The ENRICH Study: Engaging Community and Municipal Services to Promote High Quality Aging in Place After Hip Fracture

ENRICH 研究：社区和市政服务的参与促进髋部骨折后高质量的就地养老

基本信息

批准号：
10338361
负责人：
Jason Raymond Falvey
金额：
$ 24.17万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-30 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10338361
关键词：
Address Aging Award Baltimore Caring Censuses Characteristics Communities Conduct Clinical Trials Data Data Analyses Development Disabled Persons Disadvantaged Durable Medical Equipment Elderly Environment Equipment Funding Goals Health Status Health care facility Hip Fractures Hip region structure Home Home Care Services Home Nursing Care Hospitalization Housing Individual Infrastructure Intervention Interview Journals Link Maryland Medicare claim Mentors Mentorship Methods Mission Modeling Municipalities National Institute on Aging Neighborhoods Older Population Outcome Outcomes Research Patient-Focused Outcomes Patients Physical activity Population Population Heterogeneity Positioning Attribute Process Protocols documentation Public Health Recommendation Recovery Rehabilitation therapy Research Research Training Resources Risk Assessment Scientist Screening procedure Self-Help Devices Services Site Survivors Testing Training Transportation Universities Work aging in place aging population base built environment career career development clinical care disability exercise training experience feasibility trial health care disparity improved longitudinal analysis medical schools neighborhood disadvantage novel patient oriented peer peer coaching physical therapist programs skills socioeconomic disadvantage successful intervention treatment as usual

Address Aging Award Baltimore Caring Censuses Characteristics Communities Conduct Clinical Trials Data Data Analyses Development Disabled Persons Disadvantaged Durable Medical Equipment Elderly Environment Equipment Funding Goals Health Status Health care facility Hip Fractures Hip region structure Home Home Care Services Home Nursing Care Hospitalization Housing Individual Infrastructure Intervention Interview Journals Link Maryland Medicare claim Mentors Mentorship Methods Mission Modeling Municipalities National Institute on Aging Neighborhoods Older Population Outcome Outcomes Research Patient-Focused Outcomes Patients Physical activity Population Population Heterogeneity Positioning Attribute Process Protocols documentation Public Health Recommendation Recovery Rehabilitation therapy Research Research Training Resources Risk Assessment Scientist Screening procedure Self-Help Devices Services Site Survivors Testing Training Transportation Universities Work aging in place aging population base built environment career career development clinical care disability exercise training experience feasibility trial health care disparity improved longitudinal analysis medical schools neighborhood disadvantage novel patient oriented peer peer coaching physical therapist programs skills socioeconomic disadvantage successful intervention treatment as usual

展开

项目摘要

PROJECT SUMMARY: The quantity and quality of aging in place after a hip fracture is poor, and these outcomes have not improved substantially over the last 20 years. The built environment in an older adult’s neighborhood has a strong influence on the quality of aging in place 4-6—yet has not been addressed in usual hip fracture care. This is especially concerning for older adults who live in socioeconomically disadvantaged neighborhoods, which have fewer resources to support high-quality built environment infrastructure. 5 Crumbling sidewalks and curbs in disadvantaged neighborhoods are associated with a 400% increase in mobility disability for older adults. 7 Older adults living in disadvantaged neighborhoods are also more likely to perceive their neighborhoods to be unsafe, and thus less likely to participate in physical activity outside. In this Beeson K76 award, Dr. Falvey proposes a novel model of ENgaging community and municipal seRvICes to promote high-quality aging in place after Hip fracture (ENRICH). ENRICH uniquely combines successful mobility interventions from prior work on hip fracture recovery, proactively identifying neighborhood- level barriers to recovery during the transition home after hip fracture, helping obtain needed services and equipment to bridge gaps related to the built environment, and provide targeted additional rehabilitation that focuses on community level mobility in a real-world environment after completion of usual care. The goal of ENRICH is promoting greater mobility in the community and allowing older adults to participate in community activities to improve the quality of aging in place. To tailor ENRICH for Baltimore, this project will 1) gather information on which factors (e.g. housing) most strongly impact the number of healthy days spent at home after hip fracture, using Medicare claims data linked with US Census Bureau data; 2 use this data to guide interviews with patient and clinician stakeholders to elucidate meaningful adaptations of ENRICH; and 3) pilot test the adapted ENRICH intervention with 24 older hip fracture patients living in disadvantaged neighborhoods. Completing these aims will help launch Dr. Falvey’s career as an independent clinician-scientist and leader in the fields of rehabilitation and aging. He proposes to gain complementary skills in longitudinal and mixed methods data analysis, patient-centered outcomes research, healthcare disparities, and conduct of clinical trials. His mentorship team, led by Dr. Jay Magaziner, is well-positioned to help him complete the study successfully and support his career development.

项目摘要：髋部骨折后衰老的数量和质量很差，这些结果尚未改善在过去的20年中，基本上是基本的。老年人社区的建筑环境有很强的在通常的髋部骨折护理中尚未解决4-6岁衰老质量的影响。这是特别是针对生活在社会经济处于弱势群体的老年人支持高质量构建环境基础设施的资源更少。 5个摇摇欲坠的人行道和路缘不利的社区与老年人的流动残疾增加400％有关。 7年龄较大居住在弱势街区的成年人也更有可能认为自己的社区是不安全，因此不太可能参加外部的体育活动。在这个Beeson K76奖中，Falvey博士提出了一种吸引社区和文化的新型模型髋部骨折（富集）后促进高质量衰老的服务。丰富独特的结合先前在髋部骨折恢复方面的工作中成功的流动性干预措施，积极识别邻里 - 髋部骨折后过渡回家期间恢复的水平障碍，帮助获得所需的服务和弥合与建筑环境有关的设备，并提供针对性的额外康复在完成通常的护理后，专注于在现实环境中的社区水平流动性。目标 Enrich正在促进社区的更大流动性，并允许老年人参加社区改善衰老质量的活动。为了量身定制巴尔的摩，该项目将1）收集有关哪些因素（例如住房）的信息使用Medicare索赔数据，髋部骨折后在家中度过的健康日子的数量最强烈影响与美国人口普查局数据有关； 2使用此数据指导患者和临床利益相关者的访谈阐明有意义的丰富改编； 3）试点测试改编的富集干预措施24 居住在灾难社区的老年髋部骨折患者。完成这些目标将有助于启动Falvey博士作为独立临床科学家的职业，康复和衰老领域的领导者。他提议获得纵向和混合方法数据分析，以患者为中心的结果研究，医疗保健分布以及进行临床试验。由Jay Magaziner博士领导的他的Mentalship团队的姿势很好，可以帮助他完成研究成功并支持他的职业发展。