scholarly journals Effectiveness Of A Staff Training Program To Stimulate Physical Activity In Homecare: A Cluster RCT

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 975-975
Author(s):  
Silke Metzelthin ◽  
Teuni H Rooijackers ◽  
G A Rixt Zijlstra ◽  
Erik van Rossum ◽  
Annemarie Koster ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Self Efficacy ◽  
Sedentary Time ◽  
Intervention Group ◽  
Lessons Learned ◽  
Mean Difference ◽  
Cluster Rct ◽  
Cost Category ◽  
At Home

Abstract Reablement encourages older adults to do things themselves rather than having things done for them. To implement reablement in practice homecare staff needs the right knowledge, attitude, skills and support. This study evaluated the effectiveness of the “Stay Active at Home” reablement training program. A 12-month cluster-RCT was conducted, involving staff (n=313) and clients (n=264) from 10 homecare teams, five of which were trained. Effects were evaluated using data from accelerometers, physical performance tests, questionnaires and electronic patient records. No beneficial effects were observed in older adults for sedentary behavior; daily, physical, and psychological functioning; and falls. In homecare staff there were no statistically significant differences between study groups for self-efficacy and outcome expectations scores except for higher self-efficacy scores in more compliant staff (adjusted mean difference: 1.9 [95% CI 0.1, 3.7]). No differences were observed for any cost category except for domestic help costs in the intervention group (adjusted mean difference: €-173 [95% CI -299, -50]). The probability that “Stay Active at Home” is cost-effective compared to usual care at a willingness-to-pay of €20,000 was 19.7%/ daily minute of sedentary time averted, 19.2%/ percent of sedentary time averted as proportion of wake/wear time, and 5.9%/QALY gained, respectively. The reablement training program needs further development based on the lessons learned before wider implementation.

scholarly journals Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teuni H. Rooijackers ◽  
G. A. Rixt Zijlstra ◽  
Erik van Rossum ◽  
Ruth G. M. Vogel ◽  
Marja Y. Veenstra ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Team Approach ◽  
Staff Members ◽  
Care Plans ◽  
Lump Sum ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Background Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n = 4). Results The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment. Trial registration ClinicalTrials.gov (Identifier NCT03293303). Registered 26 September 2017.

Effect of a brief training program for primigravid adolescents on parenting self-efficacy and mother-infant bonding in the southeast of Iran

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Zahra Moudi ◽  
Behjat Talebi ◽  
Mahnaz Shahraki Pour
Keyword(s):  
Social Support ◽  
Training Program ◽  
Self Efficacy ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Middle Income ◽  
Brief Training ◽  
Quasi Experimental ◽  
Limited Health

Abstract Background Annually, about 16 million adolescent girls give birth, accounting for 11% of all births worldwide. Ninety-five percent of these births occur in low- and middle-income countries, and previous studies have addressed the need for parenting interventions in developing countries with limited health care resources to improve parenting behaviors. Objective To explore the effect of a brief training program for primigravid adolescents on parenting self-efficacy and mother-infant bonding. Subjects We enrolled 116 married pregnant adolescents. Methods This quasi-experimental study was conducted during August 22, 2016–February 3, 2017. The intervention group received three sessions of training on neonatal care, while the control group received the routine care. We evaluated parenting self-efficacy using the Perceived Maternal Parenting Self-Efficacy (PMP S-E) questionnaire, the mother-infant bonding using the Postpartum Bonding Questionnaire (PBQ) and social support by means of the Multidimensional Scale of Perceived Social Support (MSPSS). The participants were followed up for 1 month. Results The mean ages of the intervention and the control groups were 16.37 ± 0.97 and 16.27 ± 1.12 years, respectively. The intervention group obtained higher self-efficacy and bonding scores compared to the control group. The logistic regression model showed that the second (evoking behaviors) and the third (reading behavior or signaling) subscales of the PMP S-E, the route of delivery and women’s educational levels could predict the mother-infant bonding scores. Conclusion Primigravid adolescents can benefit from brief interventions during pregnancy through improving their parenting self-efficacy and mother-infant bonding.

scholarly journals Older Adults with COVID-19 Can Choose Care at Home: Lessons Learned from New York City

2020 ◽  
Vol 35 (9) ◽  
pp. 2755-2756
Author(s):  
Justina L. Groeger ◽  
Joanna L. Starrels ◽  
Amy R. Ehrlich
Keyword(s):  
Older Adults ◽  
New York ◽  
New York City ◽  
York City ◽  
Lessons Learned ◽  
Care At Home ◽  
At Home

Exploring Older Adults’ Experiences and Perceptions with a Peer-Led Wheelchair Training Program

2020 ◽  
Vol 87 (3) ◽  
pp. 192-199
Author(s):  
Alice Pellichero ◽  
Krista L. Best ◽  
François Routhier ◽  
William C. Miller
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Self Efficacy ◽  
Social Inclusion ◽  
Social Connectedness ◽  
Qualitative Interviews ◽  
Community Based ◽  
Wheelchair Users ◽  
Perceived Impact

Background. Manual wheelchair (MWC) training is important, but less than 50% of new wheelchair users receive any training. The Wheelchair training Self-efficacy Enhanced for Use (WheelSeeU), a community-based peer-led MWC training program, is feasible and effective for improving wheelchair skills. However, implementing effective programs requires an understanding of stakeholders’ experiences. Purpose. Explore older adults’ perceptions about their participation in the WheelSeeU program. Method. Qualitative interviews were conducted with participants who completed the WheelSeeU program. Thematic analysis was conducted. Findings. Three themes emerged. 1. Getting my life back described participants’ perceived impact of the WheelSeeU program on their lives. 2. I can do it too, implied critical facilitators for success. 3. Social gains, revealed participants’ feelings of social inclusion through participation in the program. Implications. Older adults expressed satisfaction and quality of participation with the WheelSeeU program that increased autonomy, improved MWC mobility and self-efficacy, and enhanced social connectedness.

The effectiveness of a minimal psychological intervention on self-management beliefs and behaviors in depressed chronically ill elderly persons: a randomized trial

2011 ◽  
Vol 24 (2) ◽  
pp. 288-297 ◽  
Author(s):  
Catharina C. M. Jonkers ◽  
Femke Lamers ◽  
Hans Bosma ◽  
Job F. M. Metsemakers ◽  
Jacques Th. M. van Eijk
Keyword(s):  
Social Participation ◽  
Self Efficacy ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Chronically Ill ◽  
Mean Difference ◽  
Self Management ◽  
Daily Functioning ◽  
Control Group ◽  
Elderly Persons

ABSTRACTBackground: Chronically ill patients often develop symptoms of depression. They run the risk of sliding into a downward spiral because of the interaction between depression and chronic illness. A minimal psychological intervention (MPI) has been developed to break through the spiral by applying principles of self-management and cognitive behavioral therapy. This study examines the effects of the MPI on self-efficacy, anxiety, daily functioning and social participation.Methods: A randomized controlled trial compared the MPI with usual care in 361 primary care patients. Nurses visited patients at home over a period of three months. Patients were aged 60 years and older, had minor depression or mild to moderate major depression and either type 2 diabetes mellitus (DM) or chronic obstructive pulmonary disease (COPD). Outcomes were measured at baseline and at one week, three months, and nine months after the intervention period.Results: At nine months after treatment, the MPI was associated with less anxiety (mean difference 2.5; 95% CI 0.7–4.2) and better self efficacy skills (mean difference 1.8; 95% CI 3.4–0.2), daily functioning (mean difference 1.7; 95% CI 0.6–2.7), and social participation (mean difference 1.3; 95% CI 0.4–2.2). Effect sizes for these outcomes were small to medium (0.29–0.40). Differences were primarily due to a stabilization of outcomes in the intervention group and deterioration in the control group. No major differences were observed between DM and COPD patients.Conclusions: The intervention appears to be reasonably effective in improving care for chronically ill elderly people. We recommend further evaluation of the MPI, including emphasis on detection and watchful waiting.

Increasing the Availability of Physical Activity Programs for Older Adults: Lessons Learned From Texercise Stakeholders

2016 ◽  
Vol 24 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Alan B. Stevens ◽  
Shannon B. Thiel ◽  
Jennifer L. Thorud ◽  
Matthew Lee Smith ◽  
Doris Howell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Program Implementation ◽  
Self Efficacy ◽  
Community Organizations ◽  
Lessons Learned ◽  
Multiple Stakeholders ◽  
Stakeholder Support ◽  
Implementation And Dissemination ◽  
Underlying Processes

Many initiatives have been developed to facilitate older adults’ engagement in physical activity (PA) and document its benefits. One example is Texercise, a 12-week program with a focus on increasing participants’ self-efficacy. The goal of this paper is to augment the knowledgebase of PA program implementation and dissemination by elucidating the experience of Texercise implementation as perceived by multiple stakeholders. We conducted 28 semistructured stakeholder interviews and categorized the responses into four preset themes: (1) program delivery and advocacy; (2) value/merit of the program; (3) successes/challenges of offering and sustaining the program; and (4) recommendations for enhancing implementation and delivery. We identified emergent subthemes through further analysis. Many perceptions that are broadly applicable to community organizations emerged. Our findings highlight the importance of stakeholder support when embedding PA programs in communities. Furthermore, the findings are crucial to understanding underlying processes that support widespread program dissemination and sustainability.

scholarly journals A Technology Training Program to Alleviate Social Isolation and Loneliness Among Homebound Older Adults: A Community Case Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Frances N. Jiménez ◽  
Joan F. Brazier ◽  
Natalie M. Davoodi ◽  
L. Carter Florence ◽  
Kali S. Thomas ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Social Isolation ◽  
Technology Training ◽  
Lessons Learned ◽  
Community Based ◽  
Program Staff ◽  
Facilitators And Barriers ◽  
Homebound Older Adults ◽  
Ict Training

Despite substantial evidence of the negative health consequences of social isolation and loneliness and the outsized impact on older adults, evidence on which interventions are most effective in alleviating social isolation and loneliness is inconclusive. Further complicating the translation of evidence into practice is the lack of studies assessing implementation and scalability considerations for socialization programs delivered by community-based organizations (CBOs). Our primary objective was to describe the implementation barriers, facilitators, and lessons learned from an information and communication technology (ICT) training program aimed at reducing social isolation and loneliness for homebound older adults in a home-delivered meals program. Participants received in-home, one-on-one ICT training lessons delivered by volunteers over a 14-week period with the goal of increasing social technology use. To assess implementation facilitators and barriers, 23 interviews were conducted with program staff (n = 2), volunteers (n = 3), and participants (n = 18). Transcripts were analyzed using thematic analysis. Aspects that facilitated implementation included the organization's existing relationship with clientele, an established infrastructure to deliver community-based interventions, alignment of intervention goals with broader organizational aims, and funding to support dedicated program staff. Challenges to implementation included significant program staff time and resources, coordinating data sharing efforts across multiple project partners, participant and volunteer recruitment, and interruptions due to COVID-19. Implications of these facilitators and barriers for scalability of community-based ICT training interventions for older adults are described. Lessons learned include identifying successful participant and volunteer recruitment strategies based on organizational capacity and existing recruitment avenues; using a targeted approach to identify potential participants; incorporating flexibility into intervention design when working with the homebound older adult population; and monitoring the participant-volunteer relationship through volunteer-completed reports to mitigate issues. Findings from this formative evaluation provide insight on strategies CBOs can employ to overcome challenges associated with implementing technology training programs to reduce social isolation and loneliness for older adults, and thus improve overall well-being for homebound older adults. Recommendations can be integrated into program design to facilitate implementation of ICT programs in the community setting.

scholarly journals Developing a Training Program for Digital Literacy Coaches for Older Adults: Lessons Learned from the Train-the-Trainer Program

2020 ◽  
Vol 8 (11) ◽  
pp. 62
Author(s):  
Jacqueline Mary McGinty
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Lifelong Learning ◽  
Digital Literacy ◽  
Lessons Learned ◽  
Positive Health ◽  
Train The Trainer ◽  
Critical Issues ◽  
Technology Strategies ◽  
Learning Principles

Social isolation and loneliness are critical issues facing older adults. The COVID-19 pandemic increased isolation among this population, and digital technologies are considered a significant lifeline for older adults adhering to social distancing guidelines. Research has shown that lifelong learning and maintaining social connection during the senior years leads to positive health outcomes. The digital literacy training program addresses isolation and loneliness issues and promotes lifelong learning among older adults. The program's delivery is a train-the-trainer (TT) model. In the TT model for this study, volunteers facilitated eight digital technology lessons after receiving training on adult learning principles, working with older adults, and teaching technology strategies. This article aims to share the results from the TT process and the curriculum implementation from the volunteer trainers' perspectives, called coaches, who participated in the pilot program. The coaches' feedback and the observations made by the researchers offer essential insights into the design and development of a TT model for a technology training program for older adults. The findings suggest improvements for the curriculum and the TT model, including equipping the coaches with tablets at the beginning of the training, providing extended video conference practice, increasing technical support on-site, and expanding step by step instructions for training guides.

scholarly journals Motivating Diabetic and Hypertensive Patients to Increase Physical Activity: The Use of Photos and Group Dynamics

2018 ◽  
Author(s):  
Angela Yee Man Leung ◽  
Pui Hing Chau ◽  
Isaac Leung ◽  
Michael Tse ◽  
Perick Lai Choi Wong ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Lower Limb ◽  
Intervention Group ◽  
Mean Difference ◽  
Regular Physical Activity ◽  
Activity Level ◽  
Control Group ◽  
Body Strength ◽  
Group Meetings

Aims: Photovoice is a strategy to allow people to express their views and concerns about health. This project aimed to promote physical activity (PA) among patients with chronic illness, identify facilitators and barriers for PA, enhance walking within the neighbourhood, and build up efficacy in doing exercise. Design: A quasi-experimental study with waitlisted control and pre-and-post measures. Setting: Community elderly centres. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either intervention group (IG) or waitlisted control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community elderly centres in which the participants freely exchanged their views about the barriers and facilitators of regular physical activity. Participants were encourage to take photos in their neighbourhood or at homes, and brought these photos for sharing in the group meetings. The photos showed the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by Garmin Accelerometer at baseline, at Week 6 and Week 10. Other measures include the 9-item Self-efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. General linear mixed model was used to compare the outcomes between IG and CG after the intervention. Results: After the 6-week intervention, the average number of steps taken by the IG participants increased. At Week 10, there was a significant higher proportion of the IG participants who had increased at least 1,200 steps than that of the CG (Estimate=0.151, SE=0.066, p<0.05). The lower body strength of the IG participants was significantly higher than that of the CG (mean difference = 0.94, t=1.957, p<0.05) and the lower limb flexibility of the IG participants was also significantly higher than that of the CG (mean difference = 2.04, t=2.397, p<0.05) at Week 10. Conclusion: Understanding older adults’ views and thoughts about barriers to PA through photos and group discussion seemed to be a good strategy to motivate older adults with chronic illnesses to commit to regular physical activity. This photovoice intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.

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