Identifying Targets for Interventions to Improve Functional Ability to Work over the Life Course

确定干预目标以提高生命全程工作的功能能力

• 批准号: 10657197
• 负责人: NICOLE A MAESTAS
• 金额: $ 71.73万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10657197
• 关键词: Activities of Daily Living; Affect; Age; American; Assessment tool; Cognitive; Country; Data; Deterioration; Development; Economic Factors; Economics; Education; Employment; Exercise; Future; Goals; Health; Individual; International; Intervention; Knowledge; Life Cycle Stages; Longevity; Maps; Measures; Methods; Netherlands; Occupational; Occupations; Personal Satisfaction; Persons; Population; Prevention; Procedures; Productivity; Recovery; Rehabilitation therapy; Research; Respondent; Sampling; Scientific Advances and Accomplishments; Security; Standardization; Technology; Time; Vocational rehabilitation; Work; age group; base; climate change; cost; data resource; disability; effective intervention; functional loss; healthy aging; human old age (65+); improved; instrument; pandemic potential; prevent; productivity loss; psychosocial; psychosocial wellbeing; public health intervention; response; simulation; social; social factors; standardize measure

PROJECT SUMMARY/ABSTRACT As individuals age, their health may decline, in some cases leading to the loss of key functional abilities that enable them to work. These functional losses jeopardize prospects for healthy aging, which calls for ongoing engagement in socially productive activities of one’s choosing. Despite the importance of maintaining functional abilities with age, we do not yet understand how losses in particular cognitive, physical or psychosocial abilities interact with job requirements to impede work activity. In addition, it is unknown whether public health interventions could restore losses in critical abilities once they occur, or even prevent such losses in the first place. Understanding which ability losses cause the most loss in work capacity in the population is a prerequisite to identifying targets for interventions to improve functional work capacity. Once these ability losses and their impacts are understood, potential work- capacity interventions can be identified and evaluated. The ideal targets of work-capacity interventions are ability losses that lead to large productivity losses in the population, but for which relatively low- cost, effective interventions could be developed or, if interventions currently exist, could be made widely accessible. The goal of this project is to build the research base upon which work-capacity interventions may be developed. To do so, we will draw upon methods used for disability determination in the Netherlands, which measures work capacity by mapping standardized measures of functional abilities to standardized requirements of jobs across the national economy. This comprehensive mapping between abilities and jobs allows for direct computation of the set of feasible jobs and potential earnings for an individual, conditional on their education. The Netherlands is unique among countries in this approach to disability determination. First, we will adapt and harmonize the Dutch functional assessment instrument to the U.S. context and then field the assessment to a representative sample of Americans ages 25-75 at two points in time. After mapping respondents’ functional abilities to occupational requirements in the U.S., we will estimate cross-sectional levels of functional work capacity as well as longitudinal ability loss/recovery rates, overall and for different age groups. Next, we will conduct counterfactual simulations to determine the critical functional abilities that, if their loss could be reversed through future intervention, would have the greatest impact on work capacity in the U.S. population. Since prevention targets may differ from rehabilitation targets, we will also conduct the reverse exercise: we will use counterfactual simulations to determine the critical functional abilities that, if deterioration could be prevented through future intervention, would have the greatest impact on work capacity in the U.S. population. Lastly, we will simulate the effects of changes in occupational requirements arising from factors like technological change, pandemic risk, and climate change.

项目摘要/摘要 随着个人的年龄，他们的健康可能会下降，在某些情况下会导致关键功能能力的丧失 这使他们能够工作。这些功能损失危害了健康衰老的前景，这会呼吁 为了持续参与自己选择的社会生产活动。尽管很重要 随着年龄的增长，保持功能能力，我们尚不了解损失特别认知， 身体或心理社会能力与工作要求相互作用，以阻碍工作活动。另外，是 未知公共卫生干预措施一旦发生后是否可以恢复关键能力的损失，或者 甚至首先要防止这种损失。了解哪些能力损失会导致最大的损失 人口的工作能力是确定干预措施的目标的先决条件 功能性工作能力。一旦理解了这些能力损失及其影响，潜在的工作 - 容量干预措施可以识别和评估。工作能力干预的理想目标 是能力损失，导致人口的生产率损失巨大，但相对较低 成本，有效的干预措施，或者，如果目前存在干预措施，则可以广泛进行 可访问。该项目的目的是建立研究基础的工作能力干预措施 可以开发。为此，我们将利用用于确定残疾确定的方法 荷兰，通过映射标准化功能能力的标准措施来衡量工作能力 满足全国经济工作的标准化要求。这个全面的映射 能力和工作之间可以直接计算可行的工作和潜力 个人的收入，有条件的教育。荷兰在国家之间是独一无二的 这种确定残疾的方法。首先，我们将适应和协调荷兰的功能 评估工具到美国的情况，然后将评估验证到代表性样本 美国人在两个时间点上年龄在25-75岁之间。将响应的功能能力映射到 在美国占据要求，我们将估计功能性工作的横截面水平 能力以及纵向能力丧失/恢复率，整体和不同年龄段。接下来，我们 将进行反事实模拟，以确定其损失可能的关键功能能力 通过将来的干预逆转将对美国的工作能力产生最大的影响 人口。由于预防目标可能与康复目标不同，我们还将进行 反向练习：我们将使用反事实模拟来确定关键功能能力， 如果可以通过将来的干预来防止定义，将对工作产生最大的影响 美国人口的能力。最后，我们将模拟占领变化的影响 由技术变化​​，大流行风险和气候变化等因素产生的要求。