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

项目总结 撒哈拉以南非洲低收入国家(SSA LIC)尚未制定有效和可行的政策和 卫生系统应对措施，在日益增长的老年人口中促进健康老龄化，这些老年人口得到的服务很少 不堪重负的卫生系统。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，但这 挑战在SSA LIC中加剧，因为非传染性疾病(NCD)和与老龄化相关的疾病是 新出现的--而不是既定的--疾病负担。因此，人们普遍对风险的理解很差。 因素、症状、治疗和预防选择。此外，卫生系统经常受到限制-- 训练有素的保健提供者和经常出现的资源短缺，以满足老龄化相关的保健需求 年长的人。该项目利用马拉维家庭纵向研究的成熟成年人队列-- 谎言与健康(MLSFH-MAC)，为数不多的正在进行的基于人口的纵向老龄化研究之一 SSA LIC，用于探索性研究，最终目标是为开发具有成本效益的SU- 以社会网络和社会传播为目标的可污染的干预措施，作为促进健康的有效战略 老年人的老龄化问题。我们特别关注3C：心血管疾病(CVD)、认知障碍(fi 精神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 SSA LIC和全球老龄人口的健康负担昂贵，但一般可延展。总体目标 是了解关于健康老龄化的社会互动，确定影响健康知识的社会过程 和与3C相关的健康寻求行为，并产生急需的证据，以告知创新 干预设计利用社会动力通过持续的行为改变来促进健康老龄化 以及与护理的联系--为风险最大和/或受3C影响最大的老年人提供服务。Speific Aim 1将识别 在SSA LIC背景下促进健康老龄化的个人、社区和卫生系统因素 低预期寿命和高疾病负担，包括艾滋病毒/艾滋病的高流行率。Speific Aim 2将 调查与3Cs相关的健康信息通过社交网络传播的途径 农村社区的特点是对风险因素、疾病症状、治疗方案、 以及有限地接触与3Cs相关的预防性护理。基于MLSFH-MAC生成的证据和 在行为改变理论的指导下，SPECIfic Aim 3将启动一种创新的社会- 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， 重点放在以下方面：(A)通过社会传播信息，改善与3Cs有关的保健知识 和行为规范，以及(B)利用社会网络加强受 考虑到当地诊所提供的3C相关资源，最有可能受益于fi的3C。

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.