A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults.
Identifieur interne : 000308 ( Main/Exploration ); précédent : 000307; suivant : 000309A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults.
Auteurs : Ulrike Dapp [Allemagne] ; Jennifer A M. Anders ; Wolfgang Von Renteln-Kruse ; Christoph E. Minder ; Hans Peter Meier-Baumgartner ; Cameron G. Swift ; Gerhard Gillmann ; Matthias Egger ; John C. Beck ; Andreas E. StuckSource :
- The journals of gerontology. Series A, Biological sciences and medical sciences [ 1758-535X ] ; 2011.
Descripteurs français
- KwdFr :
- Allemagne (MeSH), Comportement en matière de santé (MeSH), Humains (MeSH), Indicateurs d'état de santé (MeSH), Processus de groupe (MeSH), Promotion de la santé (méthodes), Services de médecine préventive (MeSH), Services de santé pour personnes âgées (MeSH), Sujet âgé (MeSH), Visites à domicile (MeSH), Équipe soignante (MeSH).
- MESH :
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Aged (MeSH), Germany (MeSH), Group Processes (MeSH), Health Behavior (MeSH), Health Promotion (methods), Health Services for the Aged (MeSH), Health Status Indicators (MeSH), House Calls (MeSH), Humans (MeSH), Patient Care Team (MeSH), Preventive Health Services (MeSH), Reinforcement, Psychology (MeSH).
- MESH :
Abstract
BACKGROUND
To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany.
METHODS
Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse).
RESULTS
Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4-2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6-2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement.
CONCLUSIONS
HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.
DOI: 10.1093/gerona/glr021
PubMed: 21350242
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<term>Health Behavior (MeSH)</term>
<term>Health Promotion (methods)</term>
<term>Health Services for the Aged (MeSH)</term>
<term>Health Status Indicators (MeSH)</term>
<term>House Calls (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Patient Care Team (MeSH)</term>
<term>Preventive Health Services (MeSH)</term>
<term>Reinforcement, Psychology (MeSH)</term>
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<term>Indicateurs d'état de santé (MeSH)</term>
<term>Processus de groupe (MeSH)</term>
<term>Promotion de la santé (méthodes)</term>
<term>Services de médecine préventive (MeSH)</term>
<term>Services de santé pour personnes âgées (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Visites à domicile (MeSH)</term>
<term>Équipe soignante (MeSH)</term>
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<term>Health Services for the Aged</term>
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<term>Processus de groupe</term>
<term>Services de médecine préventive</term>
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<term>Visites à domicile</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4-2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6-2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.</p>
</div>
</front>
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