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The goal of this study is to evaluate the impact of the Reach-and-Map project on increasing functional capacity to optimize the functional ability of the vulnerable group of "Hard-to-Reach" older adults through increase the compatibility between their intrinsic capacity and environment.
The overall aim of this project is to conduct a comprehensive impact assessment of the Jockey Club (JC) Reach & Map Program, utilizing a framework based on the World Health Organization (WHO) Health Impact Assessment. The study will evaluate how the program influences health outcomes among hard-to-reach older adults by assessing changes in key health determinants. The findings will be disseminated to relevant stakeholders to inform future policy setting and service planning, and long-term monitoring will be undertaken to evaluate the extent to which the impact assessment influences decision-making in aged care service development.
The primary focus of the evaluation is on the functional abilities of older adults, including physical, cognitive, psychological, and social functioning. The assessment will also cover core outcomes such as quality of life, frailty, and health service use, alongside person-centered measures like loneliness and mental health. Given the diverse services received by beneficiaries, the study will account for structural and social health determinants-such as age, gender, socio-economic status, and chronic disease burden-as covariates in the analysis. In addition, the project will explore the broader effects of the JC Reach & Map Program on aged care service utilization and document both the experiences of service recipients and stakeholders involved.
Specifically, the study objectives are: (1) to evaluate the impact of the JC Reach & Map Program on frailty, quality of life, and health service use among hard-to-reach older adults, focusing on physical, cognitive, psychological, and social functions; (2) to explore the engagement experiences and perceptions of older adults regarding the services received, and their impact on well-being, community engagement, and social integration; and (3) to explore the experiences of service stakeholders in reaching and working with this population, as well as to gather their insights on ideal service models and policies for hard-to-reach older adults.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment status | Experimental | To account for time bias, each subject will be created with two clones at time zero and assigned each of the two clones to either treatment or no-treatment status, respectively. The treatment status in each evaluative endpoint (i.e., 1-month, 4-month, 10-month, and 13-month) is defined as subjects who have received the mapped intervention for the respective length of time since the time zero during which the intervention has just commenced. |
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| No-treatment status | No Intervention | To account for immortal time bias, each subject will be created with two clones at time zero and assigned each of the two clones to either treatment or no-treatment status, respectively. The corresponding no-treatment status is defined as subjects who have not received any mapped intervention for the corresponding length of time. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mapped intervention based on health status | Behavioral | Intervention will be conducted to improve lifestyle based on their needs which include 1) Home modification, 2) Lifestyle-based health promotion, 3) Geriatric symptom management, 4) Health counseling for chronic disease management, 5) Counseling-based service, 6) Social network optimization, 7) Social support optimization |
| Measure | Description | Time Frame |
|---|---|---|
| EuroQoL-5 Dimension-5 Level | Measuring Health-related quality of life (HRQL) (range from -0.59 to 1.0), higher score indicates better quality of life | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| Short Physical Performance Battery | Measuring by (range from 0 to 12), with higher score indicating better physical performance | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| 5-minute Montreal Cognitive Assessment (MoCA) | Measuring Cognitive function (range from 0 to 30), A score of 26 or over is considered to be normal. | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| 7-item Memory Complaint Scale (MCS) | Measuring Subjective Memory Score (range from 0 to 14), lower score indicates better memory performance. No MCs (0-2), Mild MCs (3-6), Moderate MCs (7-10), Severe MCs (11-14). | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| 3-item University of California, Los Angeles (UCLA) Loneliness Scale | Measuring Loneliness (range 3-9), higher score indicates greater loneliness. | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| The 8-item Geriatric Depression Scale | Measuring Depression (range 0 to 8), with higher score indicating higher risk of depression | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Health service utilization | Self-developed checklist on community care service for older adults in Hong Kong | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
| Health service utilization |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Doris Sau Fung YU, PhD | Contact | 852-3917-6319 | dyu1@hku.hk |
| Name | Affiliation | Role |
|---|---|---|
| Doris Sau Fung YU | The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Hong Kong | Recruiting | Hong Kong | Hong Kong |
There is not a plan to make individual participant data (IPD) available to other researchers.
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| 8-item Social Connectedness Scale Revised | Measuring Social connectedness (range 0 to 48), <22 indicates lack of social connectedness | Changes from baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |
Self-developed checklist on health service utilization (including visit to out-patient clinic, emergency medical service, an in-hospital service in private and/or public sectors).
[generic] With the consent from the participants, the above information will be retrieved from the electronic health record. Otherwise, self-report method will be used for collecting the data.
| From baseline to 1 month, 4 month, 10 month, and 13 month post-intervention. |