Comparison of face-to-face and online mindfulness-based public health interventions for older adults

Background

Coping with everyday stress, maintaining well-being and building up personal competencies is essential to handle today's way of living. Additionally, the actual COVID-19 pandemic also impacted the overall health of global population because of reduced social contact and other epidemiological measures. The aim of the study is to compare the effectiveness of two different approaches in conducting mindfulness-based public health interventions focused on quality of life and mental health of older adults as well as their ability to self-manage their health.

Methods

In total, 450 participants aged 65 years and older will participate in the study. Participants will be residents living in the city of Rijeka and the wider urban area consisting of six local municipalities. All engaged participants will be divided into three groups: face-to-face intervention group, online intervention group and control group. Older adults engaged in the face-to-face and online mindfulness-based intervention will participate in a seven-week workshop program base on two existing evidence-based programs: Mindfulness-based Living Programme and The Chronic Disease Self-Management Programme. The study is based on a pre-post-test design which will assess the effectiveness of public health interventions on self-efficacy in health management, social support, stress, depression, sleep, fatigue, medication use, and quality of life.

Results

Research results will provide insight into the difference in effectiveness between two forms of implementation of public health interventions, which can be important in defining health policies regarding quality of life, mental health and health self-management of older adults.

Conclusions

This study will enable policy makers in defining future public health interventions and their adaptation to various epidemiological situations such as the one caused by the COVID-19 pandemic.

Key messages

Mindfulness is known as an efficient tool in maintaining personal well-being.

Mindfulness can be an effective tool for improving mental health and resilience even during the COVID-19 pandemic.

Arterial hypertension in older age: qualitative study

Background

Arterial hypertension a.k.a silent killer is one of the most important cardiovascular, yet preventable risk factors. Although there are more than 7000 clinical studies in 2019 there is still slow progress in global control of arterial hypertension. The aim of this study is to present the results from the qualitative study of the quality of treatment and care of arterial hypertension in older persons in the city of Rijeka, Croatia.

Participants and Methods

In two focus groups with older persons (65+) who had diagnosis of arterial hypertension for more than one year, attitudes toward positive and negative experiences in health and social care system were discussed, as well as their values regarding living with arterial hypertension. In focus groups 15 participants were involved. The focus groups were recorded; transcripts were made followed by analysis of the data reduction.

Results

The specific challenges in the participants' groups were identified such as lack of knowledge about the hypertension and concerns on pharmaceutical industries and lobbies interests which can result in lower adherence to medications. Some of the participants use Internet as a health information source including invalidated websites which can represent threat in adequate care especially in older people with multimorbidities. Self-reliance is most valued among the participants, while financial stability and support in the community are also highly appreciated in the urban population with arterial hypertension.

Conclusions

This research gives a framework for additional research in the population of older people that are living with arterial hypertension. Positive health and social care experiences must be preserved, yet negative experiences such as long waiting lists, additional health care costs, ageism and others must be improved.

Key messages

Although arterial hypertension is a well-known risk factor, more effort should be made in preventive interventions and health education. Adherence to medicines.

The social engagement framework for addressing the chronic-disease-challenge

Background

The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) intends to empower citizens to self-manage chronic conditions by combining mindfulness, social engagement and ICT support. This study evaluates effects in terms of perceived effectiveness, utility, efficiency, sustainability and satisfaction with SEFAC intervention.

Methods

A prospective cohort study with 6-month pre-post design was conducted in Croatia, Italy and the Netherlands. A total of 270 citizens ≥50 and at risk of or with a chronic condition were recruited. Self-reported effects of SEFAC intervention were assessed post-intervention using 5-point Likert scale [Strongly disagree -Strongly agree] and overall satisfaction on a scale from 1-10.

Results

Post-intervention analyses of a preliminary sample of 98 participants showed the SEFAC intervention was effective. In particular, perceived effectiveness for stimulating the work towards a healthy lifestyle was found for: mindfulness training (63.3%; n = 62), social engagement (48%; n = 47) and ICT support (40.8%; n = 40). After the intervention, 57.1% participants (n = 56) reported having become more aware of moment-to-moment sensations, thoughts and emotions and being able to better accept them without getting lost in them. Most participants (73.5%; n = 72) found the intervention was beneficial (perceived utility). A total of 78.6% (n = 77) participants found it was worth the investment in time and effort (perceived efficiency) and 61% participants (n = 60) agreed the intervention led to sustainable changes/benefits that will last. Finally, satisfaction with the intervention was high overall (8.5 out of 10).

Conclusions

This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support. By this combination, self-reported effects were satisfactory. We expect this intervention to be feasible and cost-effective to promote self-management and self-care of chronic conditions.

Key messages

This study provides an innovative intervention to promote self-management and self-care of citizens with chronic conditions. This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support.