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Risk Screening & Primary Prevention of Elder Abuse in People Living with Dementia

风险筛查

基本信息

批准号：
10512584
负责人：
LAURA A MOSQUEDA
金额：
$ 61.46万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10512584
关键词：
Address Advisory Committees Affect Alzheimer&apos s disease related dementia American Behavior Behavioral Caregivers Caring Categories Cessation of life Characteristics Clinic Clinic Visits Communities County Cultural Sensitivity Data Dementia Detection Development Education Elder Abuse Elder abuse prevention Elderly Ensure Family Family Caregiver Family health status Feedback Focus Groups Goals Health Healthcare Systems Home Individual Intervention Intervention Studies Los Angeles Measures Medical Methods Monitor Morbidity - disease rate Outcome Outcome Measure Participant Patients Personal Satisfaction Persons Phase Population Preventive service Primary Health Care Primary Prevention Protocols documentation Provider Public Health Randomized Randomized Controlled Trials Reporting Research Respondent Risk Risk Assessment Risk Factors Risk Reduction Sampling Schedule Screening procedure Self Care Self Perception Sexual abuse Site Societies Surveys Target Populations Technology Time United States Centers for Medicare and Medicaid Services Validation Victimization Visit Vulnerable Populations base brief intervention caregiver interventions caregiving clinical care cost design effectiveness testing efficacy testing emotional abuse ethnic diversity evidence base feasibility testing financial exploitation follow-up improved indexing intervention effect intimate partner violence modifiable risk mortality neglect novel strategies person centered physical abuse primary care setting primary outcome racial diversity screening service utilization three-arm study tool web site

项目摘要

ABSTRACT Elder mistreatment (EM) has profound effects on 1 in 10 older Americans, and rates are amongst the highest for people living with dementia (PLWD). Family caregivers most frequently inflict this harm and are typically remorseful for their behavior. This proposal will address this societal problem through a novel approach that identifies care partners/caregivers (CPG) at primary care medical clinics, whether they are there for their own care or that of the PLWD. During the project’s R61 phase, we will develop and test the feasibility of an evidence- based brief Risk Assessment Screen (RAS) for use in primary care clinics to screen CPGs of PLWD. A 3- component intervention will be developed and feasibility-tested. The first component will direct the CPG during the clinic visit to a website specifically designed to engage them in solution-focused strategies. The second component will provide 1-3 home or technology-assisted visits with a care navigator who provides person- centered guidance to facilitate effective caregiving strategies and alerts CPGs to risks of EM. A third component will educate the clinical care team to address caregiving needs directly with the CPG during the clinic visit and schedule a follow-up visit within 2 months to monitor for change. We will develop an Outcome Tool that includes a compilation of validated measures of modifiable risk factors known to be associated with EM by CPGs which will be used to measure change in risk of EM over time. During the project’s R33 phase, the research team will conduct a cluster randomized controlled trial to test the effectiveness of the RAS and the 3-component intervention. Primary care clinics across Los Angeles County will be randomized to one of the three study arms: control, RAS only, or RAS plus intervention. Analyses will assess the impact of screening and the intervention on participants’ level of risk of EM, as well as other outcomes at the level of the CPG and the PLWD. Additionally, potential harms from the RAS and/or the intervention will be assessed. Finally, we will generate exploratory qualitative data to improve our understanding of the mechanisms of risk and change that may result from our application of the RAS and the intervention.

抽象的虐待老年人 (EM) 对十分之一的美国老年人产生了深远的影响，并且这一比例是美国老年人中最高的。痴呆症患者（PLWD）。家庭照顾者最常造成这种伤害，并且通常对自己的行为感到悔恨。该提案将通过一种新颖的方法来解决这个社会问题识别初级保健医疗诊所的护理合作伙伴/护理人员 (CPG)，无论他们是为自己而存在护理或 PLWD 的护理。在该项目的 R61 阶段，我们将开发并测试以下证据的可行性：基于简短的风险评估筛查 (RAS)，用于初级保健诊所筛查 PLWD 的 CPG。一个 3- 将制定干预措施并进行可行性测试。第一个组件将在期间指导 CPG 诊所访问专门设计的网站，旨在让他们参与以解决方案为中心的策略。第二个该部分将提供 1-3 次上门或技术辅助访视，并由护理导航员提供个人护理服务。以促进有效的护理策略为中心的指导，并提醒 CPG 关注 EM 风险。第三个组成部分将教育临床护理团队在诊所就诊期间直接与 CPG 解决护理需求，并且在 2 个月内安排一次随访以监测变化。我们将开发一个结果工具，其中包括 CPG 已知与 EM 相关的可改变风险因素的经过验证的措施汇编，将用于衡量新兴市场风险随时间的变化。在该项目的 R33 阶段，研究团队将进行整群随机对照试验来测试 RAS 和 3 组件的有效性干涉。洛杉矶县的初级保健诊所将被随机分配到三个研究组之一：控制、仅 RAS 或 RAS 加干预。分析将评估筛查和干预措施的影响参与者的 EM 风险水平，以及 CPG 和 PLWD 层面的其他结果。此外，将评估 RAS 和/或干预措施的潜在危害。最后，我们将生成探索性的定性数据，以提高我们对风险和变化机制的理解，这些风险和变化可能由我们的 RAS的应用和干预。