Clinical Research Directory

A Path to Prevention of Elder Abuse in Long-term Care. Prevalence Study Among Staff in Long-term Care.

Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff to resident abuse during the past 12 months was 64.2% (95% CI 53.3-73.9%). Similar findings was also reported in a study from Norway in which the overall prevalence of observed staff-to-resident abuse was 76% and 60% of respondents report self-perpetration of abusive acts during the past 12 months. Resident-to-resident aggression was even more common, observed by 88% of respondents. This study is part of the Swedish national research program APPEAL (A Path to Prevention of Elder Abuse in Long-term care) with the long-term goal to co-create an intervention for abuse of older people (AOP) in nursing homes together with stakeholders, i.e., staff, managers, care recipients and relatives. Study design and data collection: A cross-sectional study design will be used with slightly different data collection modes. 1. Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. Data will be collected through a digital survey. Data will be combined with available register data from Statistics Sweden, including for example sex, age, civil state and occupational related data. 2. Workplace sample. Sweden has 290 Municipalities. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the municipalities based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. In the randomization process, geographical location of the municipalities has been considered to assure national representativeness, meaning that in case several municipalities in the same geographical region were selected a new randomization was conducted. Staff in each selected municipalities will be invited to participate through managers in each organization. Data will be collected through a digital questionnaire. Organizations will be encouraged to set a side time at a staff meeting for completing the questionnaire. If this is not possible, a link to the questionnaire will be sent out by e-mail. Data will be collected anonymously. Material: The questionnaire used in the previously mentioned Norwegian study about AOP in long-term care facilities has been translated and culturally adapted. In addition, items about background characteristics of respondents as well as risk factors for AOP on both an individual and system level are included, e.g., workload and perceived support at the workplace and ageist attitudes. Analysis: Primary outcomes will be proportion of staff reporting different types of abuse (psychological, physical, sexual, financial abuse and neglect) in different relational contexts, i.e., self-perpetrated, staff-to-resident and relative-to resident abuse, and in long-term care facilities resident-to-resident abuse. Secondary outcome will be staff reported own exposure to different forms of abuse at the workplace, including by residents, co-workers, relatives and managers. Logistic regression analysis will be used to investigate associations between reporting different forms of abuse and potentially explanatory factors.

Knowledge and Interpersonal Skills to Develop Enhanced Relationships (KINDER)

The Knowledge and Interpersonal Skills to Develop Enhanced Relationships (KINDER) intervention was developed to prevent psychological elder abuse (EA) and promote high-quality caregiving by lowering relationship strain and developing CG resourcefulness. The goal of this two-arm, randomized control trial is to determine the efficacy of KINDER at mitigating psychological EA by family caregivers to persons living with dementia and to describe how the intervention may work to reduce psychological EA.

Replication and Evaluation of the RISE-APS Model In New Contexts

The goal of this study is to learn if the intervention, RISE (in partnership with APS), can be implemented in different contexts and if this RISE-APS model works in supporting older adults who are at risk of or experiencing some form of elder abuse or self-neglect. The main aims are to: 1. Adapt and implement the RISE-APS model in four new contexts 2. Evaluate the RISE-APS model implementation and effectiveness in four new locations Researchers will compare outcomes of participants who receive APS-only services to those receiving the RISE-APS model to see if the RISE-APS model works better in supporting older adults. Participants will: Receive services in either group and participate in brief telephone surveys to track their outcomes over time.

Technology-Based Intervention Usability and Pilot Testing

This research project has three main goals: (1) To create a new screening tool that helps primary care doctors spot signs of neglect in older adults with dementia. (2) To design a support program that can be delivered both in person and through a mobile app on Android phones. (3) To run a clinical trial with three groups of participants to find out how effective the screening tool is on its own, and how effective it is when combined with the support program-compared to standard care. This current phase of the project focuses on parts of goals 1 and 2, as described below.

Tele-PROTECT Therapy: Effectiveness, Empowerment, and Implementation

The purpose of this randomized trial is to conduct a fully powered effectiveness trial of video-delivered PROTECT (Tele-PROTECT) compared to a video-delivered depression education (DepEd) control condition to be delivered to 140 English- and Spanish-speaking NYC elder abuse victims. Investigators hypothesize three main aims: 1. Effectiveness Aim: Tele-PROTECT participants will have significantly greater and clinically meaningful reductions in depression when compared to the DepEd control; 2. Abuse Impact Aim: Tele-PROTECT participants will demonstrate greater safety related empowerment compared to DepEd control, which can help participants take steps to reduce risk; 3. Implementation Aim: Stakeholders' views of the factors impacting the implementation of Tele-PROTECT based on characteristics of the intervention, agency setting, and population served will contribute to a national dissemination of Tele-PROTECT Participants will * Receive 9 weeks of tele health psychotherapy delivered by a Master's level mental health clinician from the Weill Cornell Medicine research team. Participants will be assigned to "Tele-PROTECT" or "DepEd" psychotherapy randomly. * Participate in one baseline assessment and four follow-up assessments at weeks 3, 6, 9, and 12 administered by a trained member of the research team.

DETECT-RPC Universal EM Screening

The purpose of this study is to evaluate whether the use of the Detection of Elder Mistreatment Through Emergency Care Technicians-Revised for Primary Care (DETECT-RPC) screening tool increases the average reporting of elder mistreatment (EM) by homebased primary care (HBPC) clinicians.