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。项目摘要/摘要 与没有认知障碍的老年人相比，认知障碍的老年人受到老年虐待的风险。 3虐待老人是一个主要的公共卫生问题，估计在美国范围 情绪虐待的27.9％至62.3％，在患有身体虐待的3.5％–23.1％ 认知障碍（CI）。1,3-6EM因其违规，包括伤害，增加，导致严重的不利结果 服务利用，精神困扰和死亡率增加。急诊室是机会设置 确定这个脆弱的人群。克服老年人虐待的主要障碍是无法 准确地确定惊喜。据估计，当局只有24例中只有1个。这是 由于认知障碍的老年人不太可能报告他们正在受到虐待，因此有问题。 与用户体验研究，老年医学，阿尔茨海默氏病和紧急研究的领先专家合作 医学，我们将对使用老年人虐待数字的声音进行可用性和可行性评估 - 认知障碍的老年人的筛查工具。 声音是一种基于平板电脑的工具，用于筛选和确定对老年人虐待的可疑，并已开发 并根据父母赠款进行了测试，目前正在与没有认知能力的老年人进行评估 损害。 Voices Tool使用虚拟教练，交互式多媒体库（例如图形，视频剪辑， 动画等），从电子筛选中获得亲密伴侣暴力的技术，并简短的动机 采访旨在增强老年人的识别错误。在130个主题中 到目前为止使用的声音，有8岁的年长想在使用声音后自我报告，其中3个是 由ED社会工作者证实。 在这种补充中，我们将评估有认知障碍的老年人的声音工具的可行性 增强和完善EM筛选声音工具，可供认知者可用和接受 损害。我们的目标是：1）评估较老的声音筛选工具的可用性和可接受性 认知障碍的患者，2）增强和完善的声音工具可用于较老 认知障碍的成年人，3）进行可行性研究（n = 80），检查声音在 老年人忙碌的急诊科。 如果资助的话，这种补充剂将扩大我们项目的范围，将广告/ADRD人口包括在我们的 声音项目目前不包括具有CI的老年人，以使我们能够检查 我们对CI老年人的复杂干预。我们希望这个项目将带来未来的比较 有效性研究比较（声音 +人际筛查）与护理标准（亲自筛查）。

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