Participation in Cardiovascular Health Awareness Program (CHAP) by the Elderly Residents of Social Housing in Quebec: Social Network Analysis

2020 ◽  
Author(s):  
Nadia Deville-Stoetzel ◽  
Janusz Kaczorowski ◽  
Gina Agarwal ◽  
Marie-Thérèse Lussier ◽  
Magali Girard

Abstract Background: The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in small to medium size communities in Ontario. Recently, CHAP has been adapted to target older individuals living in 14 social housing buildings in Ontario (7) and Quebec (7). The participation rates in the 10-months program varied across buildings in Quebec from 23.5% to 49.1%. Social network analysis (SNA) has been successfully used to assess and strengthen participation in health promotion programs. We applied SNA methods to investigate whether interpersonal relationships between tenants within buildings influence the participation in CHAP. Methods: We used sociometric questionnaires and complete network analysis, supplemented by qualitative interviews to examine relational dynamics of two buildings in Quebec with a low and a high attendance rates. All residents of the two buildings were eligible to be interviewed for the sociometric questionnaire. The participants for the qualitative part of the study were selected at random. Results: In total, 69 seniors participated in the study, including qualitative interviews. Among study participants selected for qualitative interviews, 10 attended almost all CHAP sessions, 10 attended once and 12 did not attend any. Quantitative results helped to identify well-known and appreciated local leaders. In building 1 which had a high attendance rate (34.3%), there was a main leader (In-degree or ‘named by others’ frequency 23.2%) who attended all sessions. In building 2 which had a low attendance rate (23.9%), none of the leaders had participated in CHAP sessions. Qualitative analysis showed that tenants who did not attend CHAP sessions (or other activities in the building) generally preferred to avoid conflicts, retaliation and gossip and did not want to get involved in clans and politics within the buildings. Conclusion: In order to increase attendance at CHAP sessions among residents of subsidized housings for seniors, we identified 4 potential strategies: increase participant confidentiality; deploy community peer-networks to enhance recruitment; pair attendants to ensure their future participation; intervene through an opinion leader or through bridging individuals.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Deville-Stoetzel ◽  
Janusz Kaczorowski ◽  
Gina Agarwal ◽  
Marie-Thérèse Lussier ◽  
Magali Girard

Abstract Background The Cardiovascular Health Awareness Program (CHAP) is as a community-based cardiovascular disease prevention program recently adapted to target older adults living in 14 social housing buildings in Ontario (7) and Quebec (7). Social network analysis (SNA) has been used successfully to assess and strengthen participation in health promotion programs. We applied SNA methods to investigate whether interpersonal relationships among residents within buildings influenced their participation in CHAP. Methods Our aim was to examine relational dynamics in two social housing buildings in Quebec with low and high CHAP attendance rates, respectively. We used sociometric questionnaires and network analysis for the quantitative phase of the study, supplemented by a phase of qualitative interviews. All residents of both buildings were eligible for the sociometric questionnaire. Respondents for the qualitative interviews were purposively selected to represent the different attendance situations following the principle of content saturation. Results In total, 69 residents participated in the study, 37 through sociometric questionnaires and 32 in qualitative interviews. Of the latter, 10 attended almost all CHAP sessions, 10 attended once, and 12 attended none. Results of the quantitative analysis phase identified well-known and appreciated local leaders. In Building 1, which had a high attendance rate (34.3%), there was a main leader (in-degree or ‘named by others’ frequency 23.2%) who had attended all CHAP sessions. In Building 2, which had a low attendance rate (23.9%), none of the leaders had attended CHAP sessions. Results of the qualitative analysis phase showed that residents who did not attend CHAP sessions (or other activities in the building) generally preferred to avoid conflicts, vindictiveness, and gossip and did not want to get involved in clans and politics within their building. Conclusion We identified four potential strategies to increase attendance at CHAP sessions by residents of subsidized housing for older adults: strengthen confidentiality for those attending the sessions; use community peer networks to enhance recruitment; pair attendees to increase the likelihood of participation; and intervene through opinion leaders or bridging individuals.


Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Gina Agarwal ◽  
Magali Girard ◽  
Ricardo Angeles ◽  
Melissa Pirrie ◽  
Marie-Thérèse Lussier ◽  
...  

Abstract Background The Cardiovascular Health Awareness Program (CHAP) uses volunteers to provide cardiovascular disease (CVD) and diabetes screening in a community setting, referrals to primary care providers, and locally available programs targeting lifestyle modification. CHAP has been adapted to target older adults residing in social housing, a vulnerable segment of the population. Older adults living in social housing report poorer health status and have a higher burden of a multitude of chronic illnesses, such as CVD and diabetes. The study objective is to evaluate whether there is a reduction in unplanned CVD-related Emergency Department (ED) visits and hospital admissions among residents of social seniors’ housing buildings receiving the CHAP program for 1 year compared to residents in matched buildings not receiving the program. Methods/design This is a pragmatic, cluster randomized controlled trial in community-based social (subsidized) housing buildings in Ontario and Quebec. All residents of 14 matched pairs (intervention/control) of apartment buildings will be included. Buildings with 50–200 apartment units with the majority of residents aged 55+ and a unique postal code are included. All individuals residing within the buildings at the start of the intervention period are included (intention to treat, open cohort). The intervention instrument consists of CHAP screens for high blood pressure using automated blood pressure monitors and for diabetes using the Canadian Diabetes Risk (CANRISK) assessment tool. Monthly drop-in sessions for screening/monitoring are held within a common area of the building. Group health education sessions are also held monthly. Reports are sent to family doctors, and attendees are encouraged to visit their family doctor. The primary outcome measure is monthly CVD-related ED visits and hospitalizations over a 1-year period post randomization. Secondary outcomes are all ED visits, hospitalizations, quality of life, cost-effectiveness, and participant experience. Discussion It is anticipated that CVD-related ED visits and hospitalizations will decrease in the intervention buildings. Using the volunteer-led CHAP program, there is significant opportunity to improve the health of older adults in social housing. Trial registration ClinicalTrials.gov,NCT03549845. Registered on 15 May 2018. Updated on 21 May 2019.


2020 ◽  
Vol 12 (3) ◽  
pp. 1275 ◽  
Author(s):  
Eleni Karali ◽  
Dragana Bojovic ◽  
Gabriela Michalek ◽  
Carlo Giupponi ◽  
Reimund Schwarze

Communication and collaboration are critical for designing and implementing responses to climate change impacts and related disasters. This acknowledgement has increased interest in understanding social and institutional networks for climate change adaptation (CCA) and disaster risk reduction (DRR). In this study, we used Social Network Analysis (SNA) to explore institutional interactions within and across the communities of the aforementioned domains in Europe. Firstly, we investigated the type and intensity of interactions. We calculated SNA metrics to assess the roles of different actors and applied cluster analysis to identify actors with similar patterns of connections. SNA showed that communication is often more intensive within the two communities, while collaboration is frequent around topics related to both CCA and DRR. Cluster analysis revealed that actors tied with DRR were more closely connected, while actors tied with CCA and those with mixed connections showed no obvious clustering affinity. The European Climate Adaptation Platform, Climate-ADAPT, had the highest value for various SNA metrics, reflecting its popularity in the network and its potential for enhancing interactions among its actors. Finally, SNA was complemented by qualitative interviews, which emphasised the importance of connecting CCA and DRR in organisational mission and vision statements.


2020 ◽  
Author(s):  
Janusz Kaczorowski ◽  
Hanaa Moussa ◽  
Marie-Thérèse Lussier ◽  
Magali Girard

Abstract Background: Locally recruited and trained volunteers are a vital component of the Cardiovascular Health Awareness Program (CHAP), a community-based cardiovascular disease prevention program that has been implemented across different settings and targeting different populations. As part of expanding and adapting CHAP to new settings, we conducted a pragmatic cluster randomized controlled trial to implement CHAP targeting elderly residents of subsidized social housing buildings in Québec and Ontario. As there is some evidence that the culture of volunteering might be different for English-speakers than their French-speaking counterparts, our objective was to generate a profile of French-speaking CHAP volunteers and to compare it with English-speaking volunteers in Ontario who participated in an earlier community-based CHAP program and with volunteers in Canada as reported in the Statistics Canada's General Social Survey on Giving, Volunteering and Participating (CSGVP). Methods: A cross-sectional survey was administered online or by telephone to volunteers who participated in at least one CHAP session held in subsidized social housing in Montérégie (Québec, Canada) between March 2018 and June 2019. Results: The response rate was 79% (30/38), majority were female (87%, 26/30), retired or semi-retired (83%; 25/30), almost two-thirds (63%, 19/30) had previous work experience in the healthcare field, and 40% (12/30) had more than 10 years of volunteering experience. These characteristics were similar both to those of general profile of volunteers in Canada and to English-speaking volunteers in Ontario who participated in an earlier pharmacy-based CHAP program. The top 5 reasons for volunteering among French-speaking CHAP volunteers were identical to those reported in CSGVP: making a contribution to the community; using one’s skills and experience; improving one’s sense of well-being or health; exploring one’s own strengths; and networking with or meeting people. The majority of French-speaking CHAP volunteers, like their English counterparts in Ontario, reported a high level of satisfaction with their participation in the program, enjoyed their interaction with participants, and gained new knowledge. Conclusions: French-speaking CHAP volunteers in Quebec share many similarities with English-speaking CHAP volunteers in Ontario and volunteers in Canada in terms of background, motivation, satisfaction and perceived benefits of volunteering.


2021 ◽  
Author(s):  
Janusz Kaczorowski ◽  
Hanaa Moussa ◽  
Marie-Thérèse Lussier ◽  
Magali Girard

Abstract Background: Locally recruited and trained volunteers are a vital component of the Cardiovascular Health Awareness Program (CHAP), a community-based cardiovascular disease prevention program that has been implemented across different settings and targeting different populations. As part of expanding and adapting CHAP to new settings, we conducted a pragmatic cluster randomized controlled trial to implement CHAP targeting French-speaking elderly residents of subsidized social housing buildings in Québec and Ontario. As there is some evidence that the culture of volunteering might be different for English-speakers than their French-speaking counterparts, our objective was to generate a profile of French-speaking CHAP volunteers and to compare it with English-speaking volunteers in Ontario who participated in an earlier community-based CHAP program and with volunteers in Canada as reported in the Statistics Canada's General Social Survey on Giving, Volunteering and Participating (CSGVP). Methods: A cross-sectional survey was administered online or by telephone to French-speaking volunteers who participated in at least one CHAP session held in subsidized social housing in Montérégie (Québec, Canada) between March 2018 and June 2019. Results: The response rate was 79% (30/38), majority were female (87%, 26/30), retired or semi-retired (83%; 25/30), almost two-thirds (63%, 19/30) had previous work experience in the healthcare field, and 40% (12/30) had more than 10 years of volunteering experience. These characteristics were similar both to those of general profile of volunteers in Canada and to English-speaking volunteers in Ontario who participated in an earlier pharmacy-based CHAP program. The top 5 reasons for volunteering among French-speaking CHAP volunteers were identical to those reported in CSGVP: making a contribution to the community; using one’s skills and experience; improving one’s sense of well-being or health; exploring one’s own strengths; and networking with or meeting people. The majority of French-speaking CHAP volunteers, like their English counterparts in Ontario, reported a high level of satisfaction with their participation in the program, enjoyed their interaction with participants, and gained new knowledge. Conclusions: French-speaking CHAP volunteers in Quebec share many similarities with English-speaking CHAP volunteers in Ontario and volunteers in Canada in terms of background, motivation, satisfaction and perceived benefits of volunteering.


PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0156028 ◽  
Author(s):  
Ilan Kelman ◽  
Tobias Luthe ◽  
Romano Wyss ◽  
Silje H. Tørnblad ◽  
Yvette Evers ◽  
...  

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