University of Wisconsin - Milwaukee College of Nursing, 1921 E Hartford Ave, Milwaukee, WI, 53211, USA.
Center for Healthy Communities and Research, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
J Community Health. 2018 Oct;43(5):920-928. doi: 10.1007/s10900-018-0506-0.
The purpose of this study was to determine the impact of a nurse-led, church-based educational support group for "at-risk," older African Americans on hospitalization and emergency department use. Study nurses enrolled 81 "at-risk" older adult members of ten churches. Participants completed a trifold pamphlet identifying personal health information and support, and they attended eight monthly educational/support group sessions in their church during the 10-month intervention. Study nurses completed a risk assessment interview with each senior both pre- and post-participation. The study nurse completed post-program assessments with 64 seniors, a 79% retention rate. At the program's conclusion researchers conducted a focus group with the study RNs and used an anonymous written survey to gather participant appraisals of program elements. Neither hospitalization nor emergency department/urgent care usage was significantly different from pre- to post-program. Session attendance was moderate to high and over half of the seniors brought a family member or friend to one or more sessions. The majority of seniors initiated positive health changes (e.g., smoking cessation, weight loss, or diet changes). Participants expressed high satisfaction and expressed satisfaction to perceive that they were supporting other seniors in their community. We conclude that this intervention was successful in engaging and motivating seniors to initiate health behavior change and contributed to a health-supportive church-based community. To demonstrate a statistically significant difference in hospital and ED usage, however, a stronger intervention or a larger sample size is needed.
本研究旨在确定由护士主导、基于教会的教育支持小组对“高危”老年非裔美国人的住院和急诊使用的影响。研究护士招募了来自十所教堂的 81 名“高危”老年成年成员。参与者填写了一份三折小册子,确定个人健康信息和支持,并在 10 个月的干预期间在他们的教堂参加了八次每月的教育/支持小组会议。研究护士在参与前后分别对每位老年人进行了风险评估访谈。研究护士对 64 名老年人进行了项目后评估,保留率为 79%。在项目结束时,研究人员与研究护士进行了焦点小组讨论,并使用匿名书面调查收集了参与者对项目要素的评估。住院和急诊/紧急护理的使用在项目前后均无显著差异。课程出勤率中等偏高,超过一半的老年人带了一位家庭成员或朋友参加一次或多次课程。大多数老年人开始采取积极的健康改变(例如戒烟、减肥或改变饮食)。参与者表示非常满意,并表示他们很高兴能够支持社区中的其他老年人。我们得出结论,这种干预措施成功地吸引并激励老年人开始改变健康行为,并有助于建立一个以教会为基础的健康支持社区。然而,为了证明在医院和急诊使用方面有统计学意义的差异,需要更强有力的干预措施或更大的样本量。