Development of a Preventive Health Screening Procedure Enabling Supportive Service Planning for Home-Dwelling Older Adults (PORI75): Protocol for an Action Research Study

Abstract

Background: In Finland, at least 1 in 4 residents will be >75 years of age in 2030. The national aging policy has emphasized the need to improve supportive services to enable older people to live in their own homes for as long as possible.

Objective: This study aimed to develop a preventive health screening procedure for home-dwelling older adults aged 75 years to enable the use of clinical patient data for purposes of strategic planning of supportive services in primary care.

Methods: The action research method was applied to develop the health screening procedure with selected validated health measures in cooperation with the local practicing interprofessional health care teams from 10 primary care centers in the Social Security Center of Pori, Western Finland (99,485 residents, n=11,938, 12% of them >75 years). The selection of evidence-based validated health measures was based on the national guide to screen factors increasing fall risk and the national functioning measures database. The cut-off points of the selected health measures and laboratory tests were determined in consecutive consensus meetings with the local primary care physicians, with decisions based on internationally validated measures, national current care guidelines, and local policies in clinical practice.

Results: The health screening procedure for 75-year-old residents comprised 30 measures divided into three categories: (1) validated self-assessments (9 measures), (2) nurse-conducted screenings (14 measures), and (3) laboratory tests (7 measures). The procedure development process comprised the following steps: (1) inventory and selection of the validated health measures and laboratory tests, (2) training of practical nurses to perform screenings for the segment of 75-year-old residents and to guide them to possible further medical actions, (3) creation of research data from clinical patient data for secondary use purposes, (4) secondary data analysis, and (5) consensus meeting after the pilot test of the health screening procedure for 75-year-old residents procedure in 2019 based on the experiences of health care professionals and collected research data.

Conclusions: The developed preventive health screening procedure for 75-year-old residents enables the use of clinical patient data for purposes of strategic planning of supportive services in primary care if the potential bias by a low participation rate is controlled.

International registered report identifier (irrid): DERR1-10.2196/48753.

Keywords: Finland; clinical patient data; community; community health care; data collection; develop; health screening; older adults; pilot test; planning; primary care; screening; secondary use; self-assessment; supportive service; testing.

Figure 1

The development process of the preventive health screening procedure for home-dwelling older adults aged 75 years (PORI75) using the action research method [43,44]. PN: practical nurse.

Figure 2

Description of the developed health screening procedure for 75-year-old residents (PORI75). * LOTTA checklist and SARC-F test were included in 2020. ADL: activities of daily living; AUDIT-C: Alcohol Use Disorders Identification Test—Consumption; BNSQ: Basic Nordic Sleep Questionnaire; FROP-Com: Falls Risk for Older People in the Community; GDS 15: Geriatric Depression Scale; GFR: glomerular filtration rate; HbA1c: hemoglobin A1c; IADL: Instrumental Activities of Daily Living; PN: practical nurse; QTnurse: questionnaire included screenings performed by a health care professional; QTself: questionnaire included screenings suitable for self-assessment; UDI-6: Urinary Distress Inventory; LOTTA: Checklist for Successful Medication Therapy (translated in English). ** The BNSQ questionnaire was included only in 2019, not in 2020.