Decision Making Among Older Adults: "Firearm Retirement"

7. 项目总结

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.