Development Project 1

开发项目1

• 批准号: 7622994
• 负责人: Edward Haksing Ip
• 金额: $ 2.86万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7622994
• 关键词: Activities of Daily Living; Address; Age; Aging; Area; Award; Calibration; Canes; Characteristics; Clip; Complex; Computers; Condition; Data; Development; Discrimination; Economic Burden; Effectiveness of Interventions; Elderly; Environment; Evaluation; Floor; Funding; Geriatrics; Individual; Institution; Jogging; Judgment; Knowledge; Light; Measurement; Measures; Medicine; Methodology; Multimedia; Numbers; Older Population; Participant; Patient Self-Report; Performance; Personal Satisfaction; Phase; Population; Prevention; Prevention Research; Psychometrics; Purpose; Quality of life; Questionnaires; Race; Range; Recruitment Activity; Reporting; Research; Research Infrastructure; Respondent; Rural; Score; Societies; Speed; Study Section; System; Technology; Technology Assessment; Testing; United States; Urban Population; Walking; Work; animation; base; computerized; contextual factors; disability; experience; functional decline; functional loss; improved; innovation; instrument; research and development; response; sex; social; therapy design; tool; trafficking

The loss of functional independence with aging has profound effects on older adults' quality of life and results in substantial social and economic burden to society at large. Disability prevention has emerged as a major focus of gerontology and geriatric medicine and an early functional decline represented by mobility disability has been the focus of our OAIC since its inception. However, disability prevention research has been hindered by measurement-related issues. For example, most assessment tools target "disability" or difficulty with a very basic set of tasks rather than "ability" across a broad range of task demands. This leads to ceiling effects and, in some instances, results in measures insensitive to the effects of interventions that are designed to enhance function. Also, the focus on disability rather .than "ability" has meant that we know very little about the large segment of the older population that is "well-functioning"; i.e., those who do not report difficulties with basic functioning. Furthermore, most currently used self-report measures of mobility disability require participants to make complex judgments about the implicit meaning of apparently straightforward task descriptions such as walking 2-3 blocks. Yet, there are a number of contextual factors that are important in making such judgments. For example, is this inside or outside? Are there hills? How fast must I walk? Are there curbs or traffic? These ambiguities both add to the measure's variance and may limit the ability to compare results between different populations (e.g., rural and urban populations). To address these limitations, we propose to create and validate an innovative infrastructure that provides the capacity to assess mobility function and disability in a multimedia enhanced, and Computerized Adaptive Testing (CAT) environment, a measure we call M-CAT. The enhanced multimedia component makes extensive use of animation video clips.. Animation serves three purposes: First, it removes potential biases in judgments that may arise from characteristics such as the sex, race, age or experience of the actor. Second, it standardizes item interpretation. Respondents view the actual demands of the task and are no longer required to make implicit judgments regarding item content. For example, when asking about climbing a flight of stairs, we can present the task standardizing the speed, number of steps, light conditions and the presence or absence of handrails. And third, animation enables us to create a broad range of progressively difficult tasks in controlled settings by manipulating how the task is visually presented, an innovation in methodology that provides much finer discrimination of abilities and enables us to avoid ceiling and floor effects. We are able to capture the entire range of perceived ability of mobility from walking with a cane to jogging and walking over uneven terrain. The other component of the assessment environment, CAT, is a computer-based assessment technology that allows the customization of items (questionnaires) for each individual respondent. The computer scores every response from an individual and determines the best question to subsequently administer to that individual to efficiently determine his/her functional ability. With this improved ability to quickly "zoom in" on items that are appropriate for each individual, we can: (a) develop a measure that has a large number of items (e.g., >100) because individuals only respond to a subset of these questions based on their initial responses, (b) reduce response burden, (c) assess the mobility of older adults with a single instrument across all levels of ability, and (d) gain precision in measurement. We also expect that the correlation between scores on the M-CAT and actual performance measures of mobility disability will be higher than with widely-used measures due the enhanced precision of this measurement technology.

随着年龄的增长，功能独立性的丧失对老年人的生活质量产生了深远的影响， 对整个社会造成巨大的社会和经济负担。残疾预防已经成为一种 老年学和老年医学的主要焦点以及以活动能力为代表的早期功能衰退 自成立以来，残疾人一直是我们的OAIC的重点。然而，残疾预防研究一直是 受到与测量有关的问题的阻碍。例如，大多数评估工具针对“残疾”或困难 具有非常基本的一组任务，而不是跨越广泛任务需求的“能力”。这导致天花板 影响，在某些情况下，导致措施对干预措施的影响不敏感， 以增强功能。此外，对残疾的关注而不是“能力”意味着我们对残疾的了解很少。 大部分老年人口“功能良好”;即，那些没有报告在 基本功能。此外，大多数目前使用的自我报告措施的行动能力残疾需要 参与者对看似简单的任务的隐含意义做出复杂的判断 例如步行2-3个街区的描述。然而，有一些背景因素是重要的， 做出这样的判断。例如，这是在里面还是外面？有山吗？我得走多快？是 有路缘或交通？这些模糊性都增加了测量的方差，并且可能限制了 比较不同群体之间的结果（例如，农村和城市人口）。 为了解决这些限制，我们建议创建并验证一个创新的基础设施， 提供了能力，以评估流动功能和残疾的多媒体增强，计算机化 自适应测试（CAT）环境，我们称之为M-CAT。增强的多媒体组件 广泛使用动画视频剪辑。动画有三个目的：首先，它消除了潜在的 判断中的偏见，可能会产生的特点，如性别，种族，年龄或经验的演员。 第二，对项目解释进行了规范化。受访者认为任务的实际需求， 更长的时间需要对项目内容做出隐含的判断。例如，当问到攀岩时， 一段楼梯，我们可以提出的任务标准化的速度，步数，光线条件和 有无扶手。第三，动画使我们能够创造一个广泛的， 通过操纵任务的视觉呈现方式，在受控环境中完成困难的任务，这是 一种方法，提供了更精细的能力区分，使我们能够避免天花板和地板 方面的影响.我们能够捕捉到从拄着拐杖走路到 慢跑和在不平坦的地形上行走。 评估环境的另一个组成部分CAT是一种基于计算机的评估 技术，允许定制的项目（问卷）为每个人的答复。的 计算机对每个人的回答进行评分，并确定随后的最佳问题 以有效地确定他/她功能能力。有了这种改进的能力， 快速“放大”适合每个人的项目，我们可以：（a）制定一个衡量标准， 大量的项目（例如，>100），因为个人只回答这些问题的子集， 他们的初步反应，（B）减少反应负担，（c）评估老年人的流动性与单一的 （d）提高测量精度。我们还期待着 M-CAT评分与行动能力残疾的实际表现指标之间的相关性将更高 由于这种测量技术的精度提高，