Older People's Preventive Care Utilization

Summary

Objectives: To empower older people's decision making for taking the recommended vaccines including seasonal influenza vaccines, pneumococcal vaccines, and COVID-19 vaccine (if it is recommended annually).

Hypotheses to be tested: The interventions designed using Mental Models Approach and Patient Activation Approach will promote older people's confidence in knowledge and skills regarding vaccination decisions, perceived self-efficacy in self-management of health, positive emotional engagement with vaccination decisions and a positive future time perspective which will subsequently promote their uptake of the recommended vaccines.

Design and subjects: This will be a two-arm randomized control trial. Subjects will be community-dwelling older people aged 70 years or above.

Instruments: A questionnaire will be used to collect baseline data before the interventions and follow-up data 1 months and 4 months, respectively, after the end of interventions.

Interventions: Interventions included one booklet to communicate information about preventive care by bridging expert knowledge and older people's existing mental models, and six patient activation sections conducted over telephone. One patient activation section will be delivered per week by trained medical students.

Main outcome measures: Main outcomes will be participants' uptake of the three recommended vaccines assessed at 1 month and 4 months after the end of interventions.

Data analysis and expected results: Generalized estimating equation logistic regression will be used to assess the intervention effects. The investigators expect that the interventions can promote at least 20% increase in uptake of any one of the three recommended vaccines in the intervention group compared with the control group.

Conditions

• Health Communication

Interventions

BEHAVIORAL

MMA and patient activation intervention scheme

Design of booklet for older people's preventive care: We propose that the booklet will include 8 main topics based on what experts and current academic literature believe are important for encouraging older people's preventive care utilization. To add the social norms-related cues for the later three topics of the booklet, one qualitative study on older adults who are active in preventive care is needed. Therefore, we will interview \~20 older adults aged 70 years or above who are active in taking preventive care. We will conduct one-to-one in-depth interview to explore how participants overcome difficulties during decision making for vaccination and their positive feelings after making achievements. We will also explore and identify older adults who have a positive future perspective. Patient activation sections: . Four undergraduate medical students will be trained as the coaches to deliver the patient activation sections over six weeks. Each section will be around 20 min.

BEHAVIORAL

Control Group

Participants in the control group will receive a pamphlet about recommendation for influenza, pneumococcal, and COVID-19 vaccines (if appropriate) for older people using information from Hong Kong Department of Health. As a control for the patient activation interviews, the control group will also be informed that they will join our "telephone-based elderly care project" by the end of the baseline assessment but instead of receiving the patient activation interviews, this group will receive six control telephone care visits over six weeks. Each control telephone care visit will be around 5-10 min during which the student helper will give general guidelines about dietary health and exercise for older people. The control messages are mainly educational and designed using information derived from the websites of Hong Kong Department of Health.

Sponsors & Collaborators

• The University of Hong Kong

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

70 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-10-01

Primary Completion

2025-05-31

Completion

2025-05-31

Countries

• Hong Kong

Study Locations