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代际互动、社会资本与健康:巴西一项随机对照试验的结果

Intergenerational interaction, social capital and health: results from a randomised controlled trial in Brazil.

作者信息

de Souza Elza Maria, Grundy Emily

机构信息

Escola Superior em Ciências da Saúde (School of Health Science) Brasília, DF Brazil.

出版信息

Soc Sci Med. 2007 Oct;65(7):1397-409. doi: 10.1016/j.socscimed.2007.05.022. Epub 2007 Jul 2.

Abstract

Recent years have seen a burgeoning of intergenerational programmes aiming to improve the well being of participants. However, very few programmes have been formally evaluated. In this paper we report results from a randomised controlled trial of a school-based intergenerational intervention undertaken in Brazil. Randomly selected samples of 253 adolescents and 266 elders aged 60 and over resident in the school's catchment area were administered a questionnaire including questions on cognitive components of social capital, family relationships, and self-rated health. Participants were then randomly allocated to control and intervention groups. The intervention comprised participation in a 4 month programme of intergenerational activities in which the elders shared their memories with the students. At the end of the intervention the questionnaire was re-administered to the samples. High proportions (85-95%) of both samples completed the questionnaires but compliance with the intervention was low in the elderly group. In the analysis of results from the elderly sample, we therefore compared the control group with the group assigned to the intervention (intention to treat analysis). Results showed that adolescents in the intervention group were nearly three times more likely to rate their health as good than those in the control group, but also more likely to judge that most people were selfish. In the elderly sample, those from the intervention group were over twice as likely as those from the control group to report positively on the helpfulness of neighbours; judge most people to be honest or consider their family relationships as good. There were no significant differences between groups on other outcome measures. These results suggest that structured intergenerational activities may have positive effects on some aspects of social capital for both adolescents and elderly people, although further research is needed to elucidate the processes involved and the extent to which the findings are context specific. This study is the first to use a controlled trial design to evaluate this type of intervention and is valuable in showing that this design can be used in interventions of this kind, and also the difficulties involved.

摘要

近年来,旨在改善参与者福祉的代际项目蓬勃发展。然而,很少有项目经过正式评估。在本文中,我们报告了在巴西进行的一项基于学校的代际干预随机对照试验的结果。从学校周边地区随机抽取了253名青少年和266名60岁及以上的老年人作为样本,对他们进行了问卷调查,问题包括社会资本的认知成分、家庭关系和自评健康状况。然后,参与者被随机分配到对照组和干预组。干预措施包括参与为期4个月的代际活动项目,其中老年人与学生分享他们的记忆。干预结束时,再次对样本进行问卷调查。两个样本中都有很高比例(85 - 95%)完成了问卷,但老年组对干预的依从性较低。因此,在对老年样本的结果分析中,我们将对照组与分配到干预组的组进行了比较(意向性分析)。结果显示,干预组中的青少年将自己的健康评为良好的可能性几乎是对照组的三倍,但也更有可能认为大多数人是自私的。在老年样本中,干预组的人报告邻居乐于助人、认为大多数人诚实或认为自己的家庭关系良好的可能性是对照组的两倍多。在其他结果指标上,两组之间没有显著差异。这些结果表明,有组织的代际活动可能对青少年和老年人社会资本的某些方面产生积极影响,尽管需要进一步研究来阐明其中的过程以及这些发现的背景特异性程度。这项研究是首次使用对照试验设计来评估这类干预措施,它在表明这种设计可用于此类干预措施以及所涉及的困难方面具有重要价值。

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