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The DASH Pilot Project: developing community-based nutrition education for older adults
- Authors:
- IVERY Jan M., et al
- Journal article citation:
- Journal of Gerontological Social Work, 60(4), 2017, pp.286-299.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Nutrition-related chronic health conditions among older adults are a growing concern. In this study, nutrition education materials were created for use in senior centres by graduate nutrition students. After the materials were presented, focus groups were conducted with participants (n = 62) to obtain feedback on the content and presentation. Findings related to the participant’s knowledge of nutrition-related information, strategies to improve future class sessions, and participant recruitment will be discussed. These findings will be useful to program administrators as they develop nutrition programs for older adults who are vulnerable to nutrition-related health problems. (Edited publisher abstract)
Health promotion for mild frailty based on behaviour change: perceptions of older people and service providers
- Authors:
- AVGERINOU Christina, et al
- Journal article citation:
- Health and Social Care in the Community, 27(5), 2019, pp.1333-1343.
- Publisher:
- Wiley
Mild frailty is common among older people, but it is potentially reversible with health promotion interventions. Behaviour change may be a key to preventing progression of frailty; however, we know little about what interventions work best and how a behaviour change approach would be perceived by this group. The aim of this study was to explore how mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach. The study conducted semi‐structured interviews with 16 older people with mild frailty who received a pilot home‐based behaviour change health promotion service, including a dyad of older person/family carer, and two service providers delivering the service in two diverse areas of South England. Interviews were audio‐recorded, transcribed and thematically analysed. The concept of goal setting was acceptable to most participants, though the process of goal setting needed time and consideration. Goals on maintaining independence, monitoring of progress and receiving feedback were reported to increase motivation. Physical/mental capability and knowledge/perception of own needs were main determinants of the type of goals chosen by participants as well as the approach used by the project workers. Older people with complex needs benefited from care coordination, with a combination of goal setting and elements of social, practical and emotional support in varying proportions. Mildly frail older people responded well to a behaviour change approach to promote health and well‐being. Further consideration is needed of the most effective strategies based on complexity of needs, and how to overcome barriers among people with cognitive impairment. (Edited publisher abstract)
Occupation-focused health promotion for well older people: a cost-effectiveness analysis
- Authors:
- ZINGMARK Magnus, et al
- Journal article citation:
- British Journal of Occupational Therapy, 79(3), 2016, pp.153-162.
- Publisher:
- Sage
Introduction: The aim of this study was to evaluate three occupational therapy interventions, focused on supporting continued engagement in occupation among older people, to determine which intervention was most cost effective, evaluated as the incremental cost/quality adjusted life year gained. Method: The study was based on an exploratory randomised controlled trial. Participants were 77–82 years, single living and without home help. One hundred and seventy seven persons were randomised to an individual intervention, an activity group, a discussion group or a no intervention control group. All interventions focused on supporting the participants to maintain or improve occupational engagement. Outcomes were evaluated at baseline, three and 12 months and included general health and costs (intervention, municipality and health care). Based on linear regression models, we evaluated how outcomes had changed at each follow-up for each intervention group in relation to the control group. Results: Both group interventions resulted in quality adjusted life years gained at three months. A sustained effect on quality adjusted life years gained and lower total costs indicated that the discussion group was the most cost-effective intervention. Conclusion: Short-term, occupation-focused occupational therapy intervention delivered in group formats for well older people resulted in quality-adjusted life years gained. A one-session discussion group was most cost effective. (Publisher abstract)
Interactive video gaming compared with health education in older adults with mild cognitive impairment: a feasibility study
- Authors:
- HUGHES Tiffany F., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(9), 2014, pp.890-898.
- Publisher:
- Wiley
Objective: This study evaluates the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment. Methods: Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, the effect of the intervention on neuropsychological performance and other secondary outcomes was also explored. Results: All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were 'very much' satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. Medium effect sizes for cognitive and physical functioning in favour of the interactive video gaming condition were observed, but these effects were not statistically significant in this small sample. Conclusion: Interactive video gaming is feasible for older adults with mild cognitive impairment, and medium effect sizes in favour of the Wii group warrant a larger efficacy trial. (Edited publisher abstract)
Harvest health: translation of the chronic disease self-management program for older African Americans in a senior setting
- Authors:
- GITLIN Laura N., et al
- Journal article citation:
- Gerontologist, 48(5), October 2008, pp.698-705.
- Publisher:
- Oxford University Press
The translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior centre and evaluate pre–post benefits for African American participants is described. Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. Participants were recruited from senior centre members, area churches, and word of mouth. Baseline and 4-month post-interviews were conducted. A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed 4 sessions and 414 (79%) completed pre–post interviews. We found small but statistically significant improvements for exercise, use of cognitive management strategies, energy/fatigue, self-efficacy, health distress, and illness intrusiveness in different life domains. No changes were found for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site. The CDSMP can be translated for delivery by trained senior centre personnel to African American elders. Participant benefits compare favourably to original trial outcomes. The translated program is replicable and may help to address health disparities.
Occupational therapy led health promotion for older people: feasibility of the lifestyle matters programme
- Authors:
- MOUNTAIN Gail, et al
- Journal article citation:
- British Journal of Occupational Therapy, 71(10), October 2008, pp.406-413.
- Publisher:
- Sage
The aim of this feasibility study was to see if an occupation-based health-promoting intervention for community-living older people could be delivered successfully and also to provide some information to guide a future trial of clinical effectiveness. The participants' ages ranged from 60 to 92 years from a city in the North of England. Twenty-eight participants commenced the 8-month programme and 26 completed it; they have continued to meet independently following facilitator withdrawal. The participants were interviewed qualitatively before and after the 8-month programme. Additionally, pre-programme and post-programme measurements of cognition, depression, functional dependency and quality of life were conducted with each participant before and after the intervention. The post-intervention interviews illustrated the individualised benefits experienced by the participants, with greater self-efficacy being a significant theme. A comparison of the pre-intervention and post-intervention scores on the quantitative measures showed an upward trend on all dimensions of quality of life. The measurement of cognition, depression and dependency proved useful for screening purposes and for identifying individuals at risk, but not as an outcome measure. The delivery of the programme was feasible and its benefit to participants was observed, but there is a need for further research to test the intervention rigorously and to explore applicability in a range of settings.
The ‘Healthy Passport’ intervention with older people in an English urban environment: effects of incentives and peer-group organisers in promoting healthy living
- Author:
- HOLLAND Carol A.
- Journal article citation:
- Ageing and Society, 28(4), May 2008, pp.525-549.
- Publisher:
- Cambridge University Press
This paper reports the evaluation of the effectiveness of incentives (viz. points and prizes) and of peer-group organisers (‘older people's champions') in the outcomes of a health-improvement programme for people aged 50+ years in a multi-ethnic district of the West Midlands, England. Health promotion activities were provided, and adherence, outcome variables and barriers to adherence were assessed over six months, using a ‘passport’ format. Those aged in the fifties and of Asian origin were under represented, but people of Afro-Caribbean origin were well represented and proportionately most likely to stay in the project. Those of greater age and with more illness were most likely to drop out. There were significant improvements in exercise, diet and the uptake of influenza vaccines and eyesight tests, but slighter improvements in wellbeing. Positive outcomes related to the incentives and to liking the format. The number of reported barriers was associated with lower involvement and lack of change, as was finding activities too difficult, the level of understanding, and transport and mobility problems, but when these were controlled, age did not predict involvement. Enjoying the scheme was related to positive changes, and this was associated with support from the older people's champions.
Advice by mail is as effective as targeted interventions at preventing fall-related injuries in older people
- Author:
- NATIONAL INSTITUTE FOR HEALTH RESEARCH
- Publisher:
- National Institute for Health Research
- Publication year:
- 2021
- Place of publication:
- London
This alert summarises the findings of study that found a booklet containing advice on falls prevention reduced fractures as effectively as more intensive interventions. In a large study, the booklet was sent to older people by post. This advice alone prevented as many fractures as an exercise programme, or as multiple assessments by a range of professionals. The Prevention of Fall Injury Trial (Pre-FIT) included more than 9,000 people over 70 years old living in the community. Over a period of 18 months, the study found that the three approaches (advice alone, exercises, multiple assessments) were similarly effective in reducing fractures. The exercise programme was linked with small gains in health-related quality of life, which made it the most cost-effective approach. An economic analysis of the programme looked at the NHS costs for a year of good health (cost/QALY) with each of the three approaches. The falls prevention programme (£3,941) was slightly less cost-effective than the other two approaches. Exercise was most likely to improve quality of life and was therefore slightly more cost-effective (£3,720) than advice alone (£3,737). This NIHR Alert is based on: Lamb S, and others. Screening and Intervention to Prevent Falls and Fractures in Older People. The New England Journal of Medicine 2020;383:19 (Edited publisher abstract)
Qualitative evaluation of a community‐based intervention to reduce social isolation among older people in disadvantaged urban areas of Barcelona
- Authors:
- LAPENA Carolina, et al
- Journal article citation:
- Health and Social Care in the Community, 28(5), 2020, pp.1488-1503.
- Publisher:
- Wiley
This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community‐based intervention to reduce social isolation among older adults. The ‘School of Health for Older People’ is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi‐structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community‐dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in‐depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community. (Publisher abstract)
Never too late: prevention in an ageing world
- Author:
- INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2020
- Pagination:
- 51
- Place of publication:
- London
This report explores how health care systems can better prevent ill health across people's lives, focusing on people interventions among those aged 50 and over. It presents analysis focussing on a small number of diseases where preventative interventions by healthcare systems could make a real difference to people’s health and wellbeing. These are cardiovascular, lung cancer, type 2 diabetes and HIV. It also considers the case of flu. It presents a snapshot of the potential burden and cost of these diseases, such as costs due to sick days, presenteeism and early retirement. It also provides brief overviews of preventative interventions, which have the potential to help people live healthier for longer. The analysis presented in the report shows that failure to invest in prevention will bring substantial social, health and economic costs. It argues that in order to follow through on commitments to prevention, governments need to improve access to preventative interventions to tackle growing health inequalities; encourage populations, professionals and policymakers to promote good health and prevent illness; and effectively utilise technology to deliver preventative interventions. (Edited publisher abstract)