Effectiveness of a community-based self-care promoting program for community-dwelling older adults : a randomized controlled trial

Abstract

Background: The existing health care system tends to be focused on acute diseases or patients with high levels of need and is not ideal for meeting the challenges of an ageing population. This study introduced a community-based self-care promoting program for community-dwelling older adults, and tested its effects on maintaining health. Objectives: To determine whether the program can increase self-efficacy, quality of life (QoL), basic and instrumental activities of daily living, and medication adherence, while reducing health service utilization for community-dwelling older adults. Methods: Researchers randomly assigned 457 older adults to receive the intervention (n = 230) or be controls (n = 227). The intervention included assessment and education of self-care and health-promoting behaviors, co-produced care planning and self-efficacy enhancing components supported by a health-social partnership. The control group received placebo social calls. The outcomes were measured at pre-intervention (T1) and three months post-intervention (T2). Results: Analysis showed that the intervention group had a significantly higher score in self-efficacy (P = 0.049), activities of daily living (ADL) (P = 0.012), instrumental activities of daily living (IADL) (P = 0.021) and the physical components of QoL (P < 0.001) at T2 than at T1. The program also significantly improved the mental component of QoL (P < 0.001) and medication adherence (P < 0.001), as well as reducing the total number of health service attendances compared to the control group (P = 0.016). Conclusion: The program can help enhance the self-efficacy of community-dwelling older adults towards self-care, which may in turn enable them to maintain optimal well-being while remaining in the community.