Feasibility of the VOICES Elder Mistreatment Digital-Screening Tool for Older Adults with Cognitive Impairment

7.项目摘要/摘要 有认知障碍的老年人比没有认知障碍的老年人受到虐待的风险更大。 虐待老年人是一个主要的公共卫生问题，据估计，在美国范围内普遍存在 从27.9%到62.3%的情感虐待和3.5%-23.1%的身体虐待 认知障碍(CI)。1，3-6 EM会给受害者带来严重的不良后果，包括受伤，增加 服务利用、精神痛苦和死亡率增加。急诊部是一个合适的设置 来识别这一弱势群体。克服虐待老年人的一个主要障碍是无法 准确识别受害者身份。据估计，只有1/24的病例为当局所知。这是 有问题，因为有认知障碍的老年人不太可能报告他们受到了虐待。 与用户体验研究、老年病学、阿尔茨海默氏症和急救领域的领先专家合作 医学，我们将对使用数字化虐待老人的声音进行可用性和可行性评估- 有认知障碍的老年人的筛查工具。 Voice是一款基于平板电脑的工具，用于筛选和识别虐待老人的嫌疑，并已被开发出来 并在父母资助下进行测试，目前正在对没有认知能力的老年人进行评估 减损。语音工具利用虚拟教练、交互式多媒体库(例如图形、视频剪辑、 动画等)，亲密伴侣暴力的电子筛选技术，以及简短的动机 访谈旨在提高对老年人虐待行为的识别能力。在130名受试者中 到目前为止，有8名老年人在使用语音后希望自我报告EM，其中3例是 经教育署社工证明属实。 在本补充材料中，我们将评估认知障碍老年人使用语音工具的可行性 增强和改进EM语音筛选工具，使其可供有认知能力的人使用和接受 减损。我们的目标是：1)评估老年人语音筛选工具的可用性和可接受性 认知障碍患者，2)增强和改进声音工具，使其适用于老年人和可接受的人 有认知障碍的成年人，3)进行一项可行性研究(N=80)，检查在 繁忙的急诊科由认知障碍的老年人组成。 这一补充，如果得到资助，将扩大我们项目的范围，将AD/ADRD人口包括到我们的 Voice项目，目前不包括患有CI的老年人，使我们能够检查 我们对老年CI患者的复杂干预。我们预计这个项目将导致未来的比较 比较(声音+面对面筛查)与护理标准(面对面筛查)的有效性研究。

7. PROJECT SUMMARY/ ABSTRACT Older adults with cognitive impairment are at greater risk of elder mistreatment compared to those without.1- 3 Elder mistreatment is a major public health problem with estimated prevalence in the United State ranges from 27.9% to 62.3% for emotional abuse and 3.5%–23.1% for physical abuse among older adults with cognitive impairment (CI).1,3-6 EM causes serious adverse outcomes for its victims including injury, increased service utilization, mental distress and increased mortality. The Emergency Department is an opportune setting to identify this vulnerable population. A major barrier in overcoming elder mistreatment is the inability to accurately identify victims. It is estimated that only 1 in 24 cases become known to authorities. This is problematic as older adults with cognitive impairment are not likely to report that they are being mistreated. Working with leading experts in user experience research, geriatrics, Alzheimer’s disease, and emergency medicine, we will conduct a usability and feasibility evaluation of using the VOICES elder mistreatment digital- Screening tool for older adults with cognitive Impairment. VOICES is a tablet-based tool to screen and identify suspicion of elder mistreatment and has been developed and tested under the parent grant and is currently being evaluated with older adults without cognitive impairment. VOICES tool utilizes virtual coaching, interactive multimedia libraries (e.g. graphics, video clips, animations, etc.), techniques from electronic screening for intimate partner violence, and brief motivational interviewing designed to enhance identifying mistreatment among older adults. Among the 130 subjects who used VOICES so far, 8 older wanted to self-report EM after using VOICES and 3 of these cases were substantiated by the ED social workers. In this supplement we will evaluate the feasibility of VOICES tool by older adults with cognitive impairment to enhance and refine the EM screening VOICES tool to be useable and acceptable by persons with cognitive impairment. Our aims are: 1) to evaluate the usability and acceptability of the VOICES screening tool for older patients with cognitive impairment, 2) to enhance and refine VOICES tool to be usable and acceptable for older adults with cognitive impairment, 3) to conduct a feasibility study (N= 80) examining the use of VOICES in a busy emergency department by older adults with cognitive impairment. This supplement, if funded, will expand the scope of our project to include the AD/ADRD population to our VOICES project that does not currently include older adults with CI to allow us to examine the feasibility of our complex intervention for older adults with CI. We expect this project will lead to a future comparative effectiveness study comparing (VOICES + in-person screening) to the standard-of-care (in-person screening).