Maximizing the Scalability of the Chronic Disease Self-Management Program (CDSMP) Among Older Adults in State Correctional Settings

最大限度地提高州惩教机构中老年人慢性病自我管理计划 (CDSMP) 的可扩展性

• 批准号: 10654994
• 负责人: Rodlescia Sneed
• 金额: $ 11.98万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10654994
• 关键词: Age; Area; Assessment tool; Cholesterol; Chronic; Chronic Disease; Communicable Diseases; Communities; Complex; Data; Development; Diabetes Mellitus; Disease; Disease Management; Disease model; Educational workshop; Elderly; Emergency department visit; Ensure; Evidence based program; Exercise; Female; Funding; General Population; Gerontology; Goals; Health; Health Expenditures; Healthcare; Hospitalization; Hypertension; Imprisonment; Individual; Infrastructure; Intervention; Interview; Investigation; Justice; Link; Manuals; Mental disorders; Mentors; Morbidity - disease rate; Obesity; Outcome; Participant; Persons; Persuasive Communication; Population; Prisons; Privatization; Process; Randomized; Recommendation; Research; Research Methodology; Research Personnel; Resource-limited setting; Resources; Security; Self Care; Self Efficacy; Self Management; Standardization; Substance abuse problem; Surveys; Testing; Time; Training; biopsychosocial; burden of illness; career; community engagement; correctional system; cost; depressive symptoms; evidence base; experience; health care service; health disparity; implementation research; implementation science; implementation trial; improved; innovation; knowledge base; male; member; mortality; neglect; organizational structure; pain symptom; peer; physical conditioning; primary health service; prison population; programs; randomized trial; recruit; scale up; self-management program; social

PROJECT SUMMARY/ABSTRACT Incarcerated individuals have higher rates of chronic disease than the general population, and disease burden will likely increase as the prison population continues to age. Despite this, health care services in prison primarily focus on infectious diseases, mental illness, and substance abuse, largely neglecting chronic physical health conditions. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based program developed to support self-management for people with chronic illnesses. At least 10 randomized trials conducted in non-correctional settings have linked CDSMP to disease-related improvements and reduced healthcare expenditures. CDSMP has been used in state corrections systems via 3 approaches: 1) bringing community agency CDSMP leaders into the correctional setting to lead the program, 2) training correctional staff as program leaders, and 3) training incarcerated individuals to serve as peer leaders. To date, however, there has been little research into efficient and effective strategies for scaling up the intervention within state corrections systems using any of these approaches. Scale-up (i.e. deliberate efforts to increase the impact of successfully tested health innovations to benefit more people and promote sustainability) is an understudied concept in implementation science, with few existing empirical studies that explicitly focus on the process of scale-up. Assessing scalability, however, is crucial for ensuring sustainability of complex interventions within resource- poor settings. The research objective of this K01 is to evaluate and maximize the scalability of CDSMP among older adults in state correctional systems. Guided by the Scaling up Management Framework, we will use a mixed methods research approach to query community agency leaders, staff, and incarcerated individuals about ways to maximize the scalability of CDSMP within state correctional settings and develop and refine CDSMP scale-up strategies for these settings. Our goal is to develop scale-up strategies to be evaluated in a subsequent randomized implementation trial. The training objectives of this K01 will add expertise in implementation science and justice-involved research to my existing knowledge base in biopsychosocial models of disease, social gerontology, health disparities, quantitative analysis, and chronic disease management, to reach my goal of becoming an independent researcher who uses implementation science approaches to improve health outcomes among justice-involved populations. As the prison population continues to age, the burden of chronic disease within correctional systems will continue to increase, which contributes to skyrocketing correctional costs. Understanding how to expand evidence-based chronic disease programs within correctional systems is crucial for reducing disease-related morbidity and mortality among incarcerated individuals and for reducing costs. This line of research will identify and test scale-up strategies for chronic disease management in prisons.

项目摘要/摘要 被监禁的人患慢性病的比率高于一般人群， 随着监狱人口继续老龄化，负担可能会增加。尽管如此，监狱中的保健服务 主要集中在传染病，精神疾病和药物滥用，在很大程度上忽视了慢性生理疾病， 健康状况。慢性病自我管理计划（CDSMP）是一个基于证据的计划 旨在支持慢性病患者的自我管理。至少进行了10项随机试验 在非矫正环境中，将CDSMP与疾病相关的改善和减少的医疗保健联系起来 支出。CDSMP已通过三种方法在州矫正系统中使用：1）将社区 机构CDSMP领导人进入惩教设置，以领导该计划，2）培训惩教工作人员作为计划 领导者，和3）培训被监禁的个人作为同龄人的领导者。然而，迄今为止， 研究有效和高效的战略，以扩大国家惩教系统内的干预 使用这些方法中的任何一种。扩大规模（即，有意识地努力增加成功测试的 健康创新，使更多的人受益，促进可持续发展）是一个未充分研究的概念， 执行科学，现有的实证研究很少明确侧重于扩大规模的过程。 然而，评估可扩展性对于确保资源范围内复杂干预措施的可持续性至关重要， 可怜的设置。本K 01的研究目标是评估和最大限度地提高CDSMP的可扩展性， 州惩教系统中的老年人在扩展管理框架的指导下，我们将使用 混合方法研究方法，询问社区机构领导人，工作人员和被监禁的个人， 如何最大限度地提高CDSMP在州矫正环境中的可扩展性，并开发和完善CDSMP 这些设置的扩展策略。我们的目标是制定扩大规模的战略，以便在随后的 随机实施试验本K 01的培训目标将增加实施科学方面的专业知识 和公正参与的研究，我现有的知识基础，在生物心理社会模型的疾病，社会 老年学、健康差异、定量分析和慢性病管理，以实现我的目标， 成为一名独立的研究人员，使用实施科学方法来改善健康结果 在正义相关的人群中。随着监狱人口的不断老龄化，慢性病的负担 惩教系统内的犯罪将继续增加，这导致惩教费用飞涨。 了解如何在惩教系统内扩大循证慢性病项目至关重要 减少被监禁者中与疾病有关的发病率和死亡率以及降低成本。这 一系列研究将确定和测试监狱慢性病管理的扩大战略。