Health promotion for community-dwelling elderly: pros and cons of a preventive health centre for the elderly

pg 4-5
The increase of the elderly people in the Dutch society asks for solutions to
handle the increase in health problems. From our survey among a sample of
elderly individuals we concluded that a high percentage of the elderly could
live healthier; 53% is not sufficiently physically active, 43% does not eat
fruit every day, 16% uses sleeping pills or sedatives/tranquilizers, 14% smokes
and 5% frequently drinks too much. A healthy lifestyle can also benefit the
health of the elderly. Smoking cessation, healthier eating behavior and
physical activity have a positive effect on the health of the elderly; even
when individuals change their behaviour after they have turned 65.

At this moment their are several interventions -also for the elderly - that can
promote a healthy lifestyle. However elderly people for who these interventions
could be useful do not know that these interventions exist. It is important to
narrow the gap between the existing interventions and the awareness of at-risk
groups of these interventions, to improve their impact .

The preventive health consult for elderly people, under evaluation in this
study, is directed at 1) systematically assessing risks among elderly people,
(2) Advising and referring elderly people for who behavioural change is
important to suitable interventions.

pg 7-8
One objective of this study is to assess whether preventive health consults for
elderly people reach the elderly and whether the consults result in a better
attendance to existing interventions. This objective is operationalized by the
following research questions:
1. How many elderly people that are invited for a preventive health consult
attend a consult?
2. How many elderly people that attended a preventive health consult, are
advised to follow an intervention?
3. Are elderly people more more motivated to start an intervention after a
preventive health consult than elderly people that are not offered a preventive
health consult?
4. How many elderly peopl start an intervention and do elderly people with
consult differ in it from elderly people without consult?

A second objective is to assess how the preventive health consults were
provided: How satisfied elderly people, general practitioners and nurses are
about the preventive health consults? How is the completeness and quality of
use of the protocol for the preventive health consults by the health
professionals?

pg 9
In this study four groups of each 300 elderly individuals aged 55-74 will be
compared with each other and their own control group. Two groups of elderly
people will be invited by the general practitioner to come to the general
practice for a preventive health consult, two groups will be invited by the
general practitioner to come to the homecare. Half of the general practitioners
group half of the homecare group will have treatment according to the
Motivation Oriented method and half will have treatment according to the
solution oriented method. All intervention groups have their own waiting list
control group.
The elderly people in the intervention groups will complete a questionnaire
about four weeks prior to the consult and 10 weeks later (four weeks after the
follow-up consult). 12 weeks after the baseline measurement (six weeks after
the follow-up consult) will be assessed whether the persons (with an advice for
intervention of follow-up care) have followed-up the advice.
The control group will complete the questionnaires in a same time period.
The nurses register in each consult with a client the advices that they have
given and how the consult went.

pg 9-10
The intervention consists of a screeninig and an advice during a preventive
health consult in the general practice or homecare. This consult will be
followed by a telephonic follow-up consult of apprcximately 10 minutes.
The preventive health consults will be directed at the health subject mentioned
below:
i. Cardiovascular risk
ii. Smoking
iii. Physical activity
iv. Fat intake
iv. Excessive alcohol use
v. Loneliness
Elderely people will be screened and will get advice and refferal on these
subjects. The screening and advicing will be done by trained nurses.

Burden mainly exists in the time spend for completing the questionnaires and
attending the preventive health consult.