Maximizing the Scalability of the Chronic Disease Self-Management Program (CDSMP) Among Older Adults in State Correctional Settings

最大限度地提高州惩教机构中老年人慢性病自我管理计划 (CDSMP) 的可扩展性

• 批准号: 10654994
• 负责人: Rodlescia Sneed
• 金额: $ 11.98万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10654994
• 关键词: Age; Area; Assessment tool; Cholesterol; Chronic; Chronic Disease; Communicable Diseases; Communities; Complex; Data; Development; Diabetes Mellitus; Disease; Disease Management; Disease model; Educational workshop; Elderly; Emergency department visit; Ensure; Evidence based program; Exercise; Female; Funding; General Population; Gerontology; Goals; Health; Health Expenditures; Healthcare; Hospitalization; Hypertension; Imprisonment; Individual; Infrastructure; Intervention; Interview; Investigation; Justice; Link; Manuals; Mental disorders; Mentors; Morbidity - disease rate; Obesity; Outcome; Participant; Persons; Persuasive Communication; Population; Prisons; Privatization; Process; Randomized; Recommendation; Research; Research Methodology; Research Personnel; Resource-limited setting; Resources; Security; Self Care; Self Efficacy; Self Management; Standardization; Substance abuse problem; Surveys; Testing; Time; Training; biopsychosocial; burden of illness; career; community engagement; correctional system; cost; depressive symptoms; evidence base; experience; health care service; health disparity; implementation research; implementation science; implementation trial; improved; innovation; knowledge base; male; member; mortality; neglect; organizational structure; pain symptom; peer; physical conditioning; primary health service; prison population; programs; randomized trial; recruit; scale up; self-management program; social

PROJECT SUMMARY/ABSTRACT Incarcerated individuals have higher rates of chronic disease than the general population, and disease burden will likely increase as the prison population continues to age. Despite this, health care services in prison primarily focus on infectious diseases, mental illness, and substance abuse, largely neglecting chronic physical health conditions. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based program developed to support self-management for people with chronic illnesses. At least 10 randomized trials conducted in non-correctional settings have linked CDSMP to disease-related improvements and reduced healthcare expenditures. CDSMP has been used in state corrections systems via 3 approaches: 1) bringing community agency CDSMP leaders into the correctional setting to lead the program, 2) training correctional staff as program leaders, and 3) training incarcerated individuals to serve as peer leaders. To date, however, there has been little research into efficient and effective strategies for scaling up the intervention within state corrections systems using any of these approaches. Scale-up (i.e. deliberate efforts to increase the impact of successfully tested health innovations to benefit more people and promote sustainability) is an understudied concept in implementation science, with few existing empirical studies that explicitly focus on the process of scale-up. Assessing scalability, however, is crucial for ensuring sustainability of complex interventions within resource- poor settings. The research objective of this K01 is to evaluate and maximize the scalability of CDSMP among older adults in state correctional systems. Guided by the Scaling up Management Framework, we will use a mixed methods research approach to query community agency leaders, staff, and incarcerated individuals about ways to maximize the scalability of CDSMP within state correctional settings and develop and refine CDSMP scale-up strategies for these settings. Our goal is to develop scale-up strategies to be evaluated in a subsequent randomized implementation trial. The training objectives of this K01 will add expertise in implementation science and justice-involved research to my existing knowledge base in biopsychosocial models of disease, social gerontology, health disparities, quantitative analysis, and chronic disease management, to reach my goal of becoming an independent researcher who uses implementation science approaches to improve health outcomes among justice-involved populations. As the prison population continues to age, the burden of chronic disease within correctional systems will continue to increase, which contributes to skyrocketing correctional costs. Understanding how to expand evidence-based chronic disease programs within correctional systems is crucial for reducing disease-related morbidity and mortality among incarcerated individuals and for reducing costs. This line of research will identify and test scale-up strategies for chronic disease management in prisons.

项目摘要/摘要 被监禁的个体的慢性病率高于一般人群，疾病 随着监狱人口持续衰老，负担可能会增加。尽管如此，监狱中的医疗保健服务 主要专注于传染病，精神疾病和药物滥用，在很大程度上忽略了慢性身体 健康状况。慢性病自我管理计划（CDSMP）是一个基于证据的计划 开发旨在支持慢性疾病患者的自我管理。至少进行了10项随机试验 在非纠正环境中 支出。 CDSMP已通过3种方法用于州校正系统中：1）带来社区 代理机构CDSMP领导者进入惩教设置以领导该计划，2）培训惩教人员作为计划 领导者和3）训练被监禁的人担任同伴领导者。但是，到目前为止，几乎没有 研究有效有效的策略，以扩大州校正系统的干预措施 使用这些方法中的任何一种。扩大规模（即为了增加成功测试的影响的故意努力 健康创新以使更多的人受益并促进可持续性）是一个研究的概念 实施科学，很少有现有的经验研究明确关注扩大过程。 但是，评估可伸缩性对于确保资源内复杂干预措施的可持续性至关重要 - 设置不佳。该K01的研究目标是评估和最大化CDSMP的可伸缩性 州惩教系统中的老年人。在扩展管理框架的指导下，我们将使用 混合方法研究方法，以查询社区代理机构领导人，员工和被监禁的个人 在状态校正设置内最大化CDSMP并开发和完善CDSMP的方法 这些设置的扩展策略。我们的目标是制定扩大策略，以在随后的 随机实施试验。该K01的培训目标将增加实施科学方面的专业知识 以及与正义的研究对我现有的知识基础的研究基础，以疾病的生物心理社会模型 老年医学，健康差异，定量分析和慢性疾病管理，以实现我的目标 成为一名独立研究人员，他使用实施科学方法来改善健康成果 在涉及正义的人群中。随着监狱人口的持续年龄，慢性病的负担 在矫正系统中，将继续增加，这导致矫正成本飞涨。 了解如何在惩教系统中扩展基于证据的慢性病计划至关重要 用于降低被监禁个体中与疾病相关的发病率和死亡率，并降低成本。这 研究线将确定和测试监狱中慢性疾病管理的规模规模策略。