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Grice-Jackson T, Rogers I, Ford E, Dickinson R, Frere-Smith K, Goddard K, Silver L, Topham C, Nahar P, Musinguzi G, Bastiaens H, Van Marwijk H. A community health worker led approach to cardiovascular disease prevention in the UK-SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project. FRONTIERS IN HEALTH SERVICES 2024; 4:1152410. [PMID: 38784704 PMCID: PMC11113076 DOI: 10.3389/frhs.2024.1152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/20/2024] [Indexed: 05/25/2024]
Abstract
Background This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.
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Affiliation(s)
- Thomas Grice-Jackson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Robert Dickinson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Kat Frere-Smith
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Katie Goddard
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Linda Silver
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Catherine Topham
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Papreen Nahar
- Department of Global Health Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Central Region, Uganda
| | - Hilde Bastiaens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Harm Van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
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Zhang W, Wang J, Xie F, Wang X, Dong S, Luo N, Li F, Li Y. Development and validation of machine learning models to predict frailty risk for elderly. J Adv Nurs 2024. [PMID: 38605460 DOI: 10.1111/jan.16192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/16/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
AIMS Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly. DESIGN A prospective cohort study. METHODS We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6-7 surveys (2011-2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2-8) in 2000-2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6-7). Model performance was assessed by receiver operating curve and F2-score. RESULTS Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%). CONCLUSION Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly. IMPACT The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life. REPORTING METHOD The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Wei Zhang
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Junchao Wang
- China-Japan Union Hospital of Jilin University, Changchun, China
| | - Fang Xie
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xinghui Wang
- School of Nursing, Jilin University, Changchun, China
| | - Shanshan Dong
- Hepatopancreatobiliary Surgery Department, General External Center, First Hospital of Jilin University, Changchun, China
| | - Nan Luo
- The Second Hospital of Jilin University, Changchun, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, China
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Wang G, Chang F, Gu Z, Kasraian D, van Wesemael PJV. Co-designing community-level integral interventions for active ageing: a systematic review from the lens of community-based participatory research. BMC Public Health 2024; 24:649. [PMID: 38424550 PMCID: PMC10905784 DOI: 10.1186/s12889-024-18195-5] [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: 10/11/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND While community-level interventions for promoting active ageing have received increasing attention and there is a trend to leverage technology to support traditional physical or social interventions, little hands-on guidance exists for designing these integral interventions. This study aimed to examine the interventions reported in the literature guided by Community-Based Participatory Research (CBPR) principles. The goal is to extract insights that inform future practices in co-designing integral interventions for active ageing. METHODS The systematic review focused on community-level interventions promoting active ageing that integrated physical, social, and digital elements, i.e., integral interventions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The included interventions were analysed abductively based on the CBPR principles. RESULTS A total of 13 studies were included, and 24 design considerations were generated under eight categories. Further reflection identified the interrelated nature of these design considerations and pinpointed the gaps in current research. This study highlights the urgency and importance of sharing recruitment methods and resource allocation details, recording and reporting collaboration specifics, and disseminating findings to stakeholders beyond academia. CONCLUSIONS This study offers valuable insights and practical guidance to researchers and practitioners developing community-level integral interventions for active ageing. The findings also serve as a starting point for accumulating knowledge and practice in co-designing integral interventions for active ageing at the community level. The next crucial phase involves evaluating these design considerations within real-world cases to assess their applicability and identify potential areas for improvement.
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Affiliation(s)
- Gubing Wang
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands.
| | - Fangyuan Chang
- School of Design, Shanghai Jiao Tong University, Shanghai, China.
| | - Zhenyu Gu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Dena Kasraian
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Pieter J V van Wesemael
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands
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Grice-Jackson T, Rogers I, Ford E, Van Marwijk H, Topham C, Musinguzi G, Bastiaens H, Gibson L, Bower M, Nahar P. The Pre-Implementation Phase of a Project Seeking to Deliver a Community-Based CVD Prevention Intervention (SPICES-Sussex): A Qualitative Study Exploring Views and Experience Relating to Intervention Development. Health Promot Pract 2023:15248399231182139. [PMID: 37386868 DOI: 10.1177/15248399231182139] [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: 07/01/2023]
Abstract
BACKGROUND. Community-led health care interventions may be an effective way to tackle cardiovascular disease (CVD) risk factors, especially in materially deprived communities where health care resources are stretched and engagement with institutions is often low. To do so effectively and equitably, interventions might be developed alongside community members through community engagement. OBJECTIVES. The aim of this project was to carry out stakeholder mapping and partnership identification and to understand the views, needs, experiences of community members who would be involved in later stages of a community-based CVD prevention intervention's development and implementation. METHODS. Stakeholder mapping was carried out to identify research participants in three communities in Sussex, United Kingdom. A qualitative descriptive approach was taken during the analysis of focus groups and interviews with 47 participants. FINDINGS. Three themes were highlighted related to intervention design (a) Management: the suitability of the intervention for the community, management of volunteers, and communication; (b) Logistics: the structure and design of the intervention; and (c) Sociocultural issues, the social and cultural expectations/experiences of participants and implementers. CONCLUSIONS. Study participants were open and willing to engage in the planned community-based intervention, particularly in elements of co-design and community-led delivery. They also highlighted the importance of sociocultural factors. Based on the findings, we developed recommendations for intervention design which included (but were not limited to): (a) a focus on a bottom-up approach to intervention design, (b) the recruitment of skilled local volunteers, and (c) the importance of fun and simplicity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mark Bower
- Nottingham Trent University, Nottingham, UK
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Wang G, Kasraian D, Valk C, Lu Y, Hurst W, Jambroes M, van Wesemael P. A Toolkit for Co-Designing towards Community-Based Active Ageing: Lessons Learned during Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15591. [PMID: 36497666 PMCID: PMC9739725 DOI: 10.3390/ijerph192315591] [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: 10/15/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
It is increasingly recognized that community-based interventions for active ageing are more lasting and effective, yet the tools and methods for developing these interventions are lacking. This study investigates how to co-design community-based active ageing with older adults via the development of a toolkit to support this goal. Rapid reviews were conducted to understand (i) the effective behavioural change techniques for older adults, (ii) how to co-design with older adults for community-based interventions, and (iii) how to design tools for behaviour change that are easy to use. These reviews served as the foundation for developing a toolkit to support the co-design of community-based active ageing, which was evaluated during an interdisciplinary hackathon with older adults. Quantitative data from the surveys suggested that the confidence levels of students in developing interventions for health behaviour change and in co-designing with older adults increased after the hackathon, and the enjoyment of participating in the hackathon and of using the toolkit were statistically significant factors influencing this increase. Qualitative data from interviews and observations revealed how the toolkit was (un)used by the participants and what aspects of the toolkit can be improved. We encourage future researchers and practitioners to apply and adapt our research findings to the communities of older adults that they are working with.
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Affiliation(s)
- Gubing Wang
- Department of Built Environment, Eindhoven University of Technology, 5600MB Eindhoven, The Netherlands
| | - Dena Kasraian
- Department of Built Environment, Eindhoven University of Technology, 5600MB Eindhoven, The Netherlands
| | - Carlijn Valk
- Department of Industrial Design, Eindhoven University of Technology, 5600MB Eindhoven, The Netherlands
| | - Yuan Lu
- Department of Industrial Design, Eindhoven University of Technology, 5600MB Eindhoven, The Netherlands
| | - William Hurst
- Department of Informational Technology, Wageningen University and Research, 6706KN Wageningen, The Netherlands
| | - Marielle Jambroes
- Department of Public Health, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands
| | - Pieter van Wesemael
- Department of Built Environment, Eindhoven University of Technology, 5600MB Eindhoven, The Netherlands
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van Velsen L, Ludden G, Grünloh C. The Limitations of User-and Human-Centered Design in an eHealth Context and How to Move Beyond Them. J Med Internet Res 2022; 24:e37341. [PMID: 36197718 PMCID: PMC9582917 DOI: 10.2196/37341] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/27/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022] Open
Abstract
Human-centered design (HCD) is widely regarded as the best design approach for creating eHealth innovations that align with end users’ needs, wishes, and context and has the potential to impact health care. However, critical reflections on applying HCD within the context of eHealth are lacking. Applying a critical eye to the use of HCD approaches within eHealth, we present and discuss 9 limitations that the current practices of HCD in eHealth innovation often carry. The limitations identified range from limited reach and bias to narrow contextual and temporal focus. Design teams should carefully consider if, how, and when they should involve end users and other stakeholders in the design process and how they can combine their insights with existing knowledge and design skills. Finally, we discuss how a more critical perspective on using HCD in eHealth innovation can move the field forward and offer 3 directions of inspiration to improve our design practices: value-sensitive design, citizen science, and more-than-human design. Although value-sensitive design approaches offer a solution to some of the biased or limited views of traditional HCD approaches, combining a citizen science approach with design inspiration and imagining new futures could widen our view on eHealth innovation. Finally, a more-than-human design approach will allow eHealth solutions to care for both people and the environment. These directions can be seen as starting points that invite and support the field of eHealth innovation to do better and to try and develop more inclusive, fair, and valuable eHealth innovations that will have an impact on health and care.
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Affiliation(s)
- Lex van Velsen
- eHealth Department, Roessingh Research and Development, Enschede, Netherlands.,Department of Communication Science, University of Twente, Enschede, Netherlands
| | - Geke Ludden
- Department of Design, Production and Management, University of Twente, Enschede, Netherlands
| | - Christiane Grünloh
- eHealth Department, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Systems and Signals group, University of Twente, Enschede, Netherlands
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Partogi M, Gaviria-Valencia S, Alzate Aguirre M, Pick NJ, Bhopalwala HM, Barry BA, Kaggal VC, Scott CG, Kessler ME, Moore MM, Mitchell JD, Chaudhry R, Bonacci RP, Arruda-Olson AM. Sociotechnical Intervention for Improved Delivery of Preventive Cardiovascular Care to Rural Communities: Participatory Design Approach. J Med Internet Res 2022; 24:e27333. [PMID: 35994324 PMCID: PMC9446142 DOI: 10.2196/27333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 12/30/2021] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Clinical practice guidelines recommend antiplatelet and statin therapies as well as blood pressure control and tobacco cessation for secondary prevention in patients with established atherosclerotic cardiovascular diseases (ASCVDs). However, these strategies for risk modification are underused, especially in rural communities. Moreover, resources to support the delivery of preventive care to rural patients are fewer than those for their urban counterparts. Transformative interventions for the delivery of tailored preventive cardiovascular care to rural patients are needed. Objective A multidisciplinary team developed a rural-specific, team-based model of care intervention assisted by clinical decision support (CDS) technology using participatory design in a sociotechnical conceptual framework. The model of care intervention included redesigned workflows and a novel CDS technology for the coordination and delivery of guideline recommendations by primary care teams in a rural clinic. Methods The design of the model of care intervention comprised 3 phases: problem identification, experimentation, and testing. Input from team members (n=35) required 150 hours, including observations of clinical encounters, provider workshops, and interviews with patients and health care professionals. The intervention was prototyped, iteratively refined, and tested with user feedback. In a 3-month pilot trial, 369 patients with ASCVDs were randomized into the control or intervention arm. Results New workflows and a novel CDS tool were created to identify patients with ASCVDs who had gaps in preventive care and assign the right care team member for delivery of tailored recommendations. During the pilot, the intervention prototype was iteratively refined and tested. The pilot demonstrated feasibility for successful implementation of the sociotechnical intervention as the proportion of patients who had encounters with advanced practice providers (nurse practitioners and physician assistants), pharmacists, or tobacco cessation coaches for the delivery of guideline recommendations in the intervention arm was greater than that in the control arm. Conclusions Participatory design and a sociotechnical conceptual framework enabled the development of a rural-specific, team-based model of care intervention assisted by CDS technology for the transformation of preventive health care delivery for ASCVDs.
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Cowdell F, Dyson J, Sykes M, Dam R, Pendleton R. How and how well have older people been engaged in healthcare intervention design, development or delivery using co-methodologies: A scoping review with narrative summary. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:776-798. [PMID: 33103313 DOI: 10.1111/hsc.13199] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/17/2020] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
Co-methodological working is gaining increasing traction in healthcare, but studies with older people have been slower to develop. Our aim was to investigate how and how well older people have been engaged in healthcare intervention design, development or delivery using co-methodologies. We conducted a systematic search of four electronic databases to identify international literature published between 2009 and November 2019. We included peer-reviewed empirical research of any design. Three authors screened papers. Our review is reported in accordance with the Joanna Briggs Institute manual for scoping reviews, we have referred to the preferred reporting items for systematic reviews and meta-analyses statement. We data extracted to a bespoke spreadsheet and used the Co:Create Co-production Matrix to guide quality appraisal. Included studies (n = 48) were diverse in nature of interventions, co-methodologies and reporting. We offer a narrative summary of included papers. Establishing how older people were engaged in co-methodological work was largely straightforward. How well this was done was more challenging, however we have identified gems of good practice and offered directions for future practice. The Co:Create Co-Production Matrix was the best fit for evaluating papers, however it is not intended as a measure per se. In essence we argue that notions of 'best' and 'scores' are an oxymoron in co-methodological working, what is important that: (a) researchers embrace these methods, (b) incremental change is the way forward, (c) researchers need to do what is right for people and purpose and (d) have time to consider and articulate why they are choosing this approach and how best this can be achieved for their particular situation. Future evaluation of participant's experience of the process would enable others to learn about what works for who and in what circumstances.
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Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Judith Dyson
- School of Health Sciences, City University, London, UK
| | - Michael Sykes
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rinita Dam
- Department of Zoology, University of Oxford, Oxford, UK
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Sumner J, Chong L, Bundele A, Wei Lim Y. Co-Designing Technology for Aging in Place: A Systematic Review. THE GERONTOLOGIST 2021; 61:e395-e409. [PMID: 32506136 PMCID: PMC8437501 DOI: 10.1093/geront/gnaa064] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is a growing interest to involve older adults in the co-design of technology to maintain their well-being and independence. What remains unknown is whether the beneficial effects of co-designed solutions are greater than those reported for non co-designed solutions. The aim of this study was to evaluate the effects and experiences of co-designed technology that support older adults to age in place. RESEARCH DESIGN AND METHODS We conducted a systematic review to (a) investigate the health and well-being outcomes of co-designed technology for older adults (≥60 years), (b) identify co-design approaches and contexts where they are applied, and (c) identify barriers and facilitators of the co-design process with older adults. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey, and Business Source Premiere. RESULTS We identified 14,649 articles and included 34 projects. Four projects reported health and well-being outcomes; the effects were inconsistent. Co-design processes varied greatly and in their intensity of older adult involvement. Common facilitators of and barriers to co-design included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, and expertise in the co-design methodology. DISCUSSION AND IMPLICATIONS The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to older adults. Evaluation of the impact of co-designed technologies is needed and standardization of the definition of co-design would be helpful to researchers and designers.
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Affiliation(s)
- Jennifer Sumner
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Lin Siew Chong
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Anjali Bundele
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Yee Wei Lim
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
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Ngaruiya N, Ochieng DO, Waiganjo P. Psychosocial variables of the interactive mobile interface for geriatric persons in a Kenyan setting: An exploratory study. JOURNAL OF PSYCHOLOGY IN AFRICA 2021. [DOI: 10.1080/14330237.2021.1952701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Njeri Ngaruiya
- School of Computing and Information Technologies, Technical University of Kenya, Nairobi, Kenya
- School of Computing and Informatics, University of Nairobi, Nairobi, Kenya
| | | | - Peter Waiganjo
- School of Computing and Informatics, University of Nairobi, Nairobi, Kenya
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Broekhuis M, Weering MDV, Schuit C, Schürz S, van Velsen L. Designing a stakeholder-inclusive service model for an eHealth service to support older adults in an active and social life. BMC Health Serv Res 2021; 21:654. [PMID: 34225745 PMCID: PMC8256482 DOI: 10.1186/s12913-021-06597-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Service model design is slowly being recognized among eHealth developers as a valuable method for creating durable implementation strategies. Nonetheless, practical guidelines and case-studies that inform the community on how to design a service model for an eHealth innovation are lacking. This study describes the development of a service model for an eHealth service, titled 'SALSA', which intends to support older adults with a physically active and socially inclusive lifestyle. METHODS The service model for the SALSA service was developed in eight consecutive rounds, using a mixed-methods approach. First, a stakeholder salience analysis was conducted to identify the most relevant stakeholders. In rounds 2-4, in-depth insights about implementation barriers, facilitators and workflow processes of these stakeholders were gathered. Rounds 5 and 6 were set up to optimize the service model and receive feedback from stakeholders. In rounds 7 and 8, we focused on future implementation and integrating the service model with the technical components of the eHealth service. RESULTS While the initial goal was to create one digital platform for the eHealth service, the results of the service modelling showed how the needs of two important stakeholders, physiotherapists and sports trainers, were too different for integrating them in one platform. Therefore, the decision was made to create two platforms, one for preventive (senior sports activities) and one for curative (physical rehabilitation) purposes. CONCLUSIONS A service model shows the interplay between service model design, technical development and business modelling. The process of service modelling helps to align the interests of the different stakeholders to create support for future implementation of an eHealth service. This study provides clear documentation on how to conduct service model design processes which can enable future learning and kickstart new research. Our results show the potential that service model design has for service development and innovation in health care.
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Affiliation(s)
- Marijke Broekhuis
- Roessingh Research and Development, eHealth group, Roessinghsbleekweg 33b, 7522AH, Enschede, The Netherlands. .,Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands.
| | | | - Cheyenne Schuit
- National Foundation for the Elderly, Smallepad 30e, 3811 MG, Amersfoort, The Netherlands
| | | | - Lex van Velsen
- Roessingh Research and Development, eHealth group, Roessinghsbleekweg 33b, 7522AH, Enschede, The Netherlands.,Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
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Ching Wong AK, Yuet Wong FK, Sum Chow KK, Man Wong S. Effects of a Video-Based mHealth Program for Homebound Older Adults: Study Protocol for a Pilot Randomized Controlled Trial. Gerontology 2021; 68:353-360. [PMID: 34161946 DOI: 10.1159/000516967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although homebound older adults are among the highest users of hospital services, the existing health and social services that are provided to them in the community are limited and fragmented. This study attempts to bring this group of older adults to providers' attention by designing a health-social-oriented self-care mobile Health (mHealth) program and subjecting it to empirical testing. The aim of this study is to shift the current reactive, cure-oriented approach to a preventive and health-promoting model, empowering homebound older adults to take an active role in their health, be responsive to their care needs, and subsequently improve their holistic health. METHODS This is a pilot randomized controlled trial. The study is supported by 5 community centers with an estimated sample size of 68 subjects. The subjects will be randomly assigned to video-based mHealth or control groups when they (1) are aged 60 or over, (2) go outdoors less than once a week in the current 6 months, (3) live within the service areas, and (4) use a smartphone. Subjects in the video-based mHealth group will receive a 3-month program comprising 2 main interventions: nurse case management supported by a social service team and video messages covering self-care topics, delivered via smartphone. The control group will receive usual care. Data will be collected at 2 time points - pre-intervention (T1) and post-intervention (T2). The primary outcome will be self-efficacy, and secondary outcomes will include health outcomes (activities of daily living, instrumental activities of daily living, and medication adherence), perceived well-being outcomes (quality of life and depression), and health service utilization outcomes (outpatient clinic, emergency room, and hospital admission). DISCUSSION The current study will add to the knowledge gap in using mHealth supported by a health-social team to enhance quality of life and self-care and meet the needs of these particularly vulnerable older adults.
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Affiliation(s)
| | | | | | - Siu Man Wong
- The Hong Kong Lutheran Social Service, Homantin, Hong Kong, China
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13
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Dubuc N, Brière S, Corbin C, N'Bouke A, Bonin L, Delli-Colli N. Computerized Care-Pathways (CCPs) System to Support Person-Centered, Integrated, and Proactive Care in Home-Care Settings. Inform Health Soc Care 2021; 46:100-111. [PMID: 33406972 DOI: 10.1080/17538157.2020.1865969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This paper describes the software design/development process leading to an improved computerized clinical/management solution-RSIPA (2016 version)-integrating care pathways (CPs) specifically designed to meet the needs of frail and disabled older adults in home care. The development methodology used Soft Systems Methodology (SSM) for the initial system design and participatory design (PD) to involve stakeholders and end users, along with AGILE SCRUM methodology to provide rapid iterations in adapting to new requests. Given scarce project resources, we opted to combine methodologies to efficiently deliver a fully functional system for three of the five CP clinical phases. The development methodology aggregated assessment-based data to identify risk factors and assist in needs prioritization leading to care plans and addressed in the current system. The new Quebec RSIPA solution incorporating CCPs is a promising example of technologies that support person-centered care, clinical and management processes, and proactive care in home-care settings.
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Affiliation(s)
- Nicole Dubuc
- Faculty of Arts, Humanities and Social Sciences, Université de Sherbrooke , Sherbrooke, Quebec, Canada.,Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CHUS) , Sherbrooke, Quebec, Canada
| | - Simon Brière
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CHUS) , Sherbrooke, Quebec, Canada
| | - Cinthia Corbin
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CHUS) , Sherbrooke, Quebec, Canada
| | - Afiwa N'Bouke
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CHUS) , Sherbrooke, Quebec, Canada
| | - Lucie Bonin
- Direction de la santé publique, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Mauricie-et-du-Centre-du-Québec , Trois-Rivières, Quebec, Canada
| | - Nathalie Delli-Colli
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CHUS) , Sherbrooke, Quebec, Canada
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14
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A Microservices e-Health System for Ecological Frailty Assessment Using Wearables. SENSORS 2020; 20:s20123427. [PMID: 32560529 PMCID: PMC7349271 DOI: 10.3390/s20123427] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 01/09/2023]
Abstract
The population in developed countries is aging and this fact results in high elderly health costs, as well as a decrease in the number of active working members to support these costs. This could lead to a collapse of the current systems. One of the first insights of the decline in elderly people is frailty, which could be decelerated if it is detected at an early stage. Nowadays, health professionals measure frailty manually through questionnaires and tests of strength or gait focused on the physical dimension. Sensors are increasingly used to measure and monitor different e-health indicators while the user is performing Basic Activities of Daily Life (BADL). In this paper, we present a system based on microservices architecture, which collects sensory data while the older adults perform Instrumental ADLs (IADLs) in combination with BADLs. IADLs involve physical dimension, but also cognitive and social dimensions. With the sensory data we built a machine learning model to assess frailty status which outperforms the previous works that only used BADLs. Our model is accurate, ecological, non-intrusive, flexible and can help health professionals to automatically detect frailty.
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15
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Lawless MT, Archibald MM, Ambagtsheer RC, Kitson AL. Factors influencing communication about frailty in primary care: A scoping review. PATIENT EDUCATION AND COUNSELING 2020; 103:436-450. [PMID: 31551158 DOI: 10.1016/j.pec.2019.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/14/2019] [Accepted: 09/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To summarise the available evidence on the factors influencing communication about frailty in the primary care setting. METHODS We conducted a scoping review, searching five electronic databases (PubMed, Scopus, CINAHL, PsycINFO, and ProQuest) for studies addressing communication about frailty in primary care practice. Reference list and grey literature searching was conducted to identify additional articles. A narrative descriptive method was used to synthesise the findings. RESULTS The search identified 3185 articles and 37 were included in the review. We identified five categories of factors influencing communication about frailty at the consumer, healthcare provider, and system levels: (1) consumer perceptions, information needs, and communication preferences; (2) healthcare providers' knowledge, capacities, and attitudes; (3) clinical communication skills and training; (4) availability of information and communication technologies; and (5) care coordination, collaboration, and case management. CONCLUSION Findings offer considerations for the design and delivery of initiatives to improve communication about frailty in primary care both at the local clinical level and at the broader level of healthcare service delivery. PRACTICE IMPLICATIONS Healthcare providers and systems require practical, evidence-informed guidance regarding the development of a systematic approach to the quality and timing of communication about frailty in healthcare encounters.
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Affiliation(s)
- Michael T Lawless
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; National Health and Medical Research Council Centre of Research Excellence in Transdisciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.
| | - Mandy M Archibald
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; National Health and Medical Research Council Centre of Research Excellence in Transdisciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
| | | | - Alison L Kitson
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; National Health and Medical Research Council Centre of Research Excellence in Transdisciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
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16
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Gwyther H, van Velsen L, Shaw RL, D'Avanzo B, Bujnowska-Fedak M, Kurpas D, Szwamel K, Van't Klooster JW, Holland C. The use of technology in the context of frailty screening and management interventions: a study of stakeholders' perspectives. BMC Med Inform Decis Mak 2019; 19:110. [PMID: 31186018 PMCID: PMC6560850 DOI: 10.1186/s12911-019-0828-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 05/29/2019] [Indexed: 11/22/2022] Open
Abstract
Background Health and social care interventions show promise as a way of managing the progression of frailty in older adults. Information technology could improve the availability of interventions and services for older adults. The views of stakeholders on the acceptability of technological solutions for frailty screening and management have not been explored. Methods Focus groups were used to gather data from healthy and frail/pre-frail older adults, health and social care providers, and caregivers in three European countries – Italy, Poland and UK. Data were analysed using framework analysis in terms of facilitators or determinants of older adults’ adoption of technology. Results Our findings clustered around the perceived value; usability, affordability and accessibility; and emotional benefits of frailty screening and management technology to stakeholders. We also noted issues relating to social support, previous experience of technology and confidence of stakeholders. Conclusions Professionals and caregivers understand the benefits of technology to facilitate frailty care pathways but these views are tempered by concerns around social isolation. Frail older adults raised legitimate concerns about the accessibility and usability of technology, specifically around the potential for their personal information to be compromised. Solutions must be developed within a framework that addresses social contexts and avoids stigma around frailty and ageing.
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Affiliation(s)
- Holly Gwyther
- The Centre for Ageing Research, Lancaster University, Lancaster, LA1 4YG, UK.
| | - Lex van Velsen
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522, Enschede, AH, Netherlands
| | - Rachel L Shaw
- Research Centre for Healthy Ageing, School of Life and Health Sciences, Aston University, B4 7ET, Birmingham, UK
| | - Barbara D'Avanzo
- Laboratory of Quality Assessment of Geriatric Therapies and Services, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maria Bujnowska-Fedak
- Family Medicine Department, Wroclaw Medical University, Syrokomli 1, 51-141, Wroclaw, Poland
| | - Donata Kurpas
- Family Medicine Department, Wroclaw Medical University, Syrokomli 1, 51-141, Wroclaw, Poland.,Opole Medical School, ul. Katowicka 68, 45-060, Opole, Poland
| | - Katarzyna Szwamel
- Family Medicine Department, Wroclaw Medical University, Syrokomli 1, 51-141, Wroclaw, Poland.,Opole Medical School, ul. Katowicka 68, 45-060, Opole, Poland
| | - Jan-Willem Van't Klooster
- BMS Lab, Faculty of behavioural, management and social sciences, University of Twente, Drienerlolaan 5, 7522, Enschede, NB, Netherlands
| | - Carol Holland
- The Centre for Ageing Research, Lancaster University, Lancaster, LA1 4YG, UK
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17
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Jansen-Kosterink S, van Velsen L, Frazer S, Dekker-van Weering M, O'Caoimh R, Vollenbroek-Hutten M. Identification of community-dwelling older adults at risk of frailty using the PERSSILAA screening pathway: a methodological guide and results of a large-scale deployment in the Netherlands. BMC Public Health 2019; 19:504. [PMID: 31053090 PMCID: PMC6500037 DOI: 10.1186/s12889-019-6876-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background Among community-dwelling older adults, frailty is highly prevalent and recognized as a major public health concern. To prevent frailty it is important to identify those at risk of becoming frail, but at present, no accepted screening procedure is available. Methods The screening process developed as part of the PERSSILAA project is a two-step screening pathway. First, older adults are asked to complete a self-screening questionnaire to assess their general health status and their level of decline on physical, cognitive and nutritional domains. Second, older adults who, according to step one, are at risk of becoming frail, are invited for a face-to-face assessment focusing on the domains in depth. We deployed the PERSSILAA screening procedure in primary care in the Netherlands. Results In total, baseline data were available for 3777 community-dwelling older adults (mean age 69.9 (SD ± 3.8)) who completed first step screening. Based on predefined cut-off scores, 16.8% of the sample were classified as frail (n = 634), 20.6% as pre-frail (n = 777), and 62.3% as robust (n = 2353). Frail subjects were referred back to their GP without going through the second step. Of the pre-frail older adults, 69.7% had evidence of functional decline on the physical domain, 67% were overweight or obese and 31.0% had evidence of cognitive decline. Conclusion Pre-frailty is common among community-dwelling older adults. The PERSSILAA screening approach is a multi-factor, two-step screening process, potentially useful for primary prevention to identify those at risk of frailty and who will benefit most from preventive strategies.
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Affiliation(s)
- Stephanie Jansen-Kosterink
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522, AL, Enschede, The Netherlands. .,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands.
| | - Lex van Velsen
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522, AL, Enschede, The Netherlands.,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands
| | - Sanne Frazer
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522, AL, Enschede, The Netherlands.,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands
| | - Marit Dekker-van Weering
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522, AL, Enschede, The Netherlands.,University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands
| | - Rónán O'Caoimh
- Centre for Gerontology and Rehabilitation, University College Cork, Cork City, Ireland.,Clinical Sciences Institute, National University of Ireland Galway, Galway City, Ireland
| | - Miriam Vollenbroek-Hutten
- University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, the Netherlands.,ZiekenhuisGroep Twente (ZGT), scientific office ZGT academie, Almelo, the Netherlands
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18
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Tziraki-Segal C, De Luca V, Santana S, Romano R, Tramontano G, Scattola P, Celata C, Gelmi G, Ponce Márquez S, Lopez-Samaniego L, Zavagli V, Halkoaho A, Grimes C, Tomás MT, Fernandes B, Calzà L, Speranza P, Coppola L, Jager-Wittenaar H, O'Caoimh R, Pietilä AM, Carriazo AM, Apostolo J, Iaccarino G, Liotta G, Tramontano D, Molloy W, Triassi M, Viggiani V, Illario M. Creating a Culture of Health in Planning and Implementing Innovative Strategies Addressing Non-communicable Chronic Diseases. FRONTIERS IN SOCIOLOGY 2019; 4:9. [PMID: 33869336 PMCID: PMC8022497 DOI: 10.3389/fsoc.2019.00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/01/2019] [Indexed: 06/12/2023]
Abstract
Ongoing demographic changes are challenging health systems worldwide especially in relation to increasing longevity and the resultant rise of non-communicable diseases (NCDs). To meet these challenges, a paradigm shift to a more proactive approach to health promotion, and maintenance is needed. This new paradigm focuses on creating and implementing an ecological model of Culture of Health. The conceptualization of the Culture of Health is defined as one where good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities where citizens have the opportunity to make choices and be co-producers of healthy lifestyles. Based on Antonovsky's Salutogenesis model which asserts that the experience of health moves along a continuum across the lifespan, we will identify the key drivers for achieving a Culture of Health. These include mindset/expectations, sense of community, and civic engagement. The present article discusses these drivers and identifies areas where policy and research actions are needed to advance positive change on population health and well-being. We highlight empirical evidence of drivers within the EU guided by the activities within the thematic Action Groups of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA), focusing on Lifespan Health Promotion and Prevention of Age-Related Frailty and Disease (A3 Action Group). We will specifically focus on the effect of Culture on Health, highlighting cross-cutting drivers across domains such as innovations at the individual and community level, and in synergies with business, policy, and research entities. We will present examples of drivers for creating a Culture of Health, the barriers, the remaining gaps, and areas of future research to achieve an inclusive and sustainable asset-based community.
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Affiliation(s)
- Chariklia Tziraki-Segal
- Israel Gerontological Data Center, Hebrew University of Jerusalem, Jerusalem, Israel
- MELABEV- Community Clubs for Elders, Jerusalem, Israel
| | - Vincenzo De Luca
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Silvina Santana
- Department of Economics, Management, Industrial Engineering and Tourism, Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
| | - Rosa Romano
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Giovanni Tramontano
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - Paola Scattola
- Health Protection Agency of the Metropolitan City of Milan, Milan, Italy
| | - Corrado Celata
- Health Promotion, Screening and Prevention Unit, Milan, Italy
| | - Giusi Gelmi
- Health Protection Agency of the Metropolitan City of Milan, Milan, Italy
| | - Sara Ponce Márquez
- International Research Projects Office (IRPO), Universidad de Deusto, Bilbao, Spain
| | - Luz Lopez-Samaniego
- Progress and Health Foundation, Regional Ministry of Health of Andalucía, Seville, Spain
| | | | - Arja Halkoaho
- School of Health Care and Social Services Education and R&D, Tampere University of Applied Sciences, Tampere, Finland
| | - Corrina Grimes
- Public Health Agency of Northern Ireland, Belfast, United Kingdom
| | - Maria Teresa Tomás
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Beatriz Fernandes
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Laura Calzà
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Patrizia Speranza
- General Affairs Unit, Federico II University Hospital, Naples, Italy
| | - Liliana Coppola
- Health Promotion, Screening and Prevention Unit, Milan, Italy
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Rónán O'Caoimh
- Department of Medicine, Clinical Sciences Institute, National University of Ireland, Galway, Ireland
| | - Anna-Maija Pietilä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Joao Apostolo
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Guido Iaccarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Donatella Tramontano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - William Molloy
- Clinical Gerontology and Rehabilitation Centre, Gerontology and Rehabilitation School of Medicine, University College of Cork, Cork, Ireland
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | | | - Maddalena Illario
- Health Innovation Division, General Directorate for Health, Naples, Italy
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19
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Recognizing Physical Activity of Older People from Wearable Sensors and Inconsistent Data. SENSORS 2019; 19:s19040880. [PMID: 30791587 PMCID: PMC6412200 DOI: 10.3390/s19040880] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/15/2019] [Accepted: 02/04/2019] [Indexed: 11/25/2022]
Abstract
The physiological monitoring of older people using wearable sensors has shown great potential in improving their quality of life and preventing undesired events related to their health status. Nevertheless, creating robust predictive models from data collected unobtrusively in home environments can be challenging, especially for vulnerable ageing population. Under that premise, we propose an activity recognition scheme for older people exploiting feature extraction and machine learning, along with heuristic computational solutions to address the challenges due to inconsistent measurements in non-standardized environments. In addition, we compare the customized pipeline with deep learning architectures, such as convolutional neural networks, applied to raw sensor data without any pre- or post-processing adjustments. The results demonstrate that the generalizable deep architectures can compensate for inconsistencies during data acquisition providing a valuable alternative.
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20
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De Luca V, Tramontano G, Del Giudice C, Grimaldi I, Romano R, Liguori I, Carpinelli Mazzi M, Di Carluccio N, Riccio PA, Speranza P, Iavarone A, Abete P, Postiglione A, Cataldi M, Vallone C, Giallauria F, Cittadini A, Triggiani M, Savastano S, Menditto E, Leonardini L, Colao A, Triassi M, Iaccarino G, Postiglione A, Coscioni E, Illario M. Innovative Approaches to Active and Healthy Ageing: Campania Experience to Improve the Adoption of Innovative Good Practices. Transl Med UniSa 2019; 19:116-123. [PMID: 31360676 PMCID: PMC6581492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level.
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Affiliation(s)
- V De Luca
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,
| | - G Tramontano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - C Del Giudice
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Grimaldi
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - R Romano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Liguori
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Carpinelli Mazzi
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - PA Riccio
- Associazione Progetto Alfa Onlus, Marigliano NA, Italy
| | - P Speranza
- Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - A Iavarone
- Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy
| | - P Abete
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Cataldi
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy
| | - C Vallone
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - F Giallauria
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Cittadini
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triggiani
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy
| | - S Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - E Menditto
- Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - L Leonardini
- Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy
| | - A Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - G Iaccarino
- Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy
| | - E Coscioni
- Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - M Illario
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy,Consorzio Farmacie Servizi (COFASER), Sarno SA, Italy,Associazione Progetto Alfa Onlus, Marigliano NA, Italy,Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy,Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy,Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy,Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy,Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy,Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy,Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy,Unità Operativa Dipartimentale Promozione e potenziamento di programmi Health Innovation (DG04), Regione Campania, Naples, Italy
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Bousquet J, Illario M, Farrell J, Batey N, Carriazo AM, Malva J, Hajjam J, Colgan E, Guldemond N, Perälä-Heape M, Onorato GL, Bedbrook A, Leonardini L, Stroetman V, Birov S, Abreu C, Abrunhosa A, Agrimi A, Alalääkkölä T, Allegretti N, Alonso-Trujillo F, Álvarez-Benito M, Angioli S, Apóstolo J, Armitage G, Arnavielhe S, Baena-ParejoI M, Bamidis PD, Balenović A, Barbolini M, Baroni I, Blain H, Bernard PL, Bersani M, Berti E, Bogatyrchuk L, Bourret R, Brehm J, Brussino L, Buhr D, Bultje D, Cabeza E, Cano A, De Capitani C, Carantoña E, Cardoso A, Coll Clavero JI, Combe B, Conforti D, Coppola L, Corti F, Coscioni E, Costa E, Crooks G, Cunha A, Daien C, Dantas, Darpón Sierra J, Davoli M, Dedeu Baraldes A, De Luca V, De Nardi L, Di Ciano M, Dozet A, Ekinci B, Erve S, Espinoza Almendro JM, Fait A, Fensli R, Fernandez Nocelo S, Gálvez-Daza P, Gámez-Payá J, García Sáez M, Garcia Sanchez I, Gemicioğlu B, Goetzke W, Goossens E, Geurdens M, Gütter Z, Hansen H, Hartman S, Hegendörfer G, Heikka H, Henderson D, Héran D, Hirvonen S, Iaccarino G, Jansson N, Kallasvaara H, Kalyoncu F, Kirchmayer U, Kokko JA, Korpelainen J, Kostka T, Kuna P, Lajarín Ortega T, Lama CM, Laune D, Lauri D, Ledroit V, Levato G, Lewis L, Liotta G, Lundgren L, Lupiañez-Villanueva F, Mc Garry P, Maggio M, Manuel de Keenoy E, Martinez C, Martínez-Domene M, Martínez-Lozano Aranaga B, Massimilliano M, Maurizio A, Mayora O, Melle C, Mendez-Zorilla A, Mengon H, Mercier G, Mercier J, Meyer I, Millet Pi-Figueras A, Mitsias P, Molloy DW, Monti R, Moro ML, Muranko H, Nalin M, Nobili A, Noguès M, O’Caoimh R, Pais S, Papini D, Parkkila P, Pattichis C, Pavlickova A, Peiponen A, Pereira S, Pépin JL, Piera Jiménez J, Portheine P, Potel L, Pozzi AC, Quiñonez P, Ramirez Lauritsen X, Ramos MJ, Rännäli-Kontturi A, Risino A, Robalo-Cordeiro C, Rolla G, Roller R, Romano M, Romano V, Ruiz-Fernández J, Saccavini C, Sachinopoulou A, Sánchez Rubio MJ, Santos L, Scalvini S, Scopetani E, Smedberg D, Solana-Lara R, Sołtysik B, Sorlini M, Stericker S, Stramba Badiale M, Taillieu I, Tervahauta M, Teixeira A, Tikanmäki H, Todo-Bom A, Tooley A, Tuulonen A, Tziraki C, Ussai S, Van der Veen S, Venchiarutti A, Verdoy-Berastegi D, Verissimo M, Visconti L, Vollenbroek-Hutten M, Weinzerl K, Wozniak L, Yorgancıoğlu A, Zavagli V, Zurkuhlen AJ. The Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Ageing. Transl Med UniSa 2019; 19:66-81. [PMID: 31360670 PMCID: PMC6581486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France,VIMA, INSERM U 1168, VIMA : Ageing and chronic diseases. Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, Euforea, Brussels, Belgium, and Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET) Naples, Italy
| | - J Farrell
- LANUA International Healthcare Consultancy, Down, UK
| | - N Batey
- EIPonAHA Reference Site Collaborative network, Head of EU & International Funding, Health and Social Services Group, Welsh Government, Cardiff, UK
| | - AM Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - J Malva
- Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra; Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - J Hajjam
- CENTICH Mutualité Française Anjou Mayenne, Angers, France
| | - E Colgan
- Department of Health, Social Services and Public Safety, Northern Ireland Belfast, UK
| | - N Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | | | - GL Onorato
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - A Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - L Leonardini
- Veneto Region, Mattone Internazionale Program, Italy
| | - V Stroetman
- Empirica Communication and Technology Research, Bonn, Germany
| | - S Birov
- Empirica Communication and Technology Research, Bonn, Germany
| | - C Abreu
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - A Abrunhosa
- Comissão de Coordenação e Desenvolvimento Regional do Centro (CCDRC), Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - A Agrimi
- Aprulia Region - Research, Innovation and Capacity Building department, Bari – Italy
| | | | | | - F Alonso-Trujillo
- Agency for Social Services and Dependency of Andalusia, Seville, Spain
| | | | - S Angioli
- Campania Councillor for European Funds, Euromediterranean Basin and Youth Policies, Naples, Italy
| | - J Apóstolo
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - G Armitage
- Newcastle University, Operations Director, National Innovation Centre for Ageing, New Castle, UK
| | | | | | - PD Bamidis
- Medical Education Informatics; Lab of Medical Physics; Medical School; Aristotle University of Thessaloniki, Greece
| | - A Balenović
- Health Care Center Zagreb, City of Zagreb, AHA Reference site, Zagreb, Croatia
| | - M Barbolini
- Regione Emilia Romagna - Agenzia Sanitaria e Sociale, Regional Health and Social Agency Emilia-Romagna, Reference Site of the European Innovation Partnership on Healthy and Active Ageing, Bologna, Italy, and EU Commission Senior Public Health Expert
| | | | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France,EUROMOV. EA 2991, Euromov, University of Montpellier, France
| | - PL Bernard
- Sport Faculty, University of Montpellier, France
| | - M Bersani
- Head Unit Plans and Projects; DG Welfare – Region of Lombardy, Milano (Italy)
| | - E Berti
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - L Bogatyrchuk
- The medical improving center “Elbrus”, Zhytomir, Ukraine
| | - R Bourret
- Centre Hospitalier Valenciennes, France
| | - J Brehm
- Health region CologneBonn, Köln, Germany
| | - L Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - D Buhr
- University of Tuebingen / Steinbeis Transfercenter for Social and Technological Innovation, Tuebingen, Germany
| | - D Bultje
- Healthy Ageing Network Northern Netherlands, Groningen, The Netherlands
| | - E Cabeza
- Cap de Servei de Promoció de la Salut, Direcció General de Salut Pública i Participació, Palma de Mallorca, Spain
| | - A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain,INCLIVA, Valencia, Spain
| | - C De Capitani
- Lombardy Cluster Technologies for Living Environments, Lecco (LC), Italy
| | - E Carantoña
- Consejería de Presidencia y Participación Ciudadana, Oviedo, Spain
| | - A Cardoso
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - JI Coll Clavero
- Innovation and new technologies, Hospital de Barbastro Servicio Aragones de Salud Aragon, Spain
| | - B Combe
- Department of Rheumotology, University Hospital, Montpellier, France
| | - D Conforti
- Autonomous Province of Trento, Health and Social Solidarity Department & TrentinoSalute4.0, Trento, Italy
| | - L Coppola
- Head Unit Health Promotion and Screening; DG Welfare – Region of Lombardy, Milan, Italy
| | - F Corti
- FIMMG, Federazione Italiana Medici di Medicina Generale, Milan, Italy
| | - E Coscioni
- Department of Heart Surgery, San Giovanni di Dio e Ruggi d’Aragona Hospital, Salerno, Italy
| | - E Costa
- UCIBIO, REQUIMTE, Faculty of Pharmacy of University of Porto, Porto4ageing Reference Site, University of Porto, PORTO, Portugal
| | - G Crooks
- Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A Cunha
- Instituto Pedro Nunes, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - C Daien
- Department of Rheumotology, University Hospital, Montpellier, France
| | - Dantas
- Cáritas Diocesana de Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | | | - M Davoli
- Department of Epidemiology, ASL Roma 1, Lazio Regional Health Service, Roma, Italy
| | - A Dedeu Baraldes
- Agency for Health Quality & Assessment of Catalonia of the Ministry of Health of Catalonia – AquAs, Barcelona, Spain
| | - V De Luca
- R&D Unit, Federico II University Hospital, Naples, Italy
| | - L De Nardi
- Health Information System International Projects, Lombardia Informatica SpA, Milano, Italy
| | - M Di Ciano
- InnovaPuglia - Inhouse ICT company of Regione Puglia and Reference Site Puglia WI-FI Management, Bari, Italy
| | - A Dozet
- Health economist, Region Skåne, Sweden
| | - B Ekinci
- Head Chronic Disease Department, Ministry of Health, Ankara, Turkey
| | - S Erve
- CENTICH Mutualité Française Anjou Mayenne, Angers, France
| | | | - A Fait
- Health and Social Care Directorate, ATS Città Metropolitana (Health and Social Care Agency), Milano, Italy
| | - R Fensli
- Centre of eHealth and Health Care Technology, University of Agder, Faculty of Engineering and Science, Grimstad, Norway
| | - S Fernandez Nocelo
- Galician Health Knowledge Agency (ACIS), Regional Ministry of Public Health of Galicia
| | - P Gálvez-Daza
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - M García Sáez
- Agency for Social Services and Dependency of Andalusia, Seville, Spain
| | | | - B Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - W Goetzke
- Health region CologneBonn, Köln, Germany
| | - E Goossens
- Center for Gastrology, School of Gastrologic Sciences and Primary Food Care, Leuven, Belgium
| | - M Geurdens
- Center of Expertise in Primary Food Care, Center for Research and Innovation in Care (CRIC), Antwerp, Belgium
| | - Z Gütter
- University Hospital Olomouc - NTMC, National eHealth Centre, Olomouc, Czech Republic
| | - H Hansen
- EU Consultant & Project Manager, South Denmark European Office, Brussels, Belgium
| | - S Hartman
- Department of Social Services and Health Care, Business Development, HELSINGIN KAUPUNKI, City of Helsinki, Finland
| | | | | | - D Henderson
- Head of European Engagement, NHS 24, Glasgow, UK
| | | | | | - G Iaccarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - N Jansson
- Network Ecosystem, BusinessOulu, Oulu, Finland
| | - H Kallasvaara
- Helsinki-Uusimaa Regional Council, Helsinki, Finland
| | - F Kalyoncu
- Hacettepe University, School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Ankara, Turkey
| | - U Kirchmayer
- Department of Epidemiology, ASL Roma 1, Lazio Regional Health Service, Roma, Italy
| | - JA Kokko
- Department of Healthcare and Social Welfare, Technology Specialist, Oulu, Finland
| | - J Korpelainen
- Oulu University Hospital OYS, Hospital District, Oulu, Finland
| | - T Kostka
- Department of Geriatrics, Medical University of Lodz, Healthy Ageing Research Centre (HARC), Lodz, Poland
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - T Lajarín Ortega
- Committee of Representatives of People with disabilities and their Families, Region de Murcia, Spain
| | - CM Lama
- Regional Ministry of Health of Andalusia, Seville, Spain
| | | | | | - V Ledroit
- Alsace Lorraine Champagne Ardenne, Bureau Europe Grand Est, Bruxelles, Belgique
| | - G Levato
- SIFMED, Scuola Italiana Di Formazione E Ricerca In Medicina Di Famiglia, Milan, Italy
| | - L Lewis
- Head of Research and Development, International Foundation for Integrated Care and EIP on AHA B3 Action Group Chair, Wolfson College, Oxford, UK
| | - G Liotta
- Biomedicine and Prevention Department, University of Rome Tor Vergata, Rome, Italy
| | - L Lundgren
- Development Department, Region Norrbotten, Sweden
| | | | - P Mc Garry
- Greater Manchester Ageing Hub, Greater Manchester Combined Authority, Manchester, UK
| | - M Maggio
- Department of Medicine and Surgery - Geriatric Clinic Unit Department of Medicine Geriatric Rehabilitation, University Hospital of Parma, Italy
| | - E Manuel de Keenoy
- Kronikgune, International Centre of Excellence in Chronicity Research, Barakaldo, Bizkaia, Spain
| | - C Martinez
- Costa Cálida Cares-Senior Tourism and Services, Region de Murcia, Spain
| | - M Martínez-Domene
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - M Massimilliano
- Financial Range for Innovation, Research, International care and health sector; Friuli Venezia Giulia Autonomous Region, Central Directorate for Health, Social Health Integration, Social Policies and Family, Trieste, Italy
| | - A Maurizio
- Plans and Projects Unit, DG Welfare – Region of Lombardy, Italy
| | - O Mayora
- Bruno Kessler Foundation, eHealth Unit and TrentinoSalute4.0, Trento, Italy
| | - C Melle
- Care Management Unit, Hausach, Gesundes Kinzigtal GmbH, Kizingtal, Germany
| | | | - H Mengon
- Autonomous Province of Trento, Health and Social Solidarity Department & TrentinoSalute4.0, Trento, Italy
| | - G Mercier
- Unité Médico-Economie, Département de l’Information Médicale, University Hospital, Montpellier, France
| | - J Mercier
- Department of Physiology, CHRU, University Montpellier, PhyMedExp, INSERM U1046, CNRS UMR 9214, France
| | - I Meyer
- Care Management Unit, Hausach, Gesundes Kinzigtal GmbH, Kizingtal, Germany
| | | | - P Mitsias
- Department of Neurology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - DW Molloy
- Centre for Gerontology and Rehabilitation, School of Medicine, UCC @ St Finbarr’s Hospital, Cork, Ireland
| | - R Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - ML Moro
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - H Muranko
- GEWI Institute, Regional Innovation Partnership on Active and Healthy Ageing, Köln, Germany
| | | | - A Nobili
- Mario Negri Institute for Pharmacological Research, IRCCS; Clinical Pharmacology, Geriatrics, Internal Medicine, Milano, Italy
| | | | - R O’Caoimh
- Centre for Gerontology and Rehabilitation, School of Medicine, UCC @ St Finbarr’s Hospital, Cork, Ireland,Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Ireland
| | - S Pais
- Center for Biomedical Research-CBMR, Department of Biomedical Sciences and Medicine, International Center on Ageing-CENIE, University of Algarve, Portugal
| | - D Papini
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - P Parkkila
- Oulu University Hospital OYS, Hospital District, Oulu, Finland
| | - C Pattichis
- Dept of Computer Science, University of Cyprus, Cyprus, Greece
| | - A Pavlickova
- European Service Development Manager, NHS 24, Glasgow, UK
| | - A Peiponen
- Social services and health care division, Hospital, rehabilitation and care services, Southern service district, City of Helsinki, FINLAND
| | - S Pereira
- University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | - JL Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, France
| | - J Piera Jiménez
- Information and R&D Officer, Badalona Serveis Assistencials, Badalona, Spain
| | - P Portheine
- Coöperatie Slimmer Leven, Eindhoven, The Netherlands
| | - L Potel
- International Affairs & Public Procurement of Innovation, Hospital Procurement Network, Paris, France
| | - AC Pozzi
- IML, Lombardy Medical Initiative, Bergamo, Italy
| | - P Quiñonez
- Agency for Social Services and Dependency of Andalusia, Seville, Spain,Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - MJ Ramos
- UCIBIO, REQUIMTE, Faculty of Sciences of University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | | | - A Risino
- Health Innovation Manchester, Manchester, UK
| | - C Robalo-Cordeiro
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - G Rolla
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - R Roller
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | | | - V Romano
- IRES - Institute for Economic and Social Research - Piedmont, Torino, Italy
| | | | - C Saccavini
- Arsenàl.IT, Veneto’s Research Centre for eHealth Innovation, Venice, Italy
| | - A Sachinopoulou
- Oulu University, Center of Health and Technology, Oulu, Finland
| | - MJ Sánchez Rubio
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | - L Santos
- Odem dos Farmacêuticos, Secção Regional do Centro, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - S Scalvini
- Cardiology Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Institute of Lumezzane, Brescia, Italy
| | - E Scopetani
- Tuscany Region, Directorate Citizenship rights and social cohesion, Firenze, Italy
| | - D Smedberg
- RISE Research Institutes of Sweden, Division Safety and Transport - Measurement Science and Technology, Lund, Sweden
| | - R Solana-Lara
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - B Sołtysik
- Department of Geriatrics, Medical University of Lodz, Healthy Ageing Research Centre (HARC), Lodz, Poland
| | - M Sorlini
- International Affairs & Public Procurement of Innovation, Hospital Procurement Network, Paris, France
| | - S Stericker
- Head of Programmes, Yorkshire & Humber Academic Health Science Network, Wakefield, UK
| | - M Stramba Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - I Taillieu
- Coördinator Zorgeconomie, Fabrieken voor de Toekomst, Brugge, Belgium
| | | | - A Teixeira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Portugal
| | - H Tikanmäki
- Life Science Industries and Company Networks, BusinessOulu, Oulu, Finland
| | - A Todo-Bom
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - A Tooley
- University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | - A Tuulonen
- Tays Eye Centre, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - C Tziraki
- Research and Evaluation Department, Municipality of Jérusalem, Israël,Medicine and Health Care Science, Allilegi Community Based Organization for AD and Active Healthy Aging, Heraklion, Crete, Heraklion-Crete Reference Site Region, Greece
| | - S Ussai
- DG Welfare, Lombardy Region, Italy
| | - S Van der Veen
- Department of Med Hum, Amsterdam University Medical Centers, VU University, NL
| | - A Venchiarutti
- Friuli Venezia Giulia Autonomous Region, Central Directorate for Health, Social Health Integration, Social Policies and Family, Trieste, Italy
| | - D Verdoy-Berastegi
- Kronikgune, International Centre of Excellence in Chronicity Research, Barakaldo, Bizkaia, Spain
| | - M Verissimo
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - L Visconti
- LifeTechValley, Life Sciences Incubator BioVille, Diepenbeek, Belgium
| | - M Vollenbroek-Hutten
- University of Twente, Biomedical systems and signal group/telemedicine, Twente, The Netherlands
| | - K Weinzerl
- Human.technology Styria GmbH, Graz, Austria
| | - L Wozniak
- Research and International Relations, Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - A Yorgancıoğlu
- Celal Bayar University, School of Medicine, Department of Pulmonology, Manisa, Turkey
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An Approach to Prevent Frailty in Community Dwelling Older Adults: a pilot study performed in Campania region in the framework of the PERSSILAA project. Transl Med UniSa 2019; 19:42-48. [PMID: 31360666 PMCID: PMC6581496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We developed and tested an innovative physical training method in older adults that embeds the gym program into everyday life in the most conservative way possible. Physical training was included in the activities of local parishes where older women from Southern Italy spend most of their free time and was delivered by trained physical therapists with the support of an ICT tool known as CoCo. 113 older women (aged 72.0 [69.0-75.0] years) noncompliant to conventional exercise programs participated to the study. 57 of them underwent the final anthropometric assessment and 50 the final physical tests. In study completers handgrip strength and physical performance evaluated with the chair-stand, the two minutes step and the chair-sit and -reach tests significantly improved. Quality of life as evaluated with the EuroQol-5dimension (EQ-5D) questionnaire improved as well. In conclusion, a training program designed to minimally impact on life habits of older people is effective in improving fitness in patients noncompliant to other to physical exercise programs.
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Walters K, Frost R, Kharicha K, Avgerinou C, Gardner B, Ricciardi F, Hunter R, Liljas A, Manthorpe J, Drennan V, Wood J, Goodman C, Jovicic A, Iliffe S. Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT. Health Technol Assess 2018; 21:1-128. [PMID: 29214975 DOI: 10.3310/hta21730] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. OBJECTIVES (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). DESIGN Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. INTERVENTION DEVELOPMENT Two systematic reviews (including systematic searches of 14 databases and registries, 1990-2016 and 1980-2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65-94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the 'HomeHealth' intervention in collaboration with older people and multidisciplinary stakeholders. 'HomeHealth' comprised 3-6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. FEASIBILITY RCT Single-blind RCT, individually randomised to 'HomeHealth' or treatment as usual (TAU). SETTING Community settings in London and Hertfordshire, UK. PARTICIPANTS A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. MAIN OUTCOME MEASURES Feasibility - recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. RESULTS We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire -3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. CONCLUSIONS Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. FUTURE WORK A large, definitive RCT of the HomeHealth service is warranted. STUDY REGISTRATION This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Rachael Frost
- Department of Primary Care and Population Health, University College London, London, UK
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, London, UK
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London, UK
| | | | - Federico Ricciardi
- Department of Statistical Science, University College London, London, UK
| | - Rachael Hunter
- Department of Primary Care and Population Health, University College London, London, UK
| | - Ann Liljas
- Department of Primary Care and Population Health, University College London, London, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King's College London, London, UK
| | - Vari Drennan
- Centre for Health and Social Care Research, Kingston University and St George's, University of London, London, UK
| | - John Wood
- Department of Primary Care and Population Health, University College London, London, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Ana Jovicic
- Department of Primary Care and Population Health, University College London, London, UK
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, UK
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O'Caoimh R, Kennelly S, O'Shea D. Can the Geriatric Day Hospital Act As a Hub for Services for Older People across the Spectrum of Ageing from Active Ageing to Advanced Frailty? Front Med (Lausanne) 2018; 5:23. [PMID: 29552560 PMCID: PMC5840151 DOI: 10.3389/fmed.2018.00023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/23/2018] [Indexed: 01/10/2023] Open
Affiliation(s)
- Rónán O'Caoimh
- Clinical Sciences Institute, National University of Ireland, Galway, Galway, Ireland.,National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland
| | - Siobhán Kennelly
- National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland.,Department of Medicine for the Elderly, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Diamuid O'Shea
- National Clinical Programme for Older People, Royal College of Physicians of Ireland, Dublin, Ireland.,Department of Geriatric Medicine, St Vincent's University Hospital, Dublin, Ireland
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Dekker-van Weering M, Jansen-Kosterink S, Frazer S, Vollenbroek-Hutten M. User Experience, Actual Use, and Effectiveness of an Information Communication Technology-Supported Home Exercise Program for Pre-Frail Older Adults. Front Med (Lausanne) 2017; 4:208. [PMID: 29250523 PMCID: PMC5715376 DOI: 10.3389/fmed.2017.00208] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/07/2017] [Indexed: 11/13/2022] Open
Abstract
Objective The main objective of this study was to investigate the use and user experience of an Information Communication Technology-supported home exercise program when offered for independent use to pre-frail older adults. Our secondary aim was to explore whether the program improved quality of life and health status compared to a control group. Methods A cohort multiple randomized controlled trail is being performed. Physically pre-frail older adults (65-75 years) living independently at home were included and randomly assigned to a control group or an intervention group. The intervention group received a home exercise program (strength, balance, and flexibility exercises) for a minimal duration of 12 weeks. The control group received usual care. Primary outcomes were: use of the intervention (frequency and duration), adherence to a 3-day exercise protocol and user experience [System Usability Scale (SUS); rating 1-10]. Secondary outcomes were quality of life measured with the SF12 (Physical Component Scale and Mental Component Scale) and health status (EQ-5D), assessed before the study starts and after 12 weeks of exercising. Results Thirty-seven independently living older adults participated in the study. Sixteen participants were allocated to the intervention group and 21 to the control group. The average score on the SUS was 84.2 (±13.3), almost reaching an excellent score. Participants rated the intervention with an 8.5. Eighty percent of the participants finished the 12 week exercise protocol. The adherence to the 3-day exercise protocol was 68%. Participants in the intervention group trained on average 2.2 times (±1.3) each week. The mean duration of login for each exercise session was 24 min. The Mental Component Scale of the SF12 was significantly higher in the intervention group compared to the control group. A trend was seen in the change over time in the health status between groups. Conclusions This study provides evidence that a home-based exercise program is easy to use and has potential in improving quality of life and health status of pre-frail older adults who live at home. However, further refinement of the program is required to improve adherence and maximize the benefits and potential of exercising in the home environment. Trial Registration Unique Identifier: NTR5304. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5304.
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Affiliation(s)
- Marit Dekker-van Weering
- Telemedicine Group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
| | - Stephanie Jansen-Kosterink
- Telemedicine Group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
| | - Sanne Frazer
- Telemedicine Group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
| | - Miriam Vollenbroek-Hutten
- Biomedical Signals and Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands.,ZiekenhuisGroep Twente (ZGT), Scientific Office ZGT Academy, Almelo, Netherlands
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Jensen CM, Smith AC, Overgaard S, Wiil UK, Clemensen J. "If only had I known": a qualitative study investigating a treatment of patients with a hip fracture with short time stay in hospital. Int J Qual Stud Health Well-being 2017; 12:1307061. [PMID: 28367700 PMCID: PMC5421371 DOI: 10.1080/17482631.2017.1307061] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hip fractures are amongst the leading causes of admission to an orthopaedic ward. Systematized pathways with reduced admission time have become increasingly common as an essential tool for quality development and to improve efficiency in the hospital setting. The aim of this study was to clarify if the patients feel empowered and able to perform self-care after short time stay in hospital (STSH) due to a hip fracture. The study used descriptive phenomenology to describe experiences of the pathway. Field studies were conducted in hospitals and in the patients' homes. Interviews were performed with 10 patients recruited from two wards at a Danish University hospital, 4 family members and 15 health professionals from three hospitals. The open attitude of reflective lifeworld research guided the analysis. The findings revealed that patients felt unprepared and insecure about their future, but also had a strong desire to be in charge of their own lives. Of all the patients interviewed, none had any recollection of the information given to them by health professionals during their hospital admission. This study demonstrates that empowerment of patients with hip fractures is not adequately achieved in the pathway with STSH.
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Affiliation(s)
- Charlotte M Jensen
- a Department of Clinical Research , University of Southern Denmark , Odense , Denmark.,b Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark.,c Centre for Innovative Medical Technology , University of Southern Denmark & Odense University Hospital , Brisbane , Denmark
| | - Anthony C Smith
- c Centre for Innovative Medical Technology , University of Southern Denmark & Odense University Hospital , Brisbane , Denmark.,d Centre for Online Health , University of Queensland , Australia
| | - Soren Overgaard
- a Department of Clinical Research , University of Southern Denmark , Odense , Denmark.,b Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark
| | - Uffe Kock Wiil
- c Centre for Innovative Medical Technology , University of Southern Denmark & Odense University Hospital , Brisbane , Denmark.,e The Maersk Mc-Kinney Moller Institute , University of Southern Denmark , Odense , Denmark
| | - Jane Clemensen
- c Centre for Innovative Medical Technology , University of Southern Denmark & Odense University Hospital , Brisbane , Denmark
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Moniz-Cook E, Hart C, Woods B, Whitaker C, James I, Russell I, Edwards RT, Hilton A, Orrell M, Campion P, Stokes G, Jones RSP, Bird M, Poland F, Manthorpe J. Challenge Demcare: management of challenging behaviour in dementia at home and in care homes – development, evaluation and implementation of an online individualised intervention for care homes; and a cohort study of specialist community mental health care for families. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05150] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BackgroundDementia with challenging behaviour (CB) causes significant distress for caregivers and the person with dementia. It is associated with breakdown of care at home and disruption in care homes. Challenge Demcare aimed to assist care home staff and mental health practitioners who support families at home to respond effectively to CB.ObjectivesTo study the management of CB in care homes (ResCare) and in family care (FamCare). Following a conceptual overview, two systematic reviews and scrutiny of clinical guidelines, we (1) developed and tested a computerised intervention; (2) conducted a cluster randomised trial (CRT) of the intervention for dementia with CB in care homes; (3) conducted a process evaluation of implementation of the intervention; and (4) conducted a longitudinal observational cohort study of the management of people with dementia with CB living at home, and their carers.Review methodsCochrane review of randomised controlled trials; systematic meta-ethnographic review of quantitative and qualitative studies.DesignResCare – survey, CRT, process evaluation and stakeholder consultations. FamCare – survey, longitudinal cohort study, participatory development design process and stakeholder consultations. Comparative examination of baseline levels of CB in the ResCare trial and the FamCare study participants.SettingsResCare – 63 care homes in Yorkshire. FamCare – 33 community mental health teams for older people (CMHTsOP) in seven NHS organisations across England.ParticipantsResCare – 2386 residents and 861 staff screened for eligibility; 555 residents with dementia and CB; 277 ‘other’ residents; 632 care staff; and 92 staff champions. FamCare – every new referral (n = 5360) reviewed for eligibility; 157 patients with dementia and CB, with their carer; and 26 mental health practitioners. Stakeholder consultations – initial workshops with 83 practitioners and managers from participating organisations; and 70 additional stakeholders using eight group discussions and nine individual interviews.InterventionAn online application for case-specific action plans to reduce CB in dementia, consisting of e-learning and bespoke decision support care home and family care e-tools.Main outcome measuresResCare – survey with the Challenging Behaviour Scale; measurement of CB with the Neuropsychiatric Inventory (NPI) and medications taken from prescriptions; implementation with thematic views from participants and stakeholders. FamCare – case identification from all referrals to CMHTsOP; measurement of CB with the Revised Memory and Behaviour Problems Checklist and NPI; medications taken from prescriptions; and thematic views from stakeholders. Costs of care calculated for both settings. Comparison of the ResCare trial and FamCare study participants used the NPI, Clinical Dementia Rating and prescribed medications.ResultsResCare – training with group discussion and decision support for individualised interventions did not change practice enough to have an impact on CB in dementia. Worksite e-learning opportunities were not readily taken up by care home staff. Smaller homes with a less hierarchical management appear more ready than others to engage in innovation. FamCare – home-dwelling people with dementia and CB are referred to specialist NHS services, but treatment over 6 months, averaging nine contacts per family, had no overall impact on CB. Over 60% of people with CB had mild dementia. Families bear the majority of the care costs of dementia with CB. A care gap in the delivery of post-diagnostic help for families supporting relatives with dementia and significant CB at home has emerged. Higher levels of CB were recorded in family settings; and prescribing practices were suboptimal in both care home and family settings.LimitationsFunctionality of the software was unreliable, resulting in delays. This compromised the feasibility studies and undermined delivery of the intervention in care homes. A planned FamCare CRT could not proceed because of insufficient referrals.ConclusionsA Cochrane review of individualised functional analysis-based interventions suggests that these show promise, although delivery requires a trained dementia care workforce. Like many staff training interventions, our interactive e-learning course was well received by staff when delivered in groups with facilitated discussion. Our e-learning and decision support e-tool intervention in care homes, in its current form, without ongoing review of implementation of recommended action plans, is not effective at reducing CB when compared with usual care. This may also be true for staff training in general. A shift in priorities from early diagnosis to early recognition of dementia with clinically significant CB could bridge the emerging gap and inequities of care to families. Formalised service improvements in the NHS, to co-ordinate such interventions, may stimulate better opportunities for practice models and pathways. Separate services for care homes and family care may enhance the efficiency of delivery and the quality of research on implementation into routine care.Future workThere is scope for extending functional analysis-based interventions with communication and interaction training for carers. Our clinical workbooks, video material of real-life episodes of CB and process evaluation tool resources require further testing. There is an urgent need for evaluation of interventions for home-dwelling people with dementia with clinically significant CB, delivered by trained dementia practitioners. Realist evaluation designs may illuminate how the intervention might work, and for whom, within varying service contexts.Trial registrationCurrent Controlled Trials ISRCTN02553381 (the ResCare trial) and ISRCTN58876649 (the FamCare study).FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Esme Moniz-Cook
- Faculty of Health Sciences, University of Hull, Hull, UK
- Research and Development, Humber NHS Foundation Trust, Hull and East Yorkshire, UK
| | - Cathryn Hart
- Research and Development, Humber NHS Foundation Trust, Hull and East Yorkshire, UK
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Chris Whitaker
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Ian James
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Russell
- Swansea Trials Unit, Swansea University, Swansea, UK
| | | | - Andrea Hilton
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Martin Orrell
- Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - Peter Campion
- Faculty of Health Sciences, University of Hull, Hull, UK
| | | | - Robert SP Jones
- North Wales Clinical Psychology Programme, Bangor University, Bangor, UK
| | - Mike Bird
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Fiona Poland
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King’s College London, London, UK
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Frost R, Belk C, Jovicic A, Ricciardi F, Kharicha K, Gardner B, Iliffe S, Goodman C, Manthorpe J, Drennan VM, Walters K. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis. BMC Geriatr 2017; 17:157. [PMID: 28728570 PMCID: PMC5520298 DOI: 10.1186/s12877-017-0547-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/11/2017] [Indexed: 12/20/2022] Open
Abstract
Background Mild or pre-frailty is common and associated with increased risks of hospitalisation, functional decline, moves to long-term care, and death. Little is known about the effectiveness of health promotion in reducing these risks. This systematic review aimed to synthesise randomised controlled trials (RCTs) evaluating home and community-based health promotion interventions for older people with mild/pre-frailty. Methods We searched 20 bibliographic databases and 3 trials registers (January 1990 – May 2016) using mild/pre-frailty and associated terms. We included randomised controlled and crossover trials of health promotion interventions for community-dwelling older people (65+ years) with mild/pre-frailty and excluded studies focussing on populations in hospital, long term care facilities or with a specific condition. Risk of bias was assessed by two reviewers using the Cochrane Risk of Bias tool. We pooled study results using standardised mean differences (SMD) where possible and used narrative synthesis where insufficient outcome data were available. Results We included 10 articles reporting on seven trials (total n = 506 participants) and included five trials in a meta-analysis. Studies were predominantly small, of limited quality and six studies tested group exercise alone. One study additionally investigated a nutrition and exercise intervention and one evaluated telemonitoring. Interventions of exercise in groups showed mixed effects on functioning (no effects on self-reported functioning SMD 0.19 (95% CI -0.57 to 0.95) n = 3 studies; positive effects on performance-based functioning SMD 0.37 (95% CI 0.07 to 0.68) n = 3 studies). No studies assessed moves to long-term care or hospitalisations. Conclusions Currently the evidence base is of insufficient size, quality and breadth to recommend specific health promotion interventions for older people with mild or pre- frailty. High quality studies of rigorously developed interventions are needed. PROSPERO registration CRD42014010370 (Review 2). Electronic supplementary material The online version of this article (doi:10.1186/s12877-017-0547-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachael Frost
- Department of Primary Care and Population Health, University College London, London, UK
| | - Celia Belk
- Department of Primary Care and Population Health, University College London, London, UK
| | - Ana Jovicic
- Department of Primary Care and Population Health, University College London, London, UK
| | - Federico Ricciardi
- Department of Statistical Science, University College London, London, UK
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, London, UK
| | | | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King's College London, London, UK
| | - Vari M Drennan
- Centre for Health and Social Care Research, Kingston University & St George's, University of London, London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK.
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Noergaard B, Sandvei M, Rottmann N, Johannessen H, Wiil U, Schmidt T, Pedersen SS. Development of a Web-Based Health Care Intervention for Patients With Heart Disease: Lessons Learned From a Participatory Design Study. JMIR Res Protoc 2017; 6:e75. [PMID: 28526674 PMCID: PMC5451636 DOI: 10.2196/resprot.7084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/21/2017] [Accepted: 03/16/2017] [Indexed: 12/02/2022] Open
Abstract
Background The use of telemedicine technologies in health care has increased substantially, together with a growing interest in participatory design methods when developing telemedicine approaches. Objective We present lessons learned from a case study involving patients with heart disease and health care professionals in the development of a personalized Web-based health care intervention. Methods We used a participatory design approach inspired by the method for feasibility studies in software development. We collected qualitative data using multiple methods in 3 workshops and analyzed the data using thematic analysis. Participants were 7 patients with diagnosis of heart disease, 2 nurses, 1 physician, 2 systems architects, 3 moderators, and 3 observers. Results We present findings in 2 parts. (1) Outcomes of the participatory design process: users gave valuable feedback on ease of use of the platforms’ tracking tools, platform design, terminology, and insights into patients’ monitoring needs, information and communication technologies skills, and preferences for self-management tools. (2) Experiences from the participatory design process: patients and health care professionals contributed different perspectives, with the patients using an experience-based approach and the health care professionals using a more attitude-based approach. Conclusions The essential lessons learned concern planning and organization of workshops, including the finding that patients engaged actively and willingly in a participatory design process, whereas it was more challenging to include and engage health care professionals.
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Affiliation(s)
- Birgitte Noergaard
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Marianne Sandvei
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nina Rottmann
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Helle Johannessen
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Uffe Wiil
- Center for Health Informatics and Technology, Maersk Mc-Kinney Moller Institute, Univeristy of Southern Denmark, Odense, Denmark
| | - Thomas Schmidt
- Center for Health Informatics and Technology, Maersk Mc-Kinney Moller Institute, Univeristy of Southern Denmark, Odense, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark.,Erasmus Medical Center, Rotterdam, Netherlands
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Bousquet J, Bewick M, Cano A, Eklund P, Fico G, Goswami N, Guldemond NA, Henderson D, Hinkema MJ, Liotta G, Mair A, Molloy W, Monaco A, Monsonis-Paya I, Nizinska A, Papadopoulos H, Pavlickova A, Pecorelli S, Prados-Torres A, Roller-Wirnsberger RE, Somekh D, Vera-Muñoz C, Visser F, Farrell J, Malva J, Andersen Ranberg K, Camuzat T, Carriazo AM, Crooks G, Gutter Z, Iaccarino G, Manuel de Keenoy E, Moda G, Rodriguez-Mañas L, Vontetsianos T, Abreu C, Alonso J, Alonso-Bouzon C, Ankri J, Arredondo MT, Avolio F, Bedbrook A, Białoszewski AZ, Blain H, Bourret R, Cabrera-Umpierrez MF, Catala A, O'Caoimh R, Cesari M, Chavannes NH, Correia-da-Sousa J, Dedeu T, Ferrando M, Ferri M, Fokkens WJ, Garcia-Lizana F, Guérin O, Hellings PW, Haahtela T, Illario M, Inzerilli MC, Lodrup Carlsen KC, Kardas P, Keil T, Maggio M, Mendez-Zorrilla A, Menditto E, Mercier J, Michel JP, Murray R, Nogues M, O'Byrne-Maguire I, Pappa D, Parent AS, Pastorino M, Robalo-Cordeiro C, Samolinski B, Siciliano P, Teixeira AM, Tsartara SI, Valiulis A, Vandenplas O, Vasankari T, Vellas B, Vollenbroek-Hutten M, Wickman M, Yorgancioglu A, Zuberbier T, Barbagallo M, Canonica GW, Klimek L, Maggi S, Aberer W, Akdis C, Adcock IM, Agache I, Albera C, Alonso-Trujillo F, Angel Guarcia M, Annesi-Maesano I, Apostolo J, Arshad SH, Attalin V, Avignon A, Bachert C, Baroni I, Bel E, Benson M, Bescos C, Blasi F, Barbara C, Bergmann KC, Bernard PL, Bonini S, Bousquet PJ, Branchini B, Brightling CE, Bruguière V, Bunu C, Bush A, Caimmi DP, Calderon MA, Canovas G, Cardona V, Carlsen KH, Cesario A, Chkhartishvili E, Chiron R, Chivato T, Chung KF, d'Angelantonio M, De Carlo G, Cholley D, Chorin F, Combe B, Compas B, Costa DJ, Costa E, Coste O, Coupet AL, Crepaldi G, Custovic A, Dahl R, Dahlen SE, Demoly P, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Du Toit G, Dubakiene R, Dupeyron A, Emuzyte R, Fiocchi A, Wagner A, Fletcher M, Fonseca J, Fougère B, Gamkrelidze A, Garces G, Garcia-Aymeric J, Garcia-Zapirain B, Gemicioğlu B, Gouder C, Hellquist-Dahl B, Hermosilla-Gimeno I, Héve D, Holland C, Humbert M, Hyland M, Johnston SL, Just J, Jutel M, Kaidashev IP, Khaitov M, Kalayci O, Kalyoncu AF, Keijser W, Kerstjens H, Knezović J, Kowalski M, Koppelman GH, Kotska T, Kovac M, Kull I, Kuna P, Kvedariene V, Lepore V, MacNee W, Maggio M, Magnan A, Majer I, Manning P, Marcucci M, Marti T, Masoli M, Melen E, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mlinarić H, Momas I, Montefort S, Morais-Almeida M, Moreno-Casbas T, Mösges R, Mullol J, Nadif R, Nalin M, Navarro-Pardo E, Nekam K, Ninot G, Paccard D, Pais S, Palummeri E, Panzner P, Papadopoulos NK, Papanikolaou C, Passalacqua G, Pastor E, Perrot M, Plavec D, Popov TA, Postma DS, Price D, Raffort N, Reuzeau JC, Robine JM, Rodenas F, Robusto F, Roche N, Romano A, Romano V, Rosado-Pinto J, Roubille F, Ruiz F, Ryan D, Salcedo T, Schmid-Grendelmeier P, Schulz H, Schunemann HJ, Serrano E, Sheikh A, Shields M, Siafakas N, Scichilone N, Siciliano P, Skrindo I, Smit HA, Sourdet S, Sousa-Costa E, Spranger O, Sooronbaev T, Sruk V, Sterk PJ, Todo-Bom A, Touchon J, Tramontano D, Triggiani M, Tsartara SI, Valero AL, Valovirta E, van Ganse E, van Hage M, van den Berge M, Vandenplas O, Ventura MT, Vergara I, Vezzani G, Vidal D, Viegi G, Wagemann M, Whalley B, Wickman M, Wilson N, Yiallouros PK, Žagar M, Zaidi A, Zidarn M, Hoogerwerf EJ, Usero J, Zuffada R, Senn A, de Oliveira-Alves B. Building Bridges for Innovation in Ageing: Synergies between Action Groups of the EIP on AHA. J Nutr Health Aging 2017; 21:92-104. [PMID: 27999855 DOI: 10.1007/s12603-016-0803-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/12/2016] [Indexed: 01/08/2023]
Abstract
The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Liotta G, Orfila F, Vollenbroek-Hutten M, Roller-Winsberger R, Illario M, Musian D, Alvino S, O’Caoimh R, Cano A, Molloy W, Iaccarino G, Marazzi MC, Inzerilli MC, Madaro O, Paul C, Csonka P, Vince AC, Menditto E, Maggio M, Scarcella P, Gilardi F, Lucaroni F, Abete P, Girardi V, Barra R, Palombi L. The European Innovation Partnership on Active and Healthy Ageing Synergies: Protocol for a Prospective Observational Study to Measure the Impact of a Community-Based Program on Prevention and Mitigation of Frailty (ICP - PMF) in Community-Dwelling Older Adults. Transl Med UniSa 2016; 15:53-66. [PMID: 27896228 PMCID: PMC5120751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim of this paper is to describe the protocol of the study "Impact of a Community-based Program on Prevention and Mitigation of Frailty in community-dwelling older adults" developed in the framework of the European Innovation Partnership on Active and Healthy Ageing. This proposal has been developed by the Partnership Action groups on frailty, fall prevention and polypharmacy in older. The proposal wants to assess the impact of community-based programs aimed to counteract three main outcomes related to frailty: hospitalization, institutionalization and death. Bringing together researchers from seven European countries, the proposal aims to achieve the critical mass and the geographical extension enough to provide information useful to all older European citizens. An observational study will be carried out to calculate the incidence of the different outcomes in relation to the various interventions that will be assessed; results will be compared with data coming from already established national, regional and local dataset using the observed/expected approach. The sample will be made up by at least 2000 citizens for each outcome. All the citizens will be assessed at the baseline with two multidimensional questionnaires: the RISC questionnaire and the Short Functional Geriatric Evaluation questionnaire. The outcomes will be assessed every six-twelve months.
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Affiliation(s)
- G Liotta
- Corresponding Author: Giuseppe Liotta; e-mail:
| | - F Orfila
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - M Vollenbroek-Hutten
- Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, University of Twente, Enschede, The Netherlands
- Ziekenhuis Groep Twente, Almelo, The Netherlands
| | | | - M Illario
- DISMET, Federico II University Naples, Italy
| | | | | | - R O’Caoimh
- Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Ireland
| | - A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain
| | - W Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork City, Ireland
| | - G Iaccarino
- Department of Medicine, University of Salerno, Baronissi, Salerno
| | | | - MC Inzerilli
- Community of Sant’Egidio - Long Live the Elderly program, Rome Italy
- Rome Municipality, Italy
| | - O Madaro
- Community of Sant’Egidio - Long Live the Elderly program, Rome Italy
| | - C Paul
- ICBAS, University of Porto, Portugal
| | - P Csonka
- Educators’ Centre Association, Pecs, Hungary
| | - AC Vince
- Educators’ Centre Association, Pecs, Hungary
| | - E Menditto
- CIRFF, Center of Pharmacoeconomics, University of Naples Federico II 17University of Parma, Italy
| | - M Maggio
- University-Hospital of Parma, Emilia Romagna Region Italy
| | - P Scarcella
- Biomedicine and Prevention Dept. – University of Rome Tor Vergata, Rome, Italy
| | - F Gilardi
- Biomedicine and Prevention Dept. – University of Rome Tor Vergata, Rome, Italy
| | - F Lucaroni
- Biomedicine and Prevention Dept. – University of Rome Tor Vergata, Rome, Italy
| | - P Abete
- Medical University of Graz, Austria
| | - V Girardi
- Associazione Salute in Collina, Naples, Italy
| | - R Barra
- Associazione Salute in Collina, Naples, Italy
| | - L Palombi
- Biomedicine and Prevention Dept. – University of Rome Tor Vergata, Rome, Italy
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Active and Healthy Ageing and Independent Living 2016. J Aging Res 2016; 2016:8062079. [PMID: 27818798 PMCID: PMC5080497 DOI: 10.1155/2016/8062079] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022] Open
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Applying a Participatory Design Approach to Define Objectives and Properties of a "Data Profiling" Tool for Electronic Health Data. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2016; 2016:60-7. [PMID: 27570651 PMCID: PMC5001743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We applied a participatory design approach to define the objectives, characteristics, and features of a "data profiling" tool for primary care Electronic Health Data (EHD). Through three participatory design workshops, we collected input from potential tool users who had experience working with EHD. We present 15 recommended features and characteristics for the data profiling tool. From these recommendations we derived three overarching objectives and five properties for the tool. A data profiling tool, in Biomedical Informatics, is a visual, clear, usable, interactive, and smart tool that is designed to inform clinical and biomedical researchers of data utility and let them explore the data, while conveniently orienting the users to the tool's functionalities. We suggest that developing scalable data profiling tools will provide new capacities to disseminate knowledge about clinical data that will foster translational research and accelerate new discoveries.
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Vollenbroek-Hutten M, Pais S, Ponce S, Dekker-van Weering M, Jansen-Kosterink S, Schena F, Tabarini N, Carotenuto F, Iadicicco V, Illario M. Rest Rust ! Physical active for active and healthy ageing. Transl Med UniSa 2015; 13:19-28. [PMID: 27042429 PMCID: PMC4811345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this paper is to give an insight on how physical activity can be defined, parameterized and measured in older adults and on different options to deal with citizen physical activity promotion at European level. Three relevant aspects are highlighted: When talking about physical activity, two different aspects are often unfairly mixed up: "physical activity" and "physical capacity". Physical activity, is referred to as the level of physical activity someone is actually performing in daily life.Physical capacity is referred to as the maximum physical activity a person can perform.Both physical activity and physical capacity can be expressed in different dimensions such as time, frequency, or type of activity with the consequence that there are many tools and techniques available. In order to support people to choose an appropriate instrument in their everyday practice a list of 9 criteria that are considered important is defined.Older adults score differently across the various physical dimensions, so strategies to promote physical activity should consider individual differences, in order to adapt for these variations.
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Affiliation(s)
- M Vollenbroek-Hutten
- Roessingh Research and Development, Telemedicine group, Enschede, The Netherlands
- University of Twente, Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine group, Enschede, The Netherlands
| | - S Pais
- Center for Research and Development in Health, University of Algarve, Portugal
| | - S Ponce
- Kronikgune, Torre del BEC, Ronda de Azkue, 1, 48902 Barakaldo, Biscay, Spain
| | - M Dekker-van Weering
- Roessingh Research and Development, Telemedicine group, Enschede, The Netherlands
| | - S Jansen-Kosterink
- Roessingh Research and Development, Telemedicine group, Enschede, The Netherlands
| | - F Schena
- Department of Neurological, Biomedical and Movement Sciences – University of Verona, Italy
| | - N Tabarini
- Department of Neurological, Biomedical and Movement Sciences – University of Verona, Italy
| | - F Carotenuto
- Department of Translational Medical Sciences, Federico II University, and R&D Unit, Federico II University Hospital
| | - V Iadicicco
- Department of Translational Medical Sciences, Federico II University, and R&D Unit, Federico II University Hospital
| | - M Illario
- Department of Translational Medical Sciences, Federico II University, and R&D Unit, Federico II University Hospital
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Vuolo L, Barrea L, Savanelli MC, Savastano S, Rubino M, Scarano E, Soprano M, Illario M, Colao A, Di Somma C. Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing. Transl Med UniSa 2015; 13:13-8. [PMID: 27042428 PMCID: PMC4811344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bone impairment and malnutrition are associated with significant disability and mortality. PERSSILAA is an European project developing health services to detect and prevent frailty in older adults by addressing cognitive, physical and nutritional. METHODS Subjects underwent anthropometric measurements, calcaneal quantitative ultrasound (QUS) scan and PREDIMED (PREvención con DIeta MEDiterránea) questionnaire. AIM To investigate the association between adherence to the Mediterranean Diet (MD) and bone health. RESULTS 87 subjects (4 males and 83 females) 70.1±4.9 aged, were examined. Mean Body Mass Index (BMI) was 28.7±4.7(kg/m(2)): in particular 28 subjects (32.2%) resulted obese, 42 (48.3%) overweight, and only 17 (19.5%) with normal weight. Mean T score was -1.2±1.2: in particular 13 subjects (14.9%) resulted osteoporotic; 43 (49.5%) osteopenic; and 31 (35.6%) with normal bone mineral density. Regarding adherence to MD, 9 subjects (10.3%) were poorly adherent; 41 (47.2%) average adherent; 37 (42.5%) highly adherent. T-score was associated with PREDIMED score and osteoporotic subjects presented the lowest PREDIMED score (5.8±2.2). CONCLUSIONS These preliminary data show a significant correlation between the adherence to the MD and bone health parameters. The association between MD and bone health highlights the potential beneficial effects of nutritional interventions promoting a Mediterranean food pattern, as safe adjuvant treatment in ageing.
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Affiliation(s)
- L. Vuolo
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Federico II University, Naples, Italy
| | | | | | - S. Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Federico II University, Naples, Italy
| | - M. Rubino
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Federico II University, Naples, Italy
| | - E. Scarano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Federico II University, Naples, Italy
| | - M. Soprano
- Department of Translational Medical Sciences, Federico II University, and R&D Unit, Federico II University Hospital
| | - M. Illario
- Department of Translational Medical Sciences, Federico II University, and R&D Unit, Federico II University Hospital
| | - A. Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Federico II University, Naples, Italy
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O’ Caoimh R, Weathers E, Hally R, O’ Sullivan R, FitzGerald C, Cornally N, Svendrovski A, Healy E, O’Connell E, O’Keeffe G, Warren PL, Daly BD, Clarnette R, Smith S, Cipriani N, Bond R, Orfila F, Paúl C, William Molloy D. The Community Assessment of Risk and Treatment Strategies (CARTS): An Integrated Care Pathway to Manage Frailty and Functional Decline in Community Dwelling Older Adults. COMMUNICATIONS IN COMPUTER AND INFORMATION SCIENCE 2015. [DOI: 10.1007/978-3-319-27695-3_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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