Clinical trial NCT05621720: Adopting a Health-social Partnership Program to Promote Health and Self-care Management Among Older Adults in the Community
Official title: Adopting a Health-social Partnership Program to Promote Health and Self-care Management Among Older Adults in the Community: an Effectiveness-implementation Hybrid Design
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Healthy Aging
Keywords: Community-dwelling older adults
Self-care
Health and social partnership
Lead sponsor: The Hong Kong Polytechnic University
Sponsor class: OTHER
First posted: 2022-11-18
Enrollment: 788
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Hong Kong has notably the longest life expectancy in the world. Ever-increasing demand and challenges are posing to the healthcare, social welfare, and elderly care service system. As a global public health strategy to address the increasing burdens, there is a strong urge for an effective approach to enhance the health and self-care ability among the older adults dwelling in the community. Literature suggested that the effectiveness of community-based self-care management programs is inconclusive. In addition, though the concept of the health-social partnership has been widely promoted to improve primary care, literature addressed that the multiple barriers existed throughout the collaboration. More evidence should be sought in the local context to evaluate the effectiveness of self-care complex interventions program among older adults.

Detailed description: This randomized type 2 effectiveness-implementation hybrid trial study aims to examine the effectiveness of a community-based health-social partnership program in promoting health and self-care management among older adults dwelling in the community and to explore the reach, adoption, implementation, maintenance aspects of the implementation process of the program in a real-life setting.

This study has two parts. The first part involves a cluster randomized controlled trial with a two-arm, matched-pairs, equivalent allocation ratio, and parallel design to examine the effectiveness of this study. Based on socio-economic status, community centers will be matched into three comparable pair sets, and further randomized into three intervention and control groups. A total of 788 subjects (394 in each arm) aged 60 or above, dwelling in the community, and cognitively competent will be recruited. Three-time interval outcome measures will be collected. The second part of this study is an implementation research design concerning the implementation process of the program in a real-life setting. Focus group interviews with different stakeholders will be conducted and meeting minutes, and archives of documents will be studied. Summative data will be analyzed in the RE-AIM framework.

The findings of this study are anticipated to shed some light on the effectiveness and implementation of integrated health-social service in Hong Kong context. It will make important contributions, not only to the individuals, but also to the policymakers and service providers advocating the concept of ageing in place and health-social partnership approach care. The informed the health-social partnership collaboration practice in real-world setting can facilitate the translation of research evidence into practice to tackle the health burdens and challenges.

Eligibility criteria: Inclusion Criteria:

* (i) People aged 60 or above
* (ii) Living within the service areas of respective community centers
* (iii) Cognitively competent with Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) with score ≥22

Exclusion Criteria:

* (i) Not communicable
* (ii) Not reachable by phone
* (iii) Not living at home
* (iv) Bed bound
* (v) With serious mental illness requiring hospitalization in recent 6 months
* (vi) Already engaged in similar structured health or social programs
* (vii) Will not stay in Hong Kong for the current three months

Primary outcomes:
measure: Change in Self-efficacy
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in Instrumental Activities of Daily Living (IADL)
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
Secondary outcomes:
measure: Change in quality of life
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in self-report of pain
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in depression
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in activity of daily living
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in health service utilization
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in blood pressure
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in body mass index
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in fall incidence
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in medication adherence
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
measure: Change in capillary blood glucose
timeFrame: Baseline pre-intervention (T1), at three-month when the interventions are completed (T2), and three-month post-intervention (T3)
Other outcomes:
Locations:
city: Kowloon
country: Hong Kong
facility: The Hong Kong Polytechnic University
Study officials:
affiliation: The Hong Kong Polytechnic University
name: Frances Kam-Yuet Wong
role: PRINCIPAL_INVESTIGATOR
References: