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Hastings-Truelove A, Ghahari S, Coderre-Ball A, Kessler D, Turnnidge J, Lester B, Auais M, Dalgarno N, DePaul V, Donnelly C, Finlayson M, Hopkins-Rosseel D, Kolomitro K, Norman K, Lawson TL, Stockley D, Van Wylick R, Woo K. Barriers and facilitators to older adults’ engagement in healthy aging initiatives. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Husk K, Blockley K, Lovell R, Bethel A, Lang I, Byng R, Garside R. What approaches to social prescribing work, for whom, and in what circumstances? A realist review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:309-324. [PMID: 31502314 PMCID: PMC7027770 DOI: 10.1111/hsc.12839] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 05/06/2023]
Abstract
The use of non-medical referral, community referral or social prescribing interventions has been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve health and well-being. However, the evidence base for social prescribing currently lags considerably behind practice. In this paper, we explore what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work. Supported by an Expert Advisory Group, we conducted a realist review in two phases. The first identified evidence specifically relating to social prescribing in order to develop programme theories in the form of 'if-then' statements, articulating how social prescribing models are expected to work. In the second phase, we aimed to clarify these processes and include broader evidence to better explain the proposed mechanisms. The first phase resulted in 109 studies contributing to the synthesis, and the second phase 34. We generated 40 statements relating to organising principles of how the referral takes place (Enrolment), is accepted (Engagement), and completing an activity (Adherence). Six of these statements were prioritised using web-based nominal group technique by our Expert Group. Studies indicate that patients are more likely to enrol if they believe the social prescription will be of benefit, the referral is presented in an acceptable way that matches their needs and expectations, and concerns elicited and addressed appropriately by the referrer. Patients are more likely to engage if the activity is both accessible and transit to the first session supported. Adherence to activity programmes can be impacted through having an activity leader who is skilled and knowledgeable or through changes in the patient's conditions or symptoms. However, the evidence base is not sufficiently developed methodologically for us to make any general inferences about effectiveness of particular models or approaches.
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Affiliation(s)
- Kerryn Husk
- NIHR CLAHRC South West Peninsula (PenCLAHRC)Faculty of Medicine and DentistryUniversity of PlymouthPlymouthUK
| | - Kelly Blockley
- NIHR CLAHRC South West Peninsula (PenCLAHRC)College of Medicine and HealthUniversity of ExeterExeterUK
| | - Rebecca Lovell
- European Centre for Environment and Human HealthCollege of Medicine and HealthUniversity of ExeterExeterUK
| | - Alison Bethel
- NIHR CLAHRC South West Peninsula (PenCLAHRC)College of Medicine and HealthUniversity of ExeterExeterUK
| | - Iain Lang
- NIHR CLAHRC South West Peninsula (PenCLAHRC)College of Medicine and HealthUniversity of ExeterExeterUK
| | - Richard Byng
- NIHR CLAHRC South West Peninsula (PenCLAHRC)Faculty of Medicine and DentistryUniversity of PlymouthPlymouthUK
| | - Ruth Garside
- European Centre for Environment and Human HealthCollege of Medicine and HealthUniversity of ExeterExeterUK
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Desveaux L, Harrison S, Lee A, Mathur S, Goldstein R, Brooks D. "We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD. Heart Lung 2017; 46:308-312. [PMID: 28527832 DOI: 10.1016/j.hrtlng.2017.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 04/12/2017] [Accepted: 04/14/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite well-established improvements following rehabilitation, functional gains often diminish following discharge. OBJECTIVE To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance. METHODS Semi-structured interviews were conducted with 11 individuals with HF or COPD. RESULTS Deductive thematic analysis uncovered three themes: 1) transitioning to community exercise is challenging, highlighting participants' struggle with unstructured maintenance and a lack of appropriate programs; 2) a structured, group-based program tailored to functional ability facilitates adherence, describing participants views on the importance of routine, and accountability; and 3) "We are all there for the same purpose" - participant support for integrated exercise, including the benefit of multiple perspectives and sustainability. CONCLUSIONS A motivating program leader and access to appropriate facilities are key features to support adherence to prescribed activity. Tailored programs can be delivered consecutively to older adults with HF and COPD.
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Affiliation(s)
- Laura Desveaux
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada
| | - Samantha Harrison
- Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada
| | - Annemarie Lee
- Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada
| | - Sunita Mathur
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada
| | - Dina Brooks
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada.
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Zhang L, Zhang L, Wang J, Ding F, Zhang S. Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study. BMC Health Serv Res 2017; 17:128. [PMID: 28187728 PMCID: PMC5303293 DOI: 10.1186/s12913-017-2036-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite considerable efforts to encourage participation, even in some developed countries, proportion of patients participating in institution-based cardiac rehabilitation (CR) programs remained sub-optimal. The present study was designed to investigate the acceptability of community health service center (CHSC)-based Cardiac Rehabilitation (CR), and examine its effectiveness in terms of changes in quality of life (QOL), psychological state and exercise capacity. METHODS A consecutive series of eligible patients was recruited from the health registration system of two CHSCs in Shijiazhuang, Hebei, China. Patients in intervention site were provided with CR (CR-group) while patients in non-intervention site were offered the usual care (UC-group). Data regarding health-related QOL (HRQoL), psychological state and exercise capacity (6-min walk test = 6MWT) were collected and compared at baseline and at 6 months post-intervention. RESULTS Among invited patients eligible for CR program, 65.3% participated, while 5.3% of the participants dropped out during follow-up. Patients in CR-group showed significant decrease in the scores for anxiety and depression as per the Hospital Anxiety and Depression Scale (HADS), along with marked increases in the Short-Form Health Survey (SF-12)-based Physical (PCS) and Mental Component Summary (MCS) scores. Moreover, the measurement of 6MWT showed a significant increase of 57.42 m walking distance among CR patients in contrast with a slight increase among UC patients. CONCLUSIONS Given the high participation and low withdrawal along with considerable improvements in HRQoL, psychological state and exercise capacity, CHSC was likely to be the optimal setting for implementing CR for patients with CHD in China. TRIAL REGISTRATION ChiCTR-TRC- 12002500 . Registered 16 September 2012.
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Affiliation(s)
- Lixuan Zhang
- Department of Geriatrics, the Third Hospital of Hebei Medical University, No 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, China
| | - Li Zhang
- Department of Geriatrics, the Third Hospital of Hebei Medical University, No 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, China.
| | - Jing Wang
- Department of Geriatrics, the Third Hospital of Hebei Medical University, No 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, China
| | - Fang Ding
- Department of Geriatrics, the Third Hospital of Hebei Medical University, No 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, China
| | - Suhua Zhang
- Department of Geriatrics, the Third Hospital of Hebei Medical University, No 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, China
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Reed JL, Harris JM, Midence L, Yee EB, Grace SL. Evaluating the Heart Wise Exercise™ program: a model for safe community exercise programming. BMC Public Health 2016; 16:190. [PMID: 26922240 PMCID: PMC4769838 DOI: 10.1186/s12889-016-2866-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/15/2016] [Indexed: 01/31/2023] Open
Abstract
Background Greater availability of community exercise facilities is recommended to promote physical activity in the large number of people with chronic disease. The Heart Wise Exercise (HWE) program encourages existing community-based exercise facilities to build capacity to serve such patients, by working with interested facilities to ensure they meet safety criteria, and educating exercise leaders. Methods Using a piloted checklist, 45 HWE programs were audited for the six HWE criteria (outlined below) in the greater Ottawa and Toronto areas of Ontario, Canada. A survey was also administered to a convenience sample of HWE program participants (N = 127). Results Criteria 1: 71 % of leaders encouraged daily aerobic exercise; participants reported engaging in 194 min/week of aerobic exercise. Criteria 2: 100 % of programs incorporated a warm-up and cool-down, and 84 % encouraged self-monitoring during class. Criteria 3: 98 % of programs offered options for participants to exercise at their appropriate intensity. Criteria 4: HWE participants reported having chronic conditions including arthritis (41 %), osteoporosis (26 %) diabetes (8 %), heart disease (6 %) and chronic obstructive pulmonary disease (6 %). Criteria 5: 93 % of instructors offered health screening for participants. Criteria 6: 100 % of sites had automated external defibrillators, and 90 % of the instructors were aware of the documented emergency plan. The exercise leaders reported being ‘knowledgeable/comfortable/confident’ in providing exercise guidance to, and having clients with chronic health conditions; directing clients to other services; offering exercise intensity options; helping clients listen to their bodies; and, encouraging clients to provide information regarding their health. The participants reported being, on average, ‘somewhat happy’ to ‘very happy’ with HWE locations; program dates and times; leaders’ knowledge of disease and exercise; exercise intensity; cost; and, social aspect. Conclusions HWE programs are safe and appropriate for persons with varying chronic health conditions, and participants are satisfied with and will likely continue attending their HWE classes. Future efforts should be directed at increasing awareness of HWE programs among referring healthcare professionals and participants at risk of chronic conditions. The HWE training program should emphasize that HWE leaders regularly encourage self-monitoring and daily aerobic exercise, which is well-known to reduce the burden of many chronic diseases. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2866-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer L Reed
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada.
| | - Jennifer M Harris
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada.
| | - Liz Midence
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
| | - Elizabeth B Yee
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
| | - Sherry L Grace
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada. .,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
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