Supporting Healthy Aging by Peer Education and Support (SHAPES)

Supporting Healthy Aging by Peer Education and Support (SHAPES) - A Stepped-Wedge Cluster Randomized Trial

Canadians are living longer than ever before. However, many in our society age with long term chronic medical conditions which have a major impact on their need for healthcare, their quality of life and well-being. Encouragement of lifestyle practices which promote healthy aging and self-management techniques to deal with chronic disease is important in improving peoples' well-being

The purpose of this study is to study the impact of peer delivered education and support for seniors living in the community to see if training given to other seniors improves healthy ageing behaviours and their health literacy.

Study Overview

• Status: Completed
• Conditions: Health Behavior; Ageing
• Intervention / Treatment: Behavioral: Peer-led Health Education

Detailed Description

In Canada, between 1960 and 2009, the proportion of seniors (people aged ≥65 years) rose from 8% to 14%; it is estimated that this proportion will increase to 23-25% by 2036. The number of people in the population aged ≥80 years is projected to more than double between 2009 and 2036. This population ageing has, and will, have a major impact on healthcare, economics, education, employment and social engagement. Many in our society age with long term chronic medical conditions; the management of which is partly responsible for the increasing consumption of health care resources in later life. There is a pressing need on the part of health care providers and policy makers to contain these increasing expenditures. Encouragement of lifestyle practices which promote successful or healthy aging and self - management techniques to deal with chronic disease are therefore of paramount importance to the achievement of this goal. Cost containment, however, is not the sole reason for pursuing such practice; there is some evidence that self-management and an increase in health literacy leads to an increased sense of empowerment and an improvement in health related quality of life for seniors.

In the presence of chronic disease, self-management is seen as a critical element in containing resource demand and in empowering patients whilst increasing their health literacy. Self-management training courses have been developed for generic physical long term conditions which have led to improved outcomes and some cost savings in chronic care. There is therefore an opportunity to educate and empower seniors in both healthy ageing behaviours and self-management of chronic disease, which has the potential to contain health care resource use, improve perception of self-rated health and quality of life.

This study aims to explore the use of health coaches, where health coaching can be defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals, drawn from community dwelling seniors, rather than "expert patients" in educating and supporting their peers in healthy aging behaviours and self-management of chronic disease.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 2P4
      • Division of Geriatric Medicine, Clinical Sciences Building, University of Alberta Hosp

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Both male and female community dwelling seniors who attend seniors centres in Edmonton
• Able to commit their time to participate in the study and complete the required assessments
• Speak and understand English
• Be under the care of or have access to a Family doctor

Exclusion Criteria:

• Medical or psychological impairment which might seriously impair adherence to the program

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; No intervention
Experimental: Peer-led Health Education; A single 60 minute interactive workshop led by the trained health coach followed by a series of three one hour discussion groups	Behavioral: Peer-led Health Education; Peer-led health education

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-Rated Abilities for Healthy Practices Scale	Change in proportion of participating seniors engaged in healthy aging behaviours following the intervention compared to unexposed controls	18 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Change in physical activity levels measured by the Physical Activity Scale for the Elderly (PASE)	12 months
Number of participants seeking health care as measured by Health care seeking and resource use questionnaire	12 months
Measure self-efficacy for participating seniors using The General Self-Efficacy Scale (GES)	12 months
Participant's willingness to change assessed by readiness to change ruler	12 months
Number of participating seniors satisfied with the health coaches assessed by a semi-structured interviews	12 months

Collaborators and Investigators

• Sponsor: University of Alberta
• Collaborators: Covenant Health
• Investigators: Principal Investigator: Adrian S Wagg, MD, University of Alberta

Publications and helpful links

General Publications

• Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002 Nov 20;288(19):2469-75. doi: 10.1001/jama.288.19.2469.
• Lorig KR, Sobel DS, Stewart AL, Brown BW Jr, Bandura A, Ritter P, Gonzalez VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999 Jan;37(1):5-14. doi: 10.1097/00005650-199901000-00003.
• 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.
• Fiocco AJ, Scarcello S, Marzolini S, Chan A, Oh P, Proulx G, Greenwood C. The effects of an exercise and lifestyle intervention program on cardiovascular, metabolic factors and cognitive performance in middle-aged adults with type II diabetes: a pilot study. Can J Diabetes. 2013 Aug;37(4):214-219. doi: 10.1016/j.jcjd.2013.03.369. Epub 2013 Aug 2.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2017
• Primary Completion (Actual): October 20, 2019
• Study Completion (Actual): October 20, 2019

Study Registration Dates

• First Submitted: April 13, 2016
• First Submitted That Met QC Criteria: April 19, 2016
• First Posted (Estimate): April 20, 2016

Study Record Updates

• Last Update Posted (Actual): November 4, 2019
• Last Update Submitted That Met QC Criteria: October 31, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Keywords: Health Literacy; Health Education; Healthy Ageing; Peer Education; Health Coaches; Community Dwelling Seniors
• Other Study ID Numbers: SHAPES-0915

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No