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Uemura K, Kamitani T, Watanabe A, Okamoto H, Saho K, Yamada M. Active Learning Through Video Conferencing to Maintain Physical Activity Among Older Adults: A Pilot Randomized Controlled Trial. J Aging Phys Act 2024:1-9. [PMID: 38830609 DOI: 10.1123/japa.2023-0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/12/2024] [Accepted: 04/27/2024] [Indexed: 06/05/2024]
Abstract
This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36 weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%-100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36 weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino-City, Japan
| | - Tsukasa Kamitani
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Faculty of Engineering, Center for Liberal Arts and Sciences, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Faculty of Engineering, Center for Liberal Arts and Sciences, Toyama Prefectural University, Imizu, Japan
| | - Kenshi Saho
- Department of Electronic and Computer Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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Harada K, Masumoto K, Okada S. Between- and Within-Couple Concordance for Health Behaviors Among Japanese Older Married Couples: Examining the Moderating Role of Working Time. Int J Behav Med 2024; 31:215-228. [PMID: 36991277 DOI: 10.1007/s12529-023-10174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Although previous studies report spousal concordance for health behaviors at between-couple levels, concordance at within-couple levels remains unconfirmed. To clarify the behavioral mechanisms of spousal concordance for health behaviors among older couples at both levels, it is necessary to examine the moderators (effect modifiers) of spousal concordance. This study examined (1) whether spousal concordance for dietary variety, exercise behavior, and TV viewing behavior was observed at both the between-couple and the within-couple levels and (2) whether this spousal concordance was moderated by working time among older Japanese couples. METHOD This study analyzed data obtained from a questionnaire-based, three-wave longitudinal survey (baseline, 1-year follow-up, 3-year follow-up) among 210 Japanese older couples. Each spouse's dietary variety, exercise time, TV viewing time, the couple's working time, and demographic factors were investigated by multi-level analyses. RESULTS One spouse's dietary variety and TV viewing time, but not exercise time, were significantly associated with the other spouse's corresponding behaviors at both levels. The regressions of the wife's TV viewing time on the husband's TV viewing time were moderated by working time at the within-couple level; the regressive effects of wife's TV viewing time on husband's TV viewing time were more relevant as working time was lower. CONCLUSION This study found that spousal concordance for dietary variety and TV viewing was observed at within-couple and between-couple levels among older Japanese couples. In addition, shorter working time partly moderates the wife's influence on the husband's TV viewing among older couples at the within-couple level.
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Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan.
| | - Kouhei Masumoto
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
| | - Shuichi Okada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
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Miyazaki T, Futohashi T, Baba H. Diet, Food Intake, and Exercise Mixed Interventions (DEMI) in the Enhancement of Wellbeing among Community-Dwelling Older Adults in Japan: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Geriatrics (Basel) 2024; 9:32. [PMID: 38525749 PMCID: PMC10961817 DOI: 10.3390/geriatrics9020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
This systematic review and meta-analysis discusses the available data on the efficacy of diet, food intake, and exercise mixed interventions (DEMI) for community-dwelling older adults in Japan and assesses the evidence level. We searched the literature regarding the research questions using electronic and hand-searching methods. To ensure the reliability and quality of the evidence, we used the Cochrane risk of bias tool and GRADE system. All studies included DEMI; other interventions included group activities, health education, and community participation. All interventions were categorized into three classifications, namely "Diet and food intake", "Exercise", and "Other". Programs included lectures, practical exercises, group activities, consulting, and programs that could be implemented at home. By comparing groups and measuring outcomes at various time points, most studies reported positive results regarding the impact of the interventions. Specifically, usual gait speed, Food Frequency Questionnaire Score, and Diet Variety Score demonstrated significant improvement. Additionally, three studies demonstrated improvement in frailty. This review suggests that DEMI resulted in improvements in some outcome variables. However, the efficacy of all variables was not fully examined. The results of the meta-analysis revealed positive outcomes for some variables, although the evidence level for these outcomes was considered moderate.
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Affiliation(s)
- Takaaki Miyazaki
- Department of Rehabilitation, Tokyo University of Technology, 5-23-22 Nishikamata Ota-Ku, Tokyo 144-8535, Japan;
| | - Toshihiro Futohashi
- Department of Rehabilitation, Tokyo University of Technology, 5-23-22 Nishikamata Ota-Ku, Tokyo 144-8535, Japan;
| | - Hiroki Baba
- Department of Rehabilitation, Heisei Yokohama Hospital, 550 Totsukamach Totsuka-Ku, Yokohama 244-0003, Japan;
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Li Q, Piaseu N, Phumonsakul S, Thadakant S. Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy. Nutrients 2024; 16:217. [PMID: 38257110 PMCID: PMC10820561 DOI: 10.3390/nu16020217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.
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Affiliation(s)
- Qian Li
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
- Ph.D. Candidate in the Doctor of Philosophy Program in Nursing Science (International Program), Faculty of Medicine Ramathibodi Hospital, Faculty of Nursing, Mahidol University, Salaya 73170, Thailand
| | - Noppawan Piaseu
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Srisamorn Phumonsakul
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Streerut Thadakant
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
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Calatayud E, Oliván-Blázquez B, Sánchez Peña M, Aguilar-Latorre A, Tena-Bernal O. Cognitive and functional evolution in older adults with and without intellectual disability using a multicomponent intervention: A prospective longitudinal study. Exp Gerontol 2024; 185:112352. [PMID: 38128849 DOI: 10.1016/j.exger.2023.112352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/19/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The global population is experiencing accelerated biopsychosocial aging. Cognitive impairment is frequently associated with functional impairment in basic and instrumental daily living activities. To maintain optimal cognitive and functional functioning, health professionals recommend that older adults participate in cognitive training. AIMS This study examines the cognitive and functional evolution of older adults with and without Intellectual Disability and the factors associated with favourable evolution following the intervention of a multicomponent programme based on the human occupational model and the person-centred care model. METHODS AND PROCEDURES 247 people participated. Descriptive and univariate analyses were performed to examine baseline data. The Wilcoxon paired samples test was used to compare cognitive and functional evolution one year after the intervention. Linear regression was used to detect factors predicting favourable evolution. OUTCOMES AND RESULTS Both populations improved cognitively. There was no change in basic activities of daily living. There was an improvement in instrumental activities of daily living in the group with Intellectual Disability. None of the variables collected was a predictor of greater improvement. CONCLUSIONS AND IMPLICATIONS This study demonstrated that older people with Intellectual Disability who have supports to cope with this life stage can improve their cognitive and functional abilities.
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Affiliation(s)
- Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain; Department of Psychology and Sociology, Faculty of Social and Labour Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Marta Sánchez Peña
- Aragonese Tutelary Association for Intellectual Disability (ATADES), Sonsoles Residential Centre Termine Miraflores, s / n, 50630 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), building CIBA, Avda, San Juan Bosco, 13, 50009 Zaragoza, Spain; Department of Psychology and Sociology, Faculty of Human Sciences and Education of Huesca, University of Zaragoza, 22003 Huesca, Spain.
| | - Olga Tena-Bernal
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; Aragonese Tutelary Association for Intellectual Disability (ATADES), Santo Ángel Occupational and Residential Centre, C / Ariza n°8, 50012 Zaragoza, Spain
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Liu J, Li H, Xie Y, Zhao Y, Zhao Q, Xiao M, Wang J, Huang H. Acquisition behaviours for nutrition-related information based on a health promotion model for older adults in a long-term care facility. Nurs Open 2023; 10:6416-6427. [PMID: 37344968 PMCID: PMC10416078 DOI: 10.1002/nop2.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/11/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
AIM To explore the acquisition behaviours for nutrition-related information of older adults in a long-term care facility. DESIGN A qualitative descriptive design was used in this study. METHODS Sixteen older adults in a long-term care facility were recruited using purposive sampling between March and May 2021. Data were collected via face-to-face semi-structured interviews, based on open questions regarding acquisition behaviours for nutrition-related information and flexible question formulation, and the data were analysed using an inductive-deductive method. A health promotion model was used as a conceptual framework to regulate the refinement of themes. RESULTS Three themes were identified in this study. The first theme discussed the individual characteristics and experiences of older adults that contributed to their acquisition behaviours for nutrition-related information. The second theme described behaviour-specific cognitions of and the effects on the participants regarding the influencing factors involving various internal individual elements and external physical environment. The third theme explored the positive behavioural outcomes of the participants resulting from these acquisition behaviours. CONCLUSION Acquisition behaviours for nutrition-related information of older adults in long-term care facilities were affected by both individual characteristics and external physical environment factors. Access to nutritional information can help older adults cultivate a healthy diet. Although they exhibited a significant interest in nutrition, the participants still encountered several difficulties. Based on the actual care needs of the older people, appropriate nutritional information interventions should be provided by healthcare providers working in long-term care facilities so as to improve the ability of the older people to acquire information independently. PATIENT OR PUBLIC CONTRIBUTION All 16 participants actively participated in the interview process and the preliminary preparation of the article.
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Affiliation(s)
- Jing Liu
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Huiping Li
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Ying Xie
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yong Zhao
- School of Public Health and ManagementChongqing Medical UniversityChongqingChina
| | - Qinghua Zhao
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Mingzhao Xiao
- Office of The First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jun Wang
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Huanhuan Huang
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Tamura Y, Nishiyama C, Takenouchi S, Sato R, Kiyohara K, Nin K. Development and Effectiveness of an End-of-Life Care Program for Faculty in the Critical Care Field: A Randomized Controlled Trial. J Hosp Palliat Nurs 2023; 25:178-187. [PMID: 37204851 DOI: 10.1097/njh.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
In Japan, end-of-life care education in the critical care field is still insufficient. Therefore, this study developed and verified the effectiveness of an end-of-life care program for faculty in the critical care field in Japan through a randomized controlled trial. The study was implemented from September 2016 to March 2017. Participants were 82 college teaching staff and nurses working in the critical care field. Six months after the program, data of 37 members (84.1%) of the intervention and 39 members (84.8%) [corrected] of the control group were analyzed. The results demonstrated that the primary end point-"confidence in teaching" 6 months after program completion-differed significantly between the 2 groups (2.5 [0.69] in the intervention group vs 1.8 [0.46] in the control group, P < .001). It is suggested that attending this program will give faculty in the field of critical care continued confidence in their end-of-life care teaching, as well as allow them to implement end-of-life care teaching in their field.
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Nair SC, Sreedharan J, Vijayan K, Ibrahim H. Estimation of health literacy levels in patients with cardiovascular diseases in a Gulf country. BMC Health Serv Res 2023; 23:518. [PMID: 37221529 DOI: 10.1186/s12913-023-09364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/04/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. In the United Arab Emirates (UAE), the prevalence of deaths associated with CVD is higher than the global average, and the incidence of premature coronary heart disease is 10-15 years earlier than in Western nations. In patients with CVD, inadequate health literacy (HL) is significantly associated with poor health outcomes. The goal of this study is to assess HL levels among patients with CVD in the UAE to develop effective health system strategies for disease prevention and management. METHODS A nationwide cross-sectional survey to assess HL levels in patients with CVD was conducted between January 2019 and May 2020 in the UAE. The association between health literacy level with patient age, gender, nationality, and education was determined using the Chi-Square test. The significant variables were further analyzed by ordinal regression. RESULTS Of 336 participants (86.5% response rate), approximately half 51.5% (173/336) of the respondents were women, and 46% (146/336) of them attained high school level of education. More than 75% (268/336) of the participants were above the age of 50 years. Overall, 39.3% (132/336) of respondents possessed inadequate HL, and 46.4% (156/336) and 14.3% (48/336) demonstrated marginal and adequate HL, respectively. Inadequate health literacy was more prevalent among women, as compared to men. Age was significantly associated with HL levels. Participants under age 50 had higher adequate HL levels 45.6% (31/68), (95% CI (3.8-57.4), P < 0.001). There was no correlation between education and health literacy levels. CONCLUSION The inadequate HL levels found in outpatients with CVD is a major health concern in the UAE. To improve population health outcomes, health system interventions, including targeted educational and behavioral programs for the older population are necessary.
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Affiliation(s)
- Satish Chandrasekhar Nair
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates.
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
| | - Jayadevan Sreedharan
- Department of Community Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Karthik Vijayan
- School of Medicine, Shri Satya Sai Medical College and Research Institute, Nellikuppam, India
| | - Halah Ibrahim
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Uemura K, Tsukasa K, Watanabe A, Okamoto H, Yamada M. Association between community-level health literacy and frailty in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1253-1261. [PMID: 37087703 DOI: 10.1007/s40520-023-02405-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
AIMS We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. METHODS A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. RESULTS The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. CONCLUSIONS Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan.
| | - Kamitani Tsukasa
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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Pelikan JM, Link T, Straßmayr C, Waldherr K, Alfers T, Bøggild H, Griebler R, Lopatina M, Mikšová D, Nielsen MG, Peer S, Vrdelja M. Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS 19-Q12 Instrument in Seventeen Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14129. [PMID: 36361025 PMCID: PMC9659295 DOI: 10.3390/ijerph192114129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. METHODS For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. RESULTS The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. CONCLUSIONS The HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.
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Affiliation(s)
- Jürgen M. Pelikan
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Thomas Link
- Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Christa Straßmayr
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Karin Waldherr
- Ferdinand Porsche FernFH, A-2700 Wiener Neustadt, Austria
| | - Tobias Alfers
- Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany
| | - Henrik Bøggild
- Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Robert Griebler
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Maria Lopatina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of the Russian Federation, 101000 Moscow, Russia
| | - Dominika Mikšová
- Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Marie Germund Nielsen
- Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Sandra Peer
- Institute for Water Quality and Resource Management, TU Wien, A-1040 Vienna, Austria
| | - Mitja Vrdelja
- National Institute of Public Health, 1000 Ljubljana, Slovenia
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12
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Nair SC, Sreedharan J, Satish KP, Ibrahim H. Health literacy in a high income Arab country: A nation-wide cross-sectional survey study. PLoS One 2022; 17:e0275579. [PMID: 36197929 PMCID: PMC9534436 DOI: 10.1371/journal.pone.0275579] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Health literacy is a powerful predictor of health outcomes, but remains a global challenge. There is a paucity of published data and limited understanding of the health literacy of patients in the Middle East. The purpose of this study was to assess the patient health literacy levels in the United Arab Emirates (UAE) and identify associated demographic characteristics. METHODS A cross-sectional survey of adult patients attending public and private hospitals and primary care clinics was conducted across the UAE between January 2019 and May 2020. Chi-square test was used to analyze the association between health literacy and demographic variables. Ordinal regression was adopted to analyze the data for statistically significant independent variables. RESULTS 2349 of 2971 patients responded (79% response rate). Slightly less than one-quarter (23.9%) of patients surveyed demonstrated adequate health literacy. Over a third of women respondents (31.7%) possessed adequate health literacy, as compared to only 13% of men surveyed (p<0.001). Participant age was significantly (p<0.001) associated with health literacy levels, with approximately 50% of participants above age 50 years (51-75 years) demonstrating inadequate health literacy. Education was also positively correlated with health literacy. Adequate health literacy levels were twofold higher (30.5%, p<0.001) in patients with high school education, as compared to patients without secondary education. CONCLUSIONS The high proportion of patients with inadequate health literacy in our study confirms that the health literacy deficit is a challenge in the UAE. Targeted interventions are needed to improve health literacy, particularly for older individuals, to optimize healthcare utilization and improve individual and population health outcomes.
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Affiliation(s)
- Satish Chandrasekhar Nair
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates
- College of Medicine, UAE University, Al Ain, United Arab Emirates
| | - Jayadevan Sreedharan
- Department of Community Medicine, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Halah Ibrahim
- Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
- * E-mail:
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Li M, Sonoda N, Koh C, Yasumoto R, Morimoto A. Meta-analysis of the association between health literacy and smoking. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Bocquier A, Jacquemot AF, Dubois C, Tréhard H, Cogordan C, Maradan G, Cortaredona S, Fressard L, Davin-Casalena B, Vinet A, Verger P, Darmon N, Arquier V, Briclot G, Chamla R, Cousson-Gélie F, Danthony S, Delrieu K, Dessirier J, Féart C, Fusinati C, Gazan R, Gibert M, Lamiraud V, Maillot M, Nadal D, Trotta C, Verger EO, Viriot V. Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study"). BMC Geriatr 2022; 22:643. [PMID: 35927684 PMCID: PMC9351201 DOI: 10.1186/s12877-022-03260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION Version 3.0 (November 5, 2021).
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Affiliation(s)
- Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. .,Université de Lorraine, APEMAC, F-54000, Nancy, France.
| | - Anne-Fleur Jacquemot
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France
| | | | - Hélène Tréhard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Agnès Vinet
- Avignon Université, UPR EA4278, F-84000, Avignon, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
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15
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Nakayama K, Yonekura Y, Danya H, Hagiwara K. Associations between health literacy and information-evaluation and decision-making skills in Japanese adults. BMC Public Health 2022; 22:1473. [PMID: 35918675 PMCID: PMC9344668 DOI: 10.1186/s12889-022-13892-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Health literacy among Japanese is often low, making it difficult for them to evaluate health information and make informed decisions. However, the health literacy scales applied measure the perceived difficulty of health-related tasks; they do not directly assess the specific skills needed to perform the tasks: the skills to judge the reliability of diverse information using evaluation criteria and implement rational decision-making. Therefore, the study objectives were to investigate the following issues using a nationwide survey in Japan. (1) When obtaining information, to what extent do people apply criteria for evaluating information to confirm its reliability; when making decisions, to what extent do they seek out available options and compare pros and cons based on their own values? (2) How strongly are such skills associated with health literacy and demographic characteristics? (3) What opportunities are available to learn these skills? Methods We conducted an online questionnaire survey using a Japanese Internet research company; 3,914 valid responses were received. The measures comprised health literacy (European Health Literacy Survey Questionnaire), five items on information evaluation, four items on decision-making, and items on the availability and location of learning opportunities. We calculated Pearson correlations to explore the association of health literacy with information-evaluation and decision-making skills. Multivariate analyses were also conducted using these factors as dependent variables. Results Fewer than half (30%–50%) of respondents reported always or often evaluating information and engaging in decision-making. Health literacy was significantly and positively correlated with the specific skills of information evaluation and decision-making (r = .26 and .30, respectively) as were multivariate analyses (beta = .15 and .22, respectively). Over 40% of respondents had never learned those skills. The most common resources for learning the skills were the Internet and television; less-used resources were schools and workplaces. Conclusions Both information-evaluation and decision-making skills were associated with health literacy. However, these skills are not sufficiently widespread in Japan because there are few opportunities to acquire them. More research is needed to raise awareness of the importance of such skills for improving health literacy and providing learning opportunities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13892-5.
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Affiliation(s)
- Kazuhiro Nakayama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.
| | - Yuki Yonekura
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Hitomi Danya
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Kanako Hagiwara
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
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The Impact of Physical Activity Levels and Functional Fitness Status on the Quality of Life Perceived by Older Adults Living in Rural and Urban Areas: The Portuguese Inland Case. Healthcare (Basel) 2022; 10:healthcare10071266. [PMID: 35885795 PMCID: PMC9317387 DOI: 10.3390/healthcare10071266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022] Open
Abstract
Health-related quality of life (HRQoL) is influenced by several factors, such as living place, physical activity (PA), and functional fitness levels. Evidence shows that functional fitness and PA levels are strongly associated with positive HRQoL, especially in the older population. However, the impact of the living place has not been investigated as an influencing variable in this context. Therefore, this study aimed to investigate the relationship between the HRQoL, PA, and functional fitness of older adults living in rural and urban areas of Portugal. A cross-sectional study was performed with community-dwelling adults aged 65 years and over (n = 261) living in the city of Guarda. The participants were assessed for sociodemographic, anthropometric, clinical health, HRQoL, PA levels, and functional fitness status. The results showed that rural residents presented higher scores of HRQoL and functional fitness than older individuals living in urban areas. Regression models showed that functional fitness variables influence the HRQoL overall score and mental and physical subcomponents of HRQoL, regardless of the living place. In contrast, PA levels only influenced the HRQoL score in rural residents. The findings suggest that intervention programs to improve the physical health, quality of life, and well-being of the older population need to consider the country’s different geographical areas.
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Teggart K, Ganann R, Sihota D, Moore C, Keller H, Senson C, Phillips SM, Neil-Sztramko SE. Group-based nutrition interventions to promote healthy eating and mobility in community-dwelling older adults: a systematic review. Public Health Nutr 2022; 25:1-32. [PMID: 35570675 PMCID: PMC9991860 DOI: 10.1017/s136898002200115x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/28/2022] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status and improve physical mobility among community-dwelling older adults. DESIGN Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO and Sociological Abstracts were searched on July 15, 2020 for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute's tools) and data extraction were performed in duplicate by two independent reviewers. SETTING Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded. PARTICIPANTS Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded. RESULTS Thirty-one experimental and quasi-experimental studies with generally unclear to high risk of bias were included. Interventions included nutrition education with behaviour change techniques (BCT) (e.g. goal setting, interactive cooking demonstrations) (n 21), didactic nutrition education (n 4), interactive nutrition education (n 2), food access (n 2) and nutrition education with BCT and food access (n 2). Group-based nutrition education with BCT demonstrated the most promise in improving food and fluid intake, nutritional status and healthy eating knowledge compared with baseline or control. The impact on mobility outcomes was unclear. CONCLUSIONS Group-based nutrition education with BCT demonstrated the most promise for improving healthy eating among community-dwelling older adults. Our findings should be interpreted with caution related to generally low certainty, unclear to high risk of bias and high heterogeneity across interventions and outcomes. Higher quality research in group-based nutrition education for older adults is needed.
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Affiliation(s)
- Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Davneet Sihota
- Global Health Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Heather Keller
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Christine Senson
- Healthy and Safe Communities Department, City of Hamilton Public Health Services, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ONL8S 4L8, Canada
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Harada K. Effectiveness, Moderators and Mediators of Self-regulation Intervention on Older Adults' Exercise Behavior: a Randomized, Controlled Crossover Trial. Int J Behav Med 2022; 29:659-675. [PMID: 34997522 PMCID: PMC8741142 DOI: 10.1007/s12529-021-10049-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/16/2022]
Abstract
Background Although self-regulation interventions are effective in promoting exercise behaviors, moderators and mediators of interventions among older adults are not well established. This study aimed to examine whether (1) self-regulation intervention promoted exercise behavior, (2) health literacy and habit strength moderated the intervention effect, and (3) self-regulation and habit strength mediated the intervention effect among older adults. Methods This study was a randomized, non-blinded, controlled crossover trial. The baseline questionnaire survey assessed the average amount of exercise time per day, self-regulation, habit strength, health literacy, and socio-demographic factors. After the baseline survey, 393 community-dwelling older adults were randomly assigned to either the immediate intervention or the delayed intervention group. For the immediate group, print-based materials were provided once a week for 7 weeks before a second questionnaire survey. For the delayed group, the materials were provided only after the second survey. Finally, a third survey was conducted for both groups. Results The mixed models showed that the average exercise time was increased after the intervention in both groups. Multiple regression analyses revealed that no factor moderated the intervention effect. From the path analyses, the mediating effect of self-regulation on the relationship between intervention and changes in average exercise time was supported, but the mediating role of habit strength was not clearly indicated. Conclusions Although the mediating roles of habit strength for the intervention effects are still inconclusive, self-regulation intervention can promote exercise behavior among older adults, regardless of their health literacy level, habit strength, and socio-demographic characteristics. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10049-3.
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Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan.
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Psychometric Properties of the Health Literacy Scale Used in the Taiwan Longitudinal Study on Middle-Aged and Older People. Healthcare (Basel) 2021; 9:healthcare9101391. [PMID: 34683071 PMCID: PMC8535643 DOI: 10.3390/healthcare9101391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 11/26/2022] Open
Abstract
Health literacy, an important factor in public and personal health, is regarded as the core of patient-centered care. Older people with high health literacy are more likely to maintain a healthier lifestyle, with good control and management of chronic diseases, than those lacking or with poor health literacy. Purpose: The present study investigated the validity and reliability of the Taiwan Longitudinal Study on Aging (TLSA) Health Literacy Scale. We also evaluated the health literacy of middle-aged and older Taiwanese adults, and its probable association with health outcomes and life satisfaction. Method: We analyzed the internal consistency reliability of the nine items of the 2015 TLSA Health Literacy Scale, and their relationship with the demographic variables. Brody Instrumental Activities of Daily Living (IADL) and the Life Satisfaction Index were used for criterion validity. Moreover, exploratory factor analysis was used to examine the construct validity and to test the known-group validity. Results: The TLSA health literacy scale has good internal consistency reliability. Criterion-related validity was supported by the fact that the health literacy score was significantly correlated with the IADL and Life Satisfaction Index. Factor analysis indicated a three-factor structure. Known-group validity was supported by the results, showing that middle-aged and older people with good self-reported health status had better health literacy. Conclusions: The TLSA health literacy scale is a reliable and valid instrument for measuring health literacy in middle-aged and older people.
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Uemura K, Watanabe A, Kamitani T, Yamada M, Saho K, Okamoto H. Feasibility of active learning health education by video conferencing among older adults. Geriatr Gerontol Int 2021; 21:1064-1066. [PMID: 34569139 DOI: 10.1111/ggi.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Kazuki Uemura
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Kenshi Saho
- Department of Intelligent Robotics, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
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Shinohara T, Saida K, Tanaka S, Miyata K, Yamagami T. Effects of assessment-oriented group action supported by a health professional on the physical function in community-dwelling older adults: a feasibility study. Physiother Theory Pract 2021; 38:2495-2504. [PMID: 34097565 DOI: 10.1080/09593985.2021.1934927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Assessment-oriented group action (AGA) could be used to empower community-dwelling older adults to maintain their health by groups. AGA can be implemented with the support of a health professional to provide feedback to older adults on physical and cognitive function.Objective: To evaluate the effects of AGA.Methods: For this feasibility study, we enrolled 23 and 20 participants in the intervention and control groups, respectively. Thοse in the intervention group received feedback of their assessments and devised exercise plans with professional support. The participants performed their exercises over 12 weeks; the follow-up examination was conducted at 40 weeks. The control group only received feedback. The change in health-related consciousness and behavior was evaluated. Muscle strength and mass were measured and the timed up and go test, and the Brief-balance evaluation system test (BESTest) were performed.Results: There were no significant differences in consciousness or behavior between the groups. The score was higher in the intervention than in the control group at 40 weeks in Section-I of the Brief-BESTest, indicating that the muscle strength contributed to balance function.Conclusion: AGA did not show positive changes in consciousness or behaviors but demonstrated significant improvements and lasting effects in balance function.
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Affiliation(s)
- Tomoyuki Shinohara
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki-shi, Japan
| | - Kosuke Saida
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki-shi, Japan
| | - Shigeya Tanaka
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki-shi, Japan
| | - Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Science, Ibaraki, Japan
| | - Tetsuya Yamagami
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi-shi, Japan
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Holst C, Sukums F, Ngowi B, Diep LM, Kebede TA, Noll J, Winkler AS. Digital Health Intervention to Increase Health Knowledge Related to Diseases of High Public Health Concern in Iringa, Tanzania: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e25128. [PMID: 33885369 PMCID: PMC8103301 DOI: 10.2196/25128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/28/2021] [Accepted: 03/17/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Traditionally, health promotion and health education have been provided to communities in the global south in the form of leaflets or orally by health care workers. Digital health interventions (DHIs) such as digital health messages accessed by smartphones have the potential to reach more people at a lower cost and to contribute to strengthening of health care systems. The DHI in this study focuses on disseminating digital health education regarding 3 disease complexes of high public health concern: HIV/AIDS, tuberculosis, and Taenia solium (neuro)cysticercosis or taeniasis, a parasitic zoonotic disease that requires a One Health approach. The DHI presents the participants with animated health videos (animations) and provides access to information spots (InfoSpots) with a free-of-charge digital health platform containing messages about health to rural Tanzanian communities. OBJECTIVE The objective of this study is to measure the effect of the DHI on health knowledge uptake and retention over time in the rural communities. METHODS This is a mixed methods study including a nonrandomized controlled trial and qualitative interviews conducted in rural Tanzania. A health platform containing digital health messages for the communities was developed prior to the study. The health messages consist of text, pictures, quizzes, and animations of everyday stories, aimed at disease prevention and early treatment. The baseline and immediate postintervention assessments were completed in Iringa, Tanzania in May 2019. The participants were interviewed by enumerators and completed questionnaires regarding health knowledge. Participants in the intervention group were exposed to 3 different health animations once on a tablet device. The participants' health knowledge was assessed again immediately after the exposure. The first follow-up survey was undertaken in August 2019. The InfoSpots with the digital health platform were thereafter launched in the intervention villages in November 2019. Qualitative interviews were undertaken in February 2020. The second follow-up was completed in June 2020. RESULTS A total of 600 participants have been enrolled in the trial. We will assess (1) the difference in knowledge scores between baseline and the immediate postintervention assessments in the intervention group and (2) the difference in knowledge scores between the intervention and control groups at baseline, 3 and 6 months post-DHI rollout. Since a randomized design did not prove feasible, potential confounders (eg, age, gender, education, and time of exposure) may be introduced, and results will be adjusted. Data analysis for the 35 qualitative interviews is currently ongoing, and perspectives and experiences related to use and nonuse of the InfoSpots are being explored. CONCLUSIONS The data have been collected, and the analysis is ongoing in this digital health study, aimed at evaluating the effects of a DHI based on relevant health messages. The publications of results can be expected this year. TRIAL REGISTRATION ClinicalTrials.gov NCT03808597; https://clinicaltrials.gov/ct2/show/NCT03808597. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/25128.
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Affiliation(s)
- Christine Holst
- Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Felix Sukums
- Directorate of ICT, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Bernard Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, United Republic of Tanzania
- Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, United Republic of Tanzania
| | - Lien My Diep
- Oslo Centre for Biostatistics & Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Josef Noll
- Basic Internet Foundation, Kjeller, Norway
- Department of Technology Systems, University of Oslo, Oslo, Norway
| | - Andrea Sylvia Winkler
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Center for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany
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23
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Beidelschies M, Alejandro-Rodriguez M, Guo N, Postan A, Jones T, Bradley E, Hyman M, Rothberg MB. Patient outcomes and costs associated with functional medicine-based care in a shared versus individual setting for patients with chronic conditions: a retrospective cohort study. BMJ Open 2021; 11:e048294. [PMID: 33849860 PMCID: PMC8051390 DOI: 10.1136/bmjopen-2020-048294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To compare outcomes and costs associated with functional medicine-based care delivered in a shared medical appointment (SMA) to those delivered through individual appointments. DESIGN A retrospective cohort study was performed to assess outcomes and cost to deliver care to patients in SMAs and compared with Propensity Score (PS)-matched patients in individual appointments. SETTING A single-centre study performed at Cleveland Clinic Center for Functional Medicine. PARTICIPANTS A total of 9778 patients were assessed for eligibility and 7323 excluded. The sample included 2455 patients (226 SMAs and 2229 individual appointments) aged ≥18 years who participated in in-person SMAs or individual appointments between 1 March 2017 and 31 December 2019. Patients had a baseline Patient-Reported Outcome Measurement Information System (PROMIS) Global Physical Health (GPH) score and follow-up score at 3 months. Patients were PS-matched 1:1 with 213 per group based on age, sex, race, marital status, income, weight, body mass index, blood pressure (BP), PROMIS score and functional medicine diagnostic category. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was change in PROMIS GPH at 3 months. Secondary outcomes included change in PROMIS Global Mental Health (GMH), biometrics, and cost. RESULTS Among 213 PS-matched pairs, patients in SMAs exhibited greater improvements at 3 months in PROMIS GPH T-scores (mean difference 1.18 (95% CI 0.14 to 2.22), p=0.03) and PROMIS GMH T-scores (mean difference 1.78 (95% CI 0.66 to 2.89), p=0.002) than patients in individual appointments. SMA patients also experienced greater weight loss (kg) than patients in individual appointments (mean difference -1.4 (95% CI -2.15 to -0.64), p<0.001). Both groups experienced a 5.5 mm Hg improvement in systolic BP. SMAs were also less costly to deliver than individual appointments. CONCLUSION SMAs deliver functional medicine-based care that improves outcomes more than care delivered in individual appointments and is less costly to deliver.
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Affiliation(s)
| | | | - Ning Guo
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anna Postan
- Community Care, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tawny Jones
- Center for Functional Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Elizabeth Bradley
- Center for Functional Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mark Hyman
- Center for Functional Medicine, Cleveland Clinic, Cleveland, Ohio, USA
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24
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Uemura K, Yamada M, Kamitani T, Watanabe A, Okamoto H. [Effects of health literacy on frailty status at two-year follow-up in older adults: A prospective cohort study]. Nihon Ronen Igakkai Zasshi 2021; 58:101-110. [PMID: 33627545 DOI: 10.3143/geriatrics.58.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To investigate the longitudinal association between health literacy and frailty status at two-year follow-up in community-dwelling older adults. METHODS A total of 218 older adults (mean age, 72.5±4.9 [range 65-86] years old; men, n=81) without frailty at baseline participated in this study. Functional health literacy was assessed using the Newest Vital Sign (NVS). Comprehensive health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Comprehensive health literacy indices are constructed as a general health literacy index comprising all items along with the three sub-indices of health care, disease prevention, and health promotion domains. Demographic data and other potential confounding factors were also assessed. The total Kihon checklist score was used to monitor the presence of frailty based on a score of ≥8 at the 2-year follow-up (postal survey). RESULTS Of the 253 participants in the follow-up survey, 226 responded (response rate: 89.3%). Excluding the 8 participants with missing values, 25 (11.5%) of the 218 were reported to be frail. A multiple logistic regression analysis indicated that comprehensive health literacy (total score of HLS-EU-Q47) was independently associated with a lower risk of frailty (odds ratio per standard deviation = 0.54, 95% confidence interval = 0.33-0.87) after adjusting for the covariates (age, gender, education, body mass index, gait speed, cognitive function, and comorbidities). The health care and disease prevention domain scores of the HLS-EU-Q47 were also independently associated with a lower risk of frailty. Functional health literacy (NVS score) was not associated with frailty. CONCLUSIONS Older adults with higher comprehensive health literacy are less likely to be frail at two-year follow-up than those with a lower literacy.
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Affiliation(s)
- Kazuki Uemura
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University
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25
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Association of Health Literacy with the Implementation of Exercise during the Declaration of COVID-19 State of Emergency among Japanese Community-Dwelling Old-Old Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042100. [PMID: 33670041 PMCID: PMC7926347 DOI: 10.3390/ijerph18042100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 01/06/2023]
Abstract
Health literacy is important for promoting and maintaining good health in old-old adults. It may influence the implementation of exercise in the coronavirus disease epidemic. The present cross-sectional study investigated the association of each dimension of health literacy with the implementation of exercise during the declaration of a state of emergency due to coronavirus disease in community-dwelling old-old adults. We collected data from 483 community-dwelling old-old adults (52.8% women) aged between 77 and 99 years who participated in a mail survey. Participants were divided into exercise or nonexercise groups based on the implementation of exercise during the declaration of a state of emergency. Health literacy was assessed using a 14-item health literacy scale. There were 327 (67.7%) participants in the exercise group and 156 (32.3%) in the nonexercise group. A significantly higher score of health literacy was observed in the exercise group than in the nonexercise group (communicative health literacy score = 14.0 ± 3.6 vs. 12.7 ± 3.8, p = 0.001). In a multivariate logistic regression model adjusted for potential confounders, high communicative health literacy scores were significantly associated with the implementation of exercise during the declaration of a state of emergency (odds ratio = 1.88, 95% confidence interval = 1.20–2.93). Approximately two-thirds of community-dwelling old-old adults implement exercise during the declaration of a state of emergency. High communicative health literacy was associated with the implementation of exercise during this period.
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26
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Uemura K, Yamada M, Okamoto H. The Effectiveness of an Active Learning Program in Promoting a Healthy Lifestyle among Older Adults with Low Health Literacy: A Randomized Controlled Trial. Gerontology 2020; 67:25-35. [PMID: 33271536 DOI: 10.1159/000511357] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/05/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Older adults often have a greater need for health information and health care services because access to these helps them manage their health and the chronic conditions of aging. Therefore, low health literacy bears a special significance for the population of older adults. OBJECTIVES The aim of this study was to examine the effects of an active learning program on health literacy, lifestyle behaviors, physical function, and mental health among community-dwelling older adults with low health literacy. METHODS This single-blind, randomized controlled trial involved 60 participants aged ≥65 years with a low health literacy who were randomly assigned to an intervention (n = 30) or control (n = 30) group. Across 24 weeks, the intervention group attended weekly 90-min active learning program sessions, which involved exploratory learning, group work, and the self-planning of behavior changes that promote a healthy lifestyle. The control group attended a 90-min class, which was taught in accordance with the didactic teaching method. For both groups, the programs focused on the role of exercise, diet/nutrition, and cognitive activity for promoting health among older adults. The outcome measures were administered at baseline and week 24. Comprehensive health literacy (i.e., primary outcome) was assessed using the Health Literacy Scale-14. Lifestyle factors (i.e., physical activity, dietary variety, life-space mobility, and social network size), physical function, and depressive symptoms were measured. We used a linear mixed model to estimate the intervention effects in accordance with the intention-to-treat approach. RESULTS When compared to the control group, the intervention group demonstrated a significant improvement in communicative health literacy, step count, engagement in moderate-to-vigorous physical activity, dietary variety, life-space mobility, social network size, grip strength, gait speed, and depressive symptoms. CONCLUSIONS The active learning program can promote a healthy lifestyle and prevent functional decline among older adults who lack the confidence to engage in health communication.
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Affiliation(s)
- Kazuki Uemura
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan,
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
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27
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Aihara Y, Maeda K. Dementia Literacy and Willingness to Dementia Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218134. [PMID: 33158014 PMCID: PMC7662832 DOI: 10.3390/ijerph17218134] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 05/31/2023]
Abstract
The increasing prevalence of delayed and missed diagnoses for dementia constitutes major public concern. In this regard, inadequate knowledge and poor understanding of the condition may create a barrier to timely dementia screening. This cross-sectional study assessed dementia literacy, then identified the association between dementia literacy and willingness to undergo routine dementia screening among community-dwelling older adults in two urban areas of Japan. More specifically, structured questionnaires were distributed to a total of 854 individuals aged ≥ 65 years. A multivariate logistic regression was then used to explore the factors associated with dementia literacy and willingness to undergo routine dementia screening. Results showed that younger respondents and respondents who received dementia information from television/radio and/or paper-based sources were more likely to have high dementia literacy. While less than half of participants were willing to undergo routine dementia screening, those with higher dementia literacy were more willing to do so (albeit, not a statistically significant difference). Although there are pros and cons to routine dementia screening, it is necessary to implement such a system to detect dementia and cognitive impairment. Further, assessments should also attempt to gain information about individual beliefs and understandings related to dementia information.
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28
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Uemura K, Yamada M, Kuzuya M, Okamoto H. Effects of Active Learning Education on Arterial Stiffness of Older Adults with Low Health Literacy: A Randomized Controlled Trial. J Atheroscler Thromb 2020; 28:865-872. [PMID: 33071262 PMCID: PMC8326177 DOI: 10.5551/jat.58354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim:
We examined the effects of active learning education on arterial stiffness and physical activity of community-dwelling older adults with low health literacy.
Methods:
This study is a secondary analysis of randomized controlled trial of 60 participants aged 65 and older with low health literacy. The intervention group (
n
=30) participated in a weekly 90-minute active learning program session for 24 weeks, which addressed health promotion in older age. The control group (
n
=30) attended a 90-minute health education class in a didactic manner. The outcomes were measured at baseline and in week 24. The degree of arterial stiffness was assessed based on the cardio-ankle vascular index (CAVI) using the VS-1500 device (Fukuda Denshi Co., Ltd., Tokyo, Japan). The shortened version of the self-reported International Physical Activity Questionnaire was used to assess the amount of total physical activity determined by the metabolic equivalent hours per week. We used analysis by intention-to-treat, with multiple imputation for missing data.
Results:
Seven participants (11.7%) dropped out prior to the post-intervention assessment. The multiple imputation analysis revealed that the intervention group showed significant improvement in CAVI [between-groups difference (95% confidence interval)=-0.78 (-1.25 to -0.31), Cohen’s
d
=0.82] and physical activity [32.5 (0.3 to 64.7), Cohen’s
d
=0.57] as compared with the control group. The sensitivity analysis for the complete cases showed similar results.
Conclusion:
Active learning health education may be effective in improving arterial stiffness and physical activity in older adults with low health literacy.
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Affiliation(s)
- Kazuki Uemura
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Masafumi Kuzuya
- Institutes of Innovation for Future Society, Nagoya University.,Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University
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29
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Kita Y, Machida S, Shibagaki Y, Sakurada T. Fact-finding survey on health literacy among Japanese predialysis chronic kidney disease patients: a multi-institutional cross-sectional study. Clin Exp Nephrol 2020; 25:224-230. [PMID: 33063230 DOI: 10.1007/s10157-020-01982-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Low health literacy (HL) has been associated with poor chronic disease management and adverse outcomes. However, reports on HL in predialysis chronic kidney disease (CKD) patients are limited in Japan. METHODS From August 2019 to February 2020, the European Health Literacy Survey (Japanese version) and a patient background survey (highest level of education, income, social activities, and exercise habit) were conducted on adult predialysis CKD patients. We compared clinical parameters in two groups according to the average HL score of a healthy Japanese population. In addition, a median value of 42 items was used as a cutoff for extracting CKD patient background factors associated with HL since HLS-EU-Q47 included five items related to physical activity and exercise. RESULTS Valid responses were received from 200 patients. Median general HL index was 25.2 points. The high-HL group (≥ 25.3 points) showed a low proportion of male (56.7% vs. 70.9%, p = 0.038), high social activities (69.1% vs. 48.5%, p = 0.003), and high exercise habit (36.1% vs. 13.6%, p < 0.001). In the multivariate analysis, social activity [OR (95% CI); 2.12 (1.16-3.89), p = 0.015] and exercise habit [OR (95% CI); 2.39 (1.16-4.90), p = 0.018] were extracted as the only significant variable. CONCLUSIONS HL in Japanese predialysis CKD patients was associated with high social activity and exercise habit.
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Affiliation(s)
- Yohei Kita
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Shinji Machida
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Tsutomu Sakurada
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
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30
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Sugai K, Imamura H, Michikawa T, Asakura K, Nishiwaki Y. Awareness of Locomotive Syndrome and Factors Associated with Awareness: A Community-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197272. [PMID: 33027956 PMCID: PMC7579478 DOI: 10.3390/ijerph17197272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022]
Abstract
Locomotive syndrome is a condition of reduced mobility, and patients have a high risk of requiring nursing care. In order to investigate the level of awareness of the term “locomotive syndrome” and the factors relating to awareness in a community, awareness of locomotive syndrome was included in a questionnaire survey on health and daily life conducted in Koumi Town (Japan), which was distributed to 3181 eligible residents aged 40 years or older. Information on age, sex, marital status, educational attainment, lifestyle, and social environment was also collected, and the association of awareness with various factors was analyzed with two multivariable Poisson regression models. As a result, awareness among respondents was 44.6%. Awareness was significantly higher among women, those who were 60–79 years old, married, and had received higher education. Additionally, awareness was significantly associated with social factors, especially attendance at regional events within the last one year, in both women and men: the adjusted prevalence ratios (95% confidence intervals) were 1.26 (1.10–1.43) and 1.48 (1.19–1.83), respectively. In conclusion, in addition to strengthen awareness rising campaigns targeting men and for younger people, providing health education at social settings such as regional events may help improve future musculoskeletal health in the elderly.
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Affiliation(s)
- Keiko Sugai
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan;
| | - Haruhiko Imamura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo 143-8540, Japan; (T.M.); (K.A.); (Y.N.)
- Correspondence: ; Tel.: +81-3-3762-4151
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo 143-8540, Japan; (T.M.); (K.A.); (Y.N.)
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo 143-8540, Japan; (T.M.); (K.A.); (Y.N.)
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo 143-8540, Japan; (T.M.); (K.A.); (Y.N.)
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31
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Anami K, Murata S, Nakano H, Nonaka K, Iwase H, Shiraiwa K, Abiko T, Goda A, Horie J. The Association between Health Literacy and Gait Speed in Community-Dwelling Older Adults. Healthcare (Basel) 2020; 8:healthcare8040369. [PMID: 32998262 PMCID: PMC7712768 DOI: 10.3390/healthcare8040369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/24/2020] [Indexed: 01/19/2023] Open
Abstract
The association between gait speed, a vital health outcome in older adults, and health literacy, an important health promotion aspect, is unclear. This study examined the relationship of gait speed with health literacy, physical function, and cognitive function in community-dwelling older adults. The subjects were 240 older adults (52 men, mean age 73.8 ± 6.0 years). Gender, age, and education were self-reported, while height and weight were measured directly. Health literacy was evaluated using Communicative and Critical Health Literacy (CCHL). Grip strength, knee extension strength, toe-grip strength, sit-up test, sit-and-reach test, one-leg stance test time, 30-s chair-stand test (CS-30), and normal gait speed were measured. Subjects were divided into two groups based on normal gait speed—fast (speed ≥ 1.3 m/s) and slow (<1.3 m/s). In the logistic regression analysis, the dependent variable was normal gait speed (fast/slow). Four logistic regression models were utilized to determine whether health literacy affects gait speed. Height and CCHL were found to independently affect gait speed. That health literacy influences gait speed is a new discovery.
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Affiliation(s)
- Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan;
- Correspondence: ; Tel.: +81-742-93-5427
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan;
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan;
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
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Belleville S, Cuesta M, Bieler-Aeschlimann M, Giacomino K, Widmer A, Mittaz Hager AG, Perez-Marcos D, Cardin S, Boller B, Bier N, Aubertin-Leheudre M, Bherer L, Berryman N, Agrigoroaei S, Demonet JF. Rationale and protocol of the StayFitLonger study: a multicentre trial to measure efficacy and adherence of a home-based computerised multidomain intervention in healthy older adults. BMC Geriatr 2020; 20:315. [PMID: 32859156 PMCID: PMC7453698 DOI: 10.1186/s12877-020-01709-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background In older adults, multidomain training that includes physical and cognitive activities has been associated with improvement of physical and cognitive health. The goal of the multisite StayFitLonger study is to assess a home-based computerised training programme, which combines physical exercises, stimulating cognitive activities and virtual coaching. Methods One hundred twenty-eight cognitively healthy older adults will be recruited from the community in Switzerland, Canada and Belgium. The study will comprise (1) a 26-week double-blind randomized controlled efficacy trial and (2) a 22-week pragmatic adherence sub-study. In the efficacy trial, participants will be randomly assigned to an experimental or an active control intervention. In the experimental intervention, participants will use the StayFitLonger programme, which is computerised on a tablet and provides content that combines physical activities with a focus on strength and balance, as well as divided attention, problem solving and memory training. Outcomes will be measured before and after 26 weeks of training. The primary efficacy outcome will be performance on the “Timed-Up & Go” test. Secondary outcomes will include measures of frailty, cognition, mood, fear of falling, quality of life, and activities of daily living. Age, sex, education, baseline cognition, expectation, and adherence will be used as moderators of efficacy. Following the 26-week efficacy trial, all participants will use the experimental programme meaning that participants in the control group will ‘cross over’ to receive the StayFitLonger programme for 22 weeks. Adherence will be measured in both groups based on dose, volume and frequency of use. In addition, participants’ perception of the programme and its functionalities will be characterised through usability, acceptability and user experience. Discussion This study will determine the efficacy, adherence and participants’ perception of a home-based multidomain intervention programme and its functionalities. This will allow for further development and possible commercialization of a scientifically validated training programme. Trial registration ClinicalTrials.gov, NCT04237519 Registered on January 22, 2020 - Retrospectively registered.
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Affiliation(s)
- S Belleville
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada. .,Université de Montréal, Montréal, Canada.
| | - M Cuesta
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada
| | - M Bieler-Aeschlimann
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland.,MindMaze SA, Lausanne, Switzerland
| | - K Giacomino
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | - A Widmer
- HES-SO Valais-Wallis, School of Managment, Sierre, Switzerland
| | - A G Mittaz Hager
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | | | - S Cardin
- MindMaze SA, Lausanne, Switzerland
| | - B Boller
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - N Bier
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada
| | - M Aubertin-Leheudre
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - L Bherer
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada.,Montréal Heart Institute, Montréal, Canada
| | - N Berryman
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - S Agrigoroaei
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J F Demonet
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland
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Uemura K, Kamitani T, Yamada M, Okamoto H. Longitudinal Effects of Active Learning Education on Lifestyle Behavior and Physical Function in Older Adults. J Am Med Dir Assoc 2020; 22:459-463. [PMID: 32631801 DOI: 10.1016/j.jamda.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Sustaining benefits of an exercise program is difficult as adherence is often poor after supervised intervention is over. This study aimed to determine whether the effects of active learning education on physical activity, dietary habits, and physical function were maintained 24 weeks after intervention termination in older adults. DESIGN Non-randomized controlled trial. SETTING AND PARTICIPANTS Community-dwelling older adults aged ≥65 years who were independent in activities of daily living. METHODS The intervention group (n = 36) underwent 24 weeks of active learning education. The control group (n = 59) attended a health education class didactically. In both groups, the education program focused on exercise, diet and nutrition, and cognitive activity for health promotion. Active learning included exploratory learning, group work, and self-planning for behavior change that promoted healthy lifestyles. Outcome measures were obtained at baseline (pre), 24 weeks (post), and 48 weeks (follow-up). Physical activity was objectively measured as physical activity level (PAL) using a triaxial accelerometer. Food intake was assessed by obtaining a dietary variety score. Physical function, including gait speed and Timed Up & Go score, was tested as secondary outcome. We used a linear mixed model to estimate the effects of intervention in intention-to-treat analyses. RESULTS All outcomes in the intervention group significantly improved compared with the control group at 24 weeks, and the improvements were sustained over a 48-week follow-up period. For PAL, between-group difference in change from baseline was 0.043 (95% confidence interval = 0.007, 0.080) at 24 weeks and 0.061 (0.023, 0.099) at 48 weeks. CONCLUSIONS AND IMPLICATIONS Active learning education is effective in enhancing healthy lifestyles and physical function sustainability beyond intervention cessation. A randomized controlled trial with a larger sample size is needed to conclusively clarify the beneficial effects of active health education learning on sustainable behavior change and functional improvement.
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Affiliation(s)
- Kazuki Uemura
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan.
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
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Walters R, Leslie SJ, Polson R, Cusack T, Gorely T. Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC Public Health 2020; 20:1040. [PMID: 32605608 PMCID: PMC7329558 DOI: 10.1186/s12889-020-08991-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/27/2020] [Indexed: 12/29/2022] Open
Abstract
Background The primary aim of this review was to establish whether health literacy interventions, in adults, are effective for improving health literacy. Two secondary aims assessed the impact of health literacy interventions on health behaviours and whether health literacy interventions have been conducted in cardiovascular patients. Methods A systematic review (Prospero registration: CRD42018110772) with no start date running through until April 2020. Eligible studies were conducted in adults and included a pre/post measure of health literacy. Medline, Embase, Eric, PsychINFO, CINAHL, Psychology and Behavioural Science, HMIC, Web of Science, Scopus, Social Care Online, NHS Scotland Journals, Social Policy and Practice, and Global Health were searched. Two thousand one hundred twenty-seven papers were assessed, and 57 full text papers screened to give 22 unique datasets from 23 papers. Risk of bias was assessed regarding randomisation, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting and other biases. Intervention reporting quality was assessed using the TIDieR checklist. Results Twenty-two studies were included reporting on 10,997 participants in nine countries. The majority of studies (14/22) were published in 2018 or later. Eight studies (n = 1268 participants) also reported on behavioural outcomes. Health literacy interventions resulted in improvements in at least some aspect of health literacy in 15/22 studies (n = 10,180 participants) and improved behavioural outcomes in 7/8 studies (n = 1209 participants). Only two studies were conducted with cardiovascular patients. All studies were at risk of bias with 18 judged as high risk. In addition, there was poor reporting of intervention content with little explication of the theoretical basis for the interventions. Conclusions Health literacy interventions can improve health literacy and can also lead to changes in health behaviours. Health literacy interventions offer a way to improve outcomes for populations most at risk of health inequalities. Health literacy is a developing field with very few interventions using clear theoretical frameworks. Closer links between health literacy and behaviour change theories and frameworks could result in higher quality and more effective interventions. Prospero registration Prospero registration: CRD42018110772
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Affiliation(s)
- Ronie Walters
- Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK.
| | - Stephen J Leslie
- Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK.,NHS Highlands, Cardiology Department, Raigmore Hospital, Old Perth Road, Inverness, IV2 3JH, UK
| | - Rob Polson
- Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK
| | - Tara Cusack
- University College Dublin, Health Sciences Building, Bellfield, Dublin, Ireland
| | - Trish Gorely
- Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH, UK
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Kota M, Moriishi M, Hazama A, Hiramoto K. Assessment of the effects of a group intervention program used in home-dwelling elderly individuals to promote home exercise and prevent locomotive syndrome. J Phys Ther Sci 2019; 31:470-474. [PMID: 31320781 PMCID: PMC6565839 DOI: 10.1589/jpts.31.470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/02/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We assessed the effects of a group intervention program used in home-dwelling elderly individuals to promote home exercise and prevent locomotive syndrome. [Participants and Methods] Pre- and post-intervention evaluations were performed in all participants. Group intervention was performed thrice between the pre- and post-intervention evaluations in all participants. A total of 19 elderly individuals participated in the pre- and post-intervention evaluations. Tests used for evaluation were the two-step test, standing-up test, and 25-question geriatric locomotive function scale. [Results] Among all participants in this study, 12 who performed all 3 aforementioned tests were classified as the non-absence group, whereas 7 who were absent more than once were classified as the absence group. We examined intergroup differences with respect to changes between the pre- and post-intervention evaluations, and we observed significant changes only in the results of the two-step test. [Conclusion] We conclude that low-frequency intervention in the form of workshops led to positive results with respect to improved physical function in home-dwelling elderly individuals.
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Affiliation(s)
- Munetsugu Kota
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University: 3-2-1 Otsuka-Higashi, Asaminami-ku, Hiroshima City, Hiroshima 731-3166, Japan
| | | | - Ayane Hazama
- Welfare Department at Nishi Ward, Hiroshima City, Japan
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Lin SC, Chen IJ, Yu WR, Lee SYD, Tsai TI. Effect of a community-based participatory health literacy program on health behaviors and health empowerment among community-dwelling older adults: A quasi-experimental study. Geriatr Nurs 2019; 40:494-501. [PMID: 30935677 DOI: 10.1016/j.gerinurse.2019.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/13/2019] [Accepted: 03/15/2019] [Indexed: 02/07/2023]
Abstract
This study evaluated the effect of a community-based participatory health literacy program aimed at improving the health behaviors and health empowerment for older adults. A two-group pretest and posttest quasi-experimental design with surveys conducted at baseline (T1), immediately after the intervention (T2), and 6 months after the intervention (T3). The intervention group (n = 94) attended a 12-week health literacy program; while the comparison group (n = 78) did not. The results demonstrated that intervention group had significantly better health behavior practices for weight control (OR = 3.71, 95% CI = 1.59-8.64), regular exercise (OR = 15.26, 95% CI = 1.92-121.13), and health information navigation (OR = 2.61, 95% CI = 1.16-5.84). Health empowerment was significantly higher in the intervention group than the comparison group (p < 0.01).This study suggests that integrating community-based participatory design is effective in improving some health behaviors and health empowerment in older adults over a short period.
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Affiliation(s)
- Sz-Ching Lin
- School of Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan.
| | - I-Ju Chen
- School of Nursing, National Yang-Ming University, Taipei, Taiwan.
| | - Wen-Ry Yu
- Division of Family Medicine, Taipei City Hospital, Taipei, Taiwan.
| | - Shoou-Yih D Lee
- Department of Health Management and Policy, Faculty Lead, Griffith Leadership Center, The University of Michigan School of Public Health, USA.
| | - Tzu-I Tsai
- School of Nursing, National Yang-Ming University, Taipei, Taiwan.
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