Supporting Healthy Aging by Peer Education and Support (SHAPES) - A Stepped-Wedge Cluster Randomized Trial

In Canada, between 1960 and 2009, the proportion of seniors (people aged ≥65 years) rose from 8% to 14%; it is estimated that this proportion will increase to 23-25% by 2036. The number of people in the population aged ≥80 years is projected to more than double between 2009 and 2036. This population ageing has, and will, have a major impact on healthcare, economics, education, employment and social engagement. Many in our society age with long term chronic medical conditions; the management of which is partly responsible for the increasing consumption of health care resources in later life. There is a pressing need on the part of health care providers and policy makers to contain these increasing expenditures. Encouragement of lifestyle practices which promote successful or healthy aging and self - management techniques to deal with chronic disease are therefore of paramount importance to the achievement of this goal. Cost containment, however, is not the sole reason for pursuing such practice; there is some evidence that self-management and an increase in health literacy leads to an increased sense of empowerment and an improvement in health related quality of life for seniors.

In the presence of chronic disease, self-management is seen as a critical element in containing resource demand and in empowering patients whilst increasing their health literacy. Self-management training courses have been developed for generic physical long term conditions which have led to improved outcomes and some cost savings in chronic care. There is therefore an opportunity to educate and empower seniors in both healthy ageing behaviours and self-management of chronic disease, which has the potential to contain health care resource use, improve perception of self-rated health and quality of life.

This study aims to explore the use of health coaches, where health coaching can be defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals, drawn from community dwelling seniors, rather than "expert patients" in educating and supporting their peers in healthy aging behaviours and self-management of chronic disease.