Lauren Mei’s research while affiliated with Weill Cornell Medicine and other places

The Program of All-Inclusive Care for the Elderly (PACE) is a community-based care model in the United States that provides comprehensive health and social services to frail, nursing home-eligible adults aged 55 years and older. PACE organizations aim to support adequate pain control in their participants, yet few evidence-based pain interventions have been adopted or integrated into this setting. This article provides a roadmap for researchers who are interested in collaborating with PACE organizations to embed and evaluate evidence-based pain tools and interventions. We situate our discussion within the Consolidated Framework for Implementation Research (CFIR), a meta-theoretical framework that considers multi-level influences to implementation and evaluation of evidence-based programs. Within each CFIR domain, we identify key factors informed by our own work that merit consideration by research teams and PACE collaborators. Inner setting components pertain to the organizational culture of each PACE organization, the type and quality of electronic health record data, and availability of staff to assist with data abstraction. Outer setting components include external policies and regulations by the National PACE Association and audits conducted by the Centers for Medicare and Medicaid Services, which have implications for research participant recruitment and enrollment. Individual-level characteristics of PACE organization leaders include their receptivity toward new innovations and perceived ability to implement them. Forming and sustaining research-PACE partnerships to deliver evidence-based pain interventions pain will require attention to multi-level factors that may influence future uptake and provides a way to improve the health and well-being of patients served by these programs.

Older adults are more likely to underuse and actively avoid decision-relevant information. Although the mechanisms underlying age-related differences in information avoidance are still unknown, Fuzzy-Trace Theory (Reyna, 2012) suggests they may be due to age-related differences in information processing preferences: According to this framework, information is stored using both gist (subjective meaning) and verbatim representations (objective details/numbers). Older adults prefer gist information and gist-based information processing, whereas younger adults favor verbatim information and verbatim processing. To examine whether age-related differences in information avoidance are affected by age-related information and processing preferences, an adult lifespan sample (N = 432) completed a pre-registered online study. Participants responded to scenarios containing potentially aversive information and chose between accepting or avoiding the information. Information formatting was experimentally manipulated, with participants either being faced with receiving gist or verbatim-formatted information. Across age groups, participants were more likely to avoid verbatim numbers than qualitative gist information (p=.026); no associations were found between avoidance and information or processing preferences. At odds with prior research, age was associated with lower information avoidance (p=.010). Follow-up analyses revealed that older adults were less likely to avoid information in health-related contexts but not in contexts unrelated to health (e.g., consumer information; p=.010). Overall, participants were more likely to avoid non-health information than health information (p<.001). In sum, our findings revealed that older adults show a decreased likelihood of avoiding potentially aversive health information, but that age-related differences in information avoidance cannot be linked to age-related information or processing preferences.