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| Name | Class |
|---|---|
| Recercaixa | UNKNOWN |
| Equip Atencio Primaria Sardenya | UNKNOWN |
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Motivations:
Socio-economic and education determinants have a big impact on health outcomes, in terms of worse health status in populations living in more disadvantaged conditions. Social capital, self-management and health literacy are some of the intermediate determinants, with the potential to mitigate health inequalities through interventions driven by local health agents. These three determinants are intensely interlinked and have, separately, impacts on self-perceived health. Social capital is defined in this project as an umbrella concept, which includes quantitative aspects of social resources (structural social capital: social networks and contacts, social and civic participation) as well as qualitative or subjective aspects (cognitive social capital: perceived social support, feeling of belonging and trust) and covers relations between subjects at a micro or individual level (family and friends) as well as at a macro or community level. Health literacy is understood as cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Both are key aspects for self-management behaviours. The target of our research project are older people living in urban socioeconomically disadvantaged areas, since ageing is in itself an inequality axis and urban environments concentrate the highest health disparities.
Objectives: With the aim to reduce health inequality, an intervention has been designed to promote self-management, health literacy and social capital among older people who perceived their health as fair or poor and are living in urban socioeconomically disadvantaged areas with the aim of improving their self-perceived health. Secondarily, the efficacy of the intervention will be analysed in terms of increasing self-management, health literacy and social capital (social support and social participation), quality of life, mental health and healthy lifestyles.
In third place, behavioural health patterns will be identified in relation to health literacy, social capital, gender, socioeconomic and educational level, and they will be linked to the intervention efficacy levels.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Program "Sentirnos bien" | Experimental | The intervention Program "Sentirnos bien" is based around a group dynamic, held once a week during 3 months, aimed at:
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| Control arm | No Intervention | The control arm will receive no intervention. Once the trial is finished, i.e. after the last follow-up evaluation, this arm will receive the intervention (waiting-list approach). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Program "Sentirnos bien" (Feeling well) | Behavioral | Group-based intervention delivered face-to face and held once a week during 3 months. It comprises:
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| Measure | Description | Time Frame |
|---|---|---|
| Self-perceived health | Same question than the 12 items Short Form Survey from the RAND Medical Outcomes Study. Answers will be recategorized as positive perception (excellent, very good or good) vs negative (regular or bad) | at 3 months (just after the intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Self-perceived health | Thermometer from 0-100 | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Health related quality of life | 12 items Short Form Survey from the RAND Medical Outcomes Study. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Laura Coll-Planas, MD | Fundació Salut i Envelliment UAB | Principal Investigator |
| Sergi Blancafort, PhD | Fundació Salut i Envelliment UAB | Principal Investigator |
| Rosa Monteserin, MD PhD | Equipo Atencio Primaria Sardenya | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21768583 | Background | Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97-107. doi: 10.7326/0003-4819-155-2-201107190-00005. | |
| 17943839 | Background | Foster G, Taylor SJ, Eldridge SE, Ramsay J, Griffiths CJ. Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005108. doi: 10.1002/14651858.CD005108.pub2. |
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|
| at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Self-rated quality of life | Thermometer from 0-100 | t month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Loneliness | Scale Gierveld and De Jong | t month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Depressive symptoms | Geriatric Depression Scale | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Physical activity | International Physical Activity Questionnaire (IPAQ) | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Short Physical Performance Battery | Functional test that scores performance in three physical aspects: balance, strength and gait speed. | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Health service use | Times attending primary and hospital health care | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Unintended effects | Questions ad hoc to assess effects not intended by the intervention perceived negatively by the participant. | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Self-care / healthy habits | Scale ASA (Appraisal of Self-Care Agency Scale) | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Health literacy | questions from the European Health Literacy Scale (HLS EU-16) | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Social capital | 2 questions from the European Values Survey | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Social support | Questionnaire "Inventario de recursos sociales en ancianos" from Díaz Veiga | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| Social participation | Questionnaire "Escala Este II de Soledad - Índice de participación social subjetiva" | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) |
| 15047786 | Background | Fried LP, Carlson MC, Freedman M, Frick KD, Glass TA, Hill J, McGill S, Rebok GW, Seeman T, Tielsch J, Wasik BA, Zeger S. A social model for health promotion for an aging population: initial evidence on the Experience Corps model. J Urban Health. 2004 Mar;81(1):64-78. doi: 10.1093/jurban/jth094. |
| 22305807 | Background | Ahnquist J, Wamala SP, Lindstrom M. Social determinants of health--a question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes. Soc Sci Med. 2012 Mar;74(6):930-9. doi: 10.1016/j.socscimed.2011.11.026. Epub 2012 Jan 21. |
| 10432904 | Background | Kawachi I, Kennedy BP, Glass R. Social capital and self-rated health: a contextual analysis. Am J Public Health. 1999 Aug;89(8):1187-93. doi: 10.2105/ajph.89.8.1187. |
| 23186534 | Background | Nyqvist F, Forsman AK, Giuntoli G, Cattan M. Social capital as a resource for mental well-being in older people: a systematic review. Aging Ment Health. 2013;17(4):394-410. doi: 10.1080/13607863.2012.742490. Epub 2012 Nov 27. |
| 33413233 | Derived | Blancafort Alias S, Monteserin Nadal R, Moral I, Roque Figols M, Rojano I Luque X, Coll-Planas L. Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS. BMC Public Health. 2021 Jan 7;21(1):84. doi: 10.1186/s12889-020-10094-9. |
| 29534699 | Derived | Coll-Planas L, Blancafort S, Rojano X, Roque M, Monteserin R. Promoting self-management, health literacy and social capital to reduce health inequalities in older adults living in urban disadvantaged areas: protocol of the randomised controlled trial AEQUALIS. BMC Public Health. 2018 Mar 13;18(1):345. doi: 10.1186/s12889-018-5219-x. |