Decision Making Among Older Adults: "Firearm Retirement"

老年人的决策：“枪支退休”

• 批准号: 10164551
• 负责人: Marian Elizabeth Betz
• 金额: $ 30.96万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10164551
• 关键词: Acute; Address; Adult; Advance Directives; Aging; Alzheimer' s disease related dementia; American; Automobile Driving; Awareness; Bereavement; Caregivers; Caring; Cessation of life; Characteristics; Clinical; Cognitive; Collaborations; Decision Aid; Decision Making; Dementia; Dementia caregivers; Development; Disease; Educational Intervention; Effectiveness; Elderly; Emotional; Emotions; Empathy; Evaluation; Face; Family; Family member; Female; Firearms; Foundations; Frequencies; Funding; Future; Gender; Glare; Goals; Grief reaction; Guidelines; Gun injury; Guns; Impairment; Individual; Industry; Injury; Intervention; Knowledge; Legitimacy; Link; Location; Methods; National Institute of Mental Health; Parents; Patients; Perception; Persons; Physical Capacity; Physiological; Population; Process; Provider; Qualitative Methods; Recommendation; Research; Resources; Retirement; Rights; Risk; Rural; Subgroup; Suicide; Suicide prevention; Surveys; Terminal Disease; Testing; Time; Trust; Veterans; Work; Wrestling; Youth; cognitive ability; cognitive capacity; community setting; driving safety; effective intervention; improved; innovation; insight; instructor; male; multidisciplinary; multimodality; online resource; person centered; personalized approach; prototype; reducing suicide; suicidal risk; tool

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.

7. 项目概要 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供养者来说，“退休”在情感上是困难的——而且他们 我们研究团队的父级 R01 研究 (R01AG059613) 的重点。现在，有了 NOSI 的补充资金， 我们将扩大工作范围，探索利益相关者对“枪支退役”的看法，为我们的发展提供信息 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 他们自己做出决定，并且需要时间为过渡做准备。一个关键的知识差距是如何参与 老年枪支拥有者——在痴呆症或急性自杀风险发作之前——在同样的自主性、 以人为本的未来枪支自愿退休计划。相关资源严重匮乏 枪支退役。该 NOSI 提案以初步和正在进行的工作为基础，并响应 RFA 的要求 呼吁“创新且具有文化竞争力的干预措施”。在一年的时间里，我们的多学科、 成立的研究小组将使用定性方法来探讨主要利益相关者的观点：老年人（≥65岁） 拥有枪支和驾驶的成年人（n = 40 名男性；n = 40 名女性）；老年枪支拥有者的家庭成员（n=20）； 照顾老年人的临床医生（n=20）；以及相关组织的代表（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 推动退休的框架； (2) 根据目标 1 的关键见解，制定文化 有效的原型干预（即定制方法、交付环境和工具）以推广枪支 退休。我们的基本假设是：（1）枪支退役将与关键（但不是全部）方面密切相关 推动退休的观点和观点会因亚组而异（例如，性别、退伍军人身份、农村地区、退休频率） 携带枪支）和背景（例如，由于与疾病相关的尊严丧失而想要自杀）；和（2） 利益攸关方将建议采用多模式的资源方法，并确定可改变的障碍， 促进者以及信息传递中需要考虑的关键因素（例如可信度或合法性、信任、同理心）。 拟议的研究将满足对可用工具的迫切需求，以帮助老年人考虑枪支退休， 从而帮助减少枪支伤害和死亡，同时尊重和促进老年人的独立性， 自主权和权利。美国人口老龄化凸显了这些问题的紧迫性，我们 拟议的工作将为未来的实施和评估提供科学基础 现实世界设置中的中心工具。