Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Dallas, Texas, USA
Psychiatry, Stanford University, Palo Alto, California, USA.
BMJ Open. 2020 Sep 10;10(9):e037170. doi: 10.1136/bmjopen-2020-037170.
Elder mistreatment (EM) is a high prevalence threat to the health and well-being of older adults in the USA. Medics are well-positioned to help with identification of older adults at risk for EM, however, field robust screening tools appropriate for efficient, observation-based screening are lacking. Prior work by this team focused on the development and initial pilot testing of an observation-based EM screening tool named detection of elder abuse through emergency care technicians (DETECT), designed to be implemented by medics during the course of an emergency response (911) call. The objective of the present work is to validate and further refine this tool in preparation for clinical dissemination.
Approximately 59 400 community-dwelling older adults who place 911 calls during the 36-month study observation period will be screened by medics responding to the call using the DETECT tool. Next, a random subsample of 2520 of the 59 400 older adults screened will be selected to participate in a follow-up interview approximately 2 weeks following the completion of the screening. Follow-up interviews will consist of a medic-led semistructured interview designed to assess the older adult's likelihood of abuse exposure, physical/mental health status, cognitive functioning, and to systematically evaluate the quality and condition of their physical and social living environment. The data from 25% (n=648) of these follow-up interviews will be presented to a longitudinal, experts and all data panel for a final determination of EM exposure status, representing the closest proxy to a 'gold standard' measure available.
This study has been reviewed and approved by the Committee for the Protection of Human Subjects at the University of Texas School of Public Health. The results will be disseminated through formal presentations at local, national and international conferences and through publication in peer-reviewed scientific journals.
虐待老年人（EM）是美国威胁老年人健康和福祉的高发性问题。医务人员处于帮助识别有遭受 EM 风险的老年人的有利位置，然而，缺乏适合高效观察性筛查的强大筛查工具。该团队之前的工作重点是开发和初步试点测试一种名为通过紧急护理技术员检测虐待老年人（DETECT）的观察性 EM 筛查工具，旨在由医务人员在紧急响应（911）电话过程中实施。本工作的目的是验证和进一步完善该工具，为临床传播做准备。
在 36 个月的研究观察期内，大约 59400 名居住在社区的老年人拨打 911 电话，医务人员将使用 DETECT 工具对他们进行筛查。接下来，从 59400 名接受筛查的老年人中随机抽取 2520 名作为随机样本，参加大约在筛查完成后 2 周进行的随访访谈。随访访谈将包括一个由医务人员主导的半结构化访谈，旨在评估老年人遭受虐待的可能性、身体/心理健康状况、认知功能，并系统评估他们的身体和社会生活环境的质量和状况。将呈现 25%（n=648）的这些随访访谈的数据给一个纵向专家和所有数据小组，以最终确定 EM 暴露状况，这是目前可用的最接近“黄金标准”测量的结果。
这项研究已经经过德克萨斯大学公共卫生学院保护人类受试者委员会的审查和批准。研究结果将通过在当地、国家和国际会议上的正式演讲以及在同行评议的科学期刊上发表来传播。
