Integrating Health Promotion With and for Older People - eHealth

NCT04416815 | Recruiting

• 1 other identifier: GoteborgU-GPCC-IHOPe
• Study Type: interventional
• Target: 220
• Locations: 1 country
• Sites: 1

Brief Summary

The Integrating Health promotion with and for Older People eHealth (IHOPe) project is expected to contribute vital knowledge on how older peoples capabilities and societal resources can be used in a more efficient way to promote health, self-management and enhance teamwork in partnership.The aim is to describe and evaluate this person-centered e-support intervention that promotes a sustainable partnership between community-dwelling frail older people and health and social care professionals. A digital platform, co-created with users and designed to create inclusion of individuals who today are living in a digital alienation, will be used in the health planning. In IHOPe frail older people will be able to identify their potential health issues but also their resources together with team partners from health- and social care, family or societal representatives. The intervention consists of person-centered phone calls with a health care professional as well as access to a digital platform that is accessible to the old person and invited team-partners. The project includes a randomized controlled trial, a process evaluation and a health economic evaluation. People 75 years or older screened as frail will be included. Also, in the process evaluation team-partners using the digital platform will be included. Specifically, this project is expected to reduce hospitalizations, result in improved or retained self-efficacy whilst being cost effective. Additionally, the project is expected to enhance frail older peoples opportunities to participate as an equal partner in their contacts with health and social services.

Conditions

Frailty; Old Age

Keywords

Person-centredness; Telemedicine; RCT; e-health; Process Evaluation; Health Economic Evaluation; Health Plan; Partnership; Frailty; Elderly; Person-centred care; Patient-centred care; Person-centered care; Patient-centered care; Integrated care; Health promotion; eHealth

Outcome Measures

Primary Outcomes (1)

• A composite of changes in general self-efficacy and need for hospital care

  The primary outcome is a composite of changes in general self-efficacy and need for hospital care for unscheduled reasons. Each participant will be classified as improved, deteriorated or unchanged if at 3 months: * Deteriorated: the participant's self-efficacy has decreased by ≥ 5 units (the minimal change of clinical significance), or the participant has been admitted to hospital for unscheduled reasons two times or more. * Improved: general self-efficacy has increased by ≥ 5 units and the participant has been admitted to hospital no more than once. * Unchanged: Neither deteriorated nor improved. (Questionnaire and medical record)

  Baseline, 3

Secondary Outcomes (9)

• Health-related quality of life by EuroQol 5 dimensions health state questionnaire (EQ5D)

  Baseline, 3, 6, 12 months

• General Self Efficacy

  Baseline, 3, 6, 12 months

• Hospitalization

  Baseline, 3, 6, 12 months

• ICEpop CAPability measure for Older people (ICECAP-O)

  Baseline, 3, 6, 12 months

• A composite of changes in general self-efficacy and need for hospital care for unscheduled reasons

  Baseline, 6, 12 months

Other Outcomes (2)

• Change in burden of medicines use in everyday life based on The Living with medicines questionnaire version 3 (LMQ-3)

  Baseline, 3, 6, 12 months

• Change in the participants' self-rated overall level of medicines burden

  Baseline, 3, 6, 12 months

Study Arms (2)

Usual care

NO INTERVENTION

The participants allocated to the control group received no intervention. However, they could, on their own initiative, approach the usual range of community or health services (e.g., home help services, rehabilitation, or medical care).

eHealth

EXPERIMENTAL

The intervention will be delivered for 6 months on top of usual care.

Other: Integrating Health promotion with and for Older People - eHealth

Interventions

Integrating Health promotion with and for Older People - eHealth OTHER

The intervention will be delivered for 6 months on top of usual care. It will be provided by HCPs. If needed one home visit to install the digital platform will be conducted. A HCP will introduce how to use the digital platform and create a personal account. The intervention starts with a person-centred phone-call where a health plan is co-created and potential team members to support this are identified and invited. The health plan includes the older persons' goals, internal and external resources, and need of support from health and/or social-services. This plan will be the point of departure for the forthcoming dialogue. A digital platform will open up for extended and safe communication and visualize the health planning between the older person and team-members in different settings. The older person and the HCP and involved team members on the digital platform will regularly evaluate the health plan and commonly agreed goals.

eHealth

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• National registration within the Västra Götalands region (VGR), community dwelling people (men and women) aged 75 and older living in ordinary housing, and screened as frail at a primary care center or the emergency department but not hospitalized.

You may not qualify if:

• In need of palliative care in the final stages of life, no registered address, participating in any other conflicting randomised study, or cognitive dysfunctional (not oriented to time, place and person).

Sponsors & Collaborators

• Göteborg University: lead
• The Swedish Research Council: collaborator

Study Sites (1)

Arvid Wallgrensbacke 7

Gothenburg, Gothenburg, 405 30, Sweden

RECRUITING

Related Publications (20)

• Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63. doi: 10.1093/gerona/59.3.m255.

  PMID: 15031310 BACKGROUND

• Social Board. Being able to follow the patient's path through care Ways to link care events in the patient care process (Att kunna följa patientens väg genom vården Sätt att koppla samman vårdhändelser i patientens vårdprocess) socialstyrelsen, Editor. 2019, www.Socialstyrelsen.se, februari 2019 Stockholm.

  BACKGROUND

• McCormack B. A conceptual framework for person-centred practice with older people. Int J Nurs Pract. 2003 Jun;9(3):202-9. doi: 10.1046/j.1440-172x.2003.00423.x.

  PMID: 12801252 BACKGROUND

• Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191-215. doi: 10.1037//0033-295x.84.2.191. No abstract available.

  PMID: 847061 BACKGROUND

• Fors A, Ulin K, Cliffordson C, Ekman I, Brink E. The Cardiac Self-Efficacy Scale, a useful tool with potential to evaluate person-centred care. Eur J Cardiovasc Nurs. 2015 Dec;14(6):536-43. doi: 10.1177/1474515114548622. Epub 2014 Aug 22.

  PMID: 25149667 BACKGROUND

• Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, Carlsson J, Dahlin-Ivanoff S, Johansson IL, Kjellgren K, Liden E, Ohlen J, Olsson LE, Rosen H, Rydmark M, Sunnerhagen KS. Person-centered care--ready for prime time. Eur J Cardiovasc Nurs. 2011 Dec;10(4):248-51. doi: 10.1016/j.ejcnurse.2011.06.008. Epub 2011 Jul 20.

  PMID: 21764386 BACKGROUND

• May CR, Mair FS, Dowrick CF, Finch TL. Process evaluation for complex interventions in primary care: understanding trials using the normalization process model. BMC Fam Pract. 2007 Jul 24;8:42. doi: 10.1186/1471-2296-8-42.

  PMID: 17650326 BACKGROUND

• Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M; Medical Research Council Guidance. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008 Sep 29;337:a1655. doi: 10.1136/bmj.a1655.

  PMID: 18824488 BACKGROUND

• Grewal I, Lewis J, Flynn T, Brown J, Bond J, Coast J. Developing attributes for a generic quality of life measure for older people: preferences or capabilities? Soc Sci Med. 2006 Apr;62(8):1891-901. doi: 10.1016/j.socscimed.2005.08.023. Epub 2005 Sep 15.

  PMID: 16168542 BACKGROUND

• Schultz-Larsen K, Avlund K. Tiredness in daily activities: a subjective measure for the identification of frailty among non-disabled community-living older adults. Arch Gerontol Geriatr. 2007 Jan-Feb;44(1):83-93. doi: 10.1016/j.archger.2006.03.005. Epub 2006 Nov 13.

  PMID: 17095107 BACKGROUND

• Brooks R. EuroQol: the current state of play. Health Policy. 1996 Jul;37(1):53-72. doi: 10.1016/0168-8510(96)00822-6.

  PMID: 10158943 BACKGROUND

• Schwarzer, R, Jerusalem, M, Generalized Self-Efficacy scale. In: Weinman J, Wright S, & Johnston M, eds. Measures in health psychology: A user's portfolio Causal and control beliefs. Windsor, England. NFER-NELSON 1995. pp. 35-37.

  BACKGROUND

• Horder H, Gustafsson, S, Rydberg T, Skoog I, Waern M. A Cross-Cultural Adaptation of the ICECAP-O: Test-Retest Reliability and Item Relevance in Swedish 70-Year-Olds. Societies 2016. 6(4): p. 30.

  BACKGROUND

• Sonn U, Grimby G, Svanborg A. Activities of daily living studied longitudinally between 70 and 76 years of age. Disabil Rehabil. 1996 Feb;18(2):91-100. doi: 10.3109/09638289609166023.

  PMID: 8869511 BACKGROUND

• Gustafsson S, Horder H, Hammar IO, Skoog I. Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons. Health Psychol Res. 2018 May 8;6(1):6496. doi: 10.4081/hpr.2018.6496. eCollection 2018 May 8.

  PMID: 30596153 BACKGROUND

• Åsberg-Hulter, K., ADL-trappan (ADL- Staircase). 1990, Lund: Studentlitteratur.

  BACKGROUND

• Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005 Aug 30;173(5):489-95. doi: 10.1503/cmaj.050051.

  PMID: 16129869 BACKGROUND

• Katusiime B, Corlett SA, Krska J. Development and validation of a revised instrument to measure burden of long-term medicines use: the Living with Medicines Questionnaire version 3. Patient Relat Outcome Meas. 2018 May 28;9:155-168. doi: 10.2147/PROM.S151143. eCollection 2018.

  PMID: 29881317 BACKGROUND

• Ebrahimi Z, Barenfeld E, Gyllensten H, Olaya-Contreras P, Fors A, Fredholm E, Fuller JM, Godarzi M, Krantz B, Swedberg K, Ekman I. Integrating health promotion with and for older people - eHealth (IHOPe) - evaluating remote integrated person-centred care : Protocol of a randomised controlled trial with effectiveness, health economic, and process evaluation. BMC Geriatr. 2023 Mar 27;23(1):174. doi: 10.1186/s12877-023-03866-6.

  PMID: 36973667 BACKGROUND

• Ebrahimi Z, Olaya-Contreras P, Goudarzi M, Ekman I. Experiences of a remote, person-centred intervention in older persons living with frailty - a qualitative study. BMC Geriatr. 2025 Oct 15;25(1):779. doi: 10.1186/s12877-025-06509-0.

  PMID: 41094400 DERIVED

Related Links

• Study Protocol

MeSH Terms

Conditions

Frailty

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: The nature of the intervention means that neither participants nor the health care professionals (HCP) in the IHOPe intervention can be blinded to allocation in the RCT.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: RCT: All older people who give consent for participation and who fulfill the inclusion criteria will be randomised. Randomisation will be conducted by research nurses. Participants will be randomly assigned to either control or intervention group with a 1:1 allocation as per a computer generated randomisation. The control group will receive usual care. The intervention group will receive person-centred care intervention during 6 month on top of usual care.

Study Record Dates

• First Submitted: April 2, 2020
• First Posted: June 4, 2020
• Study Start: January 25, 2021
• Primary Completion: December 31, 2025
• Study Completion (Estimated): December 31, 2027
• Last Updated: March 12, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)