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Published in: BMC Geriatrics 1/2022

Open Access 01-12-2022 | Research

Effectiveness, satisfaction and meaningfulness of a 6-step detection and prevention program for frail community-dwelling older adults: a mixed-method evaluation

Authors: Eva Dierckx, Daan Duppen, Sylvia Hoens, Lise Switsers, An-Sofie Smetcoren, Liesbeth De Donder, D-SCOPE

Published in: BMC Geriatrics | Issue 1/2022

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Abstract

Background:

As people age, the risk of becoming frail increases, often leading to negative outcomes and less well-being. Within the light of prevention, early detection and guidance to the right care and support is crucial. This study aimed to give an overview of the descriptive results of the D-SCOPE program and evaluate the process.

Methods:

The D-SCOPE program was developed as a detection and prevention program for frail community-dwelling older adults. The program creates a continuum of care and support, consisting of 6 steps: (1) Targeted case-finding using risk profiles for purposeful selection, (2) Preventive home-visit by an older volunteer, (3) Home visits by a professional, (4), Warm referral, (5) Monthly follow-up and (6) Long-term follow-up by home visit. The effectiveness of this program, in terms of satisfaction and meaningfulness, was studied quantitatively by means of a randomized controlled trial amongst 869 people with a frailty risk profile and qualitatively by 15 focus groups interviews.

Results:

The quantitative study revealed that 83.9% of the participants found the different home visits within the D-SCOPE program useful. The focus group interviews shed light on several issues and advantages: a more efficient case finding due to the applied risk factors for frailty, a more intensive tailor-made care and support due to the warm referral, the importance of both small-scaled and larger interventions based on the wishes irrespective of the state of frailty of the older persons, the focus on a strengths-based instead of a deficit-based approach and the follow up as being one of the greatest strengths of the project. However, to fully understand the benefits of the program a shift in mind from intervention to prevention is necessary.

Conclusions:

Our quantitative data show that most participants found the home visits meaningful and were satisfied with the intervention. The qualitative findings provided more insights into the experiences of the participants with the process. Based on these insights of the 6-step model of preventive home visits, municipalities and organizations can apply this model to carry out more targeted home visits.

Trial registration:

This trial was registered at ClinicalTrials.gov, on 30/05/2017, identifier: NCT03168204.
Literature
1.
go back to reference O’Caoimh R, Galluzzo L, Rodríguez-Laso Á, Van der Heyden J, Ranhoff AH, Lamprini-Koula M, et al. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis. Ann Ist Super Sanita. 2018 Oct 1;54(3):226–38. O’Caoimh R, Galluzzo L, Rodríguez-Laso Á, Van der Heyden J, Ranhoff AH, Lamprini-Koula M, et al. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis. Ann Ist Super Sanita. 2018 Oct 1;54(3):226–38.
2.
go back to reference Hertogh C. Aging Beyond Frailty: The Future of Old Age. In: Schermer M, Pinxten W. redacteuren. Ethics, Health Policy and (Anti-) Aging: Mixed Blessings. Hertogh C. Aging Beyond Frailty: The Future of Old Age. In: Schermer M, Pinxten W. redacteuren. Ethics, Health Policy and (Anti-) Aging: Mixed Blessings.
3.
go back to reference Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig A-K, Scafoglieri A, Jansen B, et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 01 2016;17(12):1163.e1-1163.e17. Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig A-K, Scafoglieri A, Jansen B, et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 01 2016;17(12):1163.e1-1163.e17.
4.
go back to reference Dury S, Roeck ED, Duppen D, Fret B, Hoeyberghs L, Lambotte D, et al. Identifying frailty risk profiles of home-dwelling older people: focus on sociodemographic and socioeconomic characteristics. Aging Ment Health. 2017 Oct 3;21(10):1031-9. Dury S, Roeck ED, Duppen D, Fret B, Hoeyberghs L, Lambotte D, et al. Identifying frailty risk profiles of home-dwelling older people: focus on sociodemographic and socioeconomic characteristics. Aging Ment Health. 2017 Oct 3;21(10):1031-9.
5.
go back to reference De Roeck EE, Dury S, De Witte N, De Donder L, Bjerke M, De Deyn PP, et al. CFAI-Plus: Adding cognitive frailty as a new domain to the comprehensive frailty assessment instrument. Int J Geriatr Psychiatry. 2018 Jul;33(7):941–7.CrossRef De Roeck EE, Dury S, De Witte N, De Donder L, Bjerke M, De Deyn PP, et al. CFAI-Plus: Adding cognitive frailty as a new domain to the comprehensive frailty assessment instrument. Int J Geriatr Psychiatry. 2018 Jul;33(7):941–7.CrossRef
6.
go back to reference Dury S, Dierckx E, van der Vorst A, Van der Elst M, Fret B, Duppen D, et al. Detecting frail, older adults and identifying their strengths: results of a mixed-methods study. BMC Public Health. 2018 Dec;18(1):1–3.CrossRef Dury S, Dierckx E, van der Vorst A, Van der Elst M, Fret B, Duppen D, et al. Detecting frail, older adults and identifying their strengths: results of a mixed-methods study. BMC Public Health. 2018 Dec;18(1):1–3.CrossRef
7.
go back to reference Duppen D, Rossi G, Dierckx E, Hoeyberghs L, De Donder L, Consortium D-SCOPE. Focusing on positive outcomes in frailty research: development of a short well-being instrument for older adults (SWIO). Int Psychogeriatr. 2019 Jun;31(6):767–77.CrossRef Duppen D, Rossi G, Dierckx E, Hoeyberghs L, De Donder L, Consortium D-SCOPE. Focusing on positive outcomes in frailty research: development of a short well-being instrument for older adults (SWIO). Int Psychogeriatr. 2019 Jun;31(6):767–77.CrossRef
8.
go back to reference De Donder L, Smetcoren A-S, Schols JMGA, van der Vorst A, Dierckx E, D-SCOPE Consortium. Critical reflections on the blind sides of frailty in later life. J Aging Stud. 2019 Jun;1:49:66–73.CrossRef De Donder L, Smetcoren A-S, Schols JMGA, van der Vorst A, Dierckx E, D-SCOPE Consortium. Critical reflections on the blind sides of frailty in later life. J Aging Stud. 2019 Jun;1:49:66–73.CrossRef
9.
go back to reference Lambotte D, De Donder L, De Roeck EE, Hoeyberghs LJ, van der Vorst A, Duppen D, et al. Randomized controlled trial to evaluate a prevention program for frail community-dwelling older adults: a D-SCOPE protocol. BMC Geriatr. 2018;27(1):194. 18(.CrossRef Lambotte D, De Donder L, De Roeck EE, Hoeyberghs LJ, van der Vorst A, Duppen D, et al. Randomized controlled trial to evaluate a prevention program for frail community-dwelling older adults: a D-SCOPE protocol. BMC Geriatr. 2018;27(1):194. 18(.CrossRef
10.
go back to reference Bloor M, editor. Focus groups in social research. Sage; 2001 Mar. p. 8. Bloor M, editor. Focus groups in social research. Sage; 2001 Mar. p. 8.
11.
go back to reference Dierckx de Casterlé B, Gastmans C, Bryon E, Denier Y. QUAGOL: a guide for qualitative data analysis. Int J Nurs Stud. 2012 Mar 1;49(3):360–71. Dierckx de Casterlé B, Gastmans C, Bryon E, Denier Y. QUAGOL: a guide for qualitative data analysis. Int J Nurs Stud. 2012 Mar 1;49(3):360–71.
12.
go back to reference De Witte N, Gobbens R, De Donder L, Dury S, Buffel T, Schols J, et al. The comprehensive frailty assessment instrument: Development, validity and reliability. Geriatric Nursing. 2013 Jul 1;34(4):274–81. De Witte N, Gobbens R, De Donder L, Dury S, Buffel T, Schols J, et al. The comprehensive frailty assessment instrument: Development, validity and reliability. Geriatric Nursing. 2013 Jul 1;34(4):274–81.
13.
go back to reference Pearlin LI, Nguyen KB, Schieman S, Milkie MA. The life-course origins of mastery among older people. J Health Soc Behav. 2007 Jun;48(2):164–79.CrossRef Pearlin LI, Nguyen KB, Schieman S, Milkie MA. The life-course origins of mastery among older people. J Health Soc Behav. 2007 Jun;48(2):164–79.CrossRef
14.
go back to reference Steger MF, Frazier P, Oishi S, Kaler M. The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol. 2006 Jan;53(1):80.CrossRef Steger MF, Frazier P, Oishi S, Kaler M. The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol. 2006 Jan;53(1):80.CrossRef
15.
go back to reference Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985 Feb 1;49(1):71–5.CrossRef Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985 Feb 1;49(1):71–5.CrossRef
16.
go back to reference Machielse A. Sociaal isolement bij ouderen: een typologie als richtlijn voor effectieve interventies. J Soc Interv Theory Pract. 2011 Nov 30;20(4):40–61.CrossRef Machielse A. Sociaal isolement bij ouderen: een typologie als richtlijn voor effectieve interventies. J Soc Interv Theory Pract. 2011 Nov 30;20(4):40–61.CrossRef
17.
go back to reference Van der Elst M, Schoenmakers B, Dierckx E, De Roeck E, van der Vorst A, Lambotte D, et al. Towards a more effective strategy to detect community-dwelling frail older adults: validation of risk factors. Int. J. Health Gov. 2021 Jan 1;26(3):237–49. Van der Elst M, Schoenmakers B, Dierckx E, De Roeck E, van der Vorst A, Lambotte D, et al. Towards a more effective strategy to detect community-dwelling frail older adults: validation of risk factors. Int. J. Health Gov. 2021 Jan 1;26(3):237–49.
18.
go back to reference Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? Health economics and the presidential candidates. N Engl J Med. 2008 Feb 14;358(7):661–3.CrossRef Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? Health economics and the presidential candidates. N Engl J Med. 2008 Feb 14;358(7):661–3.CrossRef
19.
go back to reference Goetzel RZ. Do prevention or treatment services save money? The wrong debate. Health Aff (Millwood). 2009 Feb;28(1):37–41.CrossRef Goetzel RZ. Do prevention or treatment services save money? The wrong debate. Health Aff (Millwood). 2009 Feb;28(1):37–41.CrossRef
20.
go back to reference McGinnis JM, Williams-Russo P, Knickman JR. The Case For More Active Policy Attention To Health Promotion. Health Aff. 2002 Mar;21(2):78–93.CrossRef McGinnis JM, Williams-Russo P, Knickman JR. The Case For More Active Policy Attention To Health Promotion. Health Aff. 2002 Mar;21(2):78–93.CrossRef
21.
go back to reference Richardson AK. Investing in public health: barriers and possible solutions. J Public Health (Oxf). 2012 Aug;34(3):322–7.CrossRef Richardson AK. Investing in public health: barriers and possible solutions. J Public Health (Oxf). 2012 Aug;34(3):322–7.CrossRef
22.
go back to reference Blok C de, Meijboom B, Luijkx K, Schols J. Demand-based Provision of Housing, Welfare and Care Services to Elderly Clients: From Policy to Daily Practice Through Operations Management. Health Care Anal. 2009;Mar1;17(1):68–84.CrossRef Blok C de, Meijboom B, Luijkx K, Schols J. Demand-based Provision of Housing, Welfare and Care Services to Elderly Clients: From Policy to Daily Practice Through Operations Management. Health Care Anal. 2009;Mar1;17(1):68–84.CrossRef
23.
go back to reference Hoogendijk EO. How effective is integrated care for community-dwelling frail older people? The case of the Netherlands. Age Ageing. 2016 Sep 1;45(5):585-8. Hoogendijk EO. How effective is integrated care for community-dwelling frail older people? The case of the Netherlands. Age Ageing. 2016 Sep 1;45(5):585-8.
24.
go back to reference Ament BHL, de Vugt ME, Verhey FRJ, Kempen GIJM. Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty? Eur J Ageing. 2014 Feb;19(3):213–9. 11(.CrossRef Ament BHL, de Vugt ME, Verhey FRJ, Kempen GIJM. Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty? Eur J Ageing. 2014 Feb;19(3):213–9. 11(.CrossRef
25.
go back to reference Puts MTE, Shekary N, Widdershoven G, Heldens J, Lips P, Deeg DJH. What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2007 Mar;16(2):263–77. Puts MTE, Shekary N, Widdershoven G, Heldens J, Lips P, Deeg DJH. What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2007 Mar;16(2):263–77.
26.
go back to reference Hellström Y, Persson G, Hallberg IR. Quality of life and symptoms among older people living at home. J Adv Nurs. 2004 Dec;48(6):584–93.CrossRef Hellström Y, Persson G, Hallberg IR. Quality of life and symptoms among older people living at home. J Adv Nurs. 2004 Dec;48(6):584–93.CrossRef
27.
go back to reference Shearer NBC, Fleury J, Ward KA, O’Brien A-M. Empowerment interventions for older adults. West J Nurs Res. 2012 Feb;34(1):24–51.CrossRef Shearer NBC, Fleury J, Ward KA, O’Brien A-M. Empowerment interventions for older adults. West J Nurs Res. 2012 Feb;34(1):24–51.CrossRef
28.
go back to reference Rosemary Chapin PhD M. DSW EOC. Changing the Paradigm. J Gerontol Soc Work. 2002 Aug 8;36(3–4):165–79. Rosemary Chapin PhD M. DSW EOC. Changing the Paradigm. J Gerontol Soc Work. 2002 Aug 8;36(3–4):165–79.
29.
go back to reference Vanmechelen O, Verté D, Teugels H, Buffel T, De Donder L, Glorieux M, e.a. Zorgnoden en - behoeften: de kijk van de Brusselaar. Analyse van de sterktes, zwaktes, kansen en bedreigingen van de Brusselse woonzorg. Brussel: Gillis Printing Company. 2012. Vanmechelen O, Verté D, Teugels H, Buffel T, De Donder L, Glorieux M, e.a. Zorgnoden en - behoeften: de kijk van de Brusselaar. Analyse van de sterktes, zwaktes, kansen en bedreigingen van de Brusselse woonzorg. Brussel: Gillis Printing Company. 2012.
30.
go back to reference Kirk C. Telephone follow-up of older people after hospital admissions. Curr Aging Sci. 2014 Jul 1;7(2):144–53. Kirk C. Telephone follow-up of older people after hospital admissions. Curr Aging Sci. 2014 Jul 1;7(2):144–53.
31.
go back to reference Lewis E, Samperi S, Boyd-Skinner C. Telephone follow-up calls for older patients after hospital discharge. Age Ageing. 01 2017 Jul 1;46(4):544–6. Lewis E, Samperi S, Boyd-Skinner C. Telephone follow-up calls for older patients after hospital discharge. Age Ageing. 01 2017 Jul 1;46(4):544–6.
32.
go back to reference Crocker JB, Crocker JT, Greenwald JL. Telephone follow-up as a primary care intervention for postdischarge outcomes improvement: a systematic review. Am J Med. 2012 Sept;125(9):915–21. Crocker JB, Crocker JT, Greenwald JL. Telephone follow-up as a primary care intervention for postdischarge outcomes improvement: a systematic review. Am J Med. 2012 Sept;125(9):915–21.
Metadata
Title
Effectiveness, satisfaction and meaningfulness of a 6-step detection and prevention program for frail community-dwelling older adults: a mixed-method evaluation
Authors
Eva Dierckx
Daan Duppen
Sylvia Hoens
Lise Switsers
An-Sofie Smetcoren
Liesbeth De Donder
D-SCOPE
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03504-7

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