Empowering Homebound Older Adults in Self-care Using a Mobile Health-assisted, Person-centred Care Approach: A Hybrid Effectiveness-implementation Design
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 130
- Locations
- 2
- Primary Endpoint
- Change in self-efficacy assessed using the Chinese version of the General Self-Efficacy Scale
Study Overview
Brief Summary
The aim of the study is to evaluate the effectiveness and implementation of the mobile health (mHealth)-assisted, person-centred care (PCC) self-care support programme for homebound older adults. The researcher will compare PCC approach to a conventional care provider-led model. Participants (n = 130) will receive the intervention of six bi-weekly WhatsApp video call sessions over three months with nurse case managers (NCMs).
Detailed Description
This hybrid effectiveness-implementation, cluster-randomized controlled trial evaluates a mHealth-assisted, PCC self-care support programme for homebound older adults in Hong Kong. Participants (n = 130) receive six bi-weekly WhatsApp video call sessions with NCMs over three months. The study compares a PCC-based approach with a conventional provider-led model. Effectiveness outcomes include self-efficacy, functional independence, and psychosocial well-being. Implementation is assessed using the RE-AIM framework. Findings will inform scalable, digital health interventions for aging populations, improving functional independence, self-care engagement, and healthcare accessibility for homebound older adults.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 60 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Aged 60 years or older;
- •Unable to leave home more than twice per week due to physical or functional health problems;
- •Own and have basic proficiency in using a smartphone;
- •Speak Cantonese;
- •Indicate sufficient cognitive ability; and
- •Be moderately frail or below.
Exclusion Criteria
- •Unable to hear, see, or communicate effectively;
- •Be completely bed-bound; or
- •Reside in an area without stable internet coverage.
Arms & Interventions
Intervention Group
The intervention group emphasizes shared decision-making, goal-setting, and interdisciplinary support. The NCM will co-develop self-care plans with participants.
Intervention: PCC-based mHealth-assisted self-care support intervention (Behavioral)
Control Group
The control group does not include shared decision-making or personalized goal-setting. Self-care plans will be developed solely by the nurse case manager (NCM).
Intervention: Provider-led mHealth-assisted self-care support intervention (Behavioral)
Outcomes
Primary Outcomes
Change in self-efficacy assessed using the Chinese version of the General Self-Efficacy Scale
Time Frame: At baseline, 3 months post-intervention , and 6 months post-intervention.
Unit of Measure: Mean score on self-efficacy.
Change in instrumental activities of daily living assessed using the Chinese version of the Lawton Instrumental Activities of Daily Living Scale
Time Frame: At baseline, 3 months post-intervention , and 6 months post-intervention.
Unit of Measure: Mean score on instrumental activities of daily living.
Secondary Outcomes
- Change in psychological distress assessed using the Chinese version of 21-item Depression Anxiety Stress Scale(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Change in quality of life assessed using the Chinese version of the 12-item Short Form Health Survey version 2(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Change in perceived loneliness assessed using the Chinese version of the UCLA 3-item Loneliness Scale(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Change in functional mobility assessed using the Timed Up and Go Test(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Change in sedentary behaviour assessed using the Chinese version of the Sedentary Behaviour Questionnaire for Elderly(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Change in frequency of healthcare utilization assessed using the self-reported healthcare utilization survey(At baseline, 3 months post-intervention , and 6 months post-intervention.)
- Participant reach and recruitment success measured by recruitment records(At baseline.)
- Participant satisfaction with the intervention assessed using the Chinese version of four-dimension Client Satisfaction Questionnaire(At 3 months post-intervention and 6 months post-intervention.)
- Service provider acceptability and adoption of person-centred care approach measured by focus group interview(At 3 months post-intervention.)
- Implementation fidelity and adherence to person-centred care principles measured by session recordings and fidelity checklist(Ongoing monitoring during intervention.)
- Long-term maintenance and retention of participants measured by cost-effectiveness analysis and retention and dropout records(At 6 months post-intervention.)
- Barriers and Facilitators to the intervention measured by focus group interview(At 3 months post-intervention.)
Investigators
Arkers, Wong
Associate Professor
The Hong Kong Polytechnic University