Identifying Unmet Needs Driving Disproportionate and Avoidable Nursing Home Placements among Black and Latino Persons Living With Dementia

项目总结/摘要 在老年痴呆症患者中，黑人和拉丁美洲人使用疗养院的比例不成比例地上升 （PLWD）反映了现有计划和政策的不足，以支持大多数地方的老龄化 脆弱在社区中实现老龄化和防止可避免的NH安置被广泛认为是一种 优先由联邦，州和地方实体沿着与家庭和老年人。然而，目前还不清楚需要什么 支持黑人和拉丁裔艾滋病患者留在社区。虽然有许多看似合理的后续步骤， 解决这一知之甚少的问题，制定一项文书，以确定哪些未满足的需求， 不成比例地推动可避免的NH安置是减少 黑人和拉丁裔PLWD本5年拟议项目的目标是：1）开发和测试可行性， 旨在解决未满足需求的评估工具的可接受性、可靠性和有效性， 推动黑人和拉丁裔PLWD以比他们的白色更高的比率体验可避免的NH安置 同行采用探索性序贯混合方法研究设计，2）初步翻译 将调查结果作为政策问题纳入公共议程。目标1将使用定性访谈来描述未满足的 需要推动这些布局。对目标1的定性结果进行综合分析， 未满足需求评估工具，居家（确定帮助老年人维持日常生活的需求 社区生活），将在目标2中制定、完善和试行，并在目标3中进行心理测试。 这项研究的初步结果将用于提出可操作的、基于证据的政策建议 以解决NH安置的差异。与NIA的战略优先事项保持一致，以解决所经历的差异 少数老年人患有阿尔茨海默病或相关痴呆症（ADRD），这项研究将形成基础 随后的R 01将为社区居住的黑人和拉丁裔PLWD量身定制IN-HOME， 哪些可采取行动的未满足的需求使他们面临最大的风险。 候选人，博士茉莉特拉弗斯，博士，MHS，是一个老年护理从业者和助理 纽约大学罗里·迈耶斯护理学院教授。特拉弗斯博士的长期目标是 建立一个独立的研究生涯，专注于开发创新的方法来消除差距 黑人和拉丁裔艾滋病患者通过以下方式获得以人为本的长期护理的机会和质量： 使用混合方法。在一个由具有老年学专业知识的模范导师和科学顾问组成的团队的领导下， ADRD，混合方法，政策，调查设计和心理测量评估，特拉弗斯博士将建立在她的基础上 就获得社区长期护理机会方面的差距开展初步工作，以实现初级教育培训目标 研究涉及弱势PLWD，混合方法，政策和领导力发展。纽约大学提供了一个 特殊的环境完成拟议的研究和特拉弗斯博士谁已经开始 成为老龄化和长期护理领域的领先差距研究者。

PROJECT SUMMARY/ABSTRACT The disproportionate rise in nursing home (NH) use among Black and Latino persons living with dementia (PLWD) reflects the inadequacy of existing programs and policies to support aging in place for the most vulnerable. Enabling aging in the community and preventing avoidable NH placements is widely considered a priority by federal, state, and local entities along with families and older adults. Yet, it is unclear what is needed to support Black and Latino PLWD to remain in the community. While there are many plausible next steps to addressing this poorly understood problem, developing an instrument to identify which unmet needs are disproportionately driving avoidable NH placements is an important actionable step in reducing disparities among Black and Latino PLWD. The objectives of this 5-year proposed project are to 1) develop and test the feasibility, acceptability, reliability, and validity of an assessment instrument aimed at addressing the unmet needs that drive Black and Latino PLWD to experience avoidable NH placements at greater rates than their White counterparts using an exploratory sequential mixed methods research design, and 2) translate preliminary findings onto the public agenda as a policy issue. Aim 1 will use qualitative interviews to describe the unmet needs driving these placements. An integrative analysis of qualitative findings derived from Aim 1 will inform an unmet needs assessment instrument, IN-HOME (Identifying Needs to Help Older adults Maintain Everyday community living), that will be developed, refined and piloted in Aim 2 and psychometrically tested in Aim 3. Preliminary findings from this study will be used to generate actionable, evidence-based policy recommendations to address disparities in NH placements. Aligned with NIA’s strategic priorities to address disparities experienced by minority older adults with Alzheimer’s Disease or Related Dementias (ADRD), this study will form the basis for a subsequent R01 that will tailor IN-HOME for community-dwelling Black and Latino PLWD and investigate which actionable unmet needs place them at greatest risk for NH placements. The candidate, Dr. Jasmine Travers, PhD, MHS, is a gerontological nurse practitioner and assistant professor at New York University (NYU) Rory Meyers College of Nursing. The long-term goal of Dr. Travers is to build an independent research career focused on developing innovative approaches to eliminate disparities in access to and quality of person-centered long term care experienced by Black and Latino PLWD through the use of mixed methods. Under a team of exemplary mentors and scientific advisors with expertise in gerontology, ADRD, mixed-methods, policy, survey design, and psychometric evaluation, Dr. Travers will build on her preliminary work on disparities in access to community long-term care to accomplish training goals in primary research involving vulnerable PLWD, mixed methods, policy, and leadership development. NYU provides an exceptional environment for the completion of the proposed research and for Dr. Travers who has already begun to emerge as a leading disparities researcher in the field of aging and long-term care.