The value of health promotion programs for older people with chronic conditions in the community

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1 University of Wollongong Research Online Faculty of Science, Medicine and Health - Papers Faculty of Science, Medicine and Health 2016 The value of health promotion programs for older people with chronic conditions in the community Rebekkah Middleton University of Wollongong, rmiddle@uow.edu.au Lorna Moxham University of Wollongong, lmoxham@uow.edu.au Dominique R. Parrish University of Wollongong, dparrish@uow.edu.au Publication Details Middleton, R., Moxham, L. & Parrish, D. (2016). The value of health promotion programs for older people with chronic conditions in the community. Australian Nursing and Midwifery Journal, 24 (2), Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: research-pubs@uow.edu.au

2 The value of health promotion programs for older people with chronic conditions in the community Abstract The Ottawa Charter of Health Promotion (WHO,1996) advocates that health promotion occurs when people are able to improve and practice more successful control over their health. The concept of health promotion was founded on the notion of community action, raising awareness and instilling community accountability and involvement in one's own actions. Disciplines Medicine and Health Sciences Social and Behavioral Sciences Publication Details Middleton, R., Moxham, L. & Parrish, D. (2016). The value of health promotion programs for older people with chronic conditions in the community. Australian Nursing and Midwifery Journal, 24 (2), This journal article is available at Research Online:

3 The value of health promotion programs for older people with chronic conditions in the community Authors: Rebekkah Middleton; Professor Lorna Moxham; Dr Dominique Parrish Address: , School of Nursing, University of Wollongong, Northfields Avenue Wollongong 2522 Phone: (W) Position and Qualifications: Rebekkah Middleton Lecturer School of Nursing, University of Wollongong; RN, Dip.App.Sc(Nursing), BN, MN(Research), Graduate Certificate Emergency Nursing, Graduate Certificate Clinical Management, PhD Candidate Professor Lorna Moxham Professor in Mental Health, School of Nursing University of Wollongong Dominique Parrish Associate Dean Education, Faculty of Science, Medicine and Health, University of Wollongong 1

4 The value of health promotion programs for older people with chronic conditions in the community an overview of the literature The Ottawa Charter of Health Promotion (WHO 1996) advocates that health promotion occurs when people are able to improve and practice more successful control over their health. The concept of health promotion was founded on the notion of community action raising awareness and instilling community accountability and involvement in one s own actions. In 2007, the World Health Organization also promoted person centred approaches to healthcare the overall vision for people centred health care is one in which individuals, families and communities are served by and are able to participate in trusted systems that respond to their needs in humane and holistic ways (WHO 2007, p.7). Despite this international charter and framework, community interventions and in particular community health promotion programs involving exercise for older people with chronic health conditions are underdeveloped, certainly in Australia. Health promotion programs have proven to be effective in promoting self care and increasing levels of exercise in people with chronic illnesses, particularly when implemented in community settings outside the home environment, such as local halls or gyms (Desveaux et al. 2013). The literature establishes that older people benefit physically, cognitively and socially from being engaged in community recreational activities (Huang et al. 2015; March et al. 2015; Nishiguchi et al. 2015; Patil et al. 2015). Community health promotion programs support healthy ageing (Young et al. 2015, p.2). They are excellent means of enabling older people to participate in community programs, allowing them to be more productive, useful members of society and more independent in their life choices, while at the same time reducing the level of community expenditure and burden (Stumbo et al. 2015, p.36). Stumbo et al. (2015) also assert that older people with chronic conditions participating in health promotion programs in the community experience opportunities that allow them to maintain abilities, contribute to a cause, draw on past roles and skills, and improve their self belief. Community based health promotion programs have demonstrated benefit to older adults, with key considerations being to help regain function, stability and/or independence (Zabriskie, Lundberg & Groff 2005), and to promote self management and facilitative behaviours to maintain a healthy lifestyle and thereby prevent potential co morbidities and bring general improvement in quality of life (March et al. 2015; Rowan, Riddell & Jamnick 2013). Cogswell and Negley (2011) advocate that by increasing opportunities to support individual autonomy, the potential to increase internal motivation for improving healthy lifestyles can occur. Community based health promotion programs should encourage participants to take responsibility for their own wellness and thereby foster an internal locus of control and an increased ability to manage change (Stumbo & Peterson 2009). Even where a program is fairly prescriptive, the individual needs to be encouraged to be as autonomous as possible, so as to 2

5 promote the outcomes of the program. When personal choice is increased within a program, life and leisure satisfaction is enhanced and participants are far more likely to benefit and see results (Stumbo & Peterson 2009). Drawing on the lead authors PhD research, the following major finding was identified that supports the literature outlined here. Shifting the focus to the person involved, self management and self determination are encouraged, bringing a positive conception of health and empowerment to the individual. Such personcentredness enhances the aims community health promotion programs strive to achieve. References Cogswell, J. & Negley, S.K The Effect of Autonomy Supportive Therapeutic Recreation Programming on Integrated Motivation for Treatment among Persons who Abuse Substances. Therapeutic Recreation Journal. 45(1): Desveaux, L., Beauchamp, M., Goldstein, R. & Brooks, D Community based exercise programs as a strategy to optimize function in chronic disease: A systematic review. Medical Care. 52(3): Huang, T.T., Liu, C.B., Tsai, Y.H., Chin, Y.F. & Wong, C.H Physical fitness exercise versus cognitive behavior therapy on reducing the depressive symptoms among community dwelling elderly adults: A randomized controlled trial. International Journal of Nursing Studies. 52(10): March, S., Torres, E., Ramos, M., Ripoll, J., Garcia, A., Bulilete, O., Medina, D., Vidal, C., Cabeza, E., Llull, M., Zabaleta Del Olmo, E., Aranda, J.M., Sastre, S. & Llobera, J Adult community health promoting interventions in primary health care: A systematic review. Preventative Medicine. 76(Suppl1):S94 S104. Nishiguchi, S., Yamada, M., Tanigawa, T., Sekiyama, K., Kawagoe, T., Suzuki, M., Yoshikawa, S., Abe, N., Otsuka, Y., Nakai, R., Aoyama, T. & Tsuboyama, T A 12 Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community Dwelling Older Adults: A Randomized Controlled Trial. Journal of the American Geriatric Society. 63(7): Patil, R., Uusi Rasi, K., Tokola, K., Karinkanta, S., Kannus, P. & Sievanen, H Effects of a Multimodal Exercise Program on Physical Function, Falls, and Injuries in Older Women: A 2 Year Community Based, Randomized Controlled Trial. Journal of the American Geriatric Society. 63(7): Rowan, C., Riddell, M. & Jamnick, V The Prediabetes Detection and Physical Activity Intervention Delivery (PRE PAID) Program. Canadian Journal of Diabetes. 37(6):

6 Stumbo, N. & Peterson, C Therapeutic recreation program design. Principles and procedures. 5th edn. San Francisco: Pearson. Stumbo, N.J., Wilder, A., Zahl, M., Devries, D., Pegg, S., Greenwood, J. & Ross, J.E Community Integration: Showcasing the Evidence for Therapeutic Recreation Services. Therapeutic Recreation Journal. 49(1): World Health Organization (WHO) Ottawa Charter of Health Promotion. Toronto, Canada: OMS. World Health Organization (WHO) People centred health care: A policy framework. Geneva: WHO. Young, J., Angevaren, M., Rusted, J. & Tabet, N Aerobic exercise to improve cognitive function in older people without known cognitive impairment. Cochrane Database of Systematic Reviews. 4:1 3. Zabriskie, R.B., Lundberg, N.R. & Groff, D.G Quality of Life and Identity: The Benefits of a Community Based Therapeutic Recreation and Adaptive Sports Program. Therapeutic Recreation Journal. 39(3):