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Background: Elder abuse in long-term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue. Objectives: The objective was to evaluate the impact of a newly developed R-REM training intervention for nursing staff on knowledge, recognition and reporting of R-REM. Design: The design was a prospective cluster randomized trial with randomization at the unit level. Methods: A sample of 1405 residents (685 in the control and 720 in the intervention group) from 47 New York City nursing home units (23 experimental and 24 control) in 5 nursing homes was assessed. Data were collected at three waves: baseline, 6 and 12 months. Staff on the experimental units received the training and implementation protocols, while those on the comparison units did not. Evaluation of outcomes was conducted on an intent-to-treat basis using mixed (random and fixed effects) models for continuous knowledge variables and Poisson regressions for longitudinal count data measuring recognition and reporting. Results: There was a significant increase in knowledge post-training, controlling for pretraining levels for the intervention group (p < 0.001), significantly increased recognition of R-REM (p < 0.001), and longitudinal reporting in the intervention as contrasted with the control group (p = 0.0058). Conclusions: A longitudinal evaluation demonstrated that the training intervention was effective in enhancing knowledge, recognition and reporting of R-REM. It is recommended that this training program be implemented in long-term care facilities. [ABSTRACT FROM AUTHOR]

Abstract: This paper is one of two in a series that reports detailed findings from a larger study that simultaneously explored individual, family and neighborhood level predictors of victimization and offending among youth. The current analysis aims to identify which neighborhood level factors have better predictive power with regard to type of victimization (direct and vicarious measures) and total offending overtime (Wave 1 and Wave 2). Methods: Path analysis was conducted using data from a multi-wave, panel study (N=625) of youth ages 16–19 at Wave 1. A best fitting model was determined showing causal pathways from neighborhood level factors including crime and perception of safety, to direct and vicarious victimization through exposure to violence, and subsequent offending. Findings: Neighborhood crime significantly predicted property victimization. Neighborhood crime and perception of safety significantly predicted vicarious victimization by exposure to violence in the neighborhood. Neighborhood crime and perception of safety were significantly associated with Wave 1 offending. Findings highlight the need for professionals who work with youth to be cognizant of how their environments influence their lives. Prevention and intervention models seeking to create sustainable change among youth should consider mezzo and macro level components that build and strengthen neighborhood capacity through community partnerships. [Copyright &y& Elsevier]

Objective: To determine whether effectiveness of a diet intervention for family members of cardiovascular disease patients varies by participant sex, race/ethnicity, or age because these characteristics have been associated with unique barriers to diet change. Design: Randomized controlled trial. Setting and Participants: University medical center. Healthy adult family members of patients hospitalized with cardiovascular disease (n = 501 ; 66% women; 36% racial/ethnic minorities; mean age 48 years). Intervention: A special screening and educational intervention (SI) vs control intervention (CI) to reduce dietary saturated fat and cholesterol intake throughout 1 year. Main Outcome Measures: Absolute change in MEDFICTS (meats, eggs, dairy, fried foods, fat in baked goods, convenience foods, fats added at the table and snacks) diet score, saturated fat, and dietary cholesterol in the SI vs CI from baseline to 1 year. Analysis: t tests stratified by sex, race/ethnicity, and age group; linear regression. Significance set at P < .05. Results: The SI was effective to improve MEDFICTS score independent of sex, race/ethnicity, and age group (ß = -6.7; P < .001). There was no interaction between the SI and sex (ß = .9; P = .84), race/ ethnicity (ß = -1.1; P = .81), or age group (ß = -.6; P = .89) on change in MEDFICTS score or change in saturated fat or dietary cholesterol intake from baseline to 1 year. Conclusions and Implications: Results support the potential for a hospital-based screening and education program to improve diet in diverse populations of cardiovascular disease patient family members. [ABSTRACT FROM AUTHOR]