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Using a standardized tool (ISO-Matrix) to assess differences in the Adult Protective Services process by client
Heather Lee Mutchie1, Yueyun Zhang2, Zachary Hass3
1School of Nursing, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States.
Background And Objectives:
This study examined racial/ethnic and language-based differences in the Adult Protective Services (APS) process using the standardized Identification, Services, and Outcomes (ISO) Matrix tool to measure maltreatment identification during investigation, services, and outcomes post-intervention.
Research Design And Methods:
Data from two California county APS programs for adults aged 65 and older (n = 1,330) were analyzed. Measures included maltreatment allegations (self-neglect, neglect by others, financial abuse, emotional abuse, physical abuse), pre-test ISO Matrix scores, substantiation decisions, service types, and change in ISO Matrix scores from pre-test to case closure. Logistic regression models produced odds ratios (OR) by language (reference: English) and race/ethnicity (reference: White), adjusted for multiple comparisons.
Results:
After adjustments, only financial abuse allegations were significantly higher among Black/African American clients than White clients. Emotional abuse pre-test scores were lower for Asian (OR: 0.45), Hispanic (OR: 0.39), and higher for non-English-speaking (OR: 2.18) clients, while self-neglect scores were lower among non-English speakers (OR: 0.57). There were no differences in substantiation decisions, service types, or ISO Matrix change scores across language or racial/ethnic groups. Change scores were influenced by client engagement and initial severity.
Discussion And Implications:
This study, one of the first to use a standardized tool to assess APS disparities, found equitable substantiation and service provision across race and language groups. Financial abuse allegations were more frequently reported among Black/African American clients, consistent with previous research. Emotional abuse varied by race and language, suggesting avenues for future research on cultural factors in abuse perception.
