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Implementation and maintenance of a community-based older adult physical activity program
- Authors:
- PETRESCU-PRAHOVA Miruna, et al
- Journal article citation:
- Gerontologist, 56(4), 2016, pp.677-686.
- Publisher:
- Oxford University Press
Purpose of the study: We examine facilitators and barriers to the implementation and maintenance of Enhance®Fitness (EF), a group exercise programme for older adults, at early-adopter YMCA-affiliated sites, and summarise strategies employed by EF instructors and staff to overcome challenges. Design and methods: This qualitative study used semi-structured phone interviews with 32 instructors, staff members, and master trainers from 24 different YMCA-affiliated sites. Interviews were digitally recorded, transcribed, and analysed with a focus on the implementation and maintenance components of the RE-AIM framework. Results: We identified a series of factors affecting the implementation and maintenance of EF at YMCA-affiliated sites, which can be categorised into programme-specific (such as instructor training, the structure of the programme, reporting requirements, and insurance coverage), and organisational (such as organisational support and infrastructure for programme delivery, champions, and funding to cover the costs of programme delivery). Strategies used to overcome challenges associated with these factors include identifying parts of the programme that can be adapted, hiring staff and instructors that understand and support the programme, and educating staff and instructors about the importance of evidence-based programmes and of data collection for programme evaluation. Implications: Assessing the readiness of organisations for programme delivery and the match between programme goals and the needs of organisations and participants would help facilitate the successful implementation and maintenance of physical activity programmes in community settings. (Edited publisher abstract)
Reconnections Social Impact Bond: reducing loneliness in Worcestershire. An in-depth review produced as part of the Commissioning Better Outcomes evaluation
- Authors:
- ECORYS UK, ATQ CONSULTANTS
- Publishers:
- Ecorys UK, ATQ Consultants
- Publication year:
- 2016
- Pagination:
- 14
- Place of publication:
- Birmingham
An in-depth review of the Reconnections Social Impact Bond (SIB), which aims to directly reduce loneliness and isolation for 3,000 people over the age of 50 in Worcestershire. The SIB facilitates access to services to reconnect these individuals with their communities. The project began in May 2015 and the first outcome payments were originally planned for March 2016 with the final outcome payment schedule in mid-2019. The improved health and wellbeing of beneficiaries is expected to deliver more than £3 million worth of savings to the public sector over 15 years. The maximum amount of outcome payments attached to the SIB is £2 million based around a key payment outcome of an improvement in levels of loneliness. Key lessons from the planning and implementation phases are outlined and include: consult with possible providers/ intermediaries early on; setting up a SIB is resource intensive; development costs can be high; invest in strong research early on to engage with the Commissioners; and SIBs are a positive way of testing interventions. (Edited publisher abstract)
A scoping review of treatments for older adults with substance use problems
- Authors:
- MOWBRAY Orion, QUINN Adam
- Journal article citation:
- Research on Social Work Practice, 26(1), 2016, pp.74-87.
- Publisher:
- Sage
Objectives: To identify effective treatment services for older, substance-using adults, an examination of the evidence associated with interventions for this group is presented. Methods: Using explicit, validated criteria to identify effective interventions, 22 publications were included in a review and were subject to a critical appraisal of study methodology. Results: The review identified four types of substance use treatment service settings for older adults, with mixed efficacy. These settings included (1) primary care settings or health clinics, (2) combined individual and group-based settings, (3) individual-based treatment settings, and (4) multiple treatment/multisite settings. Conclusion: Analyses of these publications revealed primary care settings or health clinic settings offered the most evidence of effective interventions, with noticeable gaps in research on interventions within other settings. Implications for social work practice and research are discussed. (Publisher abstract)
The effect of aquatic exercise on physical functioning in the older adult: a systematic review with meta-analysis
- Authors:
- WALLER Benjamin, et al
- Journal article citation:
- Age and Ageing, 45(5), 2016, pp.593-601.
- Publisher:
- Oxford University Press
Background: Ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults resulting in a decrease in physical functioning. Exercising in water (aquatic exercise, AE) has been shown to be effective at improving physical functioning in this population; however, no systematic review with meta-analysis has been published. Purpose: To investigate the effect of AE on physical functioning in healthy older adults compared to control or land-based exercise (LE) through a systematic review with meta-analysis of randomised controlled trials. Data sources: Medline, Embase, Cinahl, PEDro, SPORTDiscus, Web of Science, Cochrane Library, published before 31st December 2015. Study selection: In total, 28 studies met the inclusion criteria and were included in the systematic review; 24 studies with 1,456 subjects (89% female) and with mean age 66.4 years were included in the meta-analysis. Data extraction: Data were extracted and checked for accuracy by three independent reviewers. Data synthesis: Size of treatment effect was measured using the standardised mean difference with 95% confidence intervals (CIs). Results: Compared to control interventions, AE had a moderate positive effect on physical functioning 0.70 [95% CI 0.48 to 0.92]. Compared to LE, AE had a small positive effect on physical functioning 0.39 [0.12 to 0.66]. Limitations: There is a high risk of bias and low methodological quality in the studies particularly when comparing AE to LE with possible over estimation of the benefit of AE. Conclusions: AE may improve physical functioning in healthy older people and is at least as effective as LE. (Publisher abstract)
Helping 50+ jobseekers back to work: lessons for the Work and Health Programme
- Author:
- AGE UK
- Publisher:
- Age UK
- Publication year:
- 2016
- Pagination:
- 27
- Place of publication:
- London
Policy report which examines why the Government's 'Work Programme' for the long term unemployed and people with a disability has failed the over 50s. It builds on a previous 2013 Age UK report and research conducted by the Centre for Economic and Social Inclusion to examines the performance of the Government's Work Programme for the long-term unemployed among its participants aged 50 and over. The report looks at why older participants get worse outcomes and what should be done to address the problem; the impact of disability and health on the employment of older people; and regional variations in performance – by geographical area and among providers. It concludes by making recommendations for the Work and Health Programme in order to improve job outcomes for people aged 50 and over. These include early referral to the scheme for jobseekers within ten years of their State Pension age; specialist initiatives for the over 50s; improved opportunities to re- and up-skill; and for the DWP to build a job brokerage service into its employment support delivery. (Edited publisher abstract)
Mobilizing resources for well-being: implications for developing interventions in the retirement transition
- Authors:
- HEAVEN Ben, et al
- Journal article citation:
- Gerontologist, 56(4), 2016, pp.615-629.
- Publisher:
- Oxford University Press
Purpose of the study: Good health and wellbeing in later life are central issues for public health. Retirement presents an opportunity to intervene to improve health and wellbeing, as individuals may adjust associated lifestyle behaviours. However, there is little evidence about how wellbeing is experienced in the context of increasingly diverse retirement transitions. Our objectives were to explore (a) views on health and wellbeing through retirement transitions and (b) acceptability of intervening in this period. Design and methods: Qualitative study involving 48 workers/retirees, aged 53–77 years of diverse socioeconomic status, were recruited from urban and rural areas in North East England. Data were collected iteratively through focus groups (n = 6), individual interviews (n = 13), interviews with couples (n = 4), using the constant comparative method. Analysis was informed by theories of the Third Age and Sen’s capabilities approach. Results: Diverse retirement transitions were shaped by unanticipated events. Central to wellbeing was the “capability” to utilise resources to achieve desirable outcomes. Participants rejected a “later life” identity, associating it with decline, and an uncertain future. Implications: Lifestyle interventions that address challenges within the retirement transition may be acceptable. Inducements to change behaviour based on possible long-term outcomes may be less appealing. Providing assistance to use resources to address personal goals may be central to effective interventions. (Edited publisher abstract)
Cognitive behavioural therapy-based intervention to reduce fear of falling in older people: therapy development and randomised controlled trial the Strategies for Increasing Independence, Confidence and Energy (STRIDE) study
- Authors:
- PARRY S.W., et al
- Journal article citation:
- Health Technology Assessment, 20(56), 2016, Online only
- Publisher:
- National Institute for Health Research
- Place of publication:
- London
Background: ‘Fear of falling’ refers to some of the psychological and social difficulties faced by older people with falls. The problem is common, affecting up to 85% of older people who fall. There is little good evidence to guide us on how to treat fear of falling, but some research suggests that talking treatments used for depression and anxiety, in particular cognitive–behavioural therapy (CBT), may be helpful. Objectives: The authors developed a new CBT intervention (CBTi) to try and help older people with this problem, and then compared the new intervention with care as usual in patients with fear of falling. To try and make this more affordable for the UK NHS, health-care assistants were trained to deliver the intervention. The study then examined whether or not the new intervention could improve falls, injuries, quality of life, depression, loneliness and physical abilities. The study also looked at how acceptable this intervention was to those having the treatment and to those delivering it, and whether or not it provided value for money. Results: Fear of falling reduced significantly for those having CBTi, as did depression scores. There was no change in any of the other things that were measured. Conclusion: Although the new intervention was acceptable to older people, there was no evidence that the new intervention was cost-effective. The new intervention reduces fear of falling in older people and may help improve depression but not other measures. Future research should focus on whether or not such an intervention, delivered with physical training, helps improve fear of falling further. (Edited publisher abstract)
Testing promising approaches to reducing loneliness: results and learnings of Age UK's loneliness Pilot
- Author:
- AGE UK
- Publisher:
- Age UK
- Publication year:
- 2016
- Pagination:
- 36
- Place of publication:
- London
This report shares the results of Age UK’s loneliness pilot programme, which aimed to find out Age UK services could better reach older people experiencing loneliness, develop individually tailored solutions and help older people access activities and services within their community. Chapter one outlines origins of the programme, which involved eight local Age UKs in a 12 month pilot. Local services developed three common approaches: recruiting ‘eyes on the ground’ to identify older people experiencing, or at risk of, loneliness; developing co-operative networks with other agencies; and use of traditional befriending services. Chapter two highlights examples of services that local Age UKs are delivering and how the adoption of certain approaches improved their impact on lonely older people. Chapter three look at some of the impacts of the programme. It found that a large number of the older people supported during the programme experienced a reduction in their loneliness scores. This was especially true amongst older people who were often lonely. Some older people also identified feelings of increased independence, wellbeing and connectedness with people. Chapter four outlines the next steps for the Age UK programme. (Edited publisher abstract)
Effects of self-management support programmes on activities of daily living of older adults: a systematic review
- Authors:
- BOLSCHER-NIEHUIS Marian J.T. ven het, et al
- Journal article citation:
- International Journal of Nursing Studies, 61, 2016, pp.230-247.
- Publisher:
- Elsevier
Background: The ability of older adults to carry out activities of daily living and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older adults to prevent activities of daily living dependence and increase the ability to adapt and to self-manage the consequences of living with a chronic condition. Objective: This systematic literature review aimed to gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home. Data sources: Searches were performed in PubMed, CINAHL, PsychInfo, EMBASE and the Cochrane Central Register of Controlled Trials (in February 2016). No limitations were applied regarding date of publication, language or country. Review methods: Publications were eligible for this review on condition that they described a self-management support programme directed at adults of on average 65 years or older, and living in the community; used a randomized control group design; and presented information about the effects on activities of daily living. The methodological quality of the included studies was independently assessed by the authors using the quality criteria for reviews of the Cochrane Effective Practice and Organisation of Care Review Group. A best evidence synthesis was performed using guidelines provided by the Cochrane Collaboration Back Review Group. Results: A total of 6246 potentially relevant references were found. After screening the references, 12 studies with a randomised controlled trial design were included. The methodological assessment of the 12 studies indicated variations in the risk of bias from low (n = 1) to unclear (n = 3) and high (n = 8). Although there was considerable variation in study population, intervention characteristics and measurement instruments used, most studies (n = 11) showed effects of self-management support programmes on the activities of daily living of older adults. Conclusions: There is a moderate level of evidence that self-management support programmes with a multi-component structure, containing disease-specific information, education of knowledge and skills and, in particular, individually tailored coaching, improve the activities of daily living of older adults. Further research is required to gain insight into the most appropriate context and approach of self-management support interventions targeting activities of daily living of older adults living in the community. (Edited publisher abstract)
Understanding and alleviating loneliness in later life: perspectives of older people
- Authors:
- SULLIVAN Mary Pat, VICTOR Christina Rita, THOMAS Michael E.
- Journal article citation:
- Quality in Ageing and Older Adults, 17(3), 2016, pp.168-178.
- Publisher:
- Emerald
Purpose: There is extensive empirical literature that has sought to establish the prevalence of, and risk factors for, loneliness and social isolation in later life. Traditional empirical gerontological approaches have characterised loneliness as a linear experience that is both pathological and easily relieved with external intervention. The purpose of this paper is to explore the potential of qualitative interview data to reveal the possible complexities in understanding loneliness, including conceptual considerations for the dynamic and multi-dimensional aspects of loneliness. Design/methodology/approach: The authors draw on two different studies where the purpose was to qualitatively examine the meaning of loneliness in the lives of older people and how they understood loneliness in the context of their daily life (n=37). Findings: Interviews with “lonely” older people revealed that loneliness is a complex and dynamic experience. The authors also identified a range of internal and external factors that contribute to vulnerability for loneliness as well as resources to alleviate it. Originality/value: The dynamic and multi-dimensional characteristics of loneliness in older people may help explain why community-based interventions to diminish it may be so challenging. (Publisher abstract)