Promoting BioPsychoSocial health of older adults using a Community for Successful Ageing program (ComSA) in Singapore: A mixed-methods evaluation.

Autor: Aw S; Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Electronic address: awsu@u.nus.edu., Koh GCH; Saw Swee Hock School of Public Health, National University of Singapore, Singapore., Tan CS; Saw Swee Hock School of Public Health, National University of Singapore, Singapore., Wong ML; Saw Swee Hock School of Public Health, National University of Singapore, Singapore., Vrijhoef HJM; Department of Patient and Care, Maastricht University Medical Centre, the Netherlands; Panaxea b.v., Amsterdam, the Netherlands., Harding SC; Tsao Foundation, Singapore., Ann B Geronimo M; Tsao Foundation, Singapore., Hildon ZJL; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2020 Aug; Vol. 258, pp. 113104. Date of Electronic Publication: 2020 Jun 09.
DOI: 10.1016/j.socscimed.2020.113104
Abstrakt: BioPsychoSocial health promotion is increasingly emphasized for Successful Ageing. Few programs are known to target BioPsychoSocial health of older adults and their community. The Community for Successful Ageing: Community Development program (ComSA CD) was developed in Singapore for this purpose. This study assessed program effects on BioPsychoSocial health and civic engagement behaviours of participants. ComSA CD offered self-care healthy lifestyle education (Bio-physical), guided autobiography (Psychological) and a civic engagement component which galvanized participants to solve community issues (Social). Recruitment occurred through self-care or guided autobiography; following which participants were funnelled into the civic engagement component. A mixed-methods quasi-experimental evaluation was conducted, using a pre-post one-year survey (N=232) with those exposed and unexposed (rejected) to ComSA CD. Using a generalized linear model, associations between post one-year BioPsychoSocial outcomes and exposure group were quantified using percentage change, adjusting for baseline outcome and group differences. Concurrently, program effects were explored through six focus groups with program implementers and participants using thematic analysis. The program had multiple positive effects. Participants recruited via self-care also taking part in civic engagement reported 31% higher frequency of self-care (95% CI=21% to 68%) post one-year compared to unexposed participants. Qualitative findings illustrated how the civic engagement component stimulated agency of participants to push for neighborhood changes and civic engagement initiatives. The quantitative survey highlighted that this effect was strongest among those funnelled from guided-autobiography (92% higher frequency of civic engagement at post one-year than unexposed; 95%CI=41% to 178%) compared to those funnelled from self-care (53% higher than unexposed, 95%CI=17% to 114%). It was found qualitatively that guided-autobiography enabled more meaningful bonding and communication than the self-care component, explaining quantitative effects on social support only present among guided autobiography participants (36% higher than unexposed; 95%CI=11% to 68%). Findings highlighted the importance of improving group dynamics for collective action.
Competing Interests: Declaration of competing interest We declare that no conflict of interest was encountered with our community partners, co-authors or stakeholders in the process of this study.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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