DOI: 10.3886/icpsr37245.v1
title: Development of a Brief Elder Abuse and Neglect Screening Tool for Emergency Medical Services: Detection of Elder Abuse Through Emergency Care Technicians (DETECT), Texas, 2015
title: Version 1

description: In collaboration with Texas Adult Protective Services (APS) and one of the largest mobile healthcare providers in North Texas -- MedStarMobile Healthcare (MedStar) -- this study developed and piloted an elder abuse (EA) screening tool: Detection of Elder Abuse Through Emergency Care Technicians (DETECT). The DETECT tool was designed specifically to help medics identify potential EA among community-dwelling older adults during an emergency response. DETECT relies entirely on the medics' systematic observations of the older adults' physical and social environment -- no direct questioning of the older adult or their caregivers is involved. The DETECT tool was developed through an iterative, user-centered design process in which input was gathered from key stakeholders, and revisions to the tool incorporated their feedback. The intent was for that process to result in an EA screening tool that was easy for medics to use in the field and that helped medics capture information about older adults, their environments, and their caregivers that is thought to be associated with the occurrence of EA.
description: The long-term goal of the DETECT project is to refine the tool and fully validate its effectiveness in assisting first responders to link older adults who are potentially living with EA to needed programs and services. However, the goals of this preliminary 5-week pilot study were far more limited. Namely, the research team's goals were to answer the following two questions about the feasibility of using the DETECT screening tool with medics in the field: (1) What procedural barriers, if any, might prevent DETECT from being used as intended by medics in the field?; and, (2) how often, if ever, are the characteristics/situations described in each of the DETECT screening items actually observed and recorded by medics in the field?
description: The researchers pilot tested the DETECT screening tool with medics in the field between September 17th and October 26th, 2015. During the pilot test, MedStar's Electronic Patient Care Reporting system (ePCR) was programmed to automatically prompt all medics to complete an EA screening using the DETECT tool while on an eligible 911 response.
description: The 26 DETECT screening items spanned 8 domains of EA indicators frequently encountered by medics (Cannell et al., 2016). For each item, response options included "Yes", "No", and "Don't know". Items related to the older adult's caregiver featured an expanded range of response options that included "Not Applicable or No Caregiver."
description: An eligible 911 response was defined as a call for a community-dwelling patient who was 65 years of age or older, the setting was the patient's residence, and the patient resided in the community (e.g., private home, unlicensed adult foster homes, unlicensed board and care homes, etc.). Other types of residences (e.g., licensed skilled nursing facilities) were excluded because reports of EA in these settings are generally not investigated by APS in Texas (Texas Department of Family and Protective Services, 2018). By definition, older adults who participated in the pilot study had to live in MedStar's service area of an estimated 978,000 residents, which included Fort Worth, Texas, and 14 surrounding communities ("MedStar Service Area/Member Cities," 2018).
description: Datasets: DS1: Development of a Brief Elder Abuse and Neglect Screening Tool for Emergency Medical Services: Detection of Elder Abuse Through Emergency Care Technicians (DETECT), Texas, 2015
description: Community-dwelling residents 65 years of age or older in Fort Worth, Texas and surrounding communities. Smallest Geographic Unit: None
description: coded on-site observation