Detection of Elder Mistreatment in the Aging Services Network

描述(由申请人提供)：尽管它对公共卫生和政策有重大影响，但虐待老年人问题(EM)几乎没有受到研究界的关注。为了在我们对其发病机制的理解上取得进展，并因此在制定预防策略方面取得进展，首先必须通过创建用于EM病例检测的强大的心理测量学工具(或在适当情况下调整现有工具)，为流行病学研究奠定基本基础。这一虐待老年人项目的长期目标是通过制定预防性干预措施，减少EM及其相关的发病率和死亡率，供老年服务提供者使用。我们的前提是，老龄服务网络是接触有EM风险或EM受害者的老年人并进行干预的理想环境。我们将建立一个已建立的学术/社区伙伴关系，即高级健康和研究(SHARE)联盟，以满足合作伙伴的共同目标，即开发一套专门用于老龄化服务环境的EM检测工具。目标1是构建一个初步的基于病例管理的筛查工具和程序，以利用定性研究方法，通过内容专家小组以及提供者、老年消费者及其照顾者的输入来识别EM。我们的重点将集中在社会服务环境中最常见的三种类型的新兴市场：情感虐待、经济剥削和忽视。目标2是对随机抽取的40名受试者进行初步测量，并在此基础上对其进行改进，以便进行更明确的测试。在目标3中，我们将通过与从老龄服务机构的护理管理和防止虐待老人计划中招募的160名受试者的“黄金标准”专家共识评估相比较，建立该量表的表现特征。分析将检查测量的可靠性、用于检测EM的因素结构及其三个亚型中的每一个，以及量表的有效性。最后，与客户和案例经理一起对该工具的可接受性进行形成性评估，将为随后的R01应用奠定基础，该应用旨在建立由老龄服务机构的专业人员检测到的EM和相关不良后果的流行病学和相关性。 专家估计，5%的虐待老人案件得到了确认或举报。改进检测是导致制定有效预防干预措施的科学进程的必要第一步。该项目将创建必要的工具，以确定哪些老年人是虐待老年人的受害者，哪些老年人需要向老龄服务网络提供护理。

DESCRIPTION (provided by applicant): Despite its significant public health and policy implications, elder mistreatment (EM) has received little attention from the research community. In order for progress to be made in our understanding of its pathogenesis and, therefore, in developing strategies for prevention, a basic foundation for epidemiological research must first be laid by creating psychometrically robust tools (or adapting existing ones where appropriate) for EM case detection. The long-term goal of this Elder Mistreatment Project is to reduce the prevalence of EM and its associated morbidity and mortality by developing preventive interventions for use by aging services providers. Our premise is that the aging services network is an ideal setting in which to access older adults who are at risk for, or victims of, EM and to intervene. We will build on an established academic/community partnership, the Senior Health and Research (SHARE) Alliance, to address the partners' shared objective of developing a set of tools for the detection of EM that are specifically designed for use in the aging services setting. Aim 1 is to construct a preliminary case management-based screening tool and process to identify EM with input from a panel of content experts as well as from providers, older adult consumers, and their caregivers using qualitative research methods. Our focus will be on the three types of EM most frequently encountered in social service settings: emotional abuse, financial exploitation, and neglect. Aim 2 is to administer the preliminary measure to a random sample of 40 subjects, and on that basis to refine it for more definitive testing. In Aim 3 we will establish the performance characteristics of the scale by comparison with "gold standard" expert consensus assessments in 160 subjects recruited from an aging service agency's care management and Elder Abuse Prevention programs. Analyses will examine the measure's reliability, factor structure for detecting EM and each of its three subtypes, and the scale's validity. Finally, a formative evaluation with clients and case managers on the acceptability of the instrument will lay the groundwork for an ensuing R01 application designed to establish the epidemiology and correlates of EM and related adverse outcomes as detected by professionals in aging services agencies. Experts estimate that <5% of cases of elder mistreatment are recognized or reported. Improving detection is the necessary first step in the scientific process that leads to development of effective preventive interventions. This project will create the tools necessary to identify older people who are victims of elder mistreatment and who present for care to the aging services network.