The Effectiveness of Community-Based Health Promotion Program for Rural Elders: A Quasi-Experimental Design

Monday, 22 July 2013

Mei-Yen Chen, RN, PhD
Graduate Institute of Nursing, Graduate Institute of Nursing, Chang Gung University of Science and Technology, Chiayi County, Taiwan

Learning Objective 1: The learner will be able to understand the effect of a community-based health promotion program for seniorís lifestyle change.

Learning Objective 2: The learner will be able to understand how to initiate health promotion program through different interveners in rural areas.


The purpose of this study was to examine the effect of a CBHP on lifestyle change, physiological indicators and depression score among seniors in two rural areas. 


A prospective quasi-experimental design was deployed. A total of 520 senior participants living in six rural villages were clustered and conveniently assigned to two intervention groups. All seniors in both group1 (n=431) and group2 (n = 89) received an annual physical check-up, and health promotion programs with similar contents were delivered for 24 weeks. Senior nursing students were the interveners for group1 and community peer supporters for group2. The primary outcome measure was the change in health-related behaviors measured by the geriatric health promotion scale (GHPS). The secondary outcome comprised changes in the short form of the Chinese geriatric depression scale (CGDS-15), fasting blood sugar, total cholesterol, waist circumference and blood pressure. 


Most of the participants were retired farmers or fishermen over 75 years old and were illiterate. The total scores and all subscales of GHPS, CGDS, along with some physiological indicators, improved significantly between pretest and posttest in both groups. After adjustment for confounders, the intervention in group1 was more effective than that in group2 in terms of self-protection behaviors. Systolic and diastolic blood pressure was significantly lower in group2. 


The findings support the view that CBHP programs are valuable for improving healthy lifestyle, fasting blood sugar, blood pressure and depression score among seniors. The low cost and effectiveness of incorporating multidisciplinary resources to help rural elders to maintain health status and a healthier lifestyle indicate that it could be a good strategy for nursing professionals to address the rapidly aging society.