Detection of Elder abuse Through Emergency Care Technicians (DETECT)

通过紧急护理技术人员检测虐待老年人行为 (DETECT)

• 批准号: 10210352
• 负责人: Michael Bradley Cannell
• 金额: $ 33.99万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10210352
• 关键词: Address; Adult; Area; Behavioral; Caregivers; Chronic; Cognitive; Communities; Computer software; County; Data; Dementia; Detection; Diagnostic; Early Diagnosis; Elder Abuse; Elderly; Emergency Care; Emergency Medical Technicians; Emergency department visit; Emergency medical service; Emergency response; Emotional; Environment; Environmental Risk Factor; Factor Analysis; Failure; Foundations; Gold; Health; Healthcare; Hospitalization; Injury; Interview; Investigation; Link; Measures; Medical; Mental Health; Methodology; Morbidity - disease rate; Paramedical Personnel; Participant; Performance; Persons; Physical environment; Pilot Projects; Population; Positioning Attribute; Predictive Value; Prevalence; Procedures; Provider; Psyche structure; Reporting; Research; Risk; Risk Factors; Sample Size; Sampling; Screening Result; Screening procedure; Sensitivity and Specificity; Services; Sexual abuse; Social Environment; Social support; Testing; Texas; Time; Trust; United States; Validation; Work; abuse neglect; aged; base; brief screening; contextual factors; design; emotional abuse; expectation; financial exploitation; follow up assessment; follow-up; improved; innovation; modifiable risk; mortality; neglect; optimism; physical abuse; polyvictimization; protective factors; psychological distress; residence; screening; social; tool

Project Summary Elder mistreatment (EM) is commonly defined as an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust, that causes harm or creates a risk of harm to an older adult. EM includes financial abuse/exploitation, neglect, emotional/psychological abuse, physical abuse, and sexual abuse. Exposure is often chronic, and commonly involves multiple forms of abuse. This is concerning as there is an estimated 11% annual prevalence among cognitively intact adults, and higher amongst those with dementia. Further, EM is linked with increased risk of physical injury, hospitalization, emergency room visits, psychological distress, morbidity, and early mortality. Nevertheless, EM is difficult to detect and often goes unrecognized. Effective and efficient EM screening tools are urgently needed to improve early detection efforts. We will gather the data required to determine the sensitivity and specificity of the DETECT tool, a screening tool designed specifically to help medics identify potential EM occurring in the community. Our proposed methodology includes in-person follow-up assessments with a random sample of older adults screened using DETECT (N = 2,500 total participants). We will conduct a brief capacity assessment and follow-up assessment 1 month after the original DETECT screening. This assessment will include validated measures of emotional, physical, and sexual abuse, neglect, financial exploitation, and poly-victimization. It will also include validated measures of other potentially modifiable risk and protective factors.23 The specific aims of the proposed project are: AIM 1: Validation of an innovative EM screening tool (DETECT). We will match DETECT screening results with an expert LEAD panel determination “gold standard” to calculate diagnostic performance for each screening item, and all screening items collectively. This comprehensive approach to validating DETECT will provide the needed empirical foundation for its broader implementation. AIM 2: Optimizing the DETECT Tool Via Systematic Item Reduction. We will use confirmatory factor analysis to determine the relative predictive value of each DETECT item. Results will inform systematic item reduction efforts, streamlining the tool for optimally efficient administration. AIM 3: Identify risk and protective factors for EM. Follow-up in-person interviews will provide rich contextual data that highlight modifiable personal and contextual factors (e.g., previous EM and/or polyvictimization, social support, unmet health and daily living needs, financial problems, and mental factors). The large sample size of the proposed study (N=2,500) will permit an unprecedented opportunity to examine predictors of EM.

项目摘要 虐待老年人（EM）通常被定义为照顾者或其他人在一个特定的环境中故意采取行动或不采取行动。 涉及对信任的期望的关系，对老年人造成伤害或造成伤害的风险。EM包括 经济虐待/剥削、忽视、情感/心理虐待、身体虐待和性虐待。曝光往往是 慢性的，通常涉及多种形式的虐待。这是令人担忧的，因为估计每年有11%的 在认知功能完整的成年人中患病率较高，在痴呆症患者中患病率较高。此外，EM与增加的 身体伤害、住院、急诊室就诊、心理困扰、发病率和早期死亡率的风险。 然而，EM很难检测到，并且经常无法识别。有效和高效的EM筛选工具是 迫切需要改进早期检测工作。我们将收集确定敏感性所需的数据， DETECT工具的特异性，这是一种专门设计用于帮助医务人员识别潜在EM的筛查工具， 社会各界我们提出的方法包括对随机抽样的老年人进行面对面的随访评估。 使用DETECT筛查的成人（N = 2，500名参与者）。我们会进行简短的能力评估和跟进 在初始DETECT筛查后1个月进行评估。这项评估将包括情感， 身体虐待和性虐待、忽视、经济剥削和多重受害。它还将包括经过验证的措施 23拟议项目的具体目标是： 目的1：验证创新的EM筛查工具（DETECT）。我们将DETECT筛查结果与 专家LEAD小组确定“金标准”，以计算每个筛查项目的诊断性能， 集体筛选项目。这种验证DETECT的综合方法将提供所需的经验 为更广泛的实施奠定了基础。 目标2：通过系统化的项目缩减优化DETECT工具。我们将使用验证性因素分析， 确定每个DETECT项目的相对预测值。结果将为系统的项目减少工作提供信息， 简化工具，以实现最佳效率的管理。 目的3：确定EM的风险和保护因素。后续的面对面访谈将提供丰富的背景数据， 突出显示可修改的个人和背景因素（例如，以往的弱势群体和/或多重受害情况，社会支助，未得到满足 健康和日常生活需要、经济问题和精神因素）。拟议研究的大样本量 （N= 2，500）将允许前所未有的机会来检查EM的预测因子。