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Remote Evidence-Based Programs for Health Promotion to Support Older Adults During the COVID-19 Pandemic and Beyond: Mixed Methods Outcome Evaluation.

作者信息

Steinman Lesley, Chadwick Kelly, Chavez Santos Erica, Sravanam Sruthi, Johnson Selisha Snowy, Rensema Elspeth, Mayotte Caitlin, Denison Paige, Lorig Kate

机构信息

Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States.

Office of Community Outreach and Engagement, Fred Hutch Cancer Center, Seattle, WA, United States.

出版信息

JMIR Aging. 2024 Jun 13;7:e52069. doi: 10.2196/52069.


DOI:10.2196/52069
PMID:38869932
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11211707/
Abstract

BACKGROUND: Evidence-based programs (EBPs) for health promotion were developed to reach older adults where they live, work, pray, and play. When the COVID-19 pandemic placed a disproportionate burden on older adults living with chronic conditions and the community-based organizations that support them, these in-person programs shifted to remote delivery. While EBPs have demonstrated effectiveness when delivered in person, less is known about outcomes when delivered remotely. OBJECTIVE: This study evaluated changes in remote EBP participants' health and well-being in a national mixed methods outcome evaluation in January 1, 2021, to March 31, 2022. METHODS: We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) for equity framework to guide the evaluation. We purposively sampled for diverse remote EBP delivery modes and delivery organizations, staff, and traditionally underserved older adults, including people of color and rural dwellers. We included 5 EBPs for self-management, falls prevention, and physical activity: videoconferencing (Chronic Disease Self-Management Program, Diabetes Self-Management Program, and EnhanceFitness), telephone plus mailed materials (Chronic Pain Self-Management Program), and enhanced self-directed mailed materials (Walk With Ease). Participant and provider data included validated surveys, in-depth interviews, and open-ended survey questions. We used descriptive statistics to characterize the sample and the magnitude of change and paired t tests (2-tailed) and the Fisher exact test to test for change in outcomes between enrollment and 6-month follow-up. Thematic analysis was used to identify similarities and differences in outcomes within and across programs. Joint display tables facilitated the integration of quantitative and qualitative findings. RESULTS: A total of 586 older adults, 198 providers, and 37 organizations providing EBPs participated in the evaluation. Of the 586 older adults, 289 (49.3%) provided follow-up outcome data. The mean age of the EBP participants was 65.4 (SD 12.0) years. Of the 289 EBP participants, 241 (83.4%) were female, 108 (37.3%) were people of color, 113 (39.1%) lived alone, and 99 (34.3%) were experiencing financial hardship. In addition, the participants reported a mean of 2.5 (SD 1.7) chronic conditions. Overall, the remote EBP participants showed statistically significant improvements in health, energy, sleep quality, loneliness, depressive symptoms, and technology anxiety. Qualitatively, participants shared improvements in knowledge, attitudes, and skills for healthier living; reduced their social isolation and loneliness; and gained better access to programs. Three-fourths of the providers (149/198, 75.2%) felt that effectiveness was maintained when switching from in-person to remote delivery. CONCLUSIONS: The findings suggest that participating in remote EBPs can improve health, social, and technological outcomes of interest for older adults and providers, with benefits extending to policy makers. Future policy and practice can better support remote EBP delivery as one model for health promotion, improving access for all older adults.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a952/11211707/9a8dcd7efbe0/aging_v7i1e52069_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a952/11211707/582b68cab19d/aging_v7i1e52069_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a952/11211707/9a8dcd7efbe0/aging_v7i1e52069_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a952/11211707/582b68cab19d/aging_v7i1e52069_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a952/11211707/9a8dcd7efbe0/aging_v7i1e52069_fig2.jpg

相似文献

[1]
Remote Evidence-Based Programs for Health Promotion to Support Older Adults During the COVID-19 Pandemic and Beyond: Mixed Methods Outcome Evaluation.

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[2]
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引用本文的文献

[1]
Effectiveness of a Telephone-Delivered Walk With Ease Program on Arthritis-Related Symptoms, Function, and Activity: A Randomized Trial.

Arthritis Care Res (Hoboken). 2025-7

[2]
United Voices Group-Singing Intervention to Address Loneliness and Social Isolation Among Older People With HIV During the COVID-19 Pandemic: Intervention Adaption Study.

JMIR Form Res. 2024-10-8

本文引用的文献

[1]
Remote Evidence-Based Health Promotion Programs During COVID: A National Evaluation of Reach and Implementation for Older Adult Health Equity.

Health Promot Pract. 2024-5

[2]
Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial.

J Cancer Surviv. 2024-4

[3]
Evaluation of a Peer Led Chronic Pain Self-Management Program in a Rural Population.

J Prim Care Community Health. 2022

[4]
Remotely Delivered Exercise to Rural Older Adults With Knee Osteoarthritis: A Pilot Study.

ACR Open Rheumatol. 2022-8

[5]
Challenges for evaluation practices and innovative approaches: Lessons during COVID-19 pandemic.

Eval Program Plann. 2022-6

[6]
Addressing health disparities through implementation science-a need to integrate an equity lens from the outset.

Implement Sci. 2022-1-31

[7]
Remote Delivery of the Chronic Pain Self-management Program Using Self-directed Materials and Small-group Telephone Support: A Pilot Study.

J Appl Gerontol. 2022-5

[8]
COVID-19 pandemic: A review of the global lockdown and its far-reaching effects.

Sci Prog. 2021

[9]
Combatting Social Isolation Among Older Adults in a Time of Physical Distancing: The COVID-19 Social Connectivity Paradox.

Front Public Health. 2020-7-21

[10]
Measuring Senior Technology Acceptance: Development of a Brief, 14-Item Scale.

Innov Aging. 2020-6-27

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