Pain in Homebound Older Adults: Association With Race and Ethnicity and Neighborhood Socioeconomic Deprivation

居家老年人的痛苦：与种族、民族和邻里社会经济剥夺的关联

• 批准号: 10615445
• 负责人: R. Sean Morrison
• 金额: $ 29.5万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615445
• 关键词: Address; Administrative Supplement; Adopted; Aging; American; Award; Black Populations; COVID-19; Caring; Censuses; Clinical Data; Community Surveys; Complex; Cross-Sectional Studies; Data; Data Set; Data Sources; Development; Elderly; Environment; Ethnic Origin; Grant; Growth; Health; Health Disparities Research; Health Status; Hispanic; Home; Hospitalization; Individual; Institutes; Link; Measures; Medical; Medicare; Modeling; Neighborhoods; Not Hispanic or Latino; Outcome; Pain; Pain Measurement; Pain management; Palliative Care; Parents; Personal Satisfaction; Policies; Population; Prevalence; Preventive care; Primary Health Care; Proxy; Quality of life; Race; Reporting; Research; Respondent; Risk; Sampling; Sampling Studies; Socioeconomic Factors; Socioeconomic Status; Surveys; Symptoms; Time; Work; base; community based care; community based service; deprivation; disability; epidemiology study; evidence base; experience; health disparity; high risk; improved; indexing; innovation; insight; interest; minority health disparity; mortality; multiple chronic conditions; parent grant; population health; prevent; racial disparity; residence; social deprivation; socioeconomics; symptom management; trend

ABSTRACT The Mount Sinai Older Adults Independence Center grant (P30AG028741) aims to examine the relationship of pain to quality of life, independence, function, and disability in older adults in general. The purpose of this proposal, for an administrative supplement to P30AG028741, is to expand the focus of the parent grant to characterize pain in a nationally representative sample of homebound older adults, assess disparities by race and ethnicity, and examine the impact of neighborhood socioeconomic deprivation on pain. There are over 7 million homebound older adults in the US. Despite having significant multimorbidity and high risk of hospitalization and mortality, just 11% of this population access medical care in the home. New models of home- based care, including home-based palliative care, are needed to address the complex needs of this population and should be informed by robust epidemiological studies in nationally representative samples. Given its prevalence, impact on well-being, and ready availability in national surveys, pain is an ideal metric to estimate the need for home-based palliative care in homebound older adults. To date, there have been no studies characterizing pain and its disparities in a nationally representative sample of older adults. Guided by a conceptual model informed by the National Institute of Minority Health and Health Disparities Research Framework, our proposed study aims to characterize pain in a nationally representative sample of homebound older adults and specifically examine (i) the association between race and ethnicity and pain; and (ii) the association between neighborhood socioeconomic deprivation and pain. The study sample will be drawn from the nationally representative National Health and Aging Trends Study and include 1730 older adults classified as homebound in 2015. In this cross-sectional study, we will undertake bivariate and multivariable analyses of survey data from the National Health and Aging Trends Study and linked data from American Community Survey to examine the association between race and ethnicity, neighborhood socioeconomic deprivation (measured as census tract Social Deprivation Index), and self/proxy-reported pain. This proposal directly addresses the objectives of the Notice of Special Interest (NOSI, NOT-AG-22-005) in enhancing understanding of the mechanisms (individual, neighborhood) underlying the pain experience, informing strategies to prevent and manage pain, and addressing equity in pain among homebound older adults. The study will be the first to examine pain in a nationally representative sample of homebound older adults and represents an important first step towards characterizing the symptom needs of homebound older adults and expanding the evidence base to plan home-based palliative care. The results will provide important insights into disparities in pain in this population and the association between neighborhood socioeconomic deprivation and symptoms. Additionally, the multilevel linked dataset we create will lay the groundwork for future research on the impact of neighborhood factors on diverse outcomes among homebound older adults.

抽象的 西奈山老年人独立中心拨款 (P30AG028741) 旨在研究以下关系： 总体而言，老年人的生活质量、独立性、功能和残疾受到痛苦。这样做的目的 针对 P30AG028741 的行政补充提案，旨在将母基金的重点扩大到 描述全国代表性的居家老年人样本中的疼痛特征，评估种族差异 和种族，并研究邻里社会经济剥夺对疼痛的影响。有超过7个 美国有 100 万居家老年人。尽管存在显着的多发病和高风险 住院和死亡，只有 11% 的人口在家中获得医疗服务。家居新模式—— 需要基于家庭的姑息治疗等基础护理来满足这一人群的复杂需求 并应通过对全国代表性样本进行的强有力的流行病学研究提供信息。鉴于其 从国家调查中的患病率、对福祉的影响以及随时可用的情况来看，疼痛是一个理想的估计指标 居家老年人对家庭姑息治疗的需求。迄今为止，还没有研究 描述具有全国代表性的老年人样本中的疼痛及其差异。由一个 概念模型由国家少数民族健康和健康差异研究所提供 框架，我们提出的研究旨在描述全国代表性的居家样本中的疼痛特征 老年人，并特别研究（i）种族和民族与疼痛之间的关联； (ii) 邻里社会经济剥夺与痛苦之间的关联。研究样本将取自 具有全国代表性的国家健康和老龄化趋势研究，包括 1730 名老年人 2015 年居家隔离。在这项横断面研究中，我们将进行双变量和多变量分析 来自国家健康和老龄化趋势研究的调查数据以及来自美国社区调查的关联数据 研究种族和族裔、邻里社会经济剥夺之间的关联（衡量为 人口普查区社会剥夺指数），以及自我/代理报告的痛苦。该提案直接针对 特别兴趣通知（NOSI，NOT-AG-22-005）的目标是增强对 疼痛体验背后的机制（个人、邻里），为预防和治疗策略提供信息 管理疼痛，并解决居家老年人疼痛的公平问题。该研究将首次 研究全国代表性的居家老年人样本中的疼痛情况，这是一项重要的首次研究 朝着描述居家老年人的症状需求和扩大证据基础迈出了一步 计划家庭姑息治疗。研究结果将为了解这一领域的疼痛差异提供重要见解 人口以及社区社会经济剥夺和症状之间的关联。此外， 我们创建的多级链接数据集将为未来研究邻里影响奠定基础 影响居家老年人不同结果的因素。