Nationwide Multi-dimensional Health Promotion Program for Community-Dwelling Older Adults

Effectiveness and Influencing Factors of a Nationwide Multi-dimensional Health Promotion Program for Community-Dwelling Older Adults

Global organizations advocate for "active" and "healthy aging," emphasizing preventive health promotion. Taiwan's Long-Term Care 2.0 and the National Health Administration's "Healthy Exercise Class" exemplify this. Evaluating these programs' effectiveness is crucial, but complex due to diverse influencing factors. This study focuses on the often-overlooked role of program leaders' facilitation skills in impacting program success.

This study investigates the effectiveness of multi-domain community health promotion programs for older adults and its influencing factors. Specifically, it aims to:

1. assess the immediate benefits (objective/subjective health status, satisfaction) for participating older adults.
2. explore related factors (group leadership skills, personal factors) using Andersen's Behavioral Model.

A prospective, single-group, pre- and post-test design will be used. Participants (leaders and older adults) will be recruited from "Healthy Exercise Class" sites nationwide. Pre- and post-intervention data will be analyzed to determine program effectiveness. Multiple linear regression will identify influencing factors, including the mediating and moderating effects of leader facilitation skill confidence. The study aims to inform policy improvements for government-led older adult health promotion.

Inclusion Criteria:

- I. Leaders

1. Medical personnel (legally certified medical professionals, social workers, care service providers with licenses, and graduates of gerontological service programs) and sports professionals (National Fitness Instructors, athletic trainers, full-time sports coaches at all levels of schools, physical education teachers, professional sports background personnel with valid certificates issued by the Chinese Taipei Olympic Committee, etc.)
2. Individuals who have completed the "Basic Training Course for Sport and Health Instructors for the Prevention and Delay of Disability" offered by the Health Promotion Administration, holding a certificate of completion, or those who have been trained by local government health bureaus and passed the mutual recognition by the National Health Administration.

II. Older Adults

1. Aged 65 or above.
2. Normal cognitive function (no diagnosis of cognitive impairment-related conditions, such as mild cognitive impairment, dementia, etc.).
3. Able to communicate in Mandarin or Taiwanese.
4. Able to fully participate in the research project.

Exclusion Criteria:

- I. Leaders

1. Individuals who are unable to complete the aforementioned training program qualification or lead the program in the community.

II. Older Adults

1. Individuals whose cognitive status is affected by mental or neurological disorders, medication use, including diagnoses of mental or neurodegenerative diseases , central nervous system infections, or long-term use of medications affecting the central nervous system .
2. Individuals who meet the diagnostic criteria for mild cognitive impairment or dementia.
3. Individuals with moderate to severe disability.
4. Individuals with severe mental illness or behavioral problems (e.g., severe depression, schizophrenia, bipolar disorder, etc.).
5. Individuals who, due to visual, auditory, or physical functional impairments, are unable to complete the assessments.
6. Individuals who, due to physical or psychological illnesses, are unable to participate in the multi-domain health promotion intervention.