JMIR Publications

ABSTRACT

Background:

Chronic diseases may impact on older adults’ health outcomes, healthcare costs, and quality of life. Self-management encourages individuals to make autonomous decision, adhere to the treatment plan, deal with emotional and social consequences, and provides choices for healthy style. New e-health solutions significantly increase the health literacy and empower patients in self-management of chronic conditions.

Objective:

The study aimed to develop a Community-based e-Health Program (CeHP) for older adults with chronic diseases and conduct a pilot evaluation.

Methods:

A single group pre- and post-test repeated measure design was adopted for the pilot evaluation. Community-dwelling older adults with chronic diseases were recruited from senior activity centers in Singapore. A systematic 3-step process of developing CeHP was coupled with a smart-device application. The development of the CeHP intervention consists of theoretical framework, client-centric participatory action research process, content validity assessment and pilot testing. Self-reported survey questionnaires were collected before and after CeHP. The instruments used were Self-care of Chronic Illness Inventory (SCCII), Healthy Aging Instrument (HAI), Short-Form Health Literacy Scale 12 Items (HL-SF 12), Patient Empowerment Scale (PES), and Social Support Questionnaire 6 items (SSQ6).

Results:

CeHP consists of health education, monitoring and advisory system for older adults to manage their chronic conditions. CeHP is an 8-week intensive program, including face-to-face and e-health (Care4Senior App) sessions. Care4Senior App covers health education topics focusing on management of hypertension, hyperlipidemia, and diabetes, brain health, healthy diet, lifestyle modification, medication adherence, exercise, and mindfulness practice. Content validity assessment indicated that the content of CeHP is valid as content validity index (CVI) ranged from 0.86 to 1 and scale-CVI was 1. Participants demonstrated improvements in BMI and HbA1c, three out of four SCCII indices, HAI score and PES scores post-intervention.

Conclusions:

CeHP is feasible, engages and empowers older adults living in the community to manage their chronic conditions. The rigorous process of program development and pilot evaluation provided strong evidence to extend CeHP to a larger-scale to encourage self-management, reduce debilitating complications of poorly controlled chronic diseases, promote healthy longevity and social support, and reduce healthcare costs.