Objective: The purpose of this longitudinal study was to examine the effectiveness of a health promotion program in a federally funded senior housing facility. The researcher examined specific health promotion interventions to determine which onsite activity (or combination of activities) produced greatest increase in perceived health status. Health promotion activities in this investigation included: 1) exercise/ movement sessions, 2) social/ supportive groups, and 3) screening/teaching events.
Design: A retrospective longitudinal panel design using a secondary analysis approach was used. Data was collected through record review of eligible residents' health files, including scores from the "Medical Outcome Trust "SF-12 Health Status" instrument. The SF-12 yields a perceived physical health score (PCS) and perceived mental health score (MCS).
Sample and Setting: The sample included 80 individuals (65 years and older) living in the federally funded housing community during the eighteen month period. Subjects voluntarily attended one or more components of the health promotion program during the specified time frame. The study was conducted in one senior housing facility, subsidized by The U.S. Department of Housing and Urban Development (HUD), located in a large urban Mid-South city.
Methods: To determine whether three interventions differ in ability to effect perceived health status of residents, the researcher established a classification matrix representing each intervention and combinations of interventions. The matrix produced seven possible categories of interventions; subjects were grouped according to the interventions classification matrix.
Pre-intervention perceived health status scores (PCS/MCS) were subtracted from 6-month scores to produce an index of change in perceptions of health from pre-intervention to 6 month. One way Analysis of Variance (ANOVA) was employed, using seven classified interventions groups with gain scores serving as continuous dependent variables. This procedure was repeated using the index of change from pre-intervention to eighteen months by subtracting pre-intervention scores from eighteen-month follow-up scores.
Findings: Using a Tukey HSD multiple comparison procedure, one statistical significant difference in perceived physical health was detected between the intervention categories. The difference (p < .05) existed between scores of residents categorized in the exercise plus screening group and the scores of those categorized in the social/supportive with screening group.
Results also revealed two statistically significant differences in perceived mental health status. The first difference (p < .05) occurred between scores of resident categorized in the exercise/movement only group (category 1) and those categorized in the social/supportive plus screening group (category 6). The second significant difference (p<. 05) occurred between the screening only (category 3) and the social/ supportive plus screening group (category 6). In both scenarios, residents in the social/supportive plus screening interventions (category 6) demonstrated substantial improvement in scores versus the residents in the exercise/movement only or screening/ teaching interventions only.
Conclusion: In this study, health promotion interventions producing the greatest gain in health status scores differed between physical health status and mental health status. Individuals classified in combined category of "exercise/movement plus screening/teaching" interventions exhibited greatest gain in perceived physical health status. However, only one statistically significant difference existed between intervention categories. This difference indicated that only individuals in "exercise/movement plus screening/teaching" scored significantly higher in perceived physical health status than individuals in the "social/supportive plus screening/teaching" category.
Conversely, health promotion interventions producing the greatest increase in gain scores of perceived mental health status were different. Residents classified in "social/supportive plus screening/teaching" intervention demonstrated the greatest gain in perceived mental health status. In this comparison, statistical difference existed between two of the intervention categories. This analysis suggested that individuals attending exercise/movement interventions only or screening/teaching interventions only had considerably lower mental health scores than those attending a combination of social/supportive plus screening/teaching interventions. These findings, although not conclusive, support the reasoning that exercise groups, social support groups or health screenings alone are not enough to maintain the perceived health of older adults.
Implications: Few researchers have attempted to compare the effects of health promotion interventions in isolation versus the combination effect. If nurses are to be mindful of resource utilization in this setting, systematic investigations are needed to validate the effectiveness of single and combined health promotion interventions.
Health promotion interventions use precious resources not always readily available, especially in government subsidized housing facilities. Nurses developing, and implementing health promotion programs, must recognize the limited resources in this setting and its consequence on health promotion programming.
Determining which health promotion intervention (or combination of interventions) produces the greatest increase in gain scores of perceived health status is significant. Federally funded housing facilities attempting services with limited resources face deciding which interventions would best serve older adult residents.
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