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Working elements of interventions for reducing problematic alcohol use among older adults

Projectomschrijving

Werkzame elementen van interventies ter vermindering van problematisch alcoholgebruik onder ouderen

Vraagstuk

Door vergrijzing komen er meer ouderen, waarbij problematisch alcoholgebruik veel voorkomt. Zij kampen met pijn, verlies van dierbaren, eenzaamheid of gaan meer drinken als invulling van hun tijd na hun pensioen. Het lichaam van ouderen breekt de alcohol minder af en zij combineren vaak alcohol- en medicijngebruik, wat slecht is voor de gezondheid. Hoe kan, met behulp van werkzame elementen uit bestaande interventies, dit problematische alcoholgebruik bij ouderen verminderd worden?

Onderzoek en verwachte uitkomst

Met Tranzo (Tilburg University) en CAPHRI (Maastricht University) als trekkers gaat een consortium van partijen uit het veld van verslavingspreventie en ouderenzorg onderzoek starten naar:
1.    Wat zijn werkzame elementen in bestaande Nederlandse interventies, voor wie werkt dat, wanneer en waarom?
2.    Hoe kunnen aanbieders van interventies, professionals en vrijwilligers succesvol met elkaar samenwerken om zo samen problematisch alcoholgebruik bij ouderen te reduceren?
Waar nodig worden interventies aangepast met de bekende werkzame elementen. Zuid-Limburg fungeert als proeftuin in dit project.

Verslagen


Samenvatting van de aanvraag

Problematic alcohol use is increasing in older adults. Urgency of this problem is growing due to an ageing population. Furthermore, older adults are at greater risk of alcohol-related harm because of physiological changes associated with ageing. However, interventions targeting alcohol consumption in older adults are scarce. In stage 1 of this grant scheme, we examined in the international literature how (i.e., which elements of interventions), in which context and why, interventions are successful in preventing and/or reducing (problematic) alcohol consumption among older adults. Three working elements of interventions were seen in different settings: 1) Providing information on the consequences of alcohol consumption and coping strategies to prevent (problematic) alcohol use. This teaches participants about the consequences of and how to deal with their drinking behavior; 2) Being in contact with others and communicate about (alcohol) problems, which helps participants to change their drinking behavior; and 3) Personalized feedback about drinking behavior. This helps participants to become aware of and get insight into their own drinking behavior. In the three studies addressing solely older adults (out of 56 included studies), interventions used the first and the third element, but the second element of being in contact was not found. This is striking because older adults are at greater risk of becoming lonely. Currently, in the Netherlands, several interventions for older adults are used in practice, but research on their working elements is lacking. Only one intervention targeting older adults (i.e., Moti-55) is incorporated by the Dutch recognition system for health promotion interventions (Loketgezondleven.nl). Furthermore, several separate interventions are used in practice – in settings ranging from universal prevention to indicated prevention in secondary care. However, it is unknown how an integrated approach of all these interventions can be developed and implemented. An integrated approach across these settings might strengthen effective care and result in better outcomes for the patient. The main goal of the current project is to investigate 1) to what extent the working elements identified in stage 1 are reflected in existing interventions at national level, in different settings, and across themes (alcohol consumption, overweight and smoking), and 2) how an integrated approach of several existing interventions can be implemented with all required preconditions in a sustainable way, in order to reduce problematic drinking behavior among older adults. This project is divided into two Work Packages (WPs). WP1 focuses on finding and prioritizing working elements in existing Dutch interventions, in different settings, across themes, and will identify preconditions for successful implementation. First, we will evaluate working elements in existing Dutch interventions, in different settings and across themes using triangulation of sources. That is, documents of descriptions of several Dutch interventions will be analyzed. Next, interviews will be performed with a) health care professionals, b) clients/patients and c) close relatives of clients/patients, using a Realist Evaluation (i.e., Context, Mechanisms, Outcomes / What, If, Then). In addition, observations will be performed during provision of the interventions to the client/patient. Second, a Delphi study will be performed with experts in the field to prioritize the identified working elements in Dutch interventions in several settings. Third, focus group interviews will be conducted with a) policymakers, b) health care professionals and c) clients to identify preconditions for successful implementation. WP2 focuses on evaluating an innovative integrated approach of interventions in one region in the South of the Netherlands, in collaboration with several parties providing interventions. First, a social network analysis followed by interviews will be performed to identify the structure of the current network, the relationship patterns between network partners and how an integrated approach can be realized (T0). Second, an integrated approach of existing currently used successful Dutch interventions will be realized, and involved relevant stakeholders into this integrated approach will be trained (e.g. in Motivation Interviewing or how to improve collaboration with network partners). Third, again a social network analysis followed by interviews will be performed to identify changes in the structure of the network, relationship patterns, and outcomes of the integrated approach on an effective health care chain which might reduce alcohol use among older adults (T1). This project will provide us insight in the working elements of currently used Dutch interventions, and will result in a guide for implementing an integrated approach of successful interventions, stimulating a chain of care to reduce problematic alcohol use among older adults.

Kenmerken

Projectnummer:
555002034
Looptijd: 59%
Looptijd: 59 %
2021
2026
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. A.D. Rozema
Verantwoordelijke organisatie:
Tilburg University