Responding to Elder Abuse in GERiAtric Care: Educational Intervention

Study Overview
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Brief Summary
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The prevalence of elder abuse has been reported between 10-15% in international studies. Elder abuse may include both physical, emotional, sexual and financial abuse as well as neglect and it occurs at the hand of both professionals and family members, including adult children and intimate partners. Elder abuse has been associated with psychological ill-health, disability, increased hospitalization, emergency department use and admission to nursing facilities. Elder abuse is however often unknown to health care providers. Older adults are hesitant to disclose abuse and health care providers are often reluctant to ask questions. In this study an interactive educational model for health care professionals about elder abuse will be tested. The model consist of theoretical lectures, brief films showing patient encounters, group discussions and forum play, a form of participatory theater. Both group discussions and forum play will be using case scenarios as a cornerstone. The validated questionnaire REAGERA-P will be used for self-reported measures

Detailed Description
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Please refer to the uploaded study protocol for a detailed description of the study.

Official Title
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Responding to Elder Abuse in GERiAtric Care Educational Intervention for Healthcare Providers: a Non-randomised Stepped Wedge Trial.

Conditions
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Healthy

Intervention / Treatment
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* Other: Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Employee at one of the clinics participating in the trial Work tasks involves direct patient contact, at least part time Participation at the training sessions Exclusion Criteria: Only administrative work and no direct patient contact Not participating at the training session

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: Non-randomized stepped wedge cluster trial (incomplete design)
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Education<br>Participants that have undergone the educational intervention | Other: Education<br>* Training for health care professionals on how to identify and manage cases of elder abuse among their patients<br>|
| No Intervention: Waitlist<br>Participants still waiting to cross over to intervention arm | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change between baseline and follow up concerning asking questions about abuse, as reported in the questionnaire REAGERA-P | Self-report measure of asking older patients about abusive experience. Will be measure both as a dichotomous value (have ever asked questions during the last 6 months) as well as a frequency measure where participants report how often they have asked patients questions about abuse during the last 6 months (on a scale from 0 to 10 or more) | Baseline, 6 month follow up, 12 month follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change between baseline and follow up concerning awareness of elder abuse and sense of responsibility for identifying victims, as reported in the questionnaire REAGERA-P | Self-reported perceived lack of awareness of elder abuse as a barrier toward identifying victims. Self reported sense of responsibility for asking questions about abuse (own responsibility, professions' responsibility, health care services responsibility) | Baseline, Immediate post-intervention (number 2), 6 month follow up, 12 month follow up | 
| Change between baseline and follow up concerning level of awareness of abuse in contact with patients, as reported in the questionnaire REAGERA-P | Patient case (Vignette) with indicators of abuse and participants self-report if they think they would have asked the patient questions about abuse | Baseline, 6 or 12 month follow up (different for different clusters) | 
| Change between baseline and follow up concerning perceived ability to ask questions about abuse, as reported in REAGERA-P | Self-reported self-efficacy for asking questions about elder abuse. Self-reported cause for concern that asking questions will a) lead to a negative reaction from the patient b) negatively impact the patient-provider relationship | Baseline, Immediate post-intervention, 6 month follow up, 12 month follow up | 
| Change between baseline and follow up concerning perceived preparedness to manage cases of elder abuse, as reported in REAGERA-P | Self-reported self-efficacy for managing cases of elder abuse. Self-reported cause for concern of not being able to offer the patient a good follow up. Self-reported collegial support, i.e., knowing which colleague to ask for help if needed when managing cases of elder abuse. Self-reported knowledge about proper documentation routines Self-reported knowledge about judicial concerns | Baseline, Immediate post-intervention (number 1and 2), 6 months follow up, 12 months follow up | 
| Change between baseline and follow up concerning preparedness at the clinic to care for older adults subjected to abuse, as reported in REAGERA-P | Self-reported evaluation of: Routines for managing cases of elder abuse at the clinic Preparedness at the clinic and in society to care for victims of elder abuse. | Baseline, 6 months follow up, 12 months follow up |