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Randomized Controlled Trial
. 2018 Apr 17:13:669-679.
doi: 10.2147/CIA.S158097. eCollection 2018.

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

Fatemeh Estebsari  1 , Maryam Dastoorpoor  2 , Davoud Mostafaei  3 , Narges Khanjani  4 , Zahra Rahimi Khalifehkandi  5 , Abbas Rahimi Foroushani  6 , Hamidreza Aghababaeian  7 , Mohammad Hossein Taghdisi  8
Affiliations
Randomized Controlled Trial

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

Fatemeh Estebsari et al. Clin Interv Aging. .

Abstract

Background: Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse.

Methods: This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ2 tests, multiple linear and logistic regression, and structural equation modeling (SEM).

Results: The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors.

Conclusion: Educational interventions can be effective in preventing elder abuse.

Keywords: elder abuse; health education; health promotion; self-efficacy; social support.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Conceptual framework of self-efficacy, social support, and health promoting behavior in reducing elder abuse. Abbreviation: HPB, health promoting behavior.
Figure 2
Figure 2
Modified SEM primary model in prevention of elder abuse risk. Notes: ––––, significant relationship; – – –, insignificant relationship. The numbers with brackets indicate the unstandardized path coefficient of the model. The numbers without brackets indicate R2 of the dependent variables of the model. Abbreviations: SEM, structural equation modeling; HPB, health promoting behavior.
Figure 3
Figure 3
SEM-modified final model in prevention of elder abuse risk. Note: The numbers with brackets indicate unstandardized path coefficient of model, The numbers without brackets indicate R2 of the dependent variables of model. Abbreviations: SEM, structural equation modeling; HPB, health promoting behavior.
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