The Gerontologist · 2026
Using a standardized tool (ISO-Matrix) to assess differences in the Adult Protective Services process by client race/ethnicity and English language acquisition.
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Mutchie Heather Lee, Zhang Yueyun, Hass Zachary, Liu Pi-Ju Marian
Аннотация
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.
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.