Community-based interventions to enhance healthy aging in disadvantaged areas: perceptions of older adults and health care professionals

Srivarathan, Abirami; Jensen, Andrea Nedergaard; Kristiansen, Maria

doi:10.1186/s12913-018-3855-6

Cited by 55 publications

(46 citation statements)

References 23 publications

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“…However, engagement in the intervention was challenged by barriers related to cultural and language diversity among residents, together with competing contextual factors (demolition plans, and territorial stigmatization), resulting in doubtful engagement in future interventions. These findings correspond with other studies [9,15] which emphasize a need for context-specific and participatory approaches to ensure that engagement in community-based health promotion interventions in areas of deprivation can be maintained.…”

Section: Discussionsupporting

confidence: 90%

“…Challenges related to the acceptance of and engagement in health promotion interventions among residents in deprived areas of social housing have previously been identified [9,15]. Nevertheless, our study shows a general positive acceptance of and engagement in community-based interventions among residents living in a deprived area of social housing.…”

Section: Social Relations and Community Engagement As Motives And Persupporting

confidence: 49%

“…Additionally, residents from deprived social housing areas are less likely to engage in health promotion interventions compared to individuals of a higher socioeconomic position [9,14]. The observed differences in engagement in health promotion interventions are a result of a complex interplay of individual and contextual factors including distrust or fear of authorities, language barriers, and lack of information about and awareness of health promotion interventions [3,9,[15][16][17][18]. Deprived population groups may be disempowered and unable to engage in traditional health promotion interventions, since these encourage individuals to exert control over their own health, often through a focus on advancing knowledge of risk factors [19,20].…”

Section: Introductionmentioning

confidence: 99%

“…Deprived population groups may be disempowered and unable to engage in traditional health promotion interventions, since these encourage individuals to exert control over their own health, often through a focus on advancing knowledge of risk factors [19,20]. Nevertheless, studies concerning recruitment approaches attempting to reach deprived population groups have found that working with residents of deprived social housing areas can enhance the acceptance of and engagement in health promotion interventions [3,9,15,[21][22][23]. This entails that residents, in collaboration with formal and informal organizations in the deprived social housing areas, are involved in the design and implementation of the health promotion intervention [3,16,[22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area

Srivarathan

Lund

Christensen

et al. 2020

IJERPH

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Emerging evidence points towards a lower quality of life, fragile social relations and suboptimal health behavior and status of residents living in social housing areas characterized by ethnic diversity and socioeconomic deprivation. Community-based health promotion interventions developed in collaboration with the target group and adjusted to the local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in deprived social housing areas. This study explores residents’ perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analyzed with focuses on participation in an everyday life context, concepts of othering, and territorial stigmatization. Engagement in the intervention was motivated by the need to establish and enhance social relations, and to explore the world outside the housing area. However, barriers including cultural and language differences among residents, and competing contextual factors, challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in deprived social housing areas. However, adequate support and efforts to overcome the identified barriers are needed.

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Section: Discussionsupporting

confidence: 90%

Section: Social Relations and Community Engagement As Motives And Persupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area

Srivarathan

Lund

Christensen

et al. 2020

IJERPH

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“…A study conducted in Denmark showed that there was a gap between users and providers perception about health promotion services. (5) By lling these gaps, public health programs and community interventions would be conducted more effectively.…”

mentioning

confidence: 99%

The “Healthy Akame!” community – government – university collaboration for health: a community-based participatory mixed-method approach to address health issue in rural Japan

Haya

Ichikawa

Shibagaki

et al. 2020

Preprint

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Background: Although Japan has a decentralized public health system, local governments have considered expert opinions over those of the community, to decide on public health programs. Differences in community’s interest may create gaps between health program’s objectives and implementation. We hypothesized that community-based participatory research (CBPR), which involves the community at every step, promotes effective program implementation and community empowerment. This study addressed the first step of CBPR, assessing community needs and developing a tailored health program for a rural community in Japan. Methods: in this study sequential exploratory mixed-method study (qualitative followed by quantitative), we first formed a community advisory board (CAB) representing community organization, city officials, and university researchers. The CAB conducted group discussions with community residents to identify community’s health issues and strength. These group discussions were analyzed using thematic analysis, and the results were used to develop a questionnaire, which was subsequently sent to all households in the community to obtain priority scores for health issues and proposed action and to assess willingness to participate in community health program. The CAB then designed a program based using the overall study results. Results: Ten group discussions with 68 participants identified the following health issues: 1) diseases, 2) unhealthy behaviors; and 3) unsupportive environment. Nature, vacant lots, and local farms were considered local strength. Of a total of 1470 households in the community, questionnaires were collected from 773 households. Cancer, lifestyle-related diseases, and cerebrovascular diseases were as the most important health problems. Improving services and access to medical checkups, use of public space for exercise, local farming, and collaboration with community health office were considered necessary to address these health problems. Considering feasibility and the availability of resources in the community, the CAB decided to focus on lifestyle-related diseases and designed activities centered on health awareness, nutrition, and exercise. These activities drew on community’s strengths and were adapted to Japanese culture. Conclusions: The community’s priority health problem was closely related to the epidemiology of diseases. The CBPR approach was useful for identifying community’s needs and for designing a unique community health program that made use of local strengths.

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Community Paramedicine Program in Social Housing and Health Service Utilization

Agarwal,

Pirrie,

Angeles

et al. 2024

JAMA Netw Open

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ImportanceCommunity Paramedicine at Clinic (CP@clinic) is a chronic disease prevention program that decreases 911 calls for emergency medical services, but its wider system effects are unknown.ObjectiveTo evaluate the effects of CP@clinic vs usual care on individual-level health service utilization outcomes.Design, Setting, and ParticipantsThis open-label, pragmatic cluster randomized clinical trial evaluated all residents 55 years or older in 30 social housing buildings in Ontario, Canada, that had (1) a unique postal code, (2) at least 50 apartments, (3) 60% or more residents 55 years or older, and (4) a similar building for pairing (15 intervention and 15 control buildings, pair-matched randomization). The 12-month intervention had a staggered start date from January 1, 2015, to December 1, 2015, and ended between December 31, 2015, and November 30, 2016. Administrative health data analysis was conducted in May 2022.InterventionCP@clinic was a health promotion and disease prevention program led by specially trained community paramedics who held weekly drop-in sessions in social housing buildings. These paramedics conducted 1-on-1 risk assessments, provided health education and referrals to relevant community resources, and, with consent, sent assessments to family physicians. Control buildings received usual care (universal health care, including free primary and specialty medical care).Main Outcome and MeasuresIndividual-level health service utilization was measured from administrative health data, with ED visits via ambulance as the primary outcome; secondary outcomes included ED visits for any reason, primary care visits, hospitalizations, length of hospital stay, laboratory tests, receipt of home care, transfer to long-term care, and medication initiation. Generalized estimating equations were used to estimate intervention effects on individual-level health service utilization, accounting for trial design and individual-level baselines.ResultsThe 30 social housing buildings had 3695 residents (1846 control and 1849 intervention participants; mean [SD] age, 72.8 [9.1] years; 2400 [65.0%] female). Intention-to-treat analysis found no significant difference in ED visits by ambulance (445 of 1849 [24.1%] vs 463 of 1846 [25.1%]; adjusted odds ratio [AOR], 0.97; 95% CI, 0.89-1.05) but found higher antihypertensive medication initiation (74 of 500 [14.8%] vs 47 of 552 [8.5%]; AOR, 1.74; 95% CI, 1.19-2.53) and lower anticoagulant initiation (48 of 1481 [3.2%] vs 69 of 1442 [4.8%]; AOR, 0.68; 95% CI, 0.53-0.86) in the intervention arm vs the control arm. CP@clinic attendance was associated with higher incidence of primary care visits (adjusted incidence rate ratio, 1.10; 95% CI, 1.03-1.17), higher odds of receiving home care (AOR, 1.07; 95% CI, 1.01-1.13), and lower odds of long-term care transfers (AOR, 0.32; 95% CI, 0.13-0.81).Conclusions and RelevanceIn this cluster randomized clinical trial of CP@clinic, the intervention did not affect the rate of ED visits by ambulance; however, there were increased primary care visits and connections to home care services, which may have increased antihypertensive medication initiation and reduced long-term care transfers from social housing. Health policymakers should consider CP@clinic’s impact as an upstream approach to improve care for older adults with low income.Trial RegistrationClinicalTrials.gov Identifier: NCT02152891

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Community-based interventions to enhance healthy aging in disadvantaged areas: perceptions of older adults and health care professionals

Cited by 55 publications

References 23 publications

Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area

Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area

The “Healthy Akame!” community – government – university collaboration for health: a community-based participatory mixed-method approach to address health issue in rural Japan

Community Paramedicine Program in Social Housing and Health Service Utilization

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