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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
390
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.
Self-perceived health
Same question than the 12 items Short Form Survey from the RAND Medical Outcomes Study. Answers will be recategorized as positive perception (excellent, very good or good) vs negative (regular or bad)
Time frame: at 3 months (just after the intervention)
Self-perceived health
Thermometer from 0-100
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Health related quality of life
12 items Short Form Survey from the RAND Medical Outcomes Study.
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Self-rated quality of life
Thermometer from 0-100
Time frame: t month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Loneliness
Scale Gierveld and De Jong
Time frame: t month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Depressive symptoms
Geriatric Depression Scale
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Physical activity
International Physical Activity Questionnaire (IPAQ)
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Short Physical Performance Battery
Functional test that scores performance in three physical aspects: balance, strength and gait speed.
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Health service use
Times attending primary and hospital health care
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Unintended effects
Questions ad hoc to assess effects not intended by the intervention perceived negatively by the participant.
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Self-care / healthy habits
Scale ASA (Appraisal of Self-Care Agency Scale)
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Health literacy
questions from the European Health Literacy Scale (HLS EU-16)
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Social capital
2 questions from the European Values Survey
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Social support
Questionnaire "Inventario de recursos sociales en ancianos" from Díaz Veiga
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
Social participation
Questionnaire "Escala Este II de Soledad - Índice de participación social subjetiva"
Time frame: at month 3 (just after the intervention) and at month 12 (9 months after the intervention)
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