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Healthy ageing in elderly with a low socio economic position: effectiveness of an integral approach

Projectomschrijving

Vraagstuk

De dubbele vergrijzing heeft gevolgen voor ouderen, hun omgeving en de maatschappij. Zo stijgt het aantal chronische zieken en zijn ouderen vaker eenzaam en afhankelijk van (mantel)zorg. Het is daarom belangrijk om gezond ouder worden te stimuleren, vooral onder lager opgeleiden die de meeste problematiek kennen. Dit project onderzoekt hoe we ouderen hierbij kunnen ondersteunen. De focus ligt op het lichamelijk en sociaal actief blijven waarin de effectief bewezen Actief Plus beweeginterventie onderdeel is.

Onderzoek

Met 4 werkpakketten (WPs) zetten we in op een integrale wijkgerichte aanpak. WP1 betreft een community analyse naar behoeften van ouderen om gezond ouder te worden en hoe professionals in zorg en welzijn dit kunnen ondersteunen. Na interventieontwikkeling en een pilot onder ouderen en professionals in WP2 bestaat WP3 uit een wijkgericht gerandomiseerd experiment. WP4 betreft onderzoek naar bevorderende en belemmerende factoren voor de implementatie van de geëvalueerde aanpak.

Verwachte uitkomst

Ontwikkeling en implementatie van een integrale aanpak in co-creatie met ouderen met een lage sociaal economische status en stakeholders. 

Verslagen


Samenvatting van de aanvraag

The rapid double ageing of our society needs serious attention as it negatively impacts individual older adults (65+), their (informal) caregivers and the society. Major negative consequences are the rising prevalence of chronic disease and older adults’ dependency of care, the strong decline in physical activity (PA) and social connectedness and the related increase of loneliness. Although these problems affect all older adults, those in low socio economic positions (LSP) are most vulnerable. The WHO subscribes this problematic situation and declared healthy ageing as a major focus point to prevent and decrease the ageing related problems and to focus on the strengths and possibilities of older adults. Healthy ageing is multidimensional. It is influenced by 1) socio-economic, cultural and environmental conditions in which individuals, networks and organizations are situated; 2) social and community factors; and 3) the personal behavior of individuals. Many Dutch municipalities struggle to meet the needs of the ageing population. Indicated by the literature and the needs of these Dutch municipalities an integral approach seems essential and promising to adequately influence this broad range of factors. The project aims to stimulate active healthy ageing in older adults with a focus on those in LSP. In an integral approach, -performed in municipalities-, the project will intervene on individual, community, policy and environmental levels to influence factors that relate to healthy ageing. From a broad Positive Health perspective we will use an integral approach in which we increase PA, strengthen social cohesion and the social network, and facilitate the creation of a physical and social environment that supports active living. The professional and voluntary networks that could be meaningful for the older adults will be supported in creating a collaborative response in activating and coaching elderly. Insights of our ZonMw funded research on using a collaborative response strategy in an integral primary health care approach will be expanded by adding co-creation with older adults and ensuring input from stakeholders to facilitate healthy ageing of older adults in their everyday surrounding and public places. Our integral approach has 3 focus points to address the needs of older adults: 1) target the multiple ageing related risk factors; 2) facilitate that processes, structures and systems in the community care for older adults are coordinated, attuned and clear for professionals and older adults; 3) help stakeholders in reaching integral thinking (i.e. holistic, coaching and population health oriented). Although the content of the integral approach will be established in the project in co-creation with older adults and stakeholders, it will definitely include the Active Plus (AP) physical activity (PA) intervention as PA and social connectedness are important in healthy ageing. AP is (cost)effective for older adults in general but also for single older adults, those with mobility limitations, with chronic disease and with low education levels (registered in RIVM CGL database). As it also emphasizes being physically active together, it resulted in less loneliness. Our previous projects showed its feasibility and low costs for municipalities. We also illustrated its suitability to mix it with social activities for older adults. AP will be combined with easy accessible local PA, social, wellfare and care related activities using inter-sectoral collaboration to strengthen social participation and cohesion. We will use 4 Work Packages (WPs): WP1: community analysis on healthy ageing in older adults, co-creation of a tailored healthy ageing approach (Elderly Active & Connected (EAC)) and its implementation strategy. WP2: pilot test the EAC in older adults and in the community stakeholders, prepare the Randomized Controlled Trial (RCT) of WP3. WP3: implementation of EAC; process and effect evaluation of it in a mixed method RCT with 10-15 disadvantaged neighborhoods (of 5 municipalities). Older adults (N=600) will be randomly assigned to the intervention group (who receive the EAC) or a matched waiting list control group. A mixed methods evaluation design will test effectiveness, feasibility, use and appreciation of the EAC. The effect evaluation will include a baseline and follow up assessments at 3 and 6 months. Evaluation will be conducted across levels (i.e. older adults; stakeholders (intermediaries who work with the older adults); municipality – policy) in each participating municipality. Primary outcomes are PA, Quality of Life, social cohesion and loneliness. Secondary outcomes are reach, use, attrition & appreciation, engagement, inter-sectoral collaboration and implementation facilitators. WP 4: Assessment of facilitators and barriers for the implementation of the integral approach; develop and disseminate practical and scientific recommendations on how to apply an integral approach for healthy ageing in LSP.

Kenmerken

Projectnummer:
555002008
Looptijd: 80%
Looptijd: 80 %
2020
2025
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
prof. dr. C.A.W. Bolman PhD
Verantwoordelijke organisatie:
Open Universiteit