Leveraging Social Networks and Linkage to Care to Foster Healthy Aging in a Low-Income Context

利用社交网络和护理联系促进低收入背景下的健康老龄化

• 批准号: 10094387
• 负责人: Iliana V Kohler
• 金额: $ 8.1万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10094387
• 关键词: AIDS/HIV problem; Adult; Affect; African; Age; Aging; Behavioral; Cardiovascular Diseases; Caring; Characteristics; Clinic; Cognitive; Communicable Diseases; Communities; Community Health Systems; Development; Diffuse; Diffusion; Disease; Economics; Elderly; Exposure to; Face; Family; Family health status; Fostering; Goals; Health; Health Personnel; Health Policy; Health Promotion; Health Services; Health system; Healthcare; High Prevalence; Individual; Intervention; Knowledge; Life; Life Expectancy; Longevity; Longitudinal Studies; Low income; Malawi; Mental Health; Network-based; Outcome; Pathway interactions; Personal Satisfaction; Policies; Population; Prevention; Preventive Health Services; Preventive care; Preventive healthcare; Productivity; Psyche structure; Public Health; Reproductive Health; Research; Resources; Risk; Risk Behaviors; Risk Factors; Role; Rural; Services; Social Interaction; Social Network; Social Processes; Stretching; Support System; Treatment Cost; Vulnerable Populations; aged; aging population; base; behavioral health; burden of illness; chronic musculoskeletal pain; cohort; cost; cost effective; effective intervention; foster care; global health; health knowledge; health seeking behavior; health training; healthy aging; high risk; improved; innovation; low income country; macrophage-3 antigen; population based; programs; public health relevance; response; social; symptom treatment; theories; therapy design; trend; uptake; virtual

PROJECT SUMMARY Sub-Saharan African low-income countries (SSA LICs) have yet to develop effective and viable policies and health systems responses to foster healthy aging among a growing elderly population that is poorly served by overstretched health systems. While behavioral and health system change is challenging in any context, this challenge is exacerbated in SSA LICs as non-communicable diseases (NCDs) and aging-related diseases are an emerging—rather than established—disease burden. As a result, there prevails a poor understanding of risk factors, symptoms, treatment and prevention options. In addition, health systems are often limited with inade- quately trained health providers and frequent resource scarcity available to meet the aging-related health needs of older people. This project leverages the Mature Adults Cohort of the Malawi Longitudinal Study of Fami- lies and Health (MLSFH-MAC), one of the very few ongoing longitudinal population-based aging studies in a SSA LIC, for explorative research with the ultimate goal to inform the development of cost-effective and sus- tainable interventions that target social networks and social diffusion as an effective strategy to foster healthy aging among older persons. We focus specifically on the 3Cs: cardiovascular diseases (CVDs), poor cognitive and mental health, and chronic musculoskeletal pain. These 3Cs are among the most demanding and socially costly, but generally malleable health burdens for aging populations in SSA LICs and globally. The Overall Aim is to understand social interactions about healthy aging, identify the social processes affecting health-knowledge and health-seeking behavior related to the 3Cs, and generate much needed evidence that will inform innovative intervention designs that leverage social dynamics to foster healthy-aging through sustained behavioral changes and linkages-to-care for older people most at risk and/or most affected by the 3Cs. Specific Aim 1 will identify individual, community and health-system factors promoting healthy aging in a SSA LIC context characterized by low life expectancy and high burden of diseases, including high prevalence of HIV/AIDS. Specific Aim 2 will investigate the pathways through which 3Cs-related health information is diffused through social networks in rural LIC communities characterized by low knowledge about risk factors, disease symptoms, treatment options, and limited exposure to 3Cs-related preventive care. Based on the generated evidence from MLSFH-MAC and guided by theories of behavioral change, Specific Aim 3 will initiate the development of an innovative social- network-based intervention design to foster healthy aging among the elderly in rural SSA LICs contexts, with the focus on pathways for: (a) improving 3Cs-related health-knowledge through social diffusion of information and behavioral norms, and (b) using social networks to enhance the linkage-to-care of the elderly affected by the 3Cs who are most likely to benefit given available 3Cs-related resources at local clinics.

项目摘要 撒哈拉以南非洲低收入国家尚未制定有效和可行的政策， 卫生系统应对措施，以促进日益增长的老年人口的健康老龄化， 过度紧张的卫生系统。虽然行为和卫生系统的变化在任何情况下都是具有挑战性的， 由于非传染性疾病（NCD）和与衰老有关的疾病是一种疾病， 新出现的疾病负担，而不是已确定的疾病负担。因此，普遍存在对风险的理解不足 因素、症状、治疗和预防选择。此外，卫生系统往往受到inade- 训练有素的保健提供者和经常缺乏资源，无法满足与老龄化有关的保健需求 of older老people.该项目利用马拉维家庭纵向研究的成熟成年人队列- 谎言和健康（MLSFH-MAC），在一个非常少的正在进行的纵向人口为基础的老龄化研究， SSA LIC，用于探索性研究，最终目标是为开发具有成本效益和可持续性的 将针对社交网络和社会传播的干预措施作为促进健康 老年人的老龄化。我们特别关注3C：心血管疾病（CVD），认知能力差 心理健康和慢性肌肉骨骼疼痛。这些3C是最苛刻和最具社会性的 对撒哈拉以南非洲低收入国家和全球的老龄人口造成代价高昂但通常具有可塑性的健康负担。总体目标 是了解健康老龄化的社会互动，确定影响健康知识的社会过程， 以及与3C相关的健康寻求行为，并产生急需的证据， 干预设计，利用社会动态，通过持续的行为变化促进健康老龄化 以及与护理最有风险和/或受3C影响最严重的老年人的联系。具体目标1将确定 个人、社区和卫生系统因素促进了以SSA LIC为特征的健康老龄化 由于预期寿命低和疾病负担高，包括艾滋病毒/艾滋病的高流行率。具体目标2将 调查3C相关健康信息通过社交网络传播的途径， 农村低收入和低感染社区的特点是对风险因素、疾病症状、治疗选择的了解较少， 以及与3C相关的预防性护理接触有限。根据MLSFH-MAC生成的证据， 在行为变化理论的指导下，具体目标3将启动创新社会的发展， 基于网络的干预设计，以促进农村SSA LIC背景下老年人的健康老龄化， 重点关注以下途径：（a）通过社会传播信息，改善与3C有关的健康知识 和行为规范，以及（B）利用社交网络，以加强联系，照顾受影响的老年人， 3C最有可能贝内于当地诊所提供的3C相关资源。