评价一项面向老年人的强化技术、综合社区健康和健康促进计划（HWePS）：一项非随机比较试验的方案。

Evaluation of a technology-enhanced, integrated community health and wellness program for seniors (HWePS): protocol of a non-randomized comparison trial.

机构信息

Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea.

Institute of Health and Environment, Seoul National University, 1 Gwanak-Ro, Gwanak-Gu, Seoul, South Korea.

出版信息

BMC Public Health. 2023 Jan 5;23(1):25. doi: 10.1186/s12889-022-14921-z.

DOI:10.1186/s12889-022-14921-z

PMID:36604644

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9813466/

Abstract

BACKGROUND

Healthy aging for all in the community is a shared public health agenda for countries with aging populations, but there is a lack of empirical evidence on community-wide preventive models that promote the health of older people residing in socially-disadvantaged communities. The Health and Wellness Program for Seniors (HWePS) is a technology-enhanced, multi-level, integrated health equity intervention model. This study evaluates the effect of the HWePS on the health and well-being of older adults residing in urban, low-income communities. METHODS/DESIGN: HWePS is a prospective, non-randomized comparison trial conducted in an intervention and a control neighborhood (dong) in Seoul, South Korea, over 12 months. Older people who reside in the small areas and meet the inclusion/exclusion criteria are eligible to participate. The multi-level, multi-faceted HWePS intervention is a preventive community care model for older residents guided by the expanded chronic care model, the comprehensive health literacy intervention model, and the Systems for Person-centered Elder Care model along with health equity frameworks. HWePS consists of four components: a health literacy intervention based on individual and community needs assessments, personalized (self-)care management featuring nurse coaching and peer support, a healthy-living and healthy-aging community initiative, and information and communication technology (ICT) systems. The primary outcomes are self-reported health and health-related quality of life. Outcome assessors and data analysts are blinded to group assignment. Process evaluation will be also conducted.

DISCUSSION

As a multi-level health equity project, HWePS has adopted a novel study design that simultaneously targets individual- and community-level factors known to contribute to health inequality in later life in the community. The study will provide insights into the effectiveness and implementation process of an integrated, multi-level, preventive community care model, which in turn can help improve the health outcomes of older residents and reduce disparities in underserved urban communities.

TRIAL REGISTRATION

ISRCTN29103760. Registered 2 September 2021, https://www.isrctn.com/ISRCTN29103760.

摘要

背景

对于人口老龄化的国家来说，实现社区内所有人的健康老龄化是一项共同的公共卫生议程，但缺乏关于促进居住在社会弱势社区的老年人健康的全社区预防模式的经验证据。老年人健康与福利计划（HWePS）是一个技术增强的、多层次的、综合的健康公平干预模式。本研究评估了 HWePS 对居住在城市低收入社区的老年人的健康和福祉的影响。

方法/设计：HWePS 是一项在韩国首尔的干预和对照社区（dong）进行的前瞻性、非随机比较试验，持续 12 个月。符合纳入/排除标准的居住在小区域内的老年人有资格参加。多层次、多方面的 HWePS 干预是一种针对老年人的预防社区护理模式，以扩展的慢性病护理模型、全面健康素养干预模型和以系统为导向的以人为本的老年护理模型以及健康公平框架为指导。HWePS 由四个部分组成：基于个人和社区需求评估的健康素养干预、以护士指导和同伴支持为特色的个性化（自我）护理管理、健康生活和健康老龄化社区倡议以及信息和通信技术（ICT）系统。主要结果是自我报告的健康和与健康相关的生活质量。结果评估者和数据分析者对组分配不知情。还将进行过程评估。