IHOPe - Integrating Health promotion with and for Older People-eHealth

Background

The Integrating Health promotion with and for Older People eHealth (IHOPe) project is expected to contribute vital knowledge on how older peoples capabilities and societal resources can be used in a more efficient way to promote health, self-management and enhance teamwork in partnership. The purpose of the project is to develop and test a new person-centred approach to preventive health and social care for frail older people at risk of being hospitalised and to assess the impact of this approach on quality of life and cost of medical, health and social care.

Frailty in older people is characterized by a loss of function, physiological reserve capacity, and an increased risk of acute illness, falls, disability and institutionalization. Identifying and collaborating with frail older people where the need for emergency care could be prevented is necessary to improve their wellbeing and decrease cost for health care. The present health and social care system is not designed to facilitate the incorporation of older people at home. Fragmented care services, collaborative challenges between organisations and a lack of preventative routines in health and social care are described as barriers for frail older people to access support and assessment to the extent they need. In addition, frail older peoples´ involvement is insufficient in current health and social care, where they risk to be marginalised. Approaches which incorporate older people’s capabilities and initiate health promoting actions are needed. Person-centred practice and digital health services are key in such a healthcare system redesign. No study has so far evaluated person-centred teamwork interventions in partnership with frail older people through e-health. Further, no study has evaluated effects of working in a person-centred health team selected by the older people themselves. Thus, there is an urgent call for innovative approaches to both initiate wellbeing promoting actions and to design a sustainable health and social care system that is accessible and resource effective.

Aim

The aim is to describe and evaluate a person-centered e-support intervention that promotes a sustainable partnership between community-dwelling frail older people and health and social care professionals.

Methods

The project includes a randomized controlled trial, a process evaluation and a health economic evaluation. The IHOPe project consists of two phases that correspond with the three steps of Development and Feasibility and Piloting and Evaluation of the MRC framework. The implementation steps will be planned for throughout the project.

Phase 1: Develop and test feasibility of a person-centered e-health intervention

and pilot the RCT design.

Phase 2: Evaluate the effects, describe the process and perform a health

economic evaluation of the person-centered e-health intervention.

People 75 years or older screened as frail at an emergency department and discharged directly to their home will be included. Also, in the process evaluation team-partners using the digital platform will be included.

The intervention consists of personcentered phone calls with a health care professional as well as access to a digital platform that is accessible to the old person and invited team-partners. A digital platform, co-created with users and designed to create inclusion of individuals who today are living in a digital alienation, will be used. During the intervention frail older people will be able to identify their potential health issues but also their resources together with team partners from health- and social care, family or societal representatives.

Expected results

Specifically, this project is expected to reduce hospitalizations, result in improved or retained self-efficacy whilst being cost effective. Additionally, the project is expected to enhance frail older peoples opportunities to participate as an equal partner in their contacts with health and social services.