A coordinated preventive care approach for healthy ageing in five European cities: A mixed methods study of process evaluation components

Abstract

Aims To evaluate specific process components of the Urban Health Centres Europe (UHCE) approach; a coordinated preventive care approach aimed at healthy ageing by decreasing falls, polypharmacy, loneliness and frailty among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain. Design Mixed methods evaluation of specific process components of the UHCE approach: reach of the target population, dose of the intervention actually delivered and received by participants and satisfaction and experience of main stakeholders involved in the approach. Methods The UHCE approach intervention consisted of a preventive assessment, shared decision‐making on a care plan and enrolment in one or more of four coordinated care‐pathways that targeted falls, polypharmacy, loneliness and frailty. Quantitative data from a questionnaire and quantitative/qualitative data from logbooks were collected among older persons involved in the approach. Qualitative data from focus groups were collected among older persons, informal caregivers and professionals involved in the approach. Quantitative data were analysed by means of descriptive statistics and multilevel logistic regression models. Qualitative data were analysed through thematic analysis. Results Having limited function was associated with non‐enrolment in falls and loneliness care‐pathways (both p < .01). The mean rating of the approach was 8.3/10 (SD 1.9). Feeling supported by a care professional and meeting people were main benefits for older persons. Mistrust towards unfamiliar care providers, lack of confidence to engage in care activities and health constraints were main barriers towards engagement in care. Conclusions Although the UHCE approach was received generally positively, health constraints and psychosocial barriers prevented older person's engagement in care. Impact Coordinated preventive care approaches for older community‐dwelling persons should address health constraints and psychosocial barriers that hinder older person's engagement in care. Trial registration: ISRCTN registry number is ISRCTN52788952. Date of registration is 13/03/2017.

Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

“…All the baseline data were collected in May 2015. More details on the study design have been described in detail elsewhere [23][24][25].…”

In safe hands: a qualitative study on older adults’ experiences of a tailored primary health care unit

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Ageing of the Diaphragm Muscle

“…The European Union has the highest proportion of older people (over 65 years of age) compared to other regions [1]. In the US, there are about 48 million inhabitants over 65 years of age.…”

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