Effectiveness of a technology-enhanced, integrated community health and wellness program for seniors: A non-randomized, cluster-allocated, quasi-experimental study

Background and objectives

Reducing health disparities in later life is an important yet challenging agenda, particularly in urban areas. The objective of this study was to examine the effectiveness of the Health and Wellness Program for Seniors (HWePS), a technology-enhanced, multilevel, integrated health equity intervention, on the health and well-being of older adults residing in urban, low-income communities.

Research design and methods

HWePS was a prospective, non-randomized, cluster-allocated quasi-experimental study conducted over 12 months in an intervention and a control neighborhood in Seoul, South Korea. Guided by proven models, the HWePS intervention includes four key components: a health literacy program tailored to individual and community needs, personalized self-care management with nurse coaching and peer support, a community initiative promoting healthy living and aging, and information and communication technology systems. Data were collected before and after the 12-week self-care program, which was the core component of a broader 12-month intervention period. The primary outcomes were self-reported health status and health-related quality of life. Secondary outcomes included walking practice, diabetes awareness, stress perception, and self-efficacy, among others.

Results

The analysis revealed a significant group-by-time interaction for self-rated health (B = 0.48, SE = 0.22, p = 0.0277), favoring the intervention group. For quality of life, only the main effects of group and time were significant, with no significant interaction (p = 0.8474). Among the secondary outcomes, walking practice rate (B = 0.93, SE = 0.19, p < 0.0001), diabetes awareness (B = 0.39; SE = 0.17; p = 0.0227), stress perception (B = -1.24, SE = 0.31, p < 0.0001), and self-efficacy (B = 1.91, SE = 0.90, p = 0.0354) were significantly improved compared to those of the control group.

Discussion and implications

HWePS, an older people-empowering, community-mobilized health disparity intervention, showed improvements in self-rated health and key health behaviors, providing preliminary evidence of its potential to reduce health disparities in a low-income urban community during the coronavirus disease 2019 pandemic.

Trial registration

ISRCTN29103760; Ethical approval: SNU IRB No. 2011/002-016.

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