Working with a robot in hospital and long-term care homes: staff experience.

Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia care. Our objective was to understand staff perspectives on using telepresence robots to support residents with dementia and their families. Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups and 11 semi-structured interviews across four long-term care (LTC) homes and one hospital in Canada. We included 22 interdisciplinary staff members (e.g., registered nurses, social workers, occupational therapists, recreational therapists) to understand their experiences with telepresence robots. Thematic analysis identified three key themes: 1) Staff Training and Support; 2) Robot Features; 3) Environmental dynamics for Implementation. Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in dementia care settings to effectively implement technology. This study contributes to future research and practice by elucidating factors facilitating staff involvement in technology research, integrating staff voices into technology implementation planning, and devising strategies to provide structural support to staff, care teams, and care homes.

Information Avoidance in Consumer Choice: Do Avoidance Tendencies and Motives Vary by Age?

Prior research suggests that older adults seek less information in consumer choices than younger adults do. However, it remains unclear if intentional information avoidance plays a role in such effects. To test this possibility, we examined age differences in deliberate information avoidance in consumer decisions and explored a range of potential motives. Adult lifespan samples completed two pre-registered online studies, which assessed information avoidance using a slider scale (Study 1, N =195) and a forced-choice task (Study 2, N = 500). In Study 1, age differences in information avoidance were not significant, but methodological limitations could have obscured age effects. In Study 2, age was associated with higher information avoidance. Avoidance was higher among participants who reported that the information would not impact decision preferences, would elicit more negative affect, and would be useless. Although age was associated with lower perceived impact on decision preferences and lower concerns about affective responses, age differences in information avoidance remained significant when these variables were statistically controlled. In conclusion, in the context of consumer choices, deliberate information avoidance is higher among older consumers. Thus, interventions to promote the acquisition of relevant information would benefit from being tailored to the target age group.

Adult age differences in risk perception and risk taking.

Research on self-reported risk perception and risk taking suggests age-related decrements in risk preference, with older adults less likely to engage in general and domain-specific risk taking (i.e., in financial, health-related, ethical, career, and leisure contexts). Data relating to social risks, however, are inconsistent. With respect to behavioral risk-taking tasks, age-related differences vary depending on task characteristics and older adults' cognitive capacities. Specifically, older adults are less good at learning to take advantageous risks and take fewer risks when faced with gains, especially financial and mortality-based ones. We contextualize these trends by referencing relevant theoretical frameworks (see Frey et al., 2021 [1]) and by drawing on the COVID-19 pandemic to illustrate recent examples of age-related differences in real-life risk responses.

Susceptibility to default effects does not differ by age.

Decision makers are more likely to passively accept than to actively reject preselected default options. Age differences in such "default effects" have not been systematically examined, but prior research reports age-related variation in several known determinants of default effects suggesting that they may be more common in older as compared to younger adults. To address this question, a representative life span sample (N = 500; Mage = 49.90, SDage = 19.34; 51% female, 49% male; 67% non-Hispanic White) responded to a preregistered online study. Participants completed a default effect task comprising two conditions, one requiring opt-out and one requiring opt-in decisions (i.e., 15 vs. 0 preselected features each). Susceptibility to defaults was assessed as the discrepancy between the number of features selected within each condition. In addition, we collected data on known determinants of default effects (i.e., perceived endowment, endorsement, ease, experience making similar choices, importance of the choice, and affective responses to the choice). Finally, we screened demographic background, personality, socioemotional and health status, and cognitive ability. Susceptibility to default effects was evident both at the individual and the group level. Unlike hypothesized, older age did not predict greater susceptibility to defaults, and older adults were less likely to endorse determinants of default effect compliance. Of the covariates assessed, only identifying as non-Hispanic White, greater perceived endorsement, greater perceived ease, and lower perceived importance of making the right choice predicted decision makers' susceptibility to default effects. Thus, our findings suggest that susceptibility to decision defaults does not vary by age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Is Reliance on the Affect Heuristic Associated With Age?

OBJECTIVES: With age, decision makers rely more on heuristic and affect-based processing. However, age differences have not been quantified with respect to the affect heuristic, which derives judgments based on positive and negative feelings toward stimuli and concepts. This study examined whether reliance on the affect heuristic is associated with age, whether these patterns vary by task type, and which covariates account for age effects. METHOD: In a preregistered study, an adult life-span sample (N = 195, 21-90 years, Mage = 52.95, 50% female, 71% non-Hispanic White) completed a battery of cognitive, personality, and socioemotional covariates as well as 3 established affect heuristic tasks: (a) a risk-benefit task, (b) a dread-inference task, and (c) an affect-impact task. Reliance on affect was indexed through (a) a negative relationship between perceived food risks and benefits, (b) a positive relationship between feelings of dread and statistical inferences about mortality risks, and (c) a positive relationship between affective responses and impact judgments when evaluating catastrophes. RESULTS: For all 3 tasks, usage of the affect heuristic was documented at the group and the individual levels. Contrary to hypotheses, age was not associated with affect heuristic use for any of the tasks. Affect heuristic indices did not correlate across tasks and showed no consistent associations with the covariates. DISCUSSION: Results suggest that the use of affect-based heuristics is context- or stimulus-dependent rather than a stable, age-associated trait. Further research is needed to validate the present results across additional domains, tasks, and stimulus types.

Age Differences in Media Consumption and Avoidance With Respect to COVID-19.

BACKGROUND: Older versus younger adults are at greater risk from coronavirus disease 2019 (COVID-19), but descriptive data show they are less likely to seek out related information in the media, although underlying mechanisms remain unclear. METHOD: A representative adult life-span sample (N = 500) completed a preregistered online study assessing changes in media consumption in response to the pandemic, self-reported and behavioral media avoidance, avoidance motives, and demographic, socioemotional, and cognitive covariates. RESULTS: Age was associated with reduced media consumption and higher behavioral media avoidance, but lower self-reported media avoidance and lower endorsement of specific avoidance motives. Age differences in aspects of affect, motivation, and cognition statistically accounted for variations in behavioral avoidance but not for the other age effects. DISCUSSION: Age differences in media use in the context of the COVID-19 pandemic are not explained by deliberate avoidance intentions and motives but associated with broader age variations in socioemotional and cognitive functioning.

The influence of verbatim versus gist formatting on younger and older adults' information acquisition and decision-making.

Fuzzy-Trace Theory suggests that decision makers encode gist representations (bottom-line meaning) and verbatim representations (details) of information but rely more on gist, a tendency that increases with age. The present study examined implications for age differences in information seeking and decision-making by presenting gist and verbatim formatted choice scenarios. Participants comprised 68 younger and 66 older adults. Predecisional information seeking, indices of decision outcomes and recall, and relevant covariates were assessed. In line with theory, older adults self-reported and demonstrated stronger preferences for gist-based processing than younger adults did. Consistent with hypotheses, the total number of reviewed grid cells (including repeat views) was higher for gist than verbatim conditions, and this effect was stronger among older adults. Also, the proportion of unique cells reviewed and the accuracy of decision attribute recall were higher in the verbatim than gist condition and these effects were stronger among younger versus older adults. Further, gist formatting was associated with stronger use of option-wise information search, more value-concordant decisions (i.e., choices aligning with self-reported choice preferences), and decreased choice satisfaction, but these effects did not vary by age. Covariates, including information-processing preferences, partially accounted for these effects. Consistent with Fuzzy-Trace Theory, this suggests that information formatting and preferences modulate age differences in predecisional information acquisition: Depending on age, using either verbatim or gist formatting to communicate information can offer different benefits. Across age groups, however, gist formatting may facilitate value-concordant (and arguably higher-quality) decision-making. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Benefits of Intergenerational Wisdom-Sharing: A Randomized Controlled Study.

Adolescents' opportunities to benefit from the life wisdom of older persons are very limited. To address this issue, we designed and tested the Building a Community Legacy Together (BCLT) program based on research on the benefits of older people's wisdom for youth development. In the intervention, the youth participants were trained prior to conducting interviews with older persons regarding their advice for living. The youth participants analyzed the information obtained and presented a summary report to the community. The participants were 93 middle and high school youth who were randomly assigned to the treatment condition with the BCLT program (n = 47) or to the control condition (n = 46). The outcome measures included sense of purpose, self-esteem, attitudes toward older people, confidence interacting with older people, and interest in working with older people. Quantitative and qualitative data were also collected regarding the subjective assessments of the program's success. We found significant positive effects for the BCLT participants regarding their sense of purpose in life, attitudes toward older people, comfort interacting with older people, and interest in working with older people. The subjective assessments of the participants were overwhelmingly positive. The findings indicate that BCLT had positive effects for the youth participants and support the further development and testing of wisdom-sharing intergenerational programs.

Factors associated with resident-to-resident elder mistreatment in nursing homes.

BACKGROUND: Resident-to-resident elder mistreatment (RREM) in nursing homes has serious physical and psychological consequences, but factors related to RREM occurrence remain unclear. This study identifies individual and environmental characteristics associated with involvement in RREM episodes. METHODS: The design was an observational study carried out in five urban and five suburban New York state nursing homes randomly selected on the basis of size and location. The sample consisted of 2011 residents in 10 facilities; 83% of facilities and 84% of eligible residents participated. RREM and potential correlates were identified through resident interviews, staff interviews, shift coupons, observation, chart review, and accident or incident reports. RESULTS: A multivariate analysis controlling for relevant covariates found that individuals involved in RREM incidents exhibit milder dementia, show behavioral symptoms, and are less functionally impaired. Although special care units (SCU) for dementia have benefits for residents, one potential hazard for SCU residents is elevated risk for RREM. CONCLUSIONS: Interventions to prevent and intervene in RREM incidents are greatly needed. The correlates identified in this research point to the need for targeted interventions, specifically for residents with milder impairment and with behavioral symptoms and individuals in SCUs.

Susceptibility to COVID-19 Scams: The Roles of Age, Individual Difference Measures, and Scam-Related Perceptions.

As the COVID-19 pandemic was unfolding, a surge in scams was registered across the globe. While COVID-19 poses higher health risks for older adults, it is unknown whether older adults are also facing higher financial risks as a result of COVID-19 scams. Here, we examined age differences in vulnerability to COVID-19 scams and individual difference measures (such as impulsivity, ad skepticism, and past experiences with fraud) that might help explain them. A lifespan sample (M = 48.03, SD = 18.56) of sixty-eight younger (18-40 years, M = 25.67, SD = 5.93), 79 middle-aged (41-64 years, M = 49.86, SD = 7.20), and 63 older adults (65-84 years, M = 69.87, SD = 4.50) recruited through Prolific completed questions and questionnaires online. In a within-subjects design, each participant responded to five COVID-19 solicitations, psychological measures, and demographic questions. Age group comparisons revealed that older adults were marginally less likely to perceive COVID-19 solicitations as genuine than middle-aged adults were. In addition, older adults perceived significantly fewer benefits than both younger and middle-aged adults did and perceived marginally higher risks than younger adults did. Hence, older adults did not exhibit greater vulnerability to COVID-19 scams. Regardless of age, intentions to respond to COVID-19 solicitations were positively predicted by higher levels of educational attainment, being married, past fraud victimization, and higher levels of positive urgency. As expected, stronger genuineness and benefit perceptions positively predicted action intentions, whereas stronger risk perceptions negatively predicted action intentions As such, COVID-19 scam susceptibility appears to be the result of a impulse control issue that is not easily inhibited, not even by past experiences of scam victimization.

Compliance with mass marketing solicitation: The role of verbatim and gist processing.

INTRODUCTION: Mass marketing scams threaten financial and personal well-being. Grounded in fuzzy-trace theory, we examined whether verbatim and gist-based risk processing predicts susceptibility to scams and whether such processing can be altered. METHODS: Seven hundred and one participants read a solicitation letter online and indicated willingness to call an "activation number" to claim an alleged $500,000 sweepstakes prize. Participants focused on the solicitation's verbatim details (hypothesized to increase risk-taking) or its broad gist (hypothesized to decrease risk-taking). RESULTS: As expected, measures of verbatim-based processing positively predicted contact intentions, whereas measures of gist-based processing negatively predicted contact intentions. Contrary to hypotheses, experimental conditions did not influence intentions (43% across conditions). Contact intentions were associated with perceptions of low risk, high benefit, and the offer's apparent genuineness, as well as self-reported decision regret, subjective vulnerability to scams, and prior experience falling for scams. CONCLUSIONS: Overall, message perceptions and prior susceptibility, rather than experimental manipulations, mattered in predicting scam susceptibility.

Do visual aids influenced patients' risk perceptions for rare and very rare risks?

OBJECTIVE: To examine whether visual aids (a graphic representation and/or conceptual illustrations) influence patients' risk perceptions for rare and very rare risks. METHODS: Participants were randomized to a scenario which varied by probability of infection (2% or 0.2%) and visual aid: numbers only, numbers + graphic representation, numbers + conceptual illustrations, or numbers + graphic representation + conceptual illustrations. Risk perceptions and likelihood of starting the medication were examined across the four formats, separately, in participants with and without a college education. RESULTS: Adding a graphic representation and/or conceptual illustrations did not affect risk perceptions among those with a higher level of education. Adding both a graphic representation + conceptual illustrations decreased risk perceptions and increased likelihood of starting the medication among participants randomized to the 2%, but not 0.2% scenario, among participants with lower levels of education. CONCLUSION: Adding a graphic representation + conceptual illustrations to numbers may influence perceptions for rare, but not very rare, risks among patients with lower education. PRACTICE IMPLICATIONS: Clinicians should be aware of the differential effects of visual aids developed to facilitate risk communication. Patients with higher levels of education may be less responsive to visual aids than those with lower education.

Influence of Explanatory Images on Risk Perceptions and Treatment Preference.

OBJECTIVE: The aim of this study was to examine whether providing patients with a series of balance scales (BS), depicting a reciprocal relationship between achieving disease control and increasing the risk of infection, influences treatment preference. METHODS: Participants were randomized to receive a description of a medication in which risk of infection was relayed using 1 of 4 formats, including numbers only, numbers + icon array (IA), numbers + BS, or numbers + IA + BS (i.e., combination). We compared the likelihood of starting the medication across the 4 formats, and evaluated whether the influence of risk formats varied by numeracy and gist risk appraisals. RESULTS: The mean ± SE likelihood of starting the medication was higher among participants randomized to the combination format (3.85 ± 0.09) compared to those who viewed the BS (3.56 ± 0.09; P = 0.0222) or numbers-only formats (3.51 ± 0.09; P = 0.0069). Viewing an IA alone was associated with a lower likelihood of starting the medication among participants lower in numeracy and endorsing a risk-avoidant noncompensatory gist risk appraisal. Conversely, viewing an IA (with or without the BS) was associated with a greater likelihood of starting the medication among patients with higher numeracy and compensatory risk appraisals. CONCLUSION: Adding explanatory images to IAs increases patient likelihood to take a medication in those with low numeracy and a noncompensatory gist risk appraisal. Explanatory images may be a feasible approach to improve willingness to try medication among subjects who are especially risk averse and believe that any risk is unacceptable.

Cost-effectiveness analysis of coronary artery disease screening in HIV-infected men.

BACKGROUND: HIV-infected patients are at increased risk of coronary artery disease (CAD). We evaluated the cost-effectiveness of cardiac screening for HIV-positive men at intermediate or greater CAD risk. DESIGN: We developed a lifetime microsimulation model of CAD incidence and progression in HIV-infected men. METHODS: Input parameters were derived from two HIV cohort studies and the literature. We compared no CAD screening with stress testing and coronary computed tomography angiography (CCTA)-based strategies. Patients with test results indicating 3-vessel/left main CAD underwent invasive coronary angiography (ICA) and received coronary artery bypass graft surgery. In the stress testing + medication and CCTA + medication strategies, patients with 1-2-vessel CAD results received lifetime medical treatment without further diagnostics whereas in the stress testing + intervention and CCTA + intervention strategies, patients with these results underwent ICA and received percutaneous coronary intervention. RESULTS: Compared to no screening, the stress testing + medication, stress testing + intervention, CCTA + medication, and CCTA + intervention strategies resulted in 14, 11, 19, and 14 quality-adjusted life days per patient and incremental cost-effectiveness ratios of 49,261, 57,817, 34,887 and 56,518 Euros per quality-adjusted life year (QALY), respectively. Screening only at higher CAD risk thresholds was more cost-effective. Repeated screening was clinically beneficial compared to one-time screening, but only stress testing + medication every 5 years remained cost-effective. At a willingness-to-pay threshold of 83,000 €/QALY (∼ 100,000 US$/QALY), implementing any CAD screening was cost-effective with a probability of 75-95%. CONCLUSIONS: Screening HIV-positive men for CAD would be clinically beneficial and comes at a cost-effectiveness ratio comparable to other accepted interventions in HIV care.