Health, function, and health outcomes of geriatric prisoners

老年囚犯的健康、功能和健康结果

基本信息

批准号：
8077930
负责人：
BRIE A WILLIAMS
金额：
$ 14.87万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8077930
关键词：
Activities of Daily Living Address Age Aging Applications Grants Back California Caring Cessation of life Characteristics Chronic Chronic Care Clinical Clinical Research Cognitive Cohort Studies Communities Community Healthcare County Cross-Sectional Studies Data Data Analyses Data Collection Data Sources Development Drops Economics Elderly Environment Environmental Risk Factor Event Faculty Fellowship Floor Funding Geriatrics Goals Health Health Insurance Health Status Healthcare Healthcare Systems Hospitalization Impaired cognition Impairment Imprisonment Instruction Jail K-Series Research Career Programs Knowledge Learning Length Longitudinal Studies Measurement Measures Medical Mentored Patient-Oriented Research Career Development Award Mentors Modeling Nature Outcome Outcome Assessment Participant Pattern Performance Persons Population Preparation Prevalence Primary Health Care Prisoner Prisons Provider Public Health Research Research Design Research Personnel Risk Risk Factors Sampling San Francisco Science Series State Government Stratification Stress Surveys Testing Texas Training Universities Work adverse outcome age group aged base career career development cohort cost design disability experience falls follow-up functional disability functional status health care service utilization high risk improved instrument member multidisciplinary novel physical functional ability population based prognostic prospective skills theories tool

项目摘要

DESCRIPTION (provided by applicant): I am a Geriatrician and junior faculty member at the University of California, San Francisco. My long-term goal is to become an independent researcher focused on optimizing the healthcare of disenfranchised older adults, such as geriatric prisoners. I seek a K23 award to provide me with the support necessary to accomplish the following goals: (1) to acquire additional skills in clinical research including longitudinal study design, prognostic modeling, hierarchical modeling, measurement and survey design, and assembling a prospective longitudinal cohort; and (2) to develop an independent clinical research career. The rapidly growing number of geriatric prisoners is a healthcare crisis in US prisons, an economic crisis for state governments, and has precipitated profound public health challenges in the communities to which aging prisoners are released. However, research about older prisoners is scarce. The specific aims of my proposed research address important knowledge gaps by applying the multidisciplinary perspective of Geriatrics to the healthcare of aging prisoners. The proposed research will accomplish the following aims: (1) provide the largest assessment to date of the health and functional status of geriatric prisoners and compare these levels to population-based norms; (2) examine risk factors associated with adverse health events in prison and incorporate these into a clinical tool to risk-stratify geriatric prisoners according to their risk of adverse health events; (3) determine the association between disability specific to the prison environment and adverse health events; and (4) select and develop high-fidelity measures to assess health, functional status, cognitive status, and healthcare needs of older adults after release. My strong mentoring team led by Dr. Kenneth Covinsky an NIA K24 awardee, has expertise in geriatrics, prison health, measurement science and in assembling and following a prospective cohort. This application will also provide pilot data and lay the groundwork for an R01 application focused on improving the health and healthcare of older adults after release from incarceration. RELEVANCE (See instructions): This application will describe the healthcare needs of older prisoners, create a clinical prediction tool for adverse health outcomes, and establish a cohort of older adults nearing release to measure medical, cognitive and functional status and plans for post-release healthcare. Results can be used to guide care, improve costs and decrease adverse health outcomes of incarcerated older adults and of those transitioning back to community healthcare.

描述（由申请人提供）：我是加利福尼亚大学旧金山分校的老年医生和初级教师。我的长期目标是成为一名专注于优化被剥夺特权老年人（例如老年囚犯）的医疗保健的独立研究人员。我寻求K23奖，以为我提供实现以下目标所需的支持：（1）获得临床研究的其他技能，包括纵向研究设计，预后建模，等级建模，测量和调查设计以及组装前瞻性的纵向纵向队列；（2）发展独立的临床研究职业。迅速增长的老年囚犯是美国监狱的一场医疗危机，这是州政府的经济危机，并在释放老年囚犯的社区中引起了深远的公共卫生挑战。但是，关于老年囚犯的研究很少。我拟议的研究的具体目的是通过将老年医学的多学科观点应用于老龄囚犯的医疗保健方面来解决重要的知识差距。拟议的研究将实现以下目的：（1）提供迄今为止老年囚犯健康和功能状况的最大评估，并将这些水平与基于人群的规范进行比较；（2）检查与监狱中不良健康事件相关的危险因素，并将这些事件纳入临床工具中，以根据其不良健康事件的风险将老年囚犯施加风险分类；（3）确定特定于监狱环境的残疾与不良健康事件之间的关联；（4）选择并制定高保真措施，以评估释放后老年人的健康状况，功能状况，认知状况和医疗保健需求。我的强大指导团队由NIA K24获奖者肯尼斯·科文斯基（Kenneth Covinsky）博士领导，在老年医学，监狱健康，测量科学以及集会和遵循潜在的队列方面拥有专业知识。该应用程序还将提供试点数据，并为R01应用程序奠定了基础，该应用程序着重于在监禁后改善老年人的健康和医疗保健。相关性（请参阅说明）：本申请将描述老年囚犯的医疗保健需求，为不良健康结果创建临床预测工具，并建立一群接近释放的老年人，以衡量医疗，认知和功能状况，并计划后发行后医疗保健。结果可用于指导护理，提高成本并减少被监禁的老年人的不利健康结果，以及转变为社区医疗保健的人的不利健康。