Health, function, and health outcomes of geriatric prisoners

老年囚犯的健康、功能和健康结果

• 批准号: 8077930
• 负责人: BRIE A WILLIAMS
• 金额: $ 14.87万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8077930
• 关键词: Activities of Daily Living; Address; Age; Aging; Applications Grants; Back; California; Caring; Cessation of life; Characteristics; Chronic; Chronic Care; Clinical; Clinical Research; Cognitive; Cohort Studies; Communities; Community Healthcare; County; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Data Sources; Development; Drops; Economics; Elderly; Environment; Environmental Risk Factor; Event; Faculty; Fellowship; Floor; Funding; Geriatrics; Goals; Health; Health Insurance; Health Status; Healthcare; Healthcare Systems; Hospitalization; Impaired cognition; Impairment; Imprisonment; Instruction; Jail; K-Series Research Career Programs; Knowledge; Learning; Length; Longitudinal Studies; Measurement; Measures; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Modeling; Nature; Outcome; Outcome Assessment; Participant; Pattern; Performance; Persons; Population; Preparation; Prevalence; Primary Health Care; Prisoner; Prisons; Provider; Public Health; Research; Research Design; Research Personnel; Risk; Risk Factors; Sampling; San Francisco; Science; Series; State Government; Stratification; Stress; Surveys; Testing; Texas; Training; Universities; Work; adverse outcome; age group; aged; base; career; career development; cohort; cost; design; disability; experience; falls; follow-up; functional disability; functional status; health care service utilization; high risk; improved; instrument; member; multidisciplinary; novel; physical functional ability; population based; prognostic; prospective; skills; theories; tool

DESCRIPTION (provided by applicant): I am a Geriatrician and junior faculty member at the University of California, San Francisco. My long-term goal is to become an independent researcher focused on optimizing the healthcare of disenfranchised older adults, such as geriatric prisoners. I seek a K23 award to provide me with the support necessary to accomplish the following goals: (1) to acquire additional skills in clinical research including longitudinal study design, prognostic modeling, hierarchical modeling, measurement and survey design, and assembling a prospective longitudinal cohort; and (2) to develop an independent clinical research career. The rapidly growing number of geriatric prisoners is a healthcare crisis in US prisons, an economic crisis for state governments, and has precipitated profound public health challenges in the communities to which aging prisoners are released. However, research about older prisoners is scarce. The specific aims of my proposed research address important knowledge gaps by applying the multidisciplinary perspective of Geriatrics to the healthcare of aging prisoners. The proposed research will accomplish the following aims: (1) provide the largest assessment to date of the health and functional status of geriatric prisoners and compare these levels to population-based norms; (2) examine risk factors associated with adverse health events in prison and incorporate these into a clinical tool to risk-stratify geriatric prisoners according to their risk of adverse health events; (3) determine the association between disability specific to the prison environment and adverse health events; and (4) select and develop high-fidelity measures to assess health, functional status, cognitive status, and healthcare needs of older adults after release. My strong mentoring team led by Dr. Kenneth Covinsky an NIA K24 awardee, has expertise in geriatrics, prison health, measurement science and in assembling and following a prospective cohort. This application will also provide pilot data and lay the groundwork for an R01 application focused on improving the health and healthcare of older adults after release from incarceration. RELEVANCE (See instructions): This application will describe the healthcare needs of older prisoners, create a clinical prediction tool for adverse health outcomes, and establish a cohort of older adults nearing release to measure medical, cognitive and functional status and plans for post-release healthcare. Results can be used to guide care, improve costs and decrease adverse health outcomes of incarcerated older adults and of those transitioning back to community healthcare.

描述（由申请人提供）：我是加州大学旧金山分校的一名老年病学家和初级教员。我的长期目标是成为一名独立研究员，专注于优化被剥夺权利的老年人（例如老年囚犯）的医疗保健。我寻求 K23 奖项，为我提供实现以下目标所需的支持：(1) 获得临床研究方面的额外技能，包括纵向研究设计、预后建模、分层建模、测量和调查设计以及组建前瞻性纵向队列； (2)发展独立的临床研究事业。老年囚犯数量的迅速增长对美国监狱来说是一场医疗危机，对州政府来说是一场经济危机，并给老年囚犯被释放的社区带来了深刻的公共卫生挑战。然而，关于老年囚犯的研究却很少。我提出的研究的具体目标是通过将老年病学的多学科视角应用于老年囚犯的医疗保健来解决重要的知识差距。拟议的研究将实现以下目标：（1）提供迄今为止对老年囚犯的健康和功能状态的最大评估，并将这些水平与基于人口的标准进行比较； (2) 检查与监狱中不良健康事件相关的风险因素，并将其纳入临床工具，根据老年囚犯发生不良健康事件的风险对他们进行风险分层； (3) 确定监狱环境特有的残疾与不良健康事件之间的关联； (4) 选择和制定高保真度措施来评估老年人出院后的健康、功能状态、认知状态和医疗保健需求。我强大的指导团队由 NIA K24 获奖者 Kenneth Covinsky 博士领导，他们在老年病学、监狱卫生、测量科学以及组建和跟踪前瞻性队列方面拥有专业知识。该应用程序还将提供试点数据，并为 R01 应用程序奠定基础，该应用程序致力于改善老年人出狱后的健康和医疗保健。相关性（参见说明）：该应用程序将描述老年囚犯的医疗保健需求，创建不良健康结果的临床预测工具，并建立一组即将释放的老年人，以测量医疗、认知和功能状态以及释放后医疗保健计划。结果可用于指导被监禁老年人和返回社区医疗保健的老年人的护理、降低成本并减少不良健康后果。