VOICES

Empowering older adults to be their own advocate, at their own discretion.

Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure
(VOICES)

VOICES is a digital health tool designed to assist older adults with self-identifying and self-disclosing mistreatment with discretion in the ED.
Led by a team of experts in the fields of geriatrics, intimate partner violence, emergency medicine and health information technology, the tool utilizes
virtual coaching and interactive multimedia libraries (e.g. graphics, video clips, animations, etc.) along with brief psychoeducational interviewing
to guide older adults through an educational screening process for mistreatment.

It is estimated that only 1 in 24 cases of abuse become known to authorities.¹

Why VOICES?

The mistreatment of older adults is a social justice problem for all members of society.

The World Health Organization (WHO) defines Elder Mistreatment as "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person". Elder mistreatment is a major public health problem that affects older adults regardless of race, ethnicity, education, or socioeconomic status. An estimated 1 in 10 older adults experience mistreatment, but only 1 in 24 cases become known to authorities.¹
As the U.S. population ages, the number of older adults who experience mistreatment is expected to increase, creating a need for a tool to help with educating, and assisting older adults with identifying and self-disclosing their mistreatment.

how VOICES works

We are developing and testing a digital health tool to assist older adults in self-identifying and self-disclosing Elder Mistreatment. The Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES) tool is designed to put the process of screening in the hands of the older adult, instead of the provider. The VOICES tool runs on tablets (e.g. iPads) and includes various multimedia elements such as text-to-speech, videos and animations designed to educate and screen for Elder Mistreatment.

Publications

Peer-Reviewed Original Research (Journal Publications & Conference Proceedings)

Abujarad F, Edwards C, Neugroschl J, Hwang U, Marottoli R. Digital Elder Abuse Intervention for Older People Living with Dementia. Alzheimer's & Dementia 2023, 19 DOI: 10.1002/alz.082224

Abujarad F, Edwards C, Neugroschl J, Hwang U, Marottoli R. Feasibility of a Digital Elder Mistreatment Intervention for Cognitively Impaired Older Adults. Innovation In Aging 2023, 7: 146-146. PMCID: PMC10735509, DOI: 10.1093/geroni/igad104.0478.

Edwards C, Abujarad F. Digital Informed Consent for Older Adults in Emergency Department Research. 2023, 78 DOI: 10.54941/ahfe1003449.

Abujarad F, Ellis P, Edwards C, Marottoli R. Self-Administrated Digital Elder Abuse Intervention for Older Adults in the Primary Care Setting. Poster presentation at American Geriatrics Society Annual Meeting (2023).

Abujarad F, Choo E, Pantalon M, Jubanyik K, Dziura J, Edwards C, Gill T, D'Onofrio G. Integrating a Digital Elder Mistreatment Intervention in the Emergency Department Setting. Oral presentation at SAEM Annual Meeting (2023).

Abujarad F, Edwards C, Neugroschl J, Hwang U, Marottoli R. Development and Implementation of a Self-Administrated Digital Elder Mistreatment Screening Tool for Cognitively Impaired Older Adults. Symposium presentation at Geriatrics Society of America Annual Meeting (2023).

Abujarad F, Choo E, Pantalon M, Jubanyik K, Dziura J, Edwards C, Gill T, D'Onofrio G. VOICES: A Digital Elder Mistreatment Intervention. Oral presentation at Yale Innovation Summit (2023).

Abujarad F, Edwards C, Choo E, Pantalon M, Jubanyik K, Dziura J, D’Onofrio G, Gill T. Feasibility of a Digital Elder Abuse Screening Intervention in the Emergency Department Setting; Oral presentation at American Public Health Association Annual Meeting (November 2022).

Abujarad F, Ellis P, Edwards C, Vander Wyk B, Kraemer K, Marottoli R. Feasibility of a Self-Administrated Digital Elder Abuse Intervention in the Primary Care Setting; Poster presentation at the AMIA 2022 Annual Symposium (November 2022).

Abujarad F, Edwards C, Vander Wyk B, Ellis P, Kraemer K, Marottoli R. Adaptation and evaluation of the digital elder abuse intervention “VOICES” in the primary care-based setting. Gerontechnology, 21(s),1-1, 2022. https://doi.org/10.4017/gt.2022.21.s.531.opp4

Abujarad F, Edwards C, Vander Wyk B, Mosqueda L, Hwang U, Neugroschl J, Marottoli R. Self-administrated Elder Abuse Intervention for Older Adults with Cognitive Impairment, Innovation in Aging, Volume 6, Issue Supplement_1, November 2022, Page 426, https://doi.org/10.1093/geroni/igac059.1673

Abujarad F, Choo E, Dziura J, Edwards C, Pantalon M, Jubanyik K, D’Onofrio G, Gill T. A Digital Elder Abuse Intervention for the Emergency Department, Innovation in Aging, Volume 6, Issue Supplement_1, November 2022, Page 425, https://doi.org/10.1093/geroni/igac059.1669

Abujarad F, Edwards C, Hwang U, Neugroschl J, Marottoli R. Feasibility of a Digital Elder Abuse Intervention for Older Adults with Cognitive Impairment; Poster Presentation at American Geriatrics Society Annual Meeting (April 2022)

Arowojolu O, Edwards C, Mosqueda M, Hwang U, Neugroschl J, Marottoli R, Abujarad F. Feasibility of VOICES Elder Abuse Digital-Screening Tool for Older Adults with Cognitive Impairment; Poster Presentation presented at USC Judith D. Tamkin International Symposium on Elder Abuse (March 2022)

Garcia M, Pena-Solorzano D, Edwards C, Abujarad F. The Process of Translating and Culturally Adapting a Digital Elder Abuse Intervention. International Journal of Translation and Interpretation Studies, 2(1), 07–26. 2022. https://doi.org/10.32996/ijtis.2022.2.1.2

Abujarad F, Choo E, Dziura J, Edwards C, Pantalon M, Jubanyik K, D’Onofrio G, Gill T. Patient-Centered Digital Screener for Elder Abuse in the Emergency Department; Paper Presentation at Gerontological Society of America (GSA) (November 2021)

Abujarad F, Choo E, Pantalon M, Jubanyik K, Dziura J, Edwards C, D’Onofrio G, Gill T. Feasibility of a Self-Administrated Elder Abuse Digital Screening Tool for Use in Emergency Department Settings; Podium Presentation at American Medical Informatics Association 2021 Annual Meeting (November 2021)

Abujarad F, Choo E, Edwards C, D’Onofrio G, Gill T. Increasing Identification of Elder Abuse Cases via Self-administered Digital Health Screening; Oral Abstract Presentation at American Public Health Association (APHA) 2021 Annual Meeting (October 2021)

Abujarad F, Edwards C, Choo E, Pantalon M, Jubanyik K, Dziura J, Gill T, Topaz M, D’Onofrio G. Promoting self-disclosure of elder abuse with a web-based screening, brief intervention and referral to treatment (SBIRT) approach in the emergency department; Symposia Presentation at American Psychological Association (October 2021)

Swierenga S, Ismirle J, Edwards C, Abujarad F. Usability of a Digital Elder Mistreatment Screening Tool for Older Adults with Visual and Hearing Disabilities; Paper presented at: HCII 2021 (Jul 2021). https://doi.org/10.1007/978-3-030-78224-5_24

Choo E, Edwards C, Abuwandi M, Carlson K, Bonito J, Jubanyik K, Gill T, Abujarad F. Perceptions of older adults and health professionals about digital screening tools for elder mistreatment in the emergency department. Gerontechnology. 2021 Jun;20(2):10.4017/gt.2021.20.2.33-476.11. 10.4017/gt.2021.20.2.33-476.11.

Abujarad F, Ulrich D, Edwards C, Choo E, Pantalon M, Jubanyik K, Dziura J, D'Onofrio G, Gill T.M: Development and usability evaluation of VOICES: A digital health tool to identify elder mistreatment. Journal American Geriatrics Soc (JAGS).(2021).1-10. https://doi.org/10.1111/jgs.17068

Abujarad F, Edwards C, Choo E, Pantalon M, Jubanyik K, Dziura J, D’Onofrio G, Gill T, Digital health screening tool for identification of elder mistreatment. Gerontechnology, 19(0), 1-1 https://doi.org/10.4017/gt.2020.19.s.70138

Abujarad F, Gill T, Pantalon M, Jubanyik K, Dziura J, D’Onofrio G, Choo E,. Perceived Value of Using a Digital Tool to Screen for Elder Mistreatment in the Emergency Department. Innovation in Aging. 2020;4(Supplement_1):195-195. https://doi.org/10.1093/geroni/igaa057.631

Abujarad F, Swierenga S, Edwards C. Building Digital Health Tools for Older Adults With Disabilities. Innovation in Aging. 2020;4(Supplement_1):861-861. https://doi.org/10.1093/geroni/igaa057.3177

Abujarad F, Choo E, Pantalon M, Jubanyik K, Dziura J, Edwards E, D’Onofrio G, Gill T. Digital Health Tool to Assist Older Adults in Self-Disclosing Elder Mistreatment. Innovation in Aging. 2020;4(Supplement_1):755-756. https://doi.org/10.1093/geroni/igaa057.2724

Jubanyik K, Choo E, Pantalon M, Dziura J, Edwards C, Gill T, D'Onofrio G, and Abujarad F, Emergency Department Tablet-Based Screening Tool for Elder Abuse. Annals of Emergency Medicine. 2020;76(4):S154.

Abujarad F, Pantalon M, Gill T, Jubanyik K, Dziura J, D'Onofrio G, and Choo E, Utilizing digital health technology to screen for and prevent elder mistreatment, Paper presented at: APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24-28)2020

Abujarad F, Ulrich D, Edwards C, Choo E, Pantalon M, Jubanyik K, Dziura J, Gill T, D'Onofrio G. Building and Testing a Digital Health Tool to Screen for Elder Mistreatment: Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES); Paper presented at: AMIA 2020 Annual Symposium (Nov 2020)

Funding

Title: "Piloting VOICES Elder Mistreatment Intervention Among PLWD in the Emergency Department”
Agency: National Institute on Aging (NIA)
Institute: IMPACT Collaboratory
I.D.#: 5U54AG063546-05
P.I.: Fuad Abujarad, Ph.D.
Total costs for project period: $293,105
Project period: 7/01/2023 – 06/30/2024

Title: "Feasibility Virtual cOaching in making Informed Choices on Elder Mistreatment Self-Disclosure (VOICES)”
Agency: National Institute of Health (NIH)
Institute: National Institute on Aging (NIA)
I.D.#: 1R01AG060084
P.I.: Fuad Abujarad, Ph.D.
Total costs for project period: $1,494,862
Project period: 09/01/2018 – 03/31/2023

Title: "The Feasibility of the VOICES Digital Health Tool for Elder Mistreatment Screening in the Primary Care Setting”
Agency: National Institute of Health (NIH)
Institute: Claude D. Pepper Older Americans Independence Center at Yale School of Medicine
I.D.#: P30AG021342
P.I.: Fuad Abujarad, Ph.D.
Total costs for project period: $40,000
Project period: 07/01/2021 – 06/30/2022

Title: “Feasibility of the VOICES Elder Mistreatment Digital-Screening Tool for Older Adults with Cognitive Impairment”
Agency: National Institute of Health (NIH)
Institute: National Institute on Aging (NIA)
I.D.#: 3R01AG060084-04S1
P.I.: Fuad Abujarad, Ph.D.
Total costs for project period: $418,679
Project period: 04/01/2021 – 03/31/2022

Title: "Feasibility of Elder Mistreatment Screening Tool, VOICES, for Older Adults with Disabilities”
Agency: National Institute of Health (NIH)
Institute: National Institute on Aging (NIA)
I.D.#: 3R01AG060084-02S1
P.I.: Fuad Abujarad, Ph.D.
Total costs for project period: $70,542
Project period: 09/01/2019 – 03/31/2021