%0 Journal Article %J Journal of applied gerontology: the official journal of the Southern Gerontological Society %D Forthcoming %T The Effect of Home- and Community-Based Services on Social Engagement. %A Sun, Peter C %A Shen, Huei-Wern %K home- and community-based care and services; long-term services and supports; volunteerism and civic engagement %X

Home- and community-based services (HCBS) help older adults to remain active in community settings. However, it is not known if there is a causal relationship between HCBS and social engagement. We used data from the 2010 and 2012 Health and Retirement Study and measured the effect of HCBS on social engagement via nearest-neighbor Mahalanobis matching, optimal pair matching, genetic matching, and optimal full matching. Genetic matching showed that the odds of social engagement for participants who received at least one HCBS (congregate meal, home-delivered meal, transportation service, case management, homemaker or housekeeping services, or caregiver services) in the prior two years was 1.07 times more likely than participants who have not received any HCBS (robust SE = .030, = .040). HCBS may remove barriers to social engagement through increasing older adults' personal resources and personal networks.

%B Journal of applied gerontology: the official journal of the Southern Gerontological Society %P 7334648231205386 %G eng %R 10.1177/07334648231205386 %0 Journal Article %J Health & Social Care in the Community %D 2022 %T Associations between volunteering and cognitive impairment: The moderating role of race/ethnicity. %A Wang, Yi %A Wong, Roger %A Amano, Takashi %A Shen, Huei-Wern %K formal volunteering %K informal volunteering %K minority ageing %K objective cognition %K subjective cognition %X

Although volunteering has been shown to benefit cognitive health, there is a paucity of evidence on informal volunteering and subjective measures of cognitive impairment. Also, little is known about whether such relationships vary by race/ethnicity. This study aimed to examine the associations of both formal and informal volunteering with older adults' objective and subjective cognition and explore the moderating role of race/ethnicity in such associations. Using data from the Health and Retirement Study in the United States (2010-2016), 9941 older adults (51+) who were cognitively unimpaired in 2010 and alive through 2016 were included. Ordered logistic regression models were performed to assess the relationships among volunteering, cognitive impairment and race/ethnicity. Findings showed that more years of formal and informal volunteering significantly reduced the odds of objective cognitive impairment; neither volunteering type was significant for subjective cognitive impairment. The relationship between informal volunteering and objective cognition varied by race/ethnicity. Compared to non-Hispanic Whites, non-Hispanic Black older adults who engaged in more years of informal volunteering had a significantly higher odds of cognitive impairment over time. The current study is one of the first to look at the associations between informal volunteering and cognition. The inclusion of subjective cognitive impairment, paired with objective measures of cognition, also adds value to the knowledge body. Our findings indicate any type of volunteering is a viable approach to prevent cognitive impairment for older populations. However, more research is needed to better understand why racial/ethnic minority, particularly non-Hispanic Black older adults, do not benefit from informal volunteering.

%B Health & Social Care in the Community %V 30 %P e4433-e4441 %G eng %N 6 %R 10.1111/hsc.13847 %0 Journal Article %J Research in Nursing & Health %D 2021 %T Within-couple dissimilarities in functional impairment as determinants of spousal care arrangement among older married couples. %A Liu, Huiying %A Li, Yuekang %A Wang, Yi %A Morrow-Howell, Nancy %A Vivian W Q Lou %A Shen, Huei-Wern %K Caregiving %K family sociology %K Functional health status %K Marriage %K within-couple perspective %X

Existing research on spousal care focuses on one spouse receiving care from the other, which fails to address the complexity that is created when both spouses experience some impairments. Our study included situations in which one or both spouses have functional impairments when examining the extent to which spouses from the same couple hold a (dis)similar level of functional impairment and whether such within-couple (dis)similarity has an impact on the spousal care arrangement. A subsample of 1170 older married couples was selected from the 2014 Health and Retirement Study. Descriptive statistics were used for describing the level of each spouse's functional impairment regarding the number of limitations in activities (activities of daily living [ADL]) or instrumental ADL (IADL). Logistic regressions were used to examine whether spousal dissimilarity in functional impairment (dissimilar, similarly low, similarly high) was associated with spousal care arrangement. Within couples with one functionally impaired spouse, the impaired spouse was more likely to receive spousal care when reporting a higher level of ADL/IADL impairment. Within couples with two functionally impaired spouses, the more impaired person was more likely to receive spousal care (without giving back) when spouses reported dissimilar level of IADL impairment; spouses were more likely to report mutual care when they had similarly high levels of IADL impairment. By documenting the role of spousal dissimilarities in functioning for determining spousal care arrangement, our study can inform couple-based interventions that capitalize on each spouse's capabilities and resources.

%B Research in Nursing & Health %V 44 %P 365-375 %G eng %N 2 %R 10.1002/nur.22113 %0 Journal Article %J CLINICAL SOCIAL WORK JOURNAL %D 2020 %T Resource and Network Predictors of Multiple Volunteering Cessations: Implications for Social Policy and Practice %A Shen, Huei-Wern %A Wang, Yi %A Wong, Roger %A Amano, Takashi %K civic engagement %K productive aging %K Volunteer activity %K Volunteer cessation %X The benefits of volunteering are well-documented, however, studies specifically investigating the cessation of volunteering in old age are relatively limited, especially on multiple stops of volunteering. The present study explores the number of times older people stop volunteering over 14 years, and examines its association with financial resources, health, family demands, social networks, neighborhood environment as well as the sociodemographic characteristics. Using eight-wave data from the Health and Retirement Study, the sample included 3914 volunteers who were 50 + in 1998 and were alive throughout 2012. Among the sample, 32.75% never stopped volunteering, 41.47% stopped once, 20.77% stopped twice, and 5.01% stopped three times. Findings from Poisson regression models indicated that respondents who were older, less educated, less religious, had lower income at baseline, later developed cognitive problems, became caregivers, and had no friends living nearby were more likely to stop volunteering multiple times. Findings from the present study suggest retaining volunteers by adjusting volunteering responsibilities for older volunteers who are more vulnerable to volunteering cessation and encouraging continued commitment by maximizing their friendship and religious networks. %B CLINICAL SOCIAL WORK JOURNAL %G eng %U https://link.springer.com/article/10.1007%2Fs10615-020-00748-x %9 Article; Early Access %R 10.1007/s10615-020-00748-x %0 Journal Article %J JOURNAL OF GERONTOLOGICAL SOCIAL WORK %D 2019 %T Depressive Symptoms among Former Spousal Caregivers: Comparing Stressors, Resources, and Circumstances of Caregiving Cessation among Older Husbands and Wives %A Angela K Perone %A Ruth E Dunkle %A Sheila Feld %A Shen, Huei-Wern %A Kim, Min Hee %A Pace, Garrett T. %K Bereavement %K Caregiving cessation %K gender %K spousal caregiving %X Little research focuses on the mental health of caregivers (CGs) who stop providing care to their community-dwelling spouse. We examine depressive symptoms of former primary CG spouses who stopped caregiving over a two-year follow-up period when the care recipient (CR): (1) no longer has functional problems; (2) continues having functional problems; or (3) dies. Using data from the Health and Retirement Study (2000-2014), we located 2,370 couples who were both 50+ at baseline and where one partner provided help with ADL and/or IADL limitations but did not do so two years later. OLS regressions stratified by gender indicated that both male and female former spousal CGs whose CR died had significantly more depressive symptoms than those who ceased caregiving when their spouse did or did not still have functional problems. Former wife CGs who were older and whose husbands had more baseline ADLs had fewer follow-up depressive symptoms; wife CGs whose husbands had a nursing home stay had more depressive symptoms. Former husband CGs who had provided longer monthly hours of care had fewer follow-up symptoms. Findings underscore the importance of targeting mental and physical health services to both former caregiving husbands and wives, especially after spousal death. %B JOURNAL OF GERONTOLOGICAL SOCIAL WORK %V 62 %P 682-700 %8 AUG 18 %G eng %9 Article %R 10.1080/01634372.2019.1647906 %0 Journal Article %J Research on Aging %D 2019 %T Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation. %A Guillermo Ernest Gonzales %A Shen, Huei-Wern %A Tam E Perry %A Wang, Yi %K Moves %K Protective factors %K Social Support %K Volunteerism %X This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults' health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 ( N = 682) in the Health and Retirement Study (2008-2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites. %B Research on Aging %V 41 %P 31-53 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/29742961?dopt=Abstract %R 10.1177/0164027518773125 %0 Journal Article %J Social Work Research %D 2018 %T Further investigations of the social and material convoy: Exploring relationships between race, volunteering, and relocation %A Tam E Perry %A Shen, Huei-Wern %A Guillermo Ernest Gonzales %K Aging in place %K Racial/ethnic differences %K Volunteerism %X This study used the social and material convoy framework to explore how individual and social resources, including volunteer engagement, inform household transitions in later life by race. Data from the 2008 and 2010 Health and Retirement Study compared non-Hispanic whites' and non-Hispanic blacks' relocation patterns in 2010 (N = 8,361). Multinomial logistic regression models tested the relationships between economic, home environment, health, social, and sociodemographic variables with relocation by race. Greater household assets, poorer health, and changing marital status reduced the likelihood of moving out of area among older white adults. However, home ownership and education reduced older black adults' likelihood of out-of-area relocation. The social and material convoy framework demonstrated racial heterogeneity as older white adults who formally volunteered in 2008 were less likely to move out of area in 2010. Although policies on formal volunteering could help older white adults age in place, the same approach may not influence older black adults. %B Social Work Research %V 42 %P 290-301 %G eng %U https://academic.oup.com/swr/article/42/4/290/5122750http://academic.oup.com/swr/article-pdf/42/4/290/26996817/svy024.pdf %N 4 %R 10.1093/swr/svy024 %0 Journal Article %J J Women Aging %D 2017 %T Caregiver stressors and depressive symptoms among older husbands and wives in the United States. %A Kim, Min Hee %A Ruth E Dunkle %A Amanda J Lehning %A Shen, Huei-Wern %A Sheila Feld %A Angela K Perone %K Activities of Daily Living %K Aged %K Caregivers %K depression %K Female %K Humans %K Independent Living %K Longitudinal Studies %K Male %K Middle Aged %K Multivariate Analysis %K Prospective Studies %K Regression Analysis %K Sex Factors %K Spouses %K Stress, Psychological %K United States %X

Framed by Pearlin's Stress Process Model, this study prospectively examines the effects of primary stress factors reflecting the duration, amount, and type of care on the depressive symptoms of spousal caregivers over a2-year period, and whether the effects of stressors differ between husbands and wives. Data are from the 2004 and 2006 waves of the Health and Retirement Study and we included community-dwelling respondents providing activities of daily life (ADL) and/or instrumental activities of daily life (IADL) help to their spouses/partners (N = 774). Results from multivariate regression models indicate that none of the primary stressors were associated with depressive symptoms. However, wives providing only personal care had significantly more depressive symptoms than wives providing only instrumental care, while husbands providing different types of care showed no such differences. To illuminate strategies for reducing the higher distress experienced by wife caregivers engaged in personal care assistance, further studies are needed incorporating couples' relational dynamics and gendered experiences in personal care.

%B J Women Aging %V 29 %P 494-504 %8 2017 Nov-Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/27673406?dopt=Abstract %R 10.1080/08952841.2016.1223962 %0 Journal Article %J Social Work Research %D 2017 %T Does a Sense of Benevolence Influence Volunteering and Caregiving among Older People? %A Shen, Huei-Wern %A Delston, J. B. %A Wang, Yi %K Activity engagement %K Caregiving %K Volunteerism %X Volunteering and caregiving are both helping behaviors, but they take place in different social contexts. Although personal resources and networks are important factors in understanding whether older people volunteer and provide family care, studies of the psychological factors influencing these behaviors are rare. Using theoretical guidance of the resource and strategic mobilization model, this study aims to construct a psychological factor-sense of benevolence (SBEN)-and elucidate the effects of SBEN on volunteering and caregiving among older adults when personal resources and networks are controlled. Authors, using data from the 2000 Health and Retirement Study, included 939 community-dwelling older adults age 55 years and older in the study. Using principal component analysis, authors retained 10 items to construct the SBEN scale (Cronbach's alpha =.86). Two separate logistic regression models were used to assess the relationships between SBEN and volunteering and SBEN and caregiving. Findings show that higher SBEN increased the likelihood for older people to give care but was not related to volunteering. SBEN may be used as a construct to help understand the psychological factors behind older individuals' helping behaviors to family. Further research identifying mechanisms of engaging older volunteers-that is, psychological and institutional motivating factors-is needed. %B Social Work Research %V 41 %P 155-166 %G eng %U http://academic.oup.com/swr/article/41/3/155/4080844/Does-a-Sense-of-Benevolence-Influence-Volunteeringhttp://academic.oup.com/swr/article-pdf/41/3/155/19658245/svx012.pdf %N 3 %R 10.1093/swr/svx012 %0 Journal Article %J Ageing International %D 2017 %T Resource and Strategic Mobilization Model (RSM) of Productive Aging: Examining Older Americans’ Participation in Various Productive Activities %A Shen, Huei-Wern %K Caregiving %K Employment and Labor Force %K Older Adults %K Volunteerism %X Older people involve themselves in productive activities for different reasons, and the theoretical frameworks examining their engagement are limited. This study introduces a new theoretical model, the Resource and Strategic Mobilization model (RSM), and empirically tests how personal resources and networks influence older persons' participation in three major productive activities: employment, volunteering, and caregiving. Using nationally representative American data from the 2004 Health and Retirement Study, this study included 10,089 community-dwelling older adults aged 65+. Key predictor variables reflected aspects of personal resources (finances and physical health), and personal networks (family and social). Socio-demographic characteristics were controlled to obtain independent impacts from the above predictor variables. Three separate logistic regression models were utilized to test whether older people's personal resources and networks influenced their engagement in employment, volunteering and caregiving. Findings showed that older Americans with greater financial resources were more likely to work and volunteer. In general, those with better health were more likely to participate in all three activities. Family networks were associated with providing care, and greater social network involvement was linked to volunteering. As the RSM predicts, the diverse contexts of older persons matter, as indicated by personal resources and networks, for the activities older adults are involved in. Implications of using the RSM model to understand productive activities in which older people engage are discussed. %B Ageing International %V 42 %P 23 - 43 %8 Jan-03-2017 %G eng %U http://link.springer.com/10.1007/s12126-016-9259-1 %N 1 %! Ageing Int %R 10.1007/s12126-016-9259-1 %0 Journal Article %J J Gerontol Soc Work %D 2016 %T Does Volunteering Experience Influence Advance Care Planning in Old Age? %A Shen, Huei-Wern %A Khosla, Nidhi %K Advance care planning %K Aged %K Aging %K Female %K Humans %K Income %K Logistic Models %K Male %K Middle Aged %K Social Support %K Socioeconomic factors %K Terminal Care %K Volunteers %X

Advance care planning (ACP) increases the likelihood patients will receive end-of-life care that is congruent with their preferences and lowers stress among both patients and caregivers. Previous efforts to increase ACP have mainly focused on information provision in the very late stage of life. This study examines whether a relationship exists between volunteering and ACP, and whether this relationship is associated with social support. The sample comprises 877 individuals who were aged 55+ in 2008, and were deceased before 2010. The sample is derived from seven waves (1998-2010) of data from the Health and Retirement Study. Logistic regression results showed that overall ACP and durable power of attorney for health care (DPAHC) were both higher (OR = 1.61 and 1.71, respectively) for older adults with volunteering experience in the past 10 years than those without such experience. Available social support (relatives and friends living nearby) was not associated with the relationship between volunteering and ACP. Other factors related to ACP included poorer health, death being expected, death due to cancer, older age, and being a racial minority. Involving older people in volunteer work may help to increase ACP. Future research is encouraged to identify reasons for the association between volunteering and ACP.

%B J Gerontol Soc Work %V 59 %P 423-438 %8 2016 07 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27592593?dopt=Abstract %R 10.1080/01634372.2016.1230567 %0 Journal Article %J Social Work Research %D 2016 %T Interdependence between the Social and Material Convoy: Links between Volunteering, Widowhood, and Housing Transitions %A Shen, Huei-Wern %A Tam E Perry %K Other %K Retirement Planning and Satisfaction %X Relocation in older adulthood may occur due to triggering events, such as widowhood. Guided by Kahn and Antonucci s convoy model, this study explores the influence of volunteering on decision to relocate following the death of a spouse. Using three waves of data from the Health and Retirement Study (2006, 2008, and 2010), 5,146 community-dwelling married older individuals who were 65 years or older in 2008 were included. Findings from two multinomial logistic regression models showed that widows and widowers who were not volunteering in 2008 were more likely to move out of area in 2010 than their married counterparts, whereas the relationship between widowhood and relocation was not detected among those involved in volunteering. This article emphasizes the interdependency of social relationships and residences, a fundamental of one s material convoy, for older adults. Volunteering experiences may not only affect instrumental and emotional support after the loss of a key anchor in one s social convoy, but may also facilitate a widowed older adult to age in place rather than relocate. %B Social Work Research %V 40 %P 71-82 %8 03/2016 %G eng %U http://swr.oxfordjournals.org/content/early/2016/03/28/swr.svw002.abstract %N 2 %4 aging in place/environmental gerontology/productive aging/relocation/social convoys %$ 999999 %& 71 %R 10.1093/swr/svw002 %0 Journal Article %J J Gerontol Soc Work %D 2015 %T The prevalence of older couples with ADL limitations and factors associated with ADL help receipt. %A Shen, Huei-Wern %A Sheila Feld %A Ruth E Dunkle %A Tracy Schroepfer %A Amanda J Lehning %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Cross-Sectional Studies %K Female %K Health Services Accessibility %K Humans %K Male %K Social Support %K Socioeconomic factors %X

Using the Andersen-Newman model, we investigated the prevalence of activities of daily living (ADLs) limitations in married couples, and couple characteristics associated with ADL help-receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners' health problems.

%B J Gerontol Soc Work %I 58 %V 58 %P 171-89 %8 2015 %G eng %U http://dx.doi.org/10.1080/01634372.2014.944248 %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25036802?dopt=Abstract %2 PMC4297741 %4 health/functional limitations/care needs/spousal caregiving/marital dyad %$ 999999 %R 10.1080/01634372.2014.944248 %0 Journal Article %J Research on Aging %D 2014 %T Does Becoming an ADL Spousal Caregiver Increase the Caregiver's Depressive Symptoms? %A Ruth E Dunkle %A Sheila Feld %A Amanda J Lehning %A Kim, Hyunjee %A Shen, Huei-Wern %A Kim, Min Hee %K Adult children %K Health Conditions and Status %K Healthcare %K Public Policy %X This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents depressive symptoms at follow-up, controlling for other factors identified in Pearlin s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings. %B Research on Aging %V 36 %P 655-682 %G eng %U http://roa.sagepub.com/content/early/2013/12/22/0164027513516152.abstract %N 6 %4 Depressive Symptoms/ADL/IADL/caregiver burden/stress/spousal caregiving/Public Policy %$ 999999 %& 655 %R 10.1177/0164027513516152 %0 Journal Article %J J Hous Elderly %D 2014 %T Giving Back and Staying Put: Volunteering as a Stabilizing Force in Relocation. %A Shen, Huei-Wern %A Tam E Perry %X

Relocation in older adulthood has been shown to have health-related and environmental triggering factors. This study explores the relationship between volunteering in a community and relocation. Using data from 2008 and 2010 Health and Retirement Study, which included 9,220 community-dwelling older individuals who were 65 years and older, our findings show that volunteering significantly reduces the likelihood of relocating out of the area, and such relationship is partially mediated by having friends nearby. This study is innovative because it identifies a stabilizing mechanism important for understanding "protective" factors, such as volunteering, as a way communities can retain older adults.

%B J Hous Elderly %I 28 %V 28 %P 310-328 %8 2014 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25404786?dopt=Abstract %2 PMC4232847 %4 Risk Factors/Friendship/Retirement Communities/Retirement planning/Volunteering/2143: social problems and social welfare/social gerontology %$ 999999 %R 10.1080/02763893.2014.930368 %0 Thesis %D 2010 %T Resource and Strategic Mobilization (RSM) model of productive aging: Examining older Americans' participation in various productive activities %A Shen, Huei-Wern %Y Corcoran, Mary E. %K Demographics %K Other %K Public Policy %X Older people involve themselves in productive activities for different reasons, but the theoretical frameworks examining their engagement in productive activities are limited. This study introduces and tests a theoretical model, the Resource and Strategic Mobilization model (RSM) to systematically examine how personal resources and social networks influence older persons' participation in three major productive activities: employment, volunteering, and family caregiving. Using nationally representative data from the 2004 Health and Retirement Study, this study included 15,312 community- dwelling older adults aged 55 and above. Predictor variables included personal resources (financial resources and physical resources), and personal networks (family demands and social events). Sociodemographic characteristics were controlled to obtain accurate impacts from the above three sets of predictor variables. Two age cohorts (the younger cohort, 55-64 vs. the older cohort, 65+) were examined separately, and for each age cohort, three logistic regression models were applied to assess whether older persons' personal resources and social networks influenced their engagement in employment, volunteering and caregiving. In addition, to better capture the diversity among older people, different gender groups and racial groups (Whites, Blacks and Hispanics) were also considered separately for each age cohort. Findings showed that greater financial resources influenced an older person's odds of being employed, and volunteering. In general, better health (more physical resources) increased the odds of working and of volunteering, but had a less pronounced effect on family caregiving. The greater family demands an older person had, the more likely he/she provided care to other family members. Engaging in social events influenced involvement in all three productive activities, especially volunteering. When age, gender and race were taken into consideration, the RSM model provided better prediction for those in the older cohort, and for Whites. As the RSM predicts, the diverse contexts of older persons, as indicated by personal resources and social networks, matter for what elders choose to engage in. Implications of using the RSM model to understand productive activities in which older people engage are discussed, and a new conceptual framework for productive aging based on the RSM model are presented. %I University of Michigan %C Ann Arbor, MI %V Doctor of Philosophy %G eng %U http://hdl.handle.net/2027.42/78929 %L newpubs20110418_Shen.pdf %4 Older adults %$ 24760