Dang Stuti, Garcia-Davis Sandra, Noël Polly H, Hansen Jared, Brintz Benjamin J, Munoz Richard, Valencia Rodrigo Willy Marcos, Rupper Rand, Bouldin Erin D, Trivedi Ranak, Penney Lauren S, Pugh Mary Jo, Kinosian Bruce, Intrator Orna, Leykum Luci K
Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, San Antonio, Texas, USA.
Miami VA Healthcare System, Geriatric Research, Education, & Clinical Center GRECC, Miami, Florida, USA.
J Am Geriatr Soc. 2023 Dec;71(12):3814-3825. doi: 10.1111/jgs.18577. Epub 2023 Sep 12.
Empowering Veterans to age in place is a Department of Veterans Affairs priority. Family or unpaid caregivers play an important role in supporting Veterans to achieve this goal. Effectively meeting the needs of Veterans and caregivers requires identifying unmet needs and relevant gaps in resources to address those needs.
Using a modified Socio-Ecological Model, we developed a prospective longitudinal panel design survey. We randomly selected 20,000 community-dwelling Veterans enrolled in the Veterans Health Administration (VHA), across five VHA sites. We oversampled Veterans with a higher predicted 2-year long-term institutional care (LTIC) risk. Veterans were mailed a packet containing a Veteran survey and a caregiver survey, to be answered by their caregiver if they had one. The Veteran survey assessed the following health-related domains: physical, mental, social determinants of health, and caregiver assistance. Caregivers completed questions regarding their demographic factors, caregiving activities, impact of caregiving, use of VA and non-VA services, and caregiver support resources. Follow-up surveys will be repeated twice at 12-month intervals for the same respondents. This article describes the HERO CARE survey protocol, content, and response rates.
We received responses from 8,056 Veterans and 3,579 caregivers between July 2021 and January 2022, with 95.6% being received via mail. Veteran respondents were mostly males (96.5%), over 65 years of age (94.9%), married (55.0%), Non-Hispanic White (75.2%), and residing in urban areas (80.7%).
This longitudinal survey is unique in its comprehensive assessment of domains relevant to older Veterans stratified by LTIC risk and their caregivers, focusing on social determinants, caregiver support, and the use of caregiver support resources. Survey data will be linked to Centers for Medicare & Medicaid Services and VA data. The results of this study will inform better planning of non-institutional care services and policy for Veterans and their caregivers.
让退伍军人能够居家养老是退伍军人事务部的一项优先任务。家庭或无偿照料者在支持退伍军人实现这一目标方面发挥着重要作用。要有效满足退伍军人及其照料者的需求，需要识别未得到满足的需求以及解决这些需求的资源方面的相关差距。
我们采用改良的社会生态模型，设计了一项前瞻性纵向面板调查。我们从五个退伍军人健康管理局（VHA）站点中，随机选取了20000名参加VHA的社区居住退伍军人。我们对预测有较高两年期长期机构护理（LTIC）风险的退伍军人进行了过度抽样。我们给退伍军人邮寄了一个包含退伍军人调查问卷和照料者调查问卷的包裹，如果他们有照料者，由照料者回答。退伍军人调查问卷评估了以下与健康相关的领域：身体、心理、健康的社会决定因素以及照料者协助。照料者完成了关于他们的人口统计学因素、照料活动、照料影响、VA和非VA服务的使用以及照料者支持资源的问题。后续调查将对相同的受访者每隔12个月重复进行两次。本文描述了HERO CARE调查方案、内容和回复率。
在2021年7月至2022年1月期间，我们收到了8056名退伍军人和3579名照料者的回复，其中95.6%是通过邮件收到的。退伍军人受访者大多为男性（96.5%），年龄超过65岁（94.9%），已婚（55.0%），非西班牙裔白人（75.2%），居住在城市地区（80.7%）。
这项纵向调查的独特之处在于，它对按LTIC风险分层的老年退伍军人及其照料者相关领域进行了全面评估，重点关注社会决定因素、照料者支持以及照料者支持资源的使用。调查数据将与医疗保险和医疗补助服务中心以及VA的数据相链接。本研究结果将为退伍军人及其照料者的非机构护理服务和政策的更好规划提供参考。
