TY - JOUR
T1 - A community-based health–social partnership program for community-dwelling older adults
T2 - a hybrid effectiveness–implementation pilot study
AU - Wong, Arkers Kwan Ching
AU - Wong, Frances Kam Yuet
AU - Wong, Martin Chi Sang
AU - Chow, Karen Kit Sum
AU - Kwan, Dilys Kwai Sin
AU - Lau, Dubby Yun Sang
N1 - Funding Information:
This study was funded by the Departmental General Research Fund (Award no. UAK0). The funders had no role in the study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.
Funding Information:
The authors would like to thank all stakeholders who participated in and contributed to this study. We would also like thank the Rhythm Garden Lutheran Centre for the Elderly for collaborating with the research team.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: A growing body of literature supports the efficacy of the health–social approach for the implementation of complex interventions to enhance self-care health management among community-dwelling older adults. However, there is little research on how interventions with this approach are implemented and disseminated in a real community setting. Methods: This pilot study adopted an effectiveness–implementation hybrid design to 1) evaluate the effectiveness of a community-based Health–Social Partnership Program (HSPP) and 2) explore the reach, adoption, implementation, and maintenance of the HSPP in the community. Potential participants were recruited if they were aged 60 or above, owned a smartphone, and were cognitively competent. The participants received nurse-led case management with support from a social service team. Factors that hindered or facilitated the program delivery were examined to determine the implementation outcomes and sustained effects of the program. Data were collected at pre-intervention (T1), immediately post-intervention (T2), and 3 months post-intervention (T3). Results: Ninety-two older adults joined and completed the program. The recruitment rate was 76.7%. A significant interaction effect was found for the mean self-efficacy scores from T1 to T2 (Wald χ2 = 12.28, p ≤.001). Barriers to widespread program implementation included manpower shortage, lack of experienced staff, and unpredictable environment, whereas facilitators, as suggested by the older adults, providers, and community staff members, included regular communication between the research and service teams, recruitment of participants through community centers with the support of the research team, and seamless partnership among the health–social partnership team members. Strong implementation fidelity was achieved with zero attrition rate. Conclusion: Most conventional randomized controlled trials investigating the effects of community-based programs have tended to control the contextual factors rather than incorporate the program in a real setting. This pilot study was the first to use a hybrid model to test the effectiveness and outcomes of HSPP implementation. The results imply that the program has a high potential sustainability in the real-life context. Trial registration: This study was registered at clinicaltrials.gov (NCT04442867; date of first registration 23/06/2020).
AB - Background: A growing body of literature supports the efficacy of the health–social approach for the implementation of complex interventions to enhance self-care health management among community-dwelling older adults. However, there is little research on how interventions with this approach are implemented and disseminated in a real community setting. Methods: This pilot study adopted an effectiveness–implementation hybrid design to 1) evaluate the effectiveness of a community-based Health–Social Partnership Program (HSPP) and 2) explore the reach, adoption, implementation, and maintenance of the HSPP in the community. Potential participants were recruited if they were aged 60 or above, owned a smartphone, and were cognitively competent. The participants received nurse-led case management with support from a social service team. Factors that hindered or facilitated the program delivery were examined to determine the implementation outcomes and sustained effects of the program. Data were collected at pre-intervention (T1), immediately post-intervention (T2), and 3 months post-intervention (T3). Results: Ninety-two older adults joined and completed the program. The recruitment rate was 76.7%. A significant interaction effect was found for the mean self-efficacy scores from T1 to T2 (Wald χ2 = 12.28, p ≤.001). Barriers to widespread program implementation included manpower shortage, lack of experienced staff, and unpredictable environment, whereas facilitators, as suggested by the older adults, providers, and community staff members, included regular communication between the research and service teams, recruitment of participants through community centers with the support of the research team, and seamless partnership among the health–social partnership team members. Strong implementation fidelity was achieved with zero attrition rate. Conclusion: Most conventional randomized controlled trials investigating the effects of community-based programs have tended to control the contextual factors rather than incorporate the program in a real setting. This pilot study was the first to use a hybrid model to test the effectiveness and outcomes of HSPP implementation. The results imply that the program has a high potential sustainability in the real-life context. Trial registration: This study was registered at clinicaltrials.gov (NCT04442867; date of first registration 23/06/2020).
KW - Health–social
KW - Hybrid effectiveness–implementation
KW - Older adults
KW - Self-care
UR - http://www.scopus.com/inward/record.url?scp=85139489768&partnerID=8YFLogxK
U2 - 10.1186/s12877-022-03463-z
DO - 10.1186/s12877-022-03463-z
M3 - Journal article
C2 - 36207685
AN - SCOPUS:85139489768
SN - 1471-2318
VL - 22
JO - BMC Geriatrics
JF - BMC Geriatrics
IS - 1
M1 - 789
ER -