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Improving mental health and wellbeing in elderly people isolated at home due to architectural barriers: A community health intervention
Authors:Ferran Daban,Irene Garcia-Subirats,Victoria Porthé  ,Mª  José    pez,Begoñ  a de-Eyto,M Isabel Pasarí  n,Carme Borrell,Lucí  a Artazcoz,Anna Pé  rez,Elia Dí  ez
Affiliation:aAgència de Salut Pública de Barcelona, Barcelona, Spain;bCreu Roja Barcelona, Barcelona, Spain;cCentro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;dInstitut d’Investigació Biomèdica de Sant Pau, Barcelona, Spain;eDepartment of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
Abstract:
ObjectivesTo explore the health effects of a community health intervention on older people who are isolated at home due to mobility problems or architectural barriers, to identify associated characteristics and to assess participants’ satisfaction.DesignQuasi-experimental before–after study.SettingFive low-income neighbourhoods of Barcelona during 2010–15.Participants147 participants, aged ≥59, living in isolation due to mobility problems or architectural barriers were interviewed before the intervention and after 6 months.InterventionPrimary Health Care teams, public health and social workers, and other community agents carried out a community health intervention, consisting of weekly outings, facilitated by volunteers.MeasurementsWe assessed self-rated health, mental health using the General Health Questionnaire (GHQ-12), and quality of life through the EuroQol scale. Satisfaction with the programme was evaluated using a set of questions. We analysed pre and post data with McNemar tests and fitted lineal and Poisson regression models.ResultsAt 6 months, participants showed improvements in self-rated health and mental health and a reduction of anxiety. Improvements were greater among women, those who had not left home for ≥4 months, those with lower educational level, and those who had made ≥9 outings. Self-rated health [aRR: 1.29(1.04–1.62)] and mental health improvements [β: 2.92(1.64–4.2)] remained significant in the multivariate models. Mean satisfaction was 9.3 out of 10.ConclusionThis community health intervention appears to improve several health outcomes in isolated elderly people, especially among the most vulnerable groups. Replications of this type of intervention could work in similar contexts.
Keywords:Elderly   Loneliness   Social isolation   Health outcomes   Health inequalities   Community health intervention
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