Health Organisation, Policy, and Economics Research Team, Centre for Primary Care & Health Services Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
NIHR School for Primary Care Research, NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, University of Manchester, M13 9PL, UK.
Soc Sci Med. 2020 Aug;259:113149. doi: 10.1016/j.socscimed.2020.113149. Epub 2020 Jun 23.
Social prescribing to community assets, like social groups, is a current policy goal. As aging adults lead longer, healthier lives, the effects of participating in community assets raises questions about whether subjective quality of life (QoL) improves during participation and on what dimensions.
The study's goal was to examine the effectiveness of community assets at improving QoL among older people living in the community.
Examining longitudinal survey data which tracked health and wellbeing in older adults living in Salford, UK over 12 months, we first used regressions on community assets to compare the World Health Organization's QoL Assessment (WHOQOL-BREF) domains at baseline for those who already participated in community assets (54%) and with non-participants (46%). Second, we used propensity score matching to compare QoL in an 'uptake' group (no initial participation but who participated at 12 months), to those who never participated, and to a 'cessation' group who participated initially, but ceased within one year, to those who always participated.
Group comparisons confirmed that participants reported significantly higher QoL on all domains - environmental, psychological, physical, and social QoL - and on 16 predicted facets. After affirming group matching reliability, the strongest results were for the uptake group, with significant improvements in all domains, and in 18 facets. All QoL domains decreased in the cessation group, but overall, the effect was weaker. As predicted from the context, QoL relating to 'opportunities for recreation and leisure' showed the greatest effect. Furthermore, QoL increased with uptake, and decreased with cessation.
Policies to improve QoL in later life should be designed not just to promote community assets, but also maintain participation once initiated.
将社会资源(如社会团体)分配给社区是当前的政策目标。随着老年人寿命的延长和健康状况的改善,参与社区资源的影响引发了人们的疑问,即参与期间和哪些方面的主观生活质量(QoL)是否会提高。
本研究旨在探讨社区资产对改善社区中老年人生活质量的效果。
我们使用英国索尔福德的老年人健康和幸福感的纵向调查数据,首先使用社区资产回归来比较已经参与社区资产(54%)和未参与社区资产(46%)的人群在基线时的世界卫生组织生活质量评估(WHOQOL-BREF)各领域。其次,我们使用倾向评分匹配来比较“参与组”(最初未参与,但在 12 个月时参与)、从未参与过的人群和“停止组”(最初参与,但在一年内停止)的 QoL 与始终参与的人群。
组间比较证实,参与者在所有领域(环境、心理、身体和社会生活质量)和 16 个预测方面报告的 QoL 明显更高。在肯定组匹配可靠性后,最强的结果是在参与组中,所有领域和 18 个方面都有显著改善。在停止组中,所有 QoL 领域都有所下降,但总体而言,效果较弱。根据背景预测,与“娱乐和休闲机会”相关的 QoL 显示出最大的效果。此外,QoL 随着参与度的增加而增加,随着参与度的减少而减少。
为了提高晚年的生活质量,政策不仅应设计为促进社区资产,还应在开始后维持参与度。