PROJECT SUMMARY/ABSTRACT The purpose of this application is to provide research and training for the applicant’s long-term goals of addressing incarceration as a social determinant of health (SDOH), and improve the model of care in justice settings for incarcerated older adults and lay the foundations for a career in research. The population of incarcerated older adults is rapidly growing.1–4 The number of incarcerated adults aged 55 and older increased by 400% between 1993 and 2013.3 By 2030 older adults are anticipated to constitute two thirds of the incarcerated population.5 Incarceration is associated with a myriad of physical and mental health risks (e.g. HIV, diabetes, hypertension, depression, chronic stress1,6–10).1,7,11–15 Incarceration is also associated with accelerated aging,16–18 which leads to generally accepting incarcerated adults as geriatric at 50, compared to 65 in the community.2 Incarceration has also been recognized as an SDOH19,20, which is aligned with The National Institute of Nursing Research (NINR) priority research lenses in the 2020-2026 Strategic Plan.21 Correctional health, as a model of care, has unique features which challenge appropriately responding to age related changes in incarcerated older adults, specifically related to functional or behavioral changes.9,22–27 Correctional officers (COs) are integral in the daily operations of prisons and have the most contact with incarcerated people. Beyond maintaining the security of prisons, COs are also liaisons between incarcerated people and correctional nurses, often playing a major role in alerting correctional nurses to changes in a person’s condition, including functional and behavioral changes.28–33 The proposed study would use Grounded Theory, a theory-generating methodology34–37, to explore how COs perceive and respond to age related changes in incarcerated older adults, including when, how and with what consequences COs collaborate with correctional nurses. Currently, no conceptual model describes the care of incarcerated older adults or the role that COs play in their care. Grounded Theory is well-suited to explore this under-studied topic area because conceptual models can be used to inform policy, practice, future research interventions to improve outcomes for this growing vulnerable population.34,36 The training grant will support coursework, directed study, mentorship, and resources to accomplish the short-term goal exploring how COs perceive and respond to age related changes in incarcerated older adults, including when, how and with what consequences COs collaborate with correctional nurses. Supported by content and methodological experts, the applicant’s proposed training plan includes targeted training goals to expand skills in Grounded Theory application, and knowledge of incarceration as an SDOH, aging and the care of incarcerated older adults, collaboration between justice settings and academia, and networking, grant-writing, and dissemination. Informed by the NINR Strategic Plan, the proposed training and research approaches incarceration as an SDOH, as a mechanism to improve the model of care in justice settings and the care of incarcerated older adults.

PROJECT NARRATIVE Because Correctional Officers (COs) have the most contact with incarcerated older adults, it is essential to understand how they perceive and respond to age related changes in incarcerated older adults, especially behavioral changes or changes in functional ability. The proposed Grounded Theory study would generate a conceptual model or beginning local theory describing the care of incarcerated older adults, including how COs perceive and respond to age related changes in incarcerated older adults, and when, how and with what consequences COs collaborate with correctional nurses. The resulting conceptual model or beginning local theory would describe the model of care in justice settings, allowing future research to identify possible targets for future development and testing of interventions that appropriately address the unique needs of incarcerated older adults.