Effectiveness, satisfaction and meaningfulness of a 6-step detection and prevention program for frail community-dwelling older adults: a mixed-method evaluation.
Detection
Follow up
Multidimensional frailty
Prevention
Randomized controlled trial
Risk factors
Warm referral
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
14 12 2022
14 12 2022
Historique:
received:
18
04
2022
accepted:
05
10
2022
entrez:
14
12
2022
pubmed:
15
12
2022
medline:
17
12
2022
Statut:
epublish
Résumé
As people age, the risk of becoming frail increases, often leading to negative outcomes and less well-being. Within the light of prevention, early detection and guidance to the right care and support is crucial. This study aimed to give an overview of the descriptive results of the D-SCOPE program and evaluate the process. The D-SCOPE program was developed as a detection and prevention program for frail community-dwelling older adults. The program creates a continuum of care and support, consisting of 6 steps: (1) Targeted case-finding using risk profiles for purposeful selection, (2) Preventive home-visit by an older volunteer, (3) Home visits by a professional, (4), Warm referral, (5) Monthly follow-up and (6) Long-term follow-up by home visit. The effectiveness of this program, in terms of satisfaction and meaningfulness, was studied quantitatively by means of a randomized controlled trial amongst 869 people with a frailty risk profile and qualitatively by 15 focus groups interviews. The quantitative study revealed that 83.9% of the participants found the different home visits within the D-SCOPE program useful. The focus group interviews shed light on several issues and advantages: a more efficient case finding due to the applied risk factors for frailty, a more intensive tailor-made care and support due to the warm referral, the importance of both small-scaled and larger interventions based on the wishes irrespective of the state of frailty of the older persons, the focus on a strengths-based instead of a deficit-based approach and the follow up as being one of the greatest strengths of the project. However, to fully understand the benefits of the program a shift in mind from intervention to prevention is necessary. Our quantitative data show that most participants found the home visits meaningful and were satisfied with the intervention. The qualitative findings provided more insights into the experiences of the participants with the process. Based on these insights of the 6-step model of preventive home visits, municipalities and organizations can apply this model to carry out more targeted home visits. This trial was registered at ClinicalTrials.gov, on 30/05/2017, identifier: NCT03168204.
Sections du résumé
BACKGROUND
As people age, the risk of becoming frail increases, often leading to negative outcomes and less well-being. Within the light of prevention, early detection and guidance to the right care and support is crucial. This study aimed to give an overview of the descriptive results of the D-SCOPE program and evaluate the process.
METHODS
The D-SCOPE program was developed as a detection and prevention program for frail community-dwelling older adults. The program creates a continuum of care and support, consisting of 6 steps: (1) Targeted case-finding using risk profiles for purposeful selection, (2) Preventive home-visit by an older volunteer, (3) Home visits by a professional, (4), Warm referral, (5) Monthly follow-up and (6) Long-term follow-up by home visit. The effectiveness of this program, in terms of satisfaction and meaningfulness, was studied quantitatively by means of a randomized controlled trial amongst 869 people with a frailty risk profile and qualitatively by 15 focus groups interviews.
RESULTS
The quantitative study revealed that 83.9% of the participants found the different home visits within the D-SCOPE program useful. The focus group interviews shed light on several issues and advantages: a more efficient case finding due to the applied risk factors for frailty, a more intensive tailor-made care and support due to the warm referral, the importance of both small-scaled and larger interventions based on the wishes irrespective of the state of frailty of the older persons, the focus on a strengths-based instead of a deficit-based approach and the follow up as being one of the greatest strengths of the project. However, to fully understand the benefits of the program a shift in mind from intervention to prevention is necessary.
CONCLUSIONS
Our quantitative data show that most participants found the home visits meaningful and were satisfied with the intervention. The qualitative findings provided more insights into the experiences of the participants with the process. Based on these insights of the 6-step model of preventive home visits, municipalities and organizations can apply this model to carry out more targeted home visits.
TRIAL REGISTRATION
This trial was registered at ClinicalTrials.gov, on 30/05/2017, identifier: NCT03168204.
Identifiants
pubmed: 36517745
doi: 10.1186/s12877-022-03504-7
pii: 10.1186/s12877-022-03504-7
pmc: PMC9753377
doi:
Banques de données
ClinicalTrials.gov
['NCT03168204']
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
966Subventions
Organisme : Flemish government agency for Innovation by Science and Technology
ID : IWT-140027 SBO
Informations de copyright
© 2022. The Author(s).
Références
Health Aff (Millwood). 2009 Jan-Feb;28(1):37-41
pubmed: 19124851
Int J Geriatr Psychiatry. 2018 Jul;33(7):941-947
pubmed: 29637620
Ann Ist Super Sanita. 2018 Jul-Sep;54(3):226-238
pubmed: 30284550
West J Nurs Res. 2012 Feb;34(1):24-51
pubmed: 20675621
Eur J Ageing. 2014 Feb 19;11(3):213-219
pubmed: 28804327
BMC Public Health. 2018 Jan 30;18(1):191
pubmed: 29378540
Am J Med. 2012 Sep;125(9):915-21
pubmed: 22938927
J Health Soc Behav. 2007 Jun;48(2):164-79
pubmed: 17583272
J Public Health (Oxf). 2012 Aug;34(3):322-7
pubmed: 22696599
Age Ageing. 2016 Sep;45(5):585-8
pubmed: 27146300
Aging Ment Health. 2017 Oct;21(10):1031-1039
pubmed: 27267783
Health Care Anal. 2009 Mar;17(1):68-84
pubmed: 18642082
J Adv Nurs. 2004 Dec;48(6):584-93
pubmed: 15548249
N Engl J Med. 2008 Feb 14;358(7):661-3
pubmed: 18272889
J Aging Stud. 2019 Jun;49:66-73
pubmed: 31229220
Int Psychogeriatr. 2019 Jun;31(6):767-777
pubmed: 31060639
Geriatr Nurs. 2013 Jul-Aug;34(4):274-81
pubmed: 23608069
Int J Nurs Stud. 2012 Mar;49(3):360-71
pubmed: 21996649
J Am Med Dir Assoc. 2016 Dec 1;17(12):1163.e1-1163.e17
pubmed: 27886869
Health Aff (Millwood). 2002 Mar-Apr;21(2):78-93
pubmed: 11900188
Qual Life Res. 2007 Mar;16(2):263-77
pubmed: 17033894
BMC Geriatr. 2018 Aug 27;18(1):194
pubmed: 30149798
J Pers Assess. 1985 Feb;49(1):71-5
pubmed: 16367493
Age Ageing. 2017 Jul 1;46(4):544-546
pubmed: 28104599
Curr Aging Sci. 2014;7(2):144-53
pubmed: 25101710