Uncovering the Causes, Contexts, and Consequences of Elder Mistreatment in People with Dementia

摘要 父项目的主要目标是调查导致 阿尔茨海默病和相关痴呆症患者中的虐待老年人(EM)。 应用滥用干预模型作为理论框架，该项目确定了新兴市场风险和保护措施 ADRD患者(潜在受害者)、其护理伙伴(CP；潜在犯罪者)和 5如最初提议的，研究征聘程序在很大程度上取决于 在痴呆症护理诊所临床招募ADRD患者及其CPS。新冠肺炎大流行 极大地影响临床操作、医疗保健利用模式和患者研究的可能性 参与，导致总体研究入学人数较低，黑人参与者的代表性不足，以及潜在的 样本偏差。拟议的补充活动将有助于扩大以社区为基础的 通过纳入更多地点和组织类型并充分利用我们的 扩大了整个南加州的目标地理区域。虽然最初是临床的辅助 在招聘工作中，该项目寻求建立以社区为基础的转介战略，作为研究的主要内容 推荐源。目标1：扩大基于社区的转诊策略的使用，以招募多样化的研究 样本。作为一种潜在的方法进行试点，以支持应对临床招募的招募工作 挑战，基于社区的转介策略产生了急需的参与者数量和样本 多样性。从照料组织和成人日间保健中心招募研究参与者的努力将 扩大到包括整个广袤的南加州地区的地点。招聘范围也将扩大 与基于信仰的社区、老年人住房站点、退休人员组织、老年中心和 学术老年学/老年病学课程。为不同种族群体和人群提供服务的组织 较低的社会经济地位将被优先考虑，以促进更多地招募在我们的 初步样本。目标1a：实施因地制宜的招聘方法，以吸引黑人 与ADRD和他们的CP一起生活在研究中。将加强和扩大招聘伙伴关系 与黑人服务组织和那些服务于黑人居民比例较高的地理区域的组织。 还将加强和建立与教会和其他信仰社区的联系，以建立 与潜在的黑人参与者建立信任和融洽的关系。目标2：收集有关个人特征的数据 与ADRD和他们的CP生活在一起，他们的照顾关系，以及他们互动的环境。 将与新招募的研究参与者进行研究访谈，以系统地收集关于 EM的潜在风险因素。面试将以便捷和高效的方式进行，以适应 在有限的时间内对大量参与者进行面谈。

ABSTRACT The primary objective of the parent project is to investigate the underlying mechanisms that lead to elder mistreatment (EM) among people living with Alzheimer’s Disease and related dementias (ADRD). Applying the Abuse Intervention Model as a theoretical framework, the project identifies EM risk and protective factors among persons living with ADRD (the potential victim), their care partner (CP; potential perpetrator), and the context in which they are situated.5 As originally proposed, study recruitment procedures relied heavily on clinical recruitment of people living with ADRD and their CPs in dementia care clinics. The COVID-19 pandemic drastically affected clinical operations, healthcare utilization patterns, and likelihood of patient research participation, resulting in overall low study enrollment, an underrepresentation of Black participants, and potential sample biases. The proposed supplemental activities will enable expansion of community-based recruitment through inclusion of additional sites and types of organizations and by fully utilizing our enlarged target geographic area throughout Southern California. Though initially ancillary to clinical recruitment efforts, the project seeks to establish community-based referral strategies as the study’s primary referral source. Aim 1: Expand use of community-based referral strategies to recruit a diverse study sample. Piloted as a potential approach to bolster recruitment efforts in response to clinical recruitment challenges, community-based referral strategies have yielded much-needed participant volume and sample diversity. Efforts to recruit study participants from caregiving organizations and adult day health care centers will be expanded to include sites throughout the vast Southern California region. Recruitment will also be broadened to initiate work with faith-based communities, older adult housing sites, retiree organizations, senior centers, and academic gerontology/geriatrics programs. Organizations serving racially diverse groups and populations with low socioeconomic status will be prioritized to facilitate greater recruitment of groups underrepresented in our preliminary sample. Aim 1a: Implement culturally tailored recruitment approaches to engage Black people living with ADRD and their CPs in research. Recruitment partnerships will be strengthened and expanded with Black-serving organizations and those serving geographic areas with high proportions of Black residents. Connections will also be strengthened and established with churches and other faith-based communities to build trust and rapport with prospective Black participants. Aim 2: Collect data on characteristics of individuals living with ADRD and their CPs, their caregiving relationship, and the environment in which they interact. Research interviews will be conducted with newly recruited study participants to systematically collect data on potential risk factors for EM. Interviews will be conducted with expediency and efficiency to accommodate the high volume of participants being interviewed within a limited time frame.