Health and well-being promotion strategies for ‘hard to reach’ older people in England: a mapping exercise

Iliffe, Steve; Walters, Kate; Manthorpe, Jill; Goodman, Claire

doi:10.1017/s1463423617000378

Cited by 7 publications

(10 citation statements)

References 18 publications

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“…Also, despite the well‐known capability of health checkups to reduce mortality, their efficacy for preventing long‐term care dependence in older adults has not been elucidated . Furthermore, the substantial characteristics of “hard‐to‐reach” older residents who did not participate in these health promotions could not be conjectured from the results of the above studies, as all the older adults enrolled in these studies, including even “non‐participants” in health checkups, were actually responders to invitations in field, outpatient clinic, postal, and home‐visit health‐promotion surveys.…”

Section: Introductionmentioning

confidence: 99%

Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

Igarashi

Okuno

Kodera

et al. 2019

Geriatrics Gerontology Int

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Aim: Despite efforts toward health promotion and preventive care for older adults, including health checkups and postal Kihon Checklist survey, one fifth of community-dwelling older adults do not participate in them. The aim of the present study was to examine the relationship between this non-participation and the end of certification-free survival in older adults.Methods: In a cohort of 4120 older adults with no prior history of Long-Term Care Insurance certification, the associations of non-participation with risk of later death without certification and support/care-need certification for 72 months were evaluated using Cox proportional hazards analysis.Results: Of them, 4022 (mean age 72.7 years, 54.7% women) were followed up (97.6%). At baseline, 1072 received health checkups, 2085 replied to the Kihon Checklist alone and 865 did not participate. During 72 months, 310 deaths without certification and 701 certifications occurred. After adjustment, non-participating individuals had significantly higher hazard ratios for death up to 72 months and for certification up to 36 months, compared with the other two groups. The Kruskal-Wallis test showed associations of increasing incidence of certification due to stroke in pre-old (aged 65-74 years) men for 72 months, and due to arthralgia/fracture and dementia in old (aged ≥75 years) women for 24 months, with non-participation in health promotions. Certified non-participating individuals incurred higher estimated Long-Term Care Insurance expenditure per person for 72 months, especially in pre-old men and old women. Conclusions:Health promotion by health checkup and even Kihon Checklist survey increases certification-free survival in older residents, and decreases Long-Term Care Insurance expenditure.

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Section: Introductionmentioning

confidence: 99%

Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

Igarashi

Okuno

Kodera

et al. 2019

Geriatrics Gerontology Int

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“…Poor English was reported as a problem to engage in health promotion by participating older people from BME groups and by professionals with work experience of this group. Addressing language difficulties has been reported as a priority in both national and local policies to facilitate use of services and participation in health promotion for older people from BME groups [32]. It is possible that reducing language barriers may furthermore provide opportunities for a more person-centred approach and shared decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…Further, poor literacy was reported by both some older people in deprived areas and professionals with experience working with them. Low levels of literacy are often associated with older people from BME groups [32], suggesting literacy problems could be given more attention among older people in deprived areas too.…”

Section: Discussionmentioning

confidence: 99%

Engaging ‘hard to reach’ groups in health promotion: the views of older people and professionals from a qualitative study in England

et al. 2019

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Background Older people living in deprived areas, from black and minority ethnic groups (BME) or aged over 85 years (oldest old) are recognised as ‘hard to reach’. Engaging these groups in health promotion is of particular importance when seeking to target those who may benefit the most and to reduce health inequalities. This study aimed to explore what influences them practicing health promotion and elicit the views of cross-sector professionals with experiences of working with ‘hard to reach’ older people, to help inform best practice on engagement. Methods ‘Hard to reach’ older people were recruited through primary care by approaching those not attending for preventative healthcare, and via day centres. Nineteen participated in an interview ( n = 15) or focus group ( n = 4); including some overlaps: 17 were from a deprived area, 12 from BME groups, and five were oldest old. Cross-sector health promotion professionals across England with experience of health promotion with older people were identified through online searches and snowball sampling. A total of 31 of these 44 professionals completed an online survey including open questions on barriers and facilitators to uptake in these groups. Thematic analysis was used to develop a framework of higher and lower level themes. Interpretations were discussed and agreed within the team. Results Older people’s motivation to stay healthy and independent reflected their everyday behaviour including practicing activities to feel or stay well, level of social engagement, and enthusiasm for and belief in health promotion. All of the oldest old reported trying to live healthily, often facilitated by others, yet sometimes being restricted due to poor health. Most older people from BME groups reported a strong wish to remain independent which was often positively influenced by their social network. Older people living in deprived areas reported reluctance to undertake health promotion activities, conveyed apathy and reported little social interaction. Cross-sector health professionals consistently reported similar themes as the older people, reinforcing the views of the older people through examples. Conclusions The study shows some shared themes across the three ‘hard-to-reach’ groups but also some distinct differences, suggesting that a carefully outlined strategy should be considered to reach successfully the group targeted. Electronic supplementary material The online version of this article (10.1186/s12889-019-6911-1) contains supplementary material, which is available to authorized users.

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“…Such guidance may influence behaviour change; however, information processing and, consequently, elaboration to behaviour change are complex procedures that rely on perceived relevance of the topic, quality of the message and credibility of the source that provides that message (Wilson, ). Information needs to be accessible and appropriate to all patients including “hard to reach” groups, such as older people, black, Asian and minority ethnic groups and people who do not speak English (Iliffe, Walters, Manthorpe, Goodman, & Kharicha, ). PIMs that provide simple, targeted, evidence‐based and culturally appropriate messages on diet and nutrition from credible sources such as clinical settings and charitable organisations and are available to all patients with cancer, could prompt behaviour change.…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Availability and quality assessment of online nutrition information materials for pelvic cancer patients in the UK

et al. 2019

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Objective Written information can be an essential source of support in the promotion of lifestyle changes after a cancer diagnosis. This study aimed to identify and assess the quality of available online patient information materials (PIMs) in relation to diet and nutrition for patients with pelvic cancer. Methods The online sources of the National Health Service, cancer centres and charitable organisations throughout the UK were searched. Content was assessed using an evidence‐based checklist, and readability with two validated formulas. Consumer feedback was sought through patient and public involvement (PPI) groups. Results Forty PIMs were identified; four were designed specifically for pelvic cancers (bladder, bowel, prostate) and 36 were generic (relevant for all cancers). Most PIMs had a good content score, with PIMs from charities scoring higher overall than PIMs from cancer centres [32 (4) vs. 23 (11), p < 0.001]. Seventy‐three percent of PIMs had a readability score within acceptable levels (6th–8th grade; reading ability of 11–14 year‐olds). PPI contributors found most PIMs useful and comprehensive but lacking specific information needed to meet individual needs. Conclusion There is limited availability of online PIMs for cancer survivors and even fewer tailored to pelvic cancers. Most materials have comprehensive content and acceptable readability. Some PIMs may require improvement.

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Health and well-being promotion strategies for ‘hard to reach’ older people in England: a mapping exercise

Abstract: Document analysis revealed a range of policy statements that may indicate tailoring of policy and practice to local conditions, the salience of national priorities, some innovative local responses to policy challenges and even dissenting views that seek to redefine the policy problem.

Cited by 7 publications

References 18 publications

Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

Engaging ‘hard to reach’ groups in health promotion: the views of older people and professionals from a qualitative study in England

Availability and quality assessment of online nutrition information materials for pelvic cancer patients in the UK

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