Feasibility of the VOICES Elder Mistreatment Digital-Screening Tool for Older Adults with Cognitive Impairment

VOICES 老年人虐待数字筛查工具针对认知障碍老年人的可行性

• 批准号: 10287674
• 负责人: Fuad Abujarad
• 金额: $ 41.87万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10287674
• 关键词: Accident and Emergency department; Adult; Age; Alzheimer' s Disease; Alzheimer' s disease care; Award; Behavior; Caregivers; Clip; Complex; Country; Decision Making; Dementia; Disclosure; Distress; Elder Abuse; Elderly; Emergency Medicine; Emotional; Ethics; Evaluation; Family member; Feasibility Studies; Fright; Funding; Future; Geriatrics; Goals; Health Personnel; Impaired cognition; Injury; Intervention; Legal; Libraries; Methods; Modeling; Nursing Homes; Outcome; Partner Abuse; Patient Self-Report; Patients; Persons; Population; Positioning Attribute; Prevalence; Privacy; Provider; Psyche structure; Public Health; Recommendation; Reporting; Research; Risk; Safety; Screening procedure; Self Disclosure; Services; Social Workers; Tablets; Techniques; Testing; Trust; United States; Visit; Voice; Vulnerable Populations; Work; abuse neglect; adverse outcome; animation; authority; base; clinical care; comparative effectiveness study; design; digital; digital health; effectiveness evaluation; efficacy evaluation; emotional abuse; experience; health care settings; help-seeking behavior; improved; innovation; interactive multimedia; intimate partner violence; maltreatment; mortality; mortality risk; motivational enhancement therapy; neglect; older patient; parent grant; parent project; physical abuse; point of care; prevent; relationship abuse; screening; service utilization; standard of care; tool; usability; user centered design; virtual coach

7. PROJECT SUMMARY/ ABSTRACT Older adults with cognitive impairment are at greater risk of elder mistreatment compared to those without.1- 3 Elder mistreatment is a major public health problem with estimated prevalence in the United State ranges from 27.9% to 62.3% for emotional abuse and 3.5%–23.1% for physical abuse among older adults with cognitive impairment (CI).1,3-6 EM causes serious adverse outcomes for its victims including injury, increased service utilization, mental distress and increased mortality. The Emergency Department is an opportune setting to identify this vulnerable population. A major barrier in overcoming elder mistreatment is the inability to accurately identify victims. It is estimated that only 1 in 24 cases become known to authorities. This is problematic as older adults with cognitive impairment are not likely to report that they are being mistreated. Working with leading experts in user experience research, geriatrics, Alzheimer’s disease, and emergency medicine, we will conduct a usability and feasibility evaluation of using the VOICES elder mistreatment digital- Screening tool for older adults with cognitive Impairment. VOICES is a tablet-based tool to screen and identify suspicion of elder mistreatment and has been developed and tested under the parent grant and is currently being evaluated with older adults without cognitive impairment. VOICES tool utilizes virtual coaching, interactive multimedia libraries (e.g. graphics, video clips, animations, etc.), techniques from electronic screening for intimate partner violence, and brief motivational interviewing designed to enhance identifying mistreatment among older adults. Among the 130 subjects who used VOICES so far, 8 older wanted to self-report EM after using VOICES and 3 of these cases were substantiated by the ED social workers. In this supplement we will evaluate the feasibility of VOICES tool by older adults with cognitive impairment to enhance and refine the EM screening VOICES tool to be useable and acceptable by persons with cognitive impairment. Our aims are: 1) to evaluate the usability and acceptability of the VOICES screening tool for older patients with cognitive impairment, 2) to enhance and refine VOICES tool to be usable and acceptable for older adults with cognitive impairment, 3) to conduct a feasibility study (N= 80) examining the use of VOICES in a busy emergency department by older adults with cognitive impairment. This supplement, if funded, will expand the scope of our project to include the AD/ADRD population to our VOICES project that does not currently include older adults with CI to allow us to examine the feasibility of our complex intervention for older adults with CI. We expect this project will lead to a future comparative effectiveness study comparing (VOICES + in-person screening) to the standard-of-care (in-person screening).

7.项目总结/摘要 与没有认知障碍的老年人相比，有认知障碍的老年人遭受虐待的风险更大。 3.虐待老年人是一个主要的公共卫生问题，估计在美国普遍存在。 从27.9%到62.3%的老年人受到精神虐待，从3.5%到23.1%的老年人受到身体虐待， 认知障碍（CI）。1，3 - 6 EM会对其受害者造成严重的不良后果，包括伤害， 服务利用率、精神痛苦和死亡率增加。急诊室是一个合适的环境 来识别这些弱势群体克服虐待老年人的一个主要障碍是， 准确识别受害者。据估计，24起案件中只有1起为当局所知。这是 这是一个问题，因为有认知障碍的老年人不太可能报告他们受到虐待。 与用户体验研究、老年医学、阿尔茨海默病和急诊领域的顶尖专家合作 医学，我们将进行一个可用性和可行性评估使用的声音老人虐待数字- 老年认知障碍筛查工具。 VOICES是一种基于平板电脑的工具，用于筛选和识别虐待老人的嫌疑， 并在父母资助下进行测试，目前正在对没有认知能力的老年人进行评估。 损伤VOICES工具利用虚拟辅导、交互式多媒体库（例如图形、视频剪辑， 动画等），亲密伴侣暴力的电子筛查技术，以及简短的动机 访谈旨在加强识别老年人中的虐待。在130名受试者中， 到目前为止，8名老年人在使用VOICES后想要自我报告EM，其中3名病例是 经艾德社工证实。 在本补充中，我们将评估VOICES工具的可行性，由老年人认知障碍， 增强和完善EM筛选VOICES工具，使其能够被认知障碍的人使用和接受。 损伤我们的目的是：1）评估VOICES筛查工具在老年人中的可用性和可接受性 认知障碍患者，2）增强和完善VOICES工具，使其适用于老年人， 3）进行一项可行性研究（N = 80），检查VOICES在 忙碌急诊科忙碌的老年人有认知障碍。 这项补助金如获拨款，将可扩大我们的计划范围，把副学士学位/副学士学位/残疾人士纳入 VOICES项目，目前不包括老年人CI，使我们能够检查的可行性 我们对老年CI患者的复杂干预。我们希望这个项目将导致未来的比较 比较（VOICES+当面筛查）与标准治疗（当面筛查）的有效性研究。

项目成果

Digital health screening tool for identification of elder mistreatment.

• DOI: 10.4017/gt.2020.19.s.70138
• 发表时间: 2020-10-03
• 期刊: Gerontechnology : international journal on the fundamental aspects of technology to serve the ageing society
• 作者: Abujarad F;Edwards C;Choo E;Pantalon M;Jubanyik K;Dziura J;D'Onofrio G;Gill T
• 通讯作者: Gill T