Older adults in vulnerable communities: Health and quality of life over time

弱势社区的老年人：随着时间的推移健康和生活质量

• 批准号: 8576314
• 负责人: KAREN Ilene FREDRIKSEN-GOLDSEN
• 金额: $ 62.55万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8576314
• 关键词: Accounting; Address; Adult; Affect; Age; Aging; Baby Booms; Biological; Bisexual; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic; Cohort Effect; Collaborations; Commit; Communities; Community Health; Complex; Confounding Factors (Epidemiology); Data; Development; Disadvantaged; Disclosure; Discrimination; Distress; Elderly; Ethnic Origin; Funding; Gays; Gender; Generations; Goals; Growth; Health; Health Care Costs; Health behavior; Health behavior change; Heterogeneity; Heterosexuals; Housing; Individual; Institute of Medicine (U.S.); Interdisciplinary Study; International; Internet; Intervention; Journals; Lesbian; Life; Measures; Mediating; NIH Program Announcements; Parents; Patient Self-Report; Peer Review; Physiological; Population; Positioning Attribute; Psyche structure; Public Health; Publishing; Quality of life; Race; Research; Research Personnel; Research Priority; Resources; Risk; Services; Sex Orientation; Social Network; Stress; Surveys; Testing; Time; Time Management; Underserved Population; United States National Institutes of Health; Universities; Victimization; Washington; Work; base; cohort; disability; disorder prevention; effective intervention; experience; health disparity; high risk; improved; innovation; longitudinal design; peer; population based; premature; programs; public health relevance; resilience; response; social; success; symposium; therapy development

DESCRIPTION (provided by applicant): Diversity, its growth and complexity, are defining features of the dramatic aging of the world-wide population. Research demonstrates that older adults from disadvantaged populations are at elevated risk of poor health, disability and premature death. The National Institutes of Health are committed to reducing and eliminating health disparities. The Centers for Disease Control and Prevention state that health disparities related to sexual orientation are one of the main gaps in health disparities research. Existing evidence demonstrates that lesbian, gay and bisexual (LGB) older adults are an at-risk, under-investigated and under-served health disparate population. This study will examine the determinants of health impacting LGB older adults to assess change in health and quality of life (QOL) over time. Based on an innovative resilience conceptual framework, the pro- posed longitudinal research will obtain data from 2,000 LGB older adults who participated in the original study in order to allow us to understand the inter-relationships between risk and protective factors as well as cohort effects as they impact health and QOL of LGB older adults over time. This multidisciplinary collaboration of University of Washington researchers and community-based collaborators addresses a critical gap by identifying modifiable mechanisms impacting health and QOL over time. The primary goals of the project are as follows: 1) Investigate how lifetime victimization, everyday discrimination, stress (perceived stress and physiological response to stress) and health behavior change affects health and QOL of LGB older adults over time; 2) Evaluate how social relations (time-varying) and sexual identity management (time-varying) affect the associations among everyday discrimination, stress, health and QOL over time; and, 3) Test whether there is cohort heterogeneity in overall levels and age growth trajectories of health and QOL, and to what extent the differences in experiences within a historical context (e.g., time of sexual identity disclosure, lifetime victimization) between Baby Boom and Silent Generation LGB older adults account for these cohort effects. As the population ages, the health care costs associated with health disparities will continue to rise. To respond to this growing public health challenge it is imperative to identfy groups at high risk of disparities and to determine the modifiable mechanisms impacting their health and QOL as they age. The findings from this project will generate needed information to directly inform and guide the development of tailored interventions that can be effectively delivered within community-based agency settings to improve the health and QOL of demographically diverse older adults.

描述（由申请人提供）：多样性，其增长和复杂性，是全球人口急剧老龄化的定义特征。研究表明，来自弱势群体的老年人健康状况不佳、残疾和过早死亡的风险更高。美国国立卫生研究院致力于减少和消除健康差距。疾病控制和预防中心指出，与性取向有关的健康差异是健康差异研究的主要空白之一。现有证据表明，女同性恋、男同性恋和双性恋（LGB）老年人是一个面临风险、调查不足和服务不足的健康差异人群。本研究将检查影响LGB老年人健康的决定因素，以评估健康和生活质量（QOL）随时间的变化。基于创新的弹性概念框架，拟议的纵向研究将从参与原始研究的2，000名LGB老年人中获得数据，以使我们能够了解风险和保护因素之间的相互关系以及随着时间的推移影响LGB老年人健康和QOL的队列效应。华盛顿大学的研究人员和社区合作者的这种多学科合作通过确定随着时间的推移影响健康和生活质量的可修改机制来解决关键差距。该项目的主要目标如下：1）调查终身受害，日常歧视，压力（感知压力和对压力的生理反应）和健康行为变化随时间影响LGB老年人的健康和生活质量;（2）社会关系的评价（时变）和性别认同管理（时变）影响日常歧视，压力，健康和生活质量之间的关联随着时间的推移;以及，3）测试健康和QOL的总体水平和年龄增长轨迹是否存在队列异质性，以及在历史背景下体验的差异程度（例如，性别身份披露的时间，一生的受害）之间的婴儿潮和沉默的一代LGB老年人解释了这些队列效应。随着人口老龄化，与健康差距相关的医疗保健费用将继续上升。为了应对这一日益增长的公共卫生挑战，必须识别差异的高风险群体，并确定随着年龄的增长影响其健康和生活质量的可改变机制。该项目的研究结果将产生所需的信息，以直接告知和指导定制干预措施的制定，这些干预措施可以在以社区为基础的机构环境中有效地提供，以改善人口统计学上多样化的老年人的健康和生活质量。