Decision Making Among Older Adults: "Firearm Retirement"

7.项目总结 汽车和枪支：两者通常都与年轻、独立和力量的观念联系在一起，但两者也都可以 对身体或认知能力下降的老年人构成伤害风险。关于“驾驶”的决定 对于老年人、他们的家庭成员和他们的赡养者来说，“退休”在情感上是困难的--他们确实是 我们研究团队的父母R01研究的重点(R01AG059613)。现在，有了这笔补充的NOSI资金， 我们将扩大我们的工作范围，探索利益相关者对“枪支退役”的看法，以了解我们制定的 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 决策本身，他们需要时间为过渡做准备。一个关键的知识缺口是如何参与 老年持枪者--在痴呆症或急性自杀风险出现之前--在使类似的自主性方面， 以人为本的自愿、未来枪支退休计划。与以下方面相关的资源明显匮乏 武器退役。这份NOSI提案建立在初步和正在进行的工作的基础上，并回应了RFA的 呼吁“创新的、有文化能力的干预措施”。在一年的时间里，我们的多学科， 已建立的研究团队将使用定性方法探索关键利益相关者的观点：老年人(≥65岁) 拥有枪支和开车的成年人(n=40男性；n=40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)；以及相关组织的代表(例如，全国步枪协会、美国退休人员协会； N=25)。通过这些会议，我们的目标是：(1)探索不同利益相关者的观点，以制定 枪支退役的概念框架，并将新兴概念/结构与理论进行比较 激励退休的框架；以及(2)在来自目标1的关键见解的启发下，制定了文化上的 适当的原型干预(即量身定做的方法、交付环境和工具)，以促进枪支 退休了。我们的基本假设是：(1)枪支退役将强烈地平行于关键(但不是所有)方面 推动退休的比例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，因疾病而丧失尊严的自杀欲望)；以及(2) 利益攸关方将建议采用多模式资源办法，确定可更改的障碍， 推动者，以及在传递信息时要考虑的关键因素(例如，可信度或合法性、信任、同理心)。 这项拟议的研究将满足对可用工具的迫切需求，以帮助老年人考虑退休枪支， 从而有助于减少枪伤和死亡，同时尊重和促进老年人的独立， 自主性和权利。美国人口老龄化突显了这些问题的紧迫性，我们的 拟议的工作将为未来实施和评估人- 真实世界设置中的居中工具。

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.