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Self-management, Health Literacy and Social Capital in Socioeconomically Disadvantaged Older Adults

Not Applicable
Completed
Conditions
Self Care
Social Capital
Health Literacy
Aging
Health Status Disparities
Subjective Health
Interventions
Behavioral: Program "Sentirnos bien" (Feeling well)
Registration Number
NCT02733523
Lead Sponsor
Fundacio Salut i Envelliment UAB
Brief Summary

Motivations:

Socio-economic and education determinants have a big impact on health outcomes, in terms of worse health status in populations living in more disadvantaged conditions. Social capital, self-management and health literacy are some of the intermediate determinants, with the potential to mitigate health inequalities through interventions driven by local health agents. These three determinants are intensely interlinked and have, separately, impacts on self-perceived health. Social capital is defined in this project as an umbrella concept, which includes quantitative aspects of social resources (structural social capital: social networks and contacts, social and civic participation) as well as qualitative or subjective aspects (cognitive social capital: perceived social support, feeling of belonging and trust) and covers relations between subjects at a micro or individual level (family and friends) as well as at a macro or community level. Health literacy is understood as cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Both are key aspects for self-management behaviours. The target of our research project are older people living in urban socioeconomically disadvantaged areas, since ageing is in itself an inequality axis and urban environments concentrate the highest health disparities.

Objectives: With the aim to reduce health inequality, an intervention has been designed to promote self-management, health literacy and social capital among older people who perceived their health as fair or poor and are living in urban socioeconomically disadvantaged areas with the aim of improving their self-perceived health. Secondarily, the efficacy of the intervention will be analysed in terms of increasing self-management, health literacy and social capital (social support and social participation), quality of life, mental health and healthy lifestyles.

In third place, behavioural health patterns will be identified in relation to health literacy, social capital, gender, socioeconomic and educational level, and they will be linked to the intervention efficacy levels.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
390
Inclusion Criteria
  • community-dwelling older adults living in the urban areas of Barcelona, Blanes or Reus in socio-economically disadvantaged neighbourhoods.
  • perception of their health as regular or bad according to the first question of the 12 items Short Form Survey from the RAND Medical Outcomes Study.
Exclusion Criteria
  • dependency to go to the local primary care center
  • cognitive decline or dementia as diagnose
  • any health condition that contraindicates physical activity
  • terminal illness
  • severe mental health disorders that difficult participating in a group dynamic

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Program "Sentirnos bien"Program "Sentirnos bien" (Feeling well)The intervention Program "Sentirnos bien" is based around a group dynamic, held once a week during 3 months, aimed at: 1. Promoting the uptake of self-care healthy habits 2. Promoting social capital at individual level: 3. Promoting health literacy
Primary Outcome Measures
NameTimeMethod
Self-perceived healthat 3 months (just after the intervention)

Same question than the 12 items Short Form Survey from the RAND Medical Outcomes Study. Answers will be recategorized as positive perception (excellent, very good or good) vs negative (regular or bad)

Secondary Outcome Measures
NameTimeMethod
Lonelinesst month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Scale Gierveld and De Jong

Depressive symptomsat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Geriatric Depression Scale

Physical activityat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

International Physical Activity Questionnaire (IPAQ)

Unintended effectsat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Questions ad hoc to assess effects not intended by the intervention perceived negatively by the participant.

Self-perceived healthat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Thermometer from 0-100

Health related quality of lifeat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

12 items Short Form Survey from the RAND Medical Outcomes Study.

Self-rated quality of lifet month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Thermometer from 0-100

Short Physical Performance Batteryat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Functional test that scores performance in three physical aspects: balance, strength and gait speed.

Health service useat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Times attending primary and hospital health care

Self-care / healthy habitsat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Scale ASA (Appraisal of Self-Care Agency Scale)

Health literacyat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

questions from the European Health Literacy Scale (HLS EU-16)

Social capitalat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

2 questions from the European Values Survey

Social supportat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Questionnaire "Inventario de recursos sociales en ancianos" from Díaz Veiga

Social participationat month 3 (just after the intervention) and at month 12 (9 months after the intervention)

Questionnaire "Escala Este II de Soledad - Índice de participación social subjetiva"

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