Enhancing Care of the Aged and Dying in Prisons

美国是世界上监禁率最高的国家。有超过1,821个州和联邦 美国有超过230万名囚犯。监狱人口的统计数据如下： 转移较长的刑期和限制提前释放的选择加剧了这一趋势。述年长成年人 自1990年以来，监狱人口的比例增加了两倍多。老年囚犯的健康状况并不 反映了自由世界的人口。事实上，囚犯通常会出现自由公民常见的健康问题， 比他们年长10-15岁的人囚犯是那个国家的监护人，也就是说，这个系统负责 不仅规定对罪犯的拘留和控制，而且规定对他们的照顾。总的来说，这些趋势有一个 对监狱系统的深远影响：美国监狱在照顾老年人和 垂死的囚犯针对这一需要，第一阶段项目"加强对老年人和狱中临终者的照顾“ （ECAD-P）证明了（1）对ECAD-P等产品（即，更正 管理人员和工作人员对EOL护理培训感兴趣）;（2）培训应该是短的、密集的、吸引人的， 交互式的，对特定环境敏感的;（3）交互式的，媒体丰富的原型 具有高可接受性和可用性。规范文件和商业化 计划表明，有可能在第二阶段开发一个全面的ECAD-P学习系统和市场潜力 存在.为ECAD-P项目提出的技术创新非常适合目标市场。 ECAD-P学习系统的技术优势、可行性和市场潜力在 第一阶段项目。第二阶段申请的目的是继续研究和开发ECAD-P 一个学习系统，重点是开发一个可扩展的商业化单元，并在一个 更多更多样化的背景。更具体地说，ECAD-P第二阶段的目标是： 规模媒体丰富的交互式计算机为基础的学习系统，包括6个模块解决结束和 监狱中的老年人护理问题; 2）对全面的ECAD-P学习进行现场可用性测试 系统在州和联邦监狱评估用户界面，易用性和感知障碍，以便 优化可扩展单元，以便更广泛地传播;以及3）测试全尺寸ECAD-P学习的扩展 在全国12个联邦（n=6）和州（n=6）监狱中使用该系统，以评估结果、使用模式和 商业化机会。持续的研究和开发将允许改进可扩展的 商业化单位。扩大对学习系统的测试将确定 学习系统，并将提供与商业产品的传播有关的重要见解。

The United States has the highest rate of incarceration in the world. There are over 1,821 state and federal prisons housing over 2.3 million prisoners in the United States. The demographics of the prison population are shifting. Longer sentences and constrained options for early release compound this trend. The older adult segment of prison populations has more than tripled since 1990. The health status of aging inmates does not mirror the free-world population. In fact, prisoners typically present with health issues common to free citizens who are 10-15 years their senior. Prisoners are wards of that state, that is, the system is responsible for providing for not only custody and control of offenders, but also their care. Collectively, these trends have had a profound impact on prison systems: U.S. prisons are facing sharply increased demands in caring for aged and dying inmates. In response to this need, Phase I project Enhancing Care for the Aged and Dying in Prisons (ECAD-P) demonstrated that (1) there is a need and interest for products such as ECAD-P (i.e., corrections administrators and staff are interested in EOL care training); (2) trainings should be short, intensive, engaging, interactive, and contextually sensitive to the specific environment; and (3) an interactive, media-rich prototype with high acceptability and usability could be developed. The specification document and commercialization plan indicate it is possible to develop a full-scale ECAD-P learning system in Phase II and market potential exists. The technological innovation proposed for the ECAD-P project is well-suited to the targeted market. Technical merit, feasibility, and market potential of the ECAD-P Learning System were demonstrated in the Phase I project. The purpose of this Phase II application is to continue research and development of the ECAD-P learning system with an emphasis on developing a scalable unit for commercialization and testing scale-up in a larger number of more diverse contexts. More specifically, the aims of ECAD-P Phase II are to 1) Develop a full scale media-rich interactive computer-based learning system consisting of 6 modules addressing EOL and geriatric care issues in prisons; 2) Conduct in-person usability testing of the full scale ECAD-P Learning System in state and federal prisons to evaluate the user interface, ease of use, and perceived barriers in order to optimize the scalable unit for broader dissemination; and 3) Test scale-up of the full scale ECAD-P Learning System in 12 federal (n=6) and state (n=6) prisons across the nation to evaluate outcomes, usage patterns, and commercialization opportunities. Continued research and development will permit the refinement the scalable unit for commercialization. Expanded testing of the learning system will establish the effectiveness of the learning system and will provide critical insights relevant to dissemination of the commercial product.