Effect of a 12-week community-based intervention to improve social capital, quality of life, self-care, and health literacy among older people: A quasi-experimental trial

Taherian, Ziba; Motamedi, Narges

Effect of a 12-week community-based intervention to improve social capital, quality of life, self-care, and health literacy among older people: A quasi-experimental trial

Document Type : Original Article

Authors

Ziba Taherian ¹
Narges Motamedi ²

¹ Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences; Social Determinants of Health Research Center, Isfahan University of Medical Science, Isfahan

Abstract

Introduction: The aim of this study was to assess the effect of a community-based intervention on social capital, quality of life, self-care, and health literacy among elderly. Materials and Methods: This quasi-experimental trial was conducted at two health-care centers in Isfahan, Iran, which assigned to the intervention and control groups. A total of 86 elderly (60 years or above) enrolled in the study. The intervention program consisted of 12 weekly group sessions with various health topics. Nine sessions held in the health-care center and three local tours in different locations of the neighborhood. The control group received routine care of health centers. Social capital, quality of life, self-care, and health literacy were assessed at baseline and 1 month after the intervention in two groups. Results: Mental component of quality of life (P = 0.026), self-care, and health literacy (P < 0.001) showed a significant increase in the intervention group compared to the control group at 1 month after the intervention. The total score of social capital and the dimensions of local community participation, social agency, feelings of security and trust, interactions with neighbors, and interactions with family and friends improved in the intervention group (P < 0.001). However, there was no significant difference in the dimensions of tolerance of diversity (P = 0.241) and value of life (P = 0.928). Conclusions: This community-based interventions with a variety of diverse and participatory components can be used as a strategy to promote the health of the elderly in primary health care.

Keywords

References

1.	World Health Organization. Integrated care for older people: Guidelines on community-level interventions to manage declines in intrinsic capacity. Geneva: World Health Organization; 2017.
2.	Mehri N, Messkoub M, Kunkel S. Trends, determinants and the implications of population aging in Iran. Ageing Int 2020;45:327-43.
3.	Huppert FA. Psychological well-being: Evidence regarding its causes and consequences. Applied psychology: health and well being 2009;1:137-64.
4.	James Rippe, editor. Lifestyle Medicine. Boca Raton: Taylor & Francis; 2019.
5.	Ten Bruggencate T, Luijkx KG, Sturm JJ. Social needs of older people: A systematic literature review. Ageing and Society 2018;38:1745-70.
6.	Geboers B, Reijneveld SA, Jansen CJ, de Winter AF. Health literacy is associated with health behaviors and social factors among older adults: Results from the LifeLines Cohort Study. J Health Commun 2016;21:45-53.
7.	Solar O, Irwin A. A conceptual framework for action on the social determinants of health. Geneva, Switzerland:WHO Document Production Services; 2010.
8.	Nyqvist F, Forsman AK. Social capital as a health resource in later life: The relevance of context. Netherlands:Springer; 2015.
9.	Coll-Planas L, Nyqvist F, Puig T, Urrútia G, Solà I, Monteserín R. Social capital interventions targeting older people and their impact on health: A systematic review. J Epidemiol Community Health 2017;71:663-72.
10.	World Health Organization. Self-care in the context of primary health care. Bangkok, Thailand: WHO Regional Office for South-East Asia; 2009.
11.	Coll-Planas L, Blancafort S, Rojano X, Roqué M, Monteserín R. Promoting self-management, health literacy and social capital to reduce health inequalities in older adults living in urban disadvantaged areas: Protocol of the randomised controlled trial AEQUALIS. BMC Public Health 2018;18:345.
12.	Manafo E, Wong S. Health literacy programs for older adults: A systematic literature review. Health Educ Res 2012;27:947-60.
13.	Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: An updated systematic review. Ann Intern Med 2011;155:97-107.
14.	Findley A. Low health literacy and older adults: Meanings, problems, and recommendations for social work. Soc Work Health Care 2015;54:65-81.
15.	de Wit L, Fenenga C, Giammarchi C, di Furia L, Hutter I, de Winter A, et al. Community-based initiatives improving critical health literacy: A systematic review and meta-synthesis of qualitative evidence. BMC Public Health 2017;18:40.
16.	Lin SC, Chen IJ, Yu WR, Lee SD, Tsai TI. Effect of a community-based participatory health literacy program on health behaviors and health empowerment among community-dwelling older adults: A quasi-experimental study. Geriatr Nurs 2019;40:494-501.
17.	O'Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner KM, et al. Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open 2019;9:e029954.
18.	Detels R GM, Abdool Karim Q, Chuan Tan C. Introduction to development and evaluation of complex multicomponent interventions. Oxford Textbook of Global Public Health. 6^th ed. UK:Oxford University Press; 2015. p. 751-60.
19.	Campbell NC, Murray E, Darbyshire J, Emery J, Farmer A, Griffiths F, et al. Designing and evaluating complex interventions to improve health care. BMJ 2007;334:455-9.
20.	Wong KC, Wong FKY, Yeung WF, Chang K. The effect of complex interventions on supporting self-care among community-dwelling older adults: A systematic review and meta-analysis. Age Ageing 2018;47:185-93.
21.	Srivarathan A, Jensen AN, Kristiansen M. Community-based interventions to enhance healthy aging in disadvantaged areas: Perceptions of older adults and health care professionals. BMC Health Serv Res 2019;19:7.
22.	Berenguera A, Pons-Vigués M, Moreno-Peral P, March S, Ripoll J, Rubio-Valera M, et al. Beyond the consultation room: Proposals to approach health promotion in primary care according to health-care users, key community informants and primary care centre workers. Health Expect 2017;20:896-910.
23.	Johnstone G, Dickins M, Lowthian J, Renehan E, Enticott J, Mortimer D, et al. Interventions to improve the health and wellbeing of older people living alone: A mixed-methods systematic review of effectiveness and accessibility. Ageing & Society 2019; 41.7:1-50.
24.	Salimi F, Garmaroudi G, Hosseini SM, Batebi AJ. Effect of self–care educational program to improving quality of life among elderly referred to health centers in Zanjan J Educ Community Health 2015;2:28-37.
25.	Montazeri A, Vahdaninia M, Mousavi SJ, Omidvari S. The Iranian version of 12-item Short Form Health Survey (SF-12): Factor structure, internal consistency and construct validity. BMC Public Health 2009;9:341.
26.	Onyx J, Bullen PJ. Measuring social capital in five communities.The journal of applied behavioral science 2000;36:23-42.
27.	Eftekharin R, Kaldi A, Sam S, Sahaf R, Vatan RF. Validity and reliability of Persian version of Onyx Social Capital Scale in elderly people. Iran J ageing 2016;11:174-89.
28.	Montazeri A, Tavousi M, Rakhshani F, Azin SA, Jahangiri K, Ebadi M, et al. Health Literacy for Iranian Adults (HELIA): Development and psychometric properties. Payesh 2014;13:589-99.
29.	Pak MH, Hashemlo LJ. Design and psychometric properties of a selfcare questionnaire for the elderly. Salmand: Iranian Journal of Ageing 2015;10:120-31.
30.	Ievdokymov V, Lehenchuk S, Zakharov D, Andrusiv U, Usatenko O, Kovalenko L. Social capital measurement based on “The value explorer” method. Manag Sci Lett 2020;10:1161-8.
31.	Bullen P, Onyx J. Social capital: The measurement tool. PO Box 181, Coogee, NSW, 2034: Citeseer; 2007.
32.	Seah B, Kowitlawakul Y, Jiang Y, Ang E, Chokkanathan S, Wang W. A review on healthy ageing interventions addressing physical, mental and social health of independent community-dwelling older adults. Geriatr Nurs 2019;40:37-50.
33.	Dickens AP, Richards SH, Greaves CJ, Campbell JL. Interventions targeting social isolation in older people: A systematic review. BMC Public Health 2011;11:647.
34.	Markle-Reid M, Ploeg J, Fraser KD, Fisher KA, Bartholomew A, Griffith LE, et al. Community program improves quality of life and self-management in older adults with diabetes mellitus and comorbidity. J Am Geriatr Soc 2018;66:263-73.
35.	World Health Organization. Global strategy and action plan on ageing and health. Geneva: World Health Organization; 2017.
36.	Blancafort Alias S, Monteserín Nadal R, Moral I, Roqué Fígols M, Rojano I Luque X, Coll-Planas L. Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: Results of the randomized trial AEQUALIS. BMC Public Health 2021;21:84.
37.	Meek KP, Bergeron CD, Towne SD, Ahn S, Ory MG, Smith ML. Restricted social engagement among adults living with chronic conditions. Int J Environ Res Public Health 2018;15:158.
38.	Uemura K, Yamada M, Okamoto H. The effectiveness of an active learning program in promoting a healthy lifestyle among older adults with low health literacy: A randomized controlled trial. Gerontology 2021;67:25-35.
39.	Wong AK, Wong FK, Chang K. Effectiveness of a community-based self-care promoting program for community-dwelling older adults: A randomized controlled trial. Age Ageing 2019;48:852-8.

Advanced Biomedical Research