Aging Among the Homeless: Social Isolation, Function and Institutional Care
Aging Among the Homeless: Social Isolation, Function and Institutional Care
批准号:
10642758
负责人:
Margot B Kushel
金额:
$65.34万
依托单位国家:
美国
项目类别:
财政年份:
2012
资助国家:
美国
项目状态:
未结题
起止时间:
2012-09-30 至 2027-05-31
关键词:
AccelerationAdherenceAdultAgeAgingBlack AmericanCOVID-19 pandemicCaringCharacteristicsClinicClinicalCommunicationCommunitiesCriminal JusticeDevelopmentDiscriminationElderlyEpidemiologistEthnic OriginEthnographyGeneral PopulationGoalsGovernmentHealthHealth PersonnelHealth systemHealthcareHealthcare SystemsHomeless personsHomelessnessHousingIndividualInstitutionInsuranceInterventionInterviewInterviewerKnowledgeLesbian Gay Bisexual Transgender QueerLinkLongitudinal cohort studyMediatingMedicalMental HealthMethodologyMethodsMorbidity - disease rateNative AmericansNatureNursesOutcomeParticipantPersonsPhysiciansPlayPoliciesPopulationPreventivePrimary CarePsychologistPublic HealthRecommendationResearchResearch MethodologyResearch PersonnelRoleSampling StudiesScientistSexual and Gender MinoritiesSocial EnvironmentSocial WorkSocial isolationStructureSubstance Use DisorderSupervisionSystemTrainingTranslatingTransportationTrustVisitWorkbarrier to carecare providersclinical developmentcohortdistrustexperiencefollow-upfunctional declinefunctional disabilitygender minority grouphealth assessmenthealth care service utilizationhigh risk populationimprovedinformantmedication compliancemembermiddle agemortalitynovelparticipant observationperceived discriminationphysical conditioningpolicy recommendationpoor health outcomeprimary care visitracial minorityracismrecruitsocial stigmatherapy designtrendtrustworthinessuptakeworking group
中文摘要
项目总结/摘要
该项目的长期目标是提高保健提供者和机构的可信度,
减少无家可归的老年人对医疗的不信任,从而改善健康状况
结果。该提案旨在更新2AG 041860,“无家可归者中的老龄化:社会隔离,功能
和机构护理”,并继续在老年人经历无家可归的人的健康结果
中年(HOPE HOME)研究,该研究招募并跟踪了450名50岁或60岁以上无家可归的成年人。
老了所有无家可归的成年人中约有一半年龄在50岁或50岁以上;预计这一趋势将继续下去。希望
HOME参与者健康状况不佳,包括身体健康问题,老年病和功能障碍。
与七八十岁的人相似的损伤。美国黑人,LGBTQ+个人,以及
无家可归者中有精神健康问题和/或物质使用障碍的人数过多
包括HOPE HOME研究样本。拥有这些身份的人可能会经历
歧视和耻辱,这影响了对医疗的不信任。不信任可能是利用卫生保健的障碍
并与无家可归的老年人的健康状况不佳有关;对这种关联知之甚少。
我们建议增聘150名“希望之家”的参与者,以代替那些已经死亡或失踪的人士
随访,并随访队列54个月,每半年进行9次结构化访谈。我们
将招募30名参与者进行深入的定性访谈,其中20人进行临床研究。
观察了解与医疗不信任相关的因素及其动态性质。我们将招募
20名在为无家可归的老年人提供服务的环境中工作的关键线人进行深入的定性访谈。
受试者的研究访视将在属于Lifelong Medical(一家CIMHC)的行政大楼进行
为无家可归的老年人服务参与者观察将在当地诊所和医疗保健机构进行
机构职能体系在研究者的监督下,经过培训的访谈者将进行结构化的
访谈以评估关键变量,研究人员和研究人员将对参与者进行
观察初级保健访问。社区咨询委员会,由社区和政策领导人组成,
无家可归者和研究参与者,将与研究团队合作,指导研究开发和翻译
将调查结果转化为工具包、实践和政策。研究结果将有助于临床,
在一个工具包中总结的方案和政策建议,旨在提高
卫生保健机构。
英文摘要
PROJECT SUMMARY/ABSTRACT
The long-term goal of this project is to increase the trustworthiness of health care providers and institutions and
decrease the rates of medical mistrust among homeless-experienced older adults, thereby, improving health
outcomes. The proposal seeks to renew 2AG041860, “Aging Among the Homeless: Social Isolation, Function
and Institutional Care” and continue the Health Outcomes in People Experiencing Homelessness in Older
Middle agE (HOPE HOME) study, which recruited and followed a cohort of 450 homeless adults age 50 or
older. Approximately half of all homeless adults are age 50 or older; this trend is expected to continue. HOPE
HOME participants have poor health, including physical health problems, geriatric conditions, and functional
impairments similar to housed individuals in their 70s and 80s. Black Americans, LGBTQ+ individuals, and
those with mental health problems and/or substance use disorders are overrepresented in the homeless
population, including in the HOPE HOME study sample. Individuals with these identities may experience
discrimination and stigma, which influence medical mistrust. Mistrust may be a barrier to health care utilization
and related to poor health outcomes in older homeless adults; little is known about this association.
We propose to recruit an additional 150 HOPE HOME participants to replace those who have died or been lost
to follow-up, and to follow the cohort for 54 months with nine semi-annual visits for structured interviews. We
will recruit a sub-sample of 30 participants for in-depth qualitative interviews and 20 of those for clinical
observation to understand the factors associated with medical mistrust and its dynamic nature. We will recruit
20 key informants who work in settings that serve homeless older adults for in-depth qualitative interviews.
Study visits for participants will take place at an administrative building belong to Lifelong Medical, a FQHC
which serves older homeless adults. Participant observations will take place at local clinics and health care
institutions. Trained interviewers, under the supervision of study investigators, will administer structured
interviews to assess key variables and study investigators with research personnel will conduct participant
observation of primary care visits. A Community Advisory Board, composed of community and policy leaders in
homelessness and study participants, will work with the study team to guide study development and translate
the findings into a toolkit, practice, and policy. Study findings will contribute to the development of clinical,
programmatic, and policy recommendations summarized in a toolkit aimed to increase trustworthiness of
health care institutions.
期刊论文(2)
专著(0)
科研奖励(0)
会议论文
Accounting for individualized competing mortality risks in estimating postmenopausal breast cancer risk.
在估计绝经后乳腺癌风险时考虑个体化竞争死亡风险。
DOI:
10.1007/s10549-016-4020-8
发表时间:
2016
期刊:
Breast cancer research and treatment
影响因子:
3.8
作者:
[Schonberg,MaraA, Li,VickyW, Eliassen,AHeather, Davis,RogerB, LaCroix,AndreaZ, McCarthy,EllenP, Rosner,BernardA, Chlebowski,RowanT, Hankinson,SusanE, Marcantonio,EdwardR, Ngo,LongH]
通讯作者:
Ngo,LongH
Loneliness among homeless-experienced older adults with cognitive or functional impairments: qualitative findings from the HOPE HOME study.
有认知或功能障碍的无家可归老年人的孤独感:HOPE HOME 研究的定性发现。
DOI:
10.1186/s12889-024-18052-5
发表时间:
2024
期刊:
BMC public health
影响因子:
4.5
作者:
[Yuan,Yeqing, Knight,KellyR, Weeks,John, King,Stephen, Olsen,Pamela, Kushel,Margot]
通讯作者:
Kushel,Margot
Adapting Advance Care Planning Tools for Permanent Supportive Housing Residents
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批准号:10112805
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项目类别:
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资助金额:$29.8万
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财政年份:2020
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负责人:Margot B Kushel
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依托单位:
Mentoring Researchers in Aging in Vulnerable Populations
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批准号:10548814
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资助金额:$18.86万
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批准号:9249452
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项目类别:
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资助金额:$18.58万
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财政年份:2015
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负责人:Margot B Kushel
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依托单位:
Mentoring Researchers in Aging in Vulnerable Populations
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批准号:8891716
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项目类别:
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资助金额:$18.58万
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财政年份:2015
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负责人:Margot B Kushel
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依托单位:
Mentoring Researchers in Aging in Vulnerable Populations
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批准号:10321287
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项目类别:
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资助金额:$18.86万
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财政年份:2015
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负责人:Margot B Kushel
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依托单位:
Aging Among the Homeless: Social Isolation, Function and Institutional Care
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批准号:10467926
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项目类别:
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资助金额:$66.08万
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财政年份:2012
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负责人:Margot B Kushel
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Aging among the homeless; geriatric conditions, health and healthcare outcomes
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批准号:9068728
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资助金额:$51.43万
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Aging Among the Homeless: Social Isolation, Function and Institutional Care
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批准号:10179260
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项目类别:
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资助金额:$60.82万
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财政年份:2012
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负责人:Margot B Kushel
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依托单位:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
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批准号:8437103
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项目类别:
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资助金额:$61.49万
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财政年份:2012
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负责人:Margot B Kushel
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依托单位:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
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批准号:8715667
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项目类别:
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资助金额:$62.25万
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财政年份:2012
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负责人:Margot B Kushel
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依托单位:
Aging Among the Homeless: Social Isolation, Function and Institutional Care
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批准号:9309917
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项目类别:
-
资助金额:$64.82万
-
财政年份:2012
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负责人:Margot B Kushel
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依托单位:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
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批准号:8547620
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项目类别:
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资助金额:$59.4万
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Pain and Misuse of Prescription Opioids in a Community-Based HIV-Infected Cohort
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批准号:7192725
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项目类别:
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资助金额:$36.15万
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财政年份:2006
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负责人:Margot B Kushel
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依托单位:
Pain and Misuse of Prescription Opioids in a Community-Based HIV-Infected Cohort
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批准号:7617917
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项目类别:
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资助金额:$34.62万
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财政年份:2006
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负责人:Margot B Kushel
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依托单位:
Pain and Misuse of Prescription Opioids in a Community-Based HIV-Infected Cohort
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批准号:7293535
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项目类别:
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资助金额:$35.2万
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财政年份:2006
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负责人:Margot B Kushel
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依托单位:
Pain and Misuse of Prescription Opioids in a Community-Based HIV-Infected Cohort
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批准号:7426949
-
项目类别:
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资助金额:$34.6万
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财政年份:2006
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负责人:Margot B Kushel
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依托单位:
A RCT of HIV Adherence Case Management and Modified DOT
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批准号:7229005
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负责人:Margot B Kushel
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依托单位:
Improving Health Care Outcomes Among the Homeless
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批准号:7021384
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资助金额:$12.18万
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负责人:Margot B Kushel
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Improving Health Care Outcomes Among the Homeless
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批准号:6474852
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项目类别:
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资助金额:$12.15万
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海外基金