A community-based health-social partnership program for community-dwelling older adults: a hybrid effectiveness-implementation pilot study. 2022

Arkers Kwan Ching Wong, and Frances Kam Yuet Wong, and Martin Chi Sang Wong, and Karen Kit Sum Chow, and Dilys Kwai Sin Kwan, and Dubby Yun Sang Lau
School of Nursing, The Hong Kong Polytechnic University, 1 Cheong Wan Road, Hung Hom, Hong Kong. arkers.wong@polyu.edu.hk.

A growing body of literature supports the efficacy of the health-social approach for the implementation of complex interventions to enhance self-care health management among community-dwelling older adults. However, there is little research on how interventions with this approach are implemented and disseminated in a real community setting. This pilot study adopted an effectiveness-implementation hybrid design to 1) evaluate the effectiveness of a community-based Health-Social Partnership Program (HSPP) and 2) explore the reach, adoption, implementation, and maintenance of the HSPP in the community. Potential participants were recruited if they were aged 60 or above, owned a smartphone, and were cognitively competent. The participants received nurse-led case management with support from a social service team. Factors that hindered or facilitated the program delivery were examined to determine the implementation outcomes and sustained effects of the program. Data were collected at pre-intervention (T1), immediately post-intervention (T2), and 3 months post-intervention (T3). Ninety-two older adults joined and completed the program. The recruitment rate was 76.7%. A significant interaction effect was found for the mean self-efficacy scores from T1 to T2 (Wald χ2 = 12.28, p ≤ .001). Barriers to widespread program implementation included manpower shortage, lack of experienced staff, and unpredictable environment, whereas facilitators, as suggested by the older adults, providers, and community staff members, included regular communication between the research and service teams, recruitment of participants through community centers with the support of the research team, and seamless partnership among the health-social partnership team members. Strong implementation fidelity was achieved with zero attrition rate. Most conventional randomized controlled trials investigating the effects of community-based programs have tended to control the contextual factors rather than incorporate the program in a real setting. This pilot study was the first to use a hybrid model to test the effectiveness and outcomes of HSPP implementation. The results imply that the program has a high potential sustainability in the real-life context. This study was registered at clinicaltrials.gov (NCT04442867; date of first registration 23/06/2020).

UI MeSH Term Description Entries
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D006293 Health Promotion Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. Health Campaigns,Promotion of Health,Wellness Programs,Promotional Items,Campaign, Health,Campaigns, Health,Health Campaign,Health Promotions,Item, Promotional,Items, Promotional,Program, Wellness,Programs, Wellness,Promotion, Health,Promotional Item,Promotions, Health,Wellness Program
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D057187 Independent Living A housing and community arrangement that maximizes independence and self-determination. Aging in Place,Community Dwelling,Dwelling, Community,Dwellings, Community,Living, Independent
D020377 Self Efficacy Cognitive mechanism based on expectations or beliefs about one's ability to perform actions necessary to produce a given effect. It is also a theoretical component of behavior change in various therapeutic treatments. (APA, Thesaurus of Psychological Index Terms, 1994) Efficacy, Self

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