RCT of Health-promoting Intervention for Older Foreign-born Adults

Livslots Angered - A Randomized Controlled Trial of a Community-based Health-promoting and Disease-preventive Program for Older Foreign Born Adults

The overarching aim with this study was to develop, implement and evaluate a health promoting programme for people from Finland or the Western Balkan region, who were 70 years of age or older and independent daily activites (1). The aim of the programme was to prevent or delay dependence in daily activities, health decline, and frailty. The study focused on both evaluation and implementation and the data collection finished in 2016

Study Overview

• Status: Completed
• Conditions: Health Behavior
• Intervention / Treatment: Behavioral: Senior meetings

Detailed Description

The study has developed tools for collaboration between the target group, staff and researchers, as well as with tools to bridge barriers to health promotion. For example, alternative ways to recruit participants and to collect and analyse data in studies with and for people who are ageing in a migration context.

The findings describe how a person-centred approach could be used to make use of the resources of the target groups, and visualise methods to bridge linguistic barriers. The education material from Older people in the risk zone has also been translated to Bosnian Serbo-Croatian and Finnish.

• Study Type: Interventional
• Enrollment (Actual): 131
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Gothenburg, Sweden, 40530
    • Synneve Dahlin-Ivanoff

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 70 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Foreign-born from Finland or any of five countries in the Western Balkans (Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, and Serbia)
• 70 years of age or older
• Living in Angered, Gothenburg
• Living in their ordinary housing
• Not dependent on informal or formal help in daily activities

Exclusion Criteria:

• Impaired cognition, Mini Mental State Examination (MMSE) below 80% of administered items

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Senior meetings; The intervention will comprise four weekly meetings in small groups (4-6 participants) in addition to an individual follow-up home visit two to three weeks after the last senior meeting.The main purpose of the senior meetings is to give information and facilitate discussion of the ageing process and provide tools and suggest strategies to enable the clients to solve the various problems that may arise at home in order to remain living at home in a safe and secure way. The information will also include what the municipality provides in the form of local meeting places, activities run by local associations, physical training for seniors, walking groups, possibilities of offering or accepting help on a voluntary basis. Furthermore, they will be informed about help and support available in their city district. Identification of risks for, and advice on, how to prevent falls will also be included.	Behavioral: Senior meetings; The intervention will be led by professionals such as a registered occupational therapist, a nurse, a physical therapist, and a social worker. The intervention will comprise four weekly meetings in small groups (4-6 participants) in addition to an individual follow-up home visit two to three weeks after the last senior meeting. To use groups involve the possibility of peer education where participants in a person-centeredness perspective are seen as experts on their own situation and learn from each other. The relationship between the personnel and the participants in the senior meetings can be described as a partnership. Respect for the participant and his/her values, and that the participant gets an opportunity to maintain and develop their own power over their own everyday activities will be essential in the meeting.
No Intervention: Control group; The control group will receive conventional care on their own initiative.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Activities of Daily Life (ADL)	The ADL-staircase	change from baseline at 6 months and 1 year
Change of Sense of Coherence (KASAM)	KASAM (by Antonovsky)	change from basline at 6 months and 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Fatigue	The Mob-T scale	baseline, 6 months, and 1 year
Change of Grip strength	North Coast-dynamometer	baseline, 6 months, and 1 year
Change of Physical activity	Questionnaire and Physical and domestic activity scale	basline, 6 months, and 1 year
Change of Balance	The balance scale	basline, 6 months, and 1 year
Change of Gait speed	Four-meter walking test	basline, 6 months, and 1 year
Change of Weight loss	The Göteborg Quality of Life Instrument	basline, 6 months, and 1 year
Change of Cognition	Mini Mental State Examination (MMSE)	basline, 6 months, and 1 year
Change of Visual impairment	KM-visual acuity chart	basline, 6 months, and 1 year
Change of Falls	Questionnaire	basline, 6 months, and 1 year
Change of Fear of falls	FES-I	baseline, 6 months, 1 year
Change of Illness	CIRS-G	Baline, 6 months, and 1 year
Change of Symptoms	The Göteborg Quality of Life Instrument	Basline, 6 months, and 1 year
Change of Change of Depression	GDS 20	Baseline, 6 months, and 1 year
Health-care consumption	Register data	Baseline, 6 months, and 1 year

Collaborators and Investigators

• Sponsor: Göteborg University
• Collaborators: The Swedish Research Council
• Investigators: Study Director: Synneve Dahlin-Ivanoff, Professor, Göteborg University

Publications and helpful links

General Publications

• Gustafsson S, Lood Q, Wilhelmson K, Haggblom-Kronlof G, Landahl S, Dahlin-Ivanoff S. A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: promoting aging migrants' capabilities implementation and RCT study protocol. BMC Geriatr. 2015 Feb 14;15:10. doi: 10.1186/s12877-015-0005-4.
• Lood Q, Gustafsson S, Dahlin Ivanoff S. Bridging barriers to health promotion: a feasibility pilot study of the 'Promoting Aging Migrants' Capabilities study'. J Eval Clin Pract. 2015 Aug;21(4):604-13. doi: 10.1111/jep.12345. Epub 2015 Mar 23.

Study record dates

Study Major Dates

• Study Start: August 1, 2012
• Primary Completion (Actual): January 1, 2016
• Study Completion (Actual): January 1, 2016

Study Registration Dates

• First Submitted: April 10, 2013
• First Submitted That Met QC Criteria: April 24, 2013
• First Posted (Estimate): April 29, 2013

Study Record Updates

• Last Update Posted (Actual): May 13, 2019
• Last Update Submitted That Met QC Criteria: May 9, 2019
• Last Verified: May 1, 2019

More Information

Terms related to this study

• Keywords: Health promotion; Elderly; Implementation; ADL; Immigrant; Randomized controlled study; Vulnerable population; KASAM
• Other Study ID Numbers: Livslots Angered