LOCAL HEALTH PROMOTION INITIATIVES 7
ASurvey of Local Health Promotion Initiatives for Older People inWales
ASurvey of Local Health Promotion Initiatives for Older People inWales
Europeis currently characterised with decreasing births and increasing lifespans due to the quality of life. The ageing population with peopleaged 50 years and above is predicted to rise above 50 % by 2055(Meyer, 2008). The population of Wales for example consists of 38 %aged above 50years (Anderson, Hilaire & Flinter, 2012). “Healthyageing a challenge for Europe” was a report aimed at policymakers, it aimed at several priority topics for health promotion:social capital, retirement and pre-retirement mental health,nutrition, injury prevention, physical activity and substance use/misuse (including alcohol and smoking) (Zandee, 2010). The Welshassembly conducted a survey to assess the coverage of healthpromotion in the topics across Welsh (Kulbok, Thatcher, Park &Meszaros, 2012).
TheHealth promotion division of the Welsh government produced aspecification for conducting the survey. A questionnaire wasdeveloped through consultations, it asked about the projects in thepriority topics (Maville& Huerta, 2008).Some of the questions asked for each project included project title,aims, organisations involved, geographical scope, number of clientsinvolved evidence bases and evaluation, target group and number ofclients involved (Meyer, Ulbricht, Baumeister, Schumann, Rüge,Bischof & John, 2008).
Thesurvey included 22 local authorities in Wales. Electronic and postalquestionnaires were sent to each of them, signed and stamped by theWelsh assembly Government. The sampled Projects included those whichprioritised people aged 50 years and above, and those that promotedhealth and well-being in the category areas such as exercise, homesafety and warmth, healthy eating emotional health, immunisation,smoking, alcohol and sexual health. The questionnaire’s targetedprimary informants such as senior promotion specialists in the localpublic health departments. In the event of non-responders, two emailreminders were sent after three and four weeks then a telephonecontacts were forwarded. The data collected was fed into a MicrosoftAccess database (Haber,n.d.).
Thequestionnaire required the primary informants to provide names andcontact details of people responsible for each project that was namedin the questionnaire to provide room for secondary informants toprovide the required supplementary information. Whenever data wasmissing the secondary informants were contacted by email/ telephone.Additional information was obtained from the organisation’swebsites responsible for the projects (McQueen,2007).
Outof the 22 questionnaires, 18 were returned. There was a varied degreeof completion although none was fully completed. Efforts were made tocontact the primary informants through the phone to complete thegaps. Some of the missing information was obtained from the internet.
Onehundred and twenty projects were included, out of them, eleven werethroughout Wales forty nine were excluded due to lack of meeting theinclusion criteria.
Physicalactivity-A majority of health promotion activities for the aged werein this category. It consisted of 3 Wales programmes and 42 local andregional projects. There was free swimming available for people aged60 years and above – the swimming pools were provided by the localauthorities. Physical activities were part of the campaign calledKeep Well This Winter (KWTW) it mainly involved information andadvice assistance (Zandee, Bossenbroek, Friesen, Blech & Engber,2010).
Healthyeating- there were lunch clubs located all over Wales although therewas limited information about the type of food they provided. Healthyfood was part of the Keep Well This Winter (KWTW) campaign. Itprovided information on healthy eating and cooking demonstrations(Davies,2006).
Homesafety and warmth- the campaign aimed at providing safe and soundroad shows that demonstrated home safety, electric blanket testing,energy efficiency, free low energy bulbs and smoke alarms (Anderson,2011).There were charitable organisations that provided home repairs,improvements and adaptations to assist in preventing falls andillnesses. In addition, there were 19 projects in 10 areas (Clark,2002).
Emotionalhealth- the initiatives provided chances for socialisation,counselling, befriending and intellectual stimulation. There lackedinitiatives that involved the aged in creative activities such asarts, the reason for such could have been due to a limitation ofhealth promotion specialists (Connolly,2010).
Smokingcessation- there were areas that planned for a review of smokingcessation of the old people. However, there were no other reports ofsmoking cessation activities for the aged.
Sensibledrinking- there lacked health based activities that specifically tookinto account alcohol drinking or its effect such as malnutrition,falls confusional states or accidents.
Sexualhealth promotion- there were no initiatives to promote the sexualhealth of the aged
Thenumber of health promotion activities targeted for the aged variedacross Wales. Provision was greatest for physical activity thatinvolved 42 local and 3 national facilities. Healthy eating, healthprotection and home safety had the fewest initiatives similar tohealth protection which only had two national immunisation campaigns.In addition, there was only one national initiative Keep Well ThisWinter (KWTW) campaign (Phyllis, 2009).
Incomparison to previous research, the health of older people is likelyto get even worse especially among those in disadvantagedcircumstances such as the disabled and from ethic minority groups.The initiatives of smoking cessation, alcohol and sexual health havea tendency to focus on the young population. Although the aged maynot be denied from accessing such programmes the services may beinappropriate for their needs (Edelstein, 2011).
Inaddition, some services are traditionally not targeted to olderpeople. There is hence the need to ensure that future services arecreated in a way to include the aged to wide age discrimination.There should hence be efforts to increase the coverage andeffectiveness of the interventions that are known to be usefulparticularly for the minority and those in residential care homeswhere evidence has been found to be lacking (Rudkin, 2003). Inaddition, existing programmes should be evaluated using random andcontrolled trials or multi method evaluations in order to establishthe efficiency and cost effectiveness. There should also beintroduced new initiatives for the aged in the fields of alcoholabuse. Sexual health promotion should be carried out in addition totheir acceptability and the value for money.
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