Aging Among the Homeless: Social Isolation, Function and Institutional Care

无家可归者的老龄化:社会孤立、功能和机构照顾

基本信息

项目摘要

PROJECT SUMMARY/ABSTRACT The long-term goal of this project is to increase the trustworthiness of health care providers and institutions and decrease the rates of medical mistrust among homeless-experienced older adults, thereby, improving health outcomes. The proposal seeks to renew 2AG041860, “Aging Among the Homeless: Social Isolation, Function and Institutional Care” and continue the Health Outcomes in People Experiencing Homelessness in Older Middle agE (HOPE HOME) study, which recruited and followed a cohort of 450 homeless adults age 50 or older. Approximately half of all homeless adults are age 50 or older; this trend is expected to continue. HOPE HOME participants have poor health, including physical health problems, geriatric conditions, and functional impairments similar to housed individuals in their 70s and 80s. Black Americans, LGBTQ+ individuals, and those with mental health problems and/or substance use disorders are overrepresented in the homeless population, including in the HOPE HOME study sample. Individuals with these identities may experience discrimination and stigma, which influence medical mistrust. Mistrust may be a barrier to health care utilization and related to poor health outcomes in older homeless adults; little is known about this association. We propose to recruit an additional 150 HOPE HOME participants to replace those who have died or been lost to follow-up, and to follow the cohort for 54 months with nine semi-annual visits for structured interviews. We will recruit a sub-sample of 30 participants for in-depth qualitative interviews and 20 of those for clinical observation to understand the factors associated with medical mistrust and its dynamic nature. We will recruit 20 key informants who work in settings that serve homeless older adults for in-depth qualitative interviews. Study visits for participants will take place at an administrative building belong to Lifelong Medical, a FQHC which serves older homeless adults. Participant observations will take place at local clinics and health care institutions. Trained interviewers, under the supervision of study investigators, will administer structured interviews to assess key variables and study investigators with research personnel will conduct participant observation of primary care visits. A Community Advisory Board, composed of community and policy leaders in homelessness and study participants, will work with the study team to guide study development and translate the findings into a toolkit, practice, and policy. Study findings will contribute to the development of clinical, programmatic, and policy recommendations summarized in a toolkit aimed to increase trustworthiness of health care institutions.
项目概要/摘要 该项目的长期目标是提高医疗保健提供者和机构的可信度, 减少无家可归的老年人对医疗的不信任率,从而改善健康状况 该提案旨在更新 2AG041860,“无家可归者的老龄化:社会隔离、功能”。 和机构护理”,并继续改善老年人无家可归者的健康状况 Middle agE (HOPE HOME) 研究招募并跟踪了 450 名 50 岁或以上无家可归的成年人 大约一半的无家可归者年龄在 50 岁或以上;预计这一趋势将持续下去。 HOME 参与者健康状况不佳,包括身体健康问题、老年病和功能障碍 与 70 多岁和 80 多岁的美国黑人、LGBTQ+ 个体和被安置者类似的障碍。 无家可归者中有心理健康问题和/或药物滥用障碍的人数过多 人群,包括 HOPE HOME 研究样本中具有这些身份的个人可能会经历的情况。 歧视和耻辱会影响医疗不信任,这可能会成为医疗保健利用的障碍。 以及与无家可归的老年人的不良健康状况有关;人们对这种关联知之甚少。 我们建议再招募 150 名 HOPE HOME 参与者来代替那些已经死亡或失踪的人 我们对队列进行为期 54 个月的随访,每半年进行 9 次访问,进行结构化访谈。 将招募 30 名参与者的子样本进行深入的定性访谈,其中 20 名参与者进行临床 我们将通过观察来了解与医疗不信任相关的因素及其动态性质。 20 位在为无家可归的老年人提供服务的环境中工作的关键信息提供者进行了深入的定性访谈。 参与者的考察访问将在终身医疗 (FQHC) 所属的行政大楼进行 该项目为无家可归的老年人提供服务,参与者的观察将在当地诊所和医疗机构进行。 训练有素的访谈员将在研究调查员的监督下进行结构化管理。 评估关键变量和研究调查人员与研究人员的访谈将对参与者进行 社区咨询委员会,由社区和政策领导人组成。 无家可归者和研究参与者,将与研究团队合作,指导研究开发和翻译 研究结果将有助于临床、实践和政策的发展。 工具包中总结的纲领性和政策建议旨在提高 医疗保健机构。

项目成果

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Margot B Kushel其他文献

Margot B Kushel的其他文献

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{{ truncateString('Margot B Kushel', 18)}}的其他基金

Adapting Advance Care Planning Tools for Permanent Supportive Housing Residents
为永久支持性住房居民调整预先护理计划工具
  • 批准号:
    10112805
  • 财政年份:
    2020
  • 资助金额:
    $ 66.08万
  • 项目类别:
Mentoring Researchers in Aging in Vulnerable Populations
指导弱势群体老龄化研究人员
  • 批准号:
    10548814
  • 财政年份:
    2015
  • 资助金额:
    $ 66.08万
  • 项目类别:
Mentoring Researchers in Aging in Vulnerable Populations
指导弱势群体老龄化研究人员
  • 批准号:
    9249452
  • 财政年份:
    2015
  • 资助金额:
    $ 66.08万
  • 项目类别:
Mentoring Researchers in Aging in Vulnerable Populations
指导弱势群体老龄化研究人员
  • 批准号:
    8891716
  • 财政年份:
    2015
  • 资助金额:
    $ 66.08万
  • 项目类别:
Mentoring Researchers in Aging in Vulnerable Populations
指导弱势群体老龄化研究人员
  • 批准号:
    10321287
  • 财政年份:
    2015
  • 资助金额:
    $ 66.08万
  • 项目类别:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
无家可归者的老龄化;
  • 批准号:
    9068728
  • 财政年份:
    2012
  • 资助金额:
    $ 66.08万
  • 项目类别:
Aging Among the Homeless: Social Isolation, Function and Institutional Care
无家可归者的老龄化:社会孤立、功能和机构照顾
  • 批准号:
    10179260
  • 财政年份:
    2012
  • 资助金额:
    $ 66.08万
  • 项目类别:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
无家可归者的老龄化;
  • 批准号:
    8437103
  • 财政年份:
    2012
  • 资助金额:
    $ 66.08万
  • 项目类别:
Aging Among the Homeless: Social Isolation, Function and Institutional Care
无家可归者的老龄化:社会孤立、功能和机构照顾
  • 批准号:
    10642758
  • 财政年份:
    2012
  • 资助金额:
    $ 66.08万
  • 项目类别:
Aging among the homeless; geriatric conditions, health and healthcare outcomes
无家可归者的老龄化;
  • 批准号:
    8715667
  • 财政年份:
    2012
  • 资助金额:
    $ 66.08万
  • 项目类别:

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