Self-management, Health Literacy and Social Capital in Socioeconomically Disadvantaged Older Adults

NCT ID: NCT02733523

Last Updated: 2018-02-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

390 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Brief Summary

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Motivations:

Socio-economic and education determinants have a big impact on health outcomes, in terms of worse health status in populations living in more disadvantaged conditions. Social capital, self-management and health literacy are some of the intermediate determinants, with the potential to mitigate health inequalities through interventions driven by local health agents. These three determinants are intensely interlinked and have, separately, impacts on self-perceived health. Social capital is defined in this project as an umbrella concept, which includes quantitative aspects of social resources (structural social capital: social networks and contacts, social and civic participation) as well as qualitative or subjective aspects (cognitive social capital: perceived social support, feeling of belonging and trust) and covers relations between subjects at a micro or individual level (family and friends) as well as at a macro or community level. Health literacy is understood as cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Both are key aspects for self-management behaviours. The target of our research project are older people living in urban socioeconomically disadvantaged areas, since ageing is in itself an inequality axis and urban environments concentrate the highest health disparities.

Objectives: With the aim to reduce health inequality, an intervention has been designed to promote self-management, health literacy and social capital among older people who perceived their health as fair or poor and are living in urban socioeconomically disadvantaged areas with the aim of improving their self-perceived health. Secondarily, the efficacy of the intervention will be analysed in terms of increasing self-management, health literacy and social capital (social support and social participation), quality of life, mental health and healthy lifestyles.

In third place, behavioural health patterns will be identified in relation to health literacy, social capital, gender, socioeconomic and educational level, and they will be linked to the intervention efficacy levels.

Detailed Description

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Conditions

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Health Status Disparities Subjective Health Self Care Social Capital Health Literacy Aging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Investigators

Study Groups

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Program "Sentirnos bien"

The intervention Program "Sentirnos bien" is based around a group dynamic, held once a week during 3 months, aimed at:

1. Promoting the uptake of self-care healthy habits
2. Promoting social capital at individual level:
3. Promoting health literacy

Group Type EXPERIMENTAL

Program "Sentirnos bien" (Feeling well)

Intervention Type BEHAVIORAL

Group-based intervention delivered face-to face and held once a week during 3 months. It comprises:

1. Promoting the uptake of self-care healthy habits: providing information, setting personal goals and sharing experiences to facilitate behavioural change, specially on physical activity and healthy dietary habits.
2. Promoting social capital at individual level: facilitating mutual knowledge and mutual support among participants and fostering participation in sociocultural and community activities in the neighbourhood through visits to the community assets accompanied by volunteers.
3. Promoting health literacy: improving navigation through the health care system, communication with health professionals, as well as the understanding and decision making when buying food.

Control arm

The control arm will receive no intervention. Once the trial is finished, i.e. after the last follow-up evaluation, this arm will receive the intervention (waiting-list approach).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Program "Sentirnos bien" (Feeling well)

Group-based intervention delivered face-to face and held once a week during 3 months. It comprises:

1. Promoting the uptake of self-care healthy habits: providing information, setting personal goals and sharing experiences to facilitate behavioural change, specially on physical activity and healthy dietary habits.
2. Promoting social capital at individual level: facilitating mutual knowledge and mutual support among participants and fostering participation in sociocultural and community activities in the neighbourhood through visits to the community assets accompanied by volunteers.
3. Promoting health literacy: improving navigation through the health care system, communication with health professionals, as well as the understanding and decision making when buying food.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* community-dwelling older adults living in the urban areas of Barcelona, Blanes or Reus in socio-economically disadvantaged neighbourhoods.
* perception of their health as regular or bad according to the first question of the 12 items Short Form Survey from the RAND Medical Outcomes Study.

Exclusion Criteria

* dependency to go to the local primary care center
* cognitive decline or dementia as diagnose
* any health condition that contraindicates physical activity
* terminal illness
* severe mental health disorders that difficult participating in a group dynamic
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Recercaixa

UNKNOWN

Sponsor Role collaborator

Equip Atencio Primaria Sardenya

UNKNOWN

Sponsor Role collaborator

Fundacio Salut i Envelliment UAB

OTHER

Sponsor Role lead

Responsible Party

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Laura Coll

MD, head of research on health and ageing

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Laura Coll-Planas, MD

Role: PRINCIPAL_INVESTIGATOR

Fundació Salut i Envelliment UAB

Sergi Blancafort, PhD

Role: PRINCIPAL_INVESTIGATOR

Fundació Salut i Envelliment UAB

Rosa Monteserin, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Equipo Atencio Primaria Sardenya

References

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Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97-107. doi: 10.7326/0003-4819-155-2-201107190-00005.

Reference Type BACKGROUND
PMID: 21768583 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 17943839 (View on PubMed)

Fried LP, Carlson MC, Freedman M, Frick KD, Glass TA, Hill J, McGill S, Rebok GW, Seeman T, Tielsch J, Wasik BA, Zeger S. A social model for health promotion for an aging population: initial evidence on the Experience Corps model. J Urban Health. 2004 Mar;81(1):64-78. doi: 10.1093/jurban/jth094.

Reference Type BACKGROUND
PMID: 15047786 (View on PubMed)

Ahnquist J, Wamala SP, Lindstrom M. Social determinants of health--a question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes. Soc Sci Med. 2012 Mar;74(6):930-9. doi: 10.1016/j.socscimed.2011.11.026. Epub 2012 Jan 21.

Reference Type BACKGROUND
PMID: 22305807 (View on PubMed)

Kawachi I, Kennedy BP, Glass R. Social capital and self-rated health: a contextual analysis. Am J Public Health. 1999 Aug;89(8):1187-93. doi: 10.2105/ajph.89.8.1187.

Reference Type BACKGROUND
PMID: 10432904 (View on PubMed)

Nyqvist F, Forsman AK, Giuntoli G, Cattan M. Social capital as a resource for mental well-being in older people: a systematic review. Aging Ment Health. 2013;17(4):394-410. doi: 10.1080/13607863.2012.742490. Epub 2012 Nov 27.

Reference Type BACKGROUND
PMID: 23186534 (View on PubMed)

Blancafort Alias S, Monteserin Nadal R, Moral I, Roque Figols M, Rojano I Luque X, Coll-Planas L. Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS. BMC Public Health. 2021 Jan 7;21(1):84. doi: 10.1186/s12889-020-10094-9.

Reference Type DERIVED
PMID: 33413233 (View on PubMed)

Coll-Planas L, Blancafort S, Rojano X, Roque M, Monteserin R. Promoting self-management, health literacy and social capital to reduce health inequalities in older adults living in urban disadvantaged areas: protocol of the randomised controlled trial AEQUALIS. BMC Public Health. 2018 Mar 13;18(1):345. doi: 10.1186/s12889-018-5219-x.

Reference Type DERIVED
PMID: 29534699 (View on PubMed)

Other Identifiers

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FSIE-Recercaixa2014

Identifier Type: -

Identifier Source: org_study_id

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