Screening and Interventions in an Acute Care Setting

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DESCRIPTION (provided by applicant): A mentored, patient oriented, Paul B. Beeson Career Development Award is proposed to provide the candidate rigorous methodological training and experience in clinical aging research that can be applied to the proposed research project in geriatric emergency medicine. The candidate's long-term career goal is to become established as an independent, funded investigator in aging research who uses a geriatric emergency medicine "laboratory" to develop and evaluate a program using emergency medical services (EMS) and emergency departments to screen for unmet needs among older adults and intervene upon identified needs. This would be the basis for an independent career in aging research, specifically in geriatric emergency medicine. This award proposes a four-year training plan with extensive mentorship to build upon the candidate's already completed training. Formal training in research methodology will occur. Topics covered will include research theory, methods, and ethics. Practical training in multidisciplinary assessments will occur. A research project will be implemented, data collected, and hypotheses tested. The mentors will provide guidance on the didactic training, the application of the developed skills to the research project, the development of the research project throughout the award period. The proposed research project is a two-part study that first evaluates the reliability and validity of EMS-based screening of older adults for depression, pill taking strategies, and dementia. The second part refines, implements, and evaluates a pilot emergency department based intervention program to address the needs identified by EMS in conjunction with the primary care physician. These results will permit the testing of several hypotheses related to the reliability and validity of the EMS screening and the impact of the emergency department intervention program. These results will lead to further major studies that evaluate the effectiveness of this EMS screening and ED intervention program. This research, by showing the value of this innovative model of health promotion, will harness the potential of the acute care system to identify and treat unmet health needs of older adults. Treating these needs, which are frequently not identified by health care providers, will prevent unnecessary illness, injury, and death among older adults.