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. 1992 Jul-Aug;107(4):417–426.

Participant evaluation and cost of a community-based health promotion program for elders.

J Rogers 1, R Grower 1, P Supino 1
PMCID: PMC1403672  PMID: 1641438

Abstract

There is little information on how best to provide health promotion and disease prevention services to elderly persons. This paper reports participants' perceptions of the effectiveness of a health promotion program consisting of health education classes and case management services. A single-group, posttest only design was used for the county-wide program, which operated independent of participants' primary care physicians. Each person received a thorough screening evaluation, was invited to health education classes, and was assigned a case manager for a 2-year health promotion period. Community residents 64-71 years of age were recruited; 475 entered the study, and 378 (79.6 percent) completed the followup evaluation interview. Only one-third of the participants attended at least one class, but a majority of those attending each class rated it very or extremely effective in increasing knowledge. To determine the effectiveness of the case managers, each participant identified the three health problems that were of greatest concern to him or her and indicated which of these priority problems were discussed with the case manager. Discussion with the case manager was significantly associated with continuing to see a personal physician for the problem, following the physician's recommendations, the problem's being under control, and the problem's improving over the 2-year followup. The classes and case management services benefited the participants who used them. How to best deliver these services to the target group needs further study.

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Selected References

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  1. ANDERSON W. F., COWAN N. R. A consultative health centre for older people; the Rutherglen experiment. Lancet. 1955 Jul 30;269(6883):239–240. doi: 10.1016/s0140-6736(55)92229-7. [DOI] [PubMed] [Google Scholar]
  2. Adelman R., Hainer J., Butler R. N., Chalmers M. A well elderly program: an intergenerational model in medical education. Gerontologist. 1988 Jun;28(3):409–413. doi: 10.1093/geront/28.3.409. [DOI] [PubMed] [Google Scholar]
  3. Benson L., Nelson E. C., Napps S. E., Roberts E., Kane-Williams E., Salisbury Z. T. Evaluation of the Staying Healthy After Fifty educational program: impact on course participants. Health Educ Q. 1989 Winter;16(4):485–508. doi: 10.1177/109019818901600404. [DOI] [PubMed] [Google Scholar]
  4. Black J. S., Sefcik T., Kapoor W. Health promotion and disease prevention in the elderly. Comparison of house staff and attending physician attitudes and practices. Arch Intern Med. 1990 Feb;150(2):389–393. [PubMed] [Google Scholar]
  5. Breslow L., Somers A. R. The lifetime health-monitoring program. A practical approach to preventive medicine. N Engl J Med. 1977 Mar 17;296(11):601–608. doi: 10.1056/NEJM197703172961104. [DOI] [PubMed] [Google Scholar]
  6. Buchner D. M., Pearson D. C. Factors associated with participation in a community senior health promotion program: a pilot study. Am J Public Health. 1989 Jun;79(6):775–777. doi: 10.2105/ajph.79.6.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Burns C. Geriatric care in general practice. A medicosocial survey of 391 patients undertaken by health visitors. J R Coll Gen Pract. 1969 Nov;18(88):287–296. [PMC free article] [PubMed] [Google Scholar]
  8. Capitman J. A., Haskins B., Bernstein J. Case management approaches in coordinated community-oriented long-term care demonstrations. Gerontologist. 1986 Aug;26(4):398–404. doi: 10.1093/geront/26.4.398. [DOI] [PubMed] [Google Scholar]
  9. DeFriese G. H., Hersh A. S., McManus M. A. A proposed research agenda for health promotion and disease prevention for children and the elderly. Health Serv Res. 1985 Feb;19(6 Pt 2):1033–1041. [PMC free article] [PubMed] [Google Scholar]
  10. Dietrich A. J., Goldberg H. Preventive content of adult primary care: do generalists and subspecialists differ? Am J Public Health. 1984 Mar;74(3):223–227. doi: 10.2105/ajph.74.3.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fitch V. L., Slivinske L. R. Maximizing effects of wellness programs for the elderly. Health Soc Work. 1988 Winter;13(1):61–67. doi: 10.1093/hsw/13.1.61. [DOI] [PubMed] [Google Scholar]
  12. Fletcher D. J., Smith G. L. Health-risk appraisal. Helping patients predict and prevent health problems. Postgrad Med. 1986 Dec;80(8):69-71, 74-6, 81-2 passim. doi: 10.1080/00325481.1986.11699632. [DOI] [PubMed] [Google Scholar]
  13. Frame P. S. A critical review of adult health maintenance. Part 2. Prevention of infectious diseases. J Fam Pract. 1986 May;22(5):417–422. [PubMed] [Google Scholar]
  14. Frame P. S., Kowulich B. A., Llewellyn A. M. Improving physician compliance with a health maintenance protocol. J Fam Pract. 1984 Sep;19(3):341–344. [PubMed] [Google Scholar]
  15. Fried L. P. Health promotion and disease prevention in the care of older adults: preventive practice in primary care. Md Med J. 1989 Feb;38(2):121–123. [PubMed] [Google Scholar]
  16. Hale W. E., Marks R. G., Stewart R. B. The Dunedin program, a Florida geriatric screening process: design and initial data. J Am Geriatr Soc. 1980 Aug;28(8):377–380. doi: 10.1111/j.1532-5415.1980.tb01102.x. [DOI] [PubMed] [Google Scholar]
  17. Heine C., Streit L. A. A wellness clinic for older persons: a positive experience for nursing students and older persons. J Nurs Educ. 1987 Jun;26(6):244–246. doi: 10.3928/0148-4834-19870601-08. [DOI] [PubMed] [Google Scholar]
  18. Higgins P. G. Biometric outcomes of a geriatric health promotion programme. J Adv Nurs. 1988 Nov;13(6):710–715. doi: 10.1111/j.1365-2648.1988.tb00561.x. [DOI] [PubMed] [Google Scholar]
  19. Johnson E. E., Utley Q. E., Hawkins J. W., Igou J. F. Caring for older adults in a nursing wellness centre. Geriatr Nurs Home Care. 1987 Jul;7(7):15–18. doi: 10.7748/eldc.7.7.15.s17. [DOI] [PubMed] [Google Scholar]
  20. Kennie D. C. Health maintenance of the elderly. J Am Geriatr Soc. 1984 Apr;32(4):316–323. doi: 10.1111/j.1532-5415.1984.tb02028.x. [DOI] [PubMed] [Google Scholar]
  21. Lowther C. P., MacLeod R. D., Williamson J. Evaluation of early diagnostic services for the elderly. Br Med J. 1970 Aug 1;3(5717):275–277. doi: 10.1136/bmj.3.5717.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Maddox G. L. Intervention strategies to enhance well-being in later life: the status and prospect of guided change. Health Serv Res. 1985 Feb;19(6 Pt 2):1007–1032. [PMC free article] [PubMed] [Google Scholar]
  23. Morrison J. D. Geriatric preventive health maintenance. J Am Geriatr Soc. 1980 Mar;28(3):133–135. doi: 10.1111/j.1532-5415.1980.tb00247.x. [DOI] [PubMed] [Google Scholar]
  24. Mossey J. M., Shapiro E. Physician use by the elderly over an eight-year period. Am J Public Health. 1985 Nov;75(11):1333–1334. doi: 10.2105/ajph.75.11.1333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Nelson E. C., McHugo G., Schnurr P., Devito C., Roberts E., Simmons J., Zubkoff W. Medical self-care education for elders: a controlled trial to evaluate impact. Am J Public Health. 1984 Dec;74(12):1357–1362. doi: 10.2105/ajph.74.12.1357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Orlandi M. A. Promoting health and preventing disease in health care settings: an analysis of barriers. Prev Med. 1987 Jan;16(1):119–130. doi: 10.1016/0091-7435(87)90011-9. [DOI] [PubMed] [Google Scholar]
  27. Price J. H., Desmond S. M., Losh D. P., Krol R. A. Family practice physicians' perceptions and practices regarding health promotion for the elderly. Am J Prev Med. 1988 Sep-Oct;4(5):274–281. [PubMed] [Google Scholar]
  28. Radecki S. E., Cowell W. G. Health promotion for elderly patients. Fam Med. 1990 Jul-Aug;22(4):299–302. [PubMed] [Google Scholar]
  29. Rogers J., Grower R., Supino P. Target groups for screening elderly outpatients. Am J Prev Med. 1988 Jan-Feb;4(1):27–34. [PubMed] [Google Scholar]
  30. Rogers J., Supino P., Grower R. Proposed evaluation criteria for screening programs for the elderly. Gerontologist. 1986 Oct;26(5):564–570. doi: 10.1093/geront/26.5.564. [DOI] [PubMed] [Google Scholar]
  31. Rosengarten L. Creating a health-promoting group for elderly couples on a home health care program. Soc Work Health Care. 1986 Summer;11(4):83–92. doi: 10.1300/J010v11n04_07. [DOI] [PubMed] [Google Scholar]
  32. Rubenstein L. Z., Rhee L., Kane R. L. The role of geriatric assessment units in caring for the elderly: an analytic review. J Gerontol. 1982 Sep;37(5):513–521. doi: 10.1093/geronj/37.5.513. [DOI] [PubMed] [Google Scholar]
  33. Shank J. C., Powell T., Llewelyn J. A five-year demonstration project associated with improvement in physician health maintenance behavior. Fam Med. 1989 Jul-Aug;21(4):273–278. [PubMed] [Google Scholar]
  34. Stults B. M. Preventive health care for the elderly. West J Med. 1984 Dec;141(6):832–845. [PMC free article] [PubMed] [Google Scholar]
  35. Thatcher R. M. Community support. Promoting health and self-care. Nurs Clin North Am. 1989 Sep;24(3):725–731. [PubMed] [Google Scholar]
  36. The periodic health examination. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J. 1979 Nov 3;121(9):1193–1254. [PMC free article] [PubMed] [Google Scholar]
  37. Volpe T. E., Kamhi E. S. Wellness promotion and elderly outreach. Nurs Adm Q. 1987 Spring;11(3):43–44. [PubMed] [Google Scholar]
  38. WILLIAMSON J., STOKOE I. H., GRAY S., FISHER M., SMITH A., MCGHEE A., STEPHENSON E. OLD PEOPLE AT HOME. THEIR UNREPORTED NEEDS. Lancet. 1964 May 23;1(7343):1117–1120. doi: 10.1016/s0140-6736(64)91803-3. [DOI] [PubMed] [Google Scholar]
  39. Walsh J. B. Previously unrecognized treatable illness in an Irish elderly population. Ir Med J. 1980 Feb;73(2):62–67. [PubMed] [Google Scholar]
  40. Williams E. I., Bennett F. M., Nixon J. V., Nicholson M. R., Gabert J. Sociomedical study of patients over 75 in general practice. Br Med J. 1972 May 20;2(5811):445–448. doi: 10.1136/bmj.2.5811.445. [DOI] [PMC free article] [PubMed] [Google Scholar]

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