Detection of Elder Mistreatment in the Aging Services Network

描述（由申请人提供）：尽管其显着的公共卫生和政策的影响，老年人虐待（EM）已很少受到关注的研究界。为了在我们对其发病机制的理解方面取得进展，因此，在制定预防策略方面，必须首先通过创建用于EM病例检测的心理测量学强大工具（或在适当情况下调整现有工具）来奠定流行病学研究的基本基础。这个老年人虐待项目的长期目标是通过制定供老龄化服务提供者使用的预防干预措施，降低EM的患病率及其相关的发病率和死亡率。我们的前提是，老龄化服务网络是一个理想的环境，在其中访问老年人谁是风险，或受害者，EM和干预。我们将建立一个成熟的学术/社区伙伴关系，即老年人健康与研究（SHARE）联盟，以实现合作伙伴的共同目标，即开发一套专门用于老年服务环境的EM检测工具。目的1是构建一个初步的基于案例管理的筛选工具和过程，以确定EM与内容专家小组以及供应商，老年消费者和他们的照顾者使用定性研究方法的输入。我们的重点将是在社会服务环境中最常见的三种类型的EM：情感虐待，经济剥削和忽视。目标2是对40名受试者的随机样本进行初步测量，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，我们将建立规模的性能特点，通过比较与“金标准”专家共识评估在160名受试者招募从老龄服务机构的护理管理和老年虐待预防计划。分析将检查测量的可靠性，用于检测EM及其三个亚型的因子结构，以及量表的有效性。最后，形成性评价与客户和个案经理的可接受性的文书将奠定基础，为随后的R 01应用程序，旨在建立流行病学和相关的EM和相关的不良后果检测的专业人员在老龄化服务机构。 专家估计，只有不到5%的虐待老年人的案件得到承认或报告。改进检测是科学进程中必要的第一步，这将导致制定有效的预防干预措施。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，以及哪些老年人向老龄服务网络寻求照顾。

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.