Health, function, and health outcomes of geriatric prisoners

我是加州大学旧金山分校弗朗西斯科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的研究人员，专注于优化被剥夺权利的老年人（如老年囚犯）的医疗保健。我寻求K23奖为我提供必要的支持，以实现以下目标：（1）获得临床研究的额外技能，包括纵向研究设计，预后建模，分层建模，测量和调查设计，以及组装前瞻性纵向队列;（2）发展独立的临床研究生涯。 老年囚犯人数的迅速增长是美国监狱的医疗危机，也是州政府的经济危机，并在老年囚犯获释的社区引发了深刻的公共卫生挑战。然而，关于老年囚犯的研究很少。我提出的研究的具体目标，通过应用老年医学的多学科视角来解决老年囚犯的医疗保健的重要知识差距。建议的研究将达致以下目的：（1）提供迄今为止最全面的评估，以评估老年囚犯的健康和功能状况，并将这些水平与以人口为基础的标准进行比较;（2）研究与监狱不良健康事件相关的风险因素，并将这些因素纳入临床工具，以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）选择并开发高保真测量方法，以评估老年人获释后的健康、功能状态、认知状态和医疗保健需求。Kenneth Covinsky博士是NIA K24获奖者，他在老年医学，监狱健康，测量科学以及组装和跟踪未来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R 01应用程序奠定基础，该应用程序专注于改善老年人从监禁中释放后的健康和医疗保健。

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.