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Risk Screening & Primary Prevention of Elder Abuse in People Living with Dementia

风险筛查

基本信息

批准号：
10703407
负责人：
LAURA A MOSQUEDA
金额：
$ 60.98万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10703407
关键词：
Address Affect Alzheimer&apos s disease related dementia American Behavior Behavioral Caregivers Caring Categories Cessation of life Characteristics Clinic Clinic Visits Communities County Cultural Sensitivity Data Dementia Dementia caregivers Detection Development Education Elder Abuse Elder abuse prevention Elderly Ensure Family Family Caregiver Feedback Focus Groups Geriatric Assessment Goals Health Healthcare Systems Home Individual Intervention Intervention Studies Los Angeles Managed Care Measures Medical Methods Monitor Morbidity - disease rate Outcome Outcome Measure Participant Patient Care Personal Satisfaction Persons Phase Population Primary Care Primary Prevention Protocols documentation Provider Public Health Randomized Randomized, Controlled Trials Reporting Research Respondent Risk Risk Assessment Risk Factors Risk Reduction Sampling Schedule Screening procedure Self Care Self Perception Sexual abuse Site Societies Surveys Target Populations Technology Time United States Centers for Medicare and Medicaid Services United States Preventative Services Task Force Validation Victimization Visit Vulnerable Populations brief intervention caregiver interventions caregiving clinical care cost design effectiveness testing efficacy testing emotional abuse ethnic diversity evidence base feasibility testing financial exploitation follow-up improved indexing intervention effect intimate partner violence modifiable risk mortality neglect novel strategies person centered physical abuse primary care clinic primary care setting primary care visit primary outcome racial diversity screening service utilization three-arm study tool web site

项目摘要

ABSTRACT Elder mistreatment (EM) has profound effects on 1 in 10 older Americans, and rates are amongst the highest for people living with dementia (PLWD). Family caregivers most frequently inflict this harm and are typically remorseful for their behavior. This proposal will address this societal problem through a novel approach that identifies care partners/caregivers (CPG) at primary care medical clinics, whether they are there for their own care or that of the PLWD. During the project’s R61 phase, we will develop and test the feasibility of an evidence- based brief Risk Assessment Screen (RAS) for use in primary care clinics to screen CPGs of PLWD. A 3- component intervention will be developed and feasibility-tested. The first component will direct the CPG during the clinic visit to a website specifically designed to engage them in solution-focused strategies. The second component will provide 1-3 home or technology-assisted visits with a care navigator who provides person- centered guidance to facilitate effective caregiving strategies and alerts CPGs to risks of EM. A third component will educate the clinical care team to address caregiving needs directly with the CPG during the clinic visit and schedule a follow-up visit within 2 months to monitor for change. We will develop an Outcome Tool that includes a compilation of validated measures of modifiable risk factors known to be associated with EM by CPGs which will be used to measure change in risk of EM over time. During the project’s R33 phase, the research team will conduct a cluster randomized controlled trial to test the effectiveness of the RAS and the 3-component intervention. Primary care clinics across Los Angeles County will be randomized to one of the three study arms: control, RAS only, or RAS plus intervention. Analyses will assess the impact of screening and the intervention on participants’ level of risk of EM, as well as other outcomes at the level of the CPG and the PLWD. Additionally, potential harms from the RAS and/or the intervention will be assessed. Finally, we will generate exploratory qualitative data to improve our understanding of the mechanisms of risk and change that may result from our application of the RAS and the intervention.

摘要虐待老年人（EM）对十分之一的美国老年人产生了深远的影响，痴呆症患者（PLWD）家庭照顾者最常造成这种伤害，为他们的行为感到骄傲。该提案将通过一种新的方法来解决这一社会问题，确定初级保健医疗诊所的护理伙伴/护理人员（CPG），无论他们是否为自己或者说是对PLWD的照顾。在项目的R61阶段，我们将开发和测试证据的可行性- 在初级保健诊所使用的基于简要风险评估筛选（RAS），以筛选PLWD的CPG。A 3- 将制定并测试干预措施的组成部分。第一个组成部分将指导中央人民政府，诊所访问一个专门设计的网站，让他们参与以解决方案为重点的战略。第二组成部分将提供1-3个家庭或技术辅助访问与护理导航谁提供人- 集中指导，以促进有效的预防策略，并提醒CPG注意EM的风险。第三组分将教育临床护理团队在诊所访视期间直接与CPG解决住院需求，在2个月内安排随访，以监测变化。我们将开发一个成果工具，其中包括由CPG编制的已知与EM相关的可改变风险因素的经验证措施汇编，将用于测量EM风险随时间的变化。在项目的R33阶段，研究团队将进行一项随机分组对照试验，以检验RAS和3组分的有效性干预洛杉矶县的初级保健诊所将随机分配至三个研究组之一：对照、仅RAS或RAS加干预。分析将评估筛查和干预的影响参与者的EM风险水平，以及CPG和PLWD水平的其他结果。此外，本发明还将评估RAS和/或干预措施的潜在危害。最后，我们将探索定性数据，以提高我们对风险机制的理解，并可能导致我们的 RAS的应用和干预。