Decision Making Among Older Adults: "Firearm Retirement"

7.项目摘要 汽车和枪支：两者通常都与年轻、独立和力量的观念有关，但两者也可以 对身体或认知能力下降的老年人造成伤害风险。关于“驾驶”的决定 “退休”对老年人，他们的家庭成员和他们的提供者来说是情感上的困难-他们是 我们研究团队的母研究R 01（R 01 AG 059613）的重点。现在，有了NOSI的补充资金， 我们将扩大工作范围，探讨持份者对“枪支退役”的意见， 具有文化能力的原型干预。先前的研究表明，对于驾驶，老年人希望 他们需要时间为过渡做准备。一个关键的知识差距是如何参与 老年人枪支拥有者-在痴呆症或急性自杀风险发作之前-在使类似的自主性， 以人为本的自愿计划，未来的枪支退休。有一个明显缺乏资源有关， 枪支退休该NOSI提案建立在初步和正在进行的工作基础上， call for“innovative创新and cultural文化competent胜任interventions干预.”在一年的时间里，我们的多学科， 已成立的研究小组将使用定性方法探讨主要利益相关者的观点：老年人（≥65岁） 拥有枪支并开车的成年人（n=40名男性; n=40名女性）;老年枪支拥有者的家庭成员（n=20）; 护理老年人的临床医生（n=20）;以及来自相关组织的代表（例如，NRA、AARP; n=25）。通过这些会议，我们的目标是：（1）探讨不同的利益相关者的观点，以制定一个 枪支退役的概念框架，并将新出现的概念/结构与 框架告知驾驶退休;（2）根据目标1的关键见解， 合格的原型干预（即，（包括有针对性的方法、投放环境和工具）， 退休我们的基本假设是：（1）枪支退役将强烈平行的关键（但不是所有）方面 驾驶退休和观点将因子组而异（例如，性别，退伍军人身份，农村地区， 携带枪支）和背景（例如，（2）因疾病而丧失尊严的自杀欲望; 利益攸关方将建议采取多模式资源办法，确定可改变的障碍， 促进者，以及在消息传递中考虑的关键因素（例如，可信度或合法性、信任、同理心）。 这项拟议中的研究将填补对可用工具的迫切需求，以帮助老年人考虑枪支退休， 从而有助于减少火器伤害和死亡，同时尊重和促进老年人的独立性， 自主权和权利。美国人口的老龄化凸显了这些问题的紧迫性， 建议的工作将为今后实施和评价人- 在现实世界的设置居中的工具。

7. PROJECT SUMMARY Cars and guns: both are often linked to perceptions of youth, independence, and strength, but both can also pose injury risks for older adults with declining physical or cognitive capacity. Decisions about “driving retirement” are emotionally difficult for older adults, their family members, and their providers – and they are the focus of our study team's parent R01 study (R01AG059613). Now, with this supplemental NOSI funding, we will expand our work to explore stakeholder views about “firearm retirement” to inform our development of a culturally competent prototype intervention. Prior work shows that, for driving, older adults want to make decisions themselves and they want time to prepare for transitions. A critical knowledge gap is how to engage older adult firearm owners – before onset of dementia or acute suicide risk – in making similarly autonomous, person-centered plans for voluntary, future firearm retirement. There is a glaring dearth of resources related to firearm retirement. This NOSI proposal builds on preliminary and ongoing work and is responsive to the RFA's call for “innovativeand culturally competent interventions.” Over a one-year period,our multi-disciplinary, established study team will use qualitative methods to explore the views of key stakeholders: older (≥65 years) adults who own firearms and drive (n=40 male; n=40 female); family members of older firearm owners (n=20); clinicians caring for older adults (n=20); and representatives from relevant organizations (e.g., NRA, AARP; n=25). Through these sessions, we aim to: (1) explore diverse stakeholder perspectives to develop a conceptual framework of firearm retirement and compare emerging concepts/constructs to theoretical frameworks informing driving retirement; and (2), informed by key insights from Aim 1, develop a culturally competent prototype intervention (i.e., tailored approaches, delivery settings, and tools) to promote firearm retirement. Our underlying hypotheses are: (1) firearm retirement will strongly parallel key (but not all) aspects of driving retirement and views will vary by subgroups (e.g., gender, Veteran status, rural location, frequency of carrying firearms) and context (e.g., desire for suicide due to illness-related loss of dignity); and (2) stakeholders will recommend a multi-modal approach of resources, with identification of modifiable barriers, facilitators, and key factors for consideration in message delivery (e.g., credibility or legitimacy, trust, empathy). The proposed research will fill a critical need for usable tools to help older adults consider firearm retirement, thereby helping reduce firearm injuries and deaths while respecting and promoting older adult independence, autonomy, and rights. The aging of the U.S. population underscores the urgency of these issues, and our proposed work will provide the scientific foundation for future implementation and evaluation of person- centered tools in real-world settings.