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. 2021 May;53(5):102020.
doi: 10.1016/j.aprim.2021.102020. Epub 2021 Mar 26.

Improving mental health and wellbeing in elderly people isolated at home due to architectural barriers: A community health intervention

Ferran Daban  1 , Irene Garcia-Subirats  2 , Victoria Porthé  3 , MªJosé López  4 , Begoña de-Eyto  5 , M Isabel Pasarín  6 , Carme Borrell  6 , Lucía Artazcoz  6 , Anna Pérez  2 , Elia Díez  6
Affiliations

Improving mental health and wellbeing in elderly people isolated at home due to architectural barriers: A community health intervention

Ferran Daban et al. Aten Primaria. 2021 May.

Abstract
in English, Spanish

Objectives: To explore the health effects of a community health intervention on older people who are isolated at home due to mobility problems or architectural barriers, to identify associated characteristics and to assess participants' satisfaction.

Design: Quasi-experimental before-after study.

Setting: Five low-income neighbourhoods of Barcelona during 2010-15.

Participants: 147 participants, aged ≥59, living in isolation due to mobility problems or architectural barriers were interviewed before the intervention and after 6 months.

Intervention: Primary Health Care teams, public health and social workers, and other community agents carried out a community health intervention, consisting of weekly outings, facilitated by volunteers.

Measurements: We assessed self-rated health, mental health using the General Health Questionnaire (GHQ-12), and quality of life through the EuroQol scale. Satisfaction with the programme was evaluated using a set of questions. We analysed pre and post data with McNemar tests and fitted lineal and Poisson regression models.

Results: At 6 months, participants showed improvements in self-rated health and mental health and a reduction of anxiety. Improvements were greater among women, those who had not left home for ≥4 months, those with lower educational level, and those who had made ≥9 outings. Self-rated health [aRR: 1.29(1.04-1.62)] and mental health improvements [β: 2.92(1.64-4.2)] remained significant in the multivariate models. Mean satisfaction was 9.3 out of 10.

Conclusion: This community health intervention appears to improve several health outcomes in isolated elderly people, especially among the most vulnerable groups. Replications of this type of intervention could work in similar contexts.

Objetivos: Explorar los efectos sobre la salud de una intervención de salud comunitaria en personas mayores aisladas en casa debido a problemas de movilidad o a barreras arquitectónicas, identificar las características asociadas y evaluar la satisfacción de las personas participantes.

Diseño: Estudio cuasi-experimental antes-después.

Emplazamiento: Cinco barrios de baja renta de Barcelona durante 2010-15.

Participantes: Se entrevistó a 147 participantes, ≥59 años, antes y 6 meses después de la intervención.

Intervención: Equipos de atención primaria, trabajadores sociales, de salud pública y otros agentes comunitarios desarrollaron una intervención que consistía en salidas semanales, facilitadas por voluntarios.

Mediciones: Se evalúo la salud autopercibida, la salud mental utilizando la escala GHQ-12 y la calidad de vida mediante la escala EuroQol. La satisfacción se evaluó mediante un conjunto de preguntas. Analizamos los datos previos y posteriores con pruebas de McNemar y modelos de regresión lineal y de Poisson ajustados.

Resultados: A los 6 meses, los participantes mostraron mejoras en la salud percibida, en la salud mental y en la reducción de la ansiedad. Las mejoras fueron mayores entre las mujeres, las personas que no habían salido de casa durante ≥4 meses, las de bajo nivel educativo y las que habían realizado ≥9 salidas. La salud percibida (aRR: 1,29 [1,04-1,62]) y las mejoras en salud mental [(β: 2,92 [1,64-4,2]) permanecieron significativas en los modelos multivariados. La satisfacción media fue de 9,3 sobre 10.

Conclusión: Esta intervención de salud comunitaria parece mejorar varios resultados de salud en las personas mayores aisladas, especialmente en los grupos más vulnerables. Replicar este tipo de intervención podría funcionar en contextos similares.

Keywords: Aislamiento social; Community health intervention; Desigualdades en salud; Elderly; Health inequalities; Health outcomes; Intervención en salud comunitaria; Loneliness; Personas mayores; Resultados en salud; Social isolation; Soledad.

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