. However, CSA by adolescents has increased. Further declines in CSA by adults are required and possible. Targeted prevention of CSA by adolescents must be prioritised.

Abstract A089: Examining the role of Social Determinants of Health (SDoH) on adherence to cancer prevention recommendations: Evidence from a national representative sample

Abstract The role of Social Determinants of Health (SDoH) on adherence to cancer prevention recommendations has not been systematically examined among adults in the United States adults despite the influential role of SDoH in shaping individuals' health behaviors and outcomes. Our purpose was to explore the effects of SDoH on adherence to cancer prevention recommendations among adults in the United States Methods: We used data from the Health Information National Trends Survey (HINTS), 6 cycle (2022). Adults aged 18 years and above were included. Adherence to cancer prevention recommendations was measured with the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations Score. SDoH was measured based on the American Cancer society's five core SDOH domains (economic stability, social and community context, neighborhood and built environment, education access, and healthcare access). Weighted hierarchical multiple regression models were conducted using each domain of SDOH as a block, controlling for age, gender, race, selfcare efficacy, cormorbidity, cancer risk perception and belief about cancer, Jackknife replicate weights were incorporated into the analyses. Results: The sample consisted of 6252 respondents with a mean age of 55.6 (SD, 17.4) years, The estimated mean adherence rate to cancer prevention recommendations among adults in the United States was 40.4% (SD 21.8) .Adherence to cancer prevention recommendations was positively associated with having a college education compare to less than high school education (Odd Ratio [OR], 6.29, P = .019), combined household income of $75,000 and above compare to combined household income of less than $20,000 ( OR, 5.11 , P= .014) , retired compared to full-time employement ( OR, 4.87, P &amp;lt; .001), access to health insurance compared to lack of health insurance (OR, 4.01, P= .020). These findings suggest that interventions targeting the effects of SDoH on cancer on adherence to cancer prevention recommendations may consider the socioeconomic context of targeted individuals. Such interventions should focus on addressing barriers related to education access, income stability, employment status and healthcare access. Citation Format: Adaeze Aroh, Ifeanyi N. Madujibeya. Examining the role of Social Determinants of Health (SDoH) on adherence to cancer prevention recommendations: Evidence from a national representative sample [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A089.

Perceived discrimination and nativity status: risk of cognitive impairment among Latin American older adults.

We examined the association between perceived discrimination and the risk of cognitive impairment with no dementia (CIND) and Alzheimer's disease and related dementias (ADRD) while considering the potential effects of nativity status. A prospective analysis of discrimination and nativity status with dementia and cognitive impairment was conducted among Latinx adults aged 51 years and older who participated in the Health and Retirement Study. A national representative sample. A sample of 1,175 Latinx adults aged 51 years and older. Demographics, cognitive functioning, perceived discrimination, and nativity status (US-born vs. non-US born) were assessed. Traditional survival analysis methods (Fine and gray models) were used to account for the semi-competing risk of death with up to 10 years of follow-up. According to our results, neither everyday discrimination nor nativity status on their own had a statistically significant association with CIND/ADRD; however, non-US-born Latinx adults who reported no discrimination had a 42% lower risk of CIND/ADRD (SHR = 0.58 [0.41, 0.83], p = .003) than US-born adults. These results highlight the need for healthcare providers to assess for discrimination and provide support and resources for those experiencing discrimination. It also highlights the need for better policies that address discrimination and reduce health disparities.