Journey to Healthy Aging: Impact of Community Based Education Programs on Knowledge and Health Behavior in Older Adults
McLarry, Sue, Forum on Public Policy: A Journal of the Oxford Round Table
The objective of this study was to determine if community based health education programs increased knowledge and health behavior in older adults. The study was a pretest-posttest design with a convenience sample of 111 independent community dwelling older adults. Participants received two disease prevention education presentations: type 2 diabetes and colorectal cancer. Knowledge was assessed as the difference in pretest and posttest scores on the Diabetic Prevention Knowledge Test (DPKT) and the Colorectal Cancer Knowledge Questionnaire (CCKQ). Health behavior change was assessed as the difference between pre and posttest scores on the Health Promoting Lifestyle Profile II Physical Activity and Nutrition subscales and completion of the fasting blood glucose (FBG) and fecal occult blood test (FOBT). There was a significant difference in paired pretest-posttest scores on the DPKT (t = 7.678, p = .000) and CCKQ (t = -6.115, p = .000). While the mean posttest score on the Physical Activity subscale was significantly higher (t = -4.094, p = .000), the Nutrition subscale mean posttest score was not significantly different (t = -1.166, p = .246). A greater proportion of participants completed the FBG (84%) than the FOBT (50%). For this profile of independent older adults, community based health education resulted in greater knowledge and limited behavior change.
The aging population is nearly a universal phenomenon. Although the global population is relatively young, worldwide in 2002 one out of 14 people was 65 years of age or older (U.S. Census Bureau 2004). The older adult population is currently largest in developed countries with growth projected in all world regions to be faster than for other population segments. Nearly 36 million adults 65 years of age and older live in the United States (Federal Interagency Forum on Aging 2005).
In 2004 in the United States, the average life expectancy from birth was 77.9 years with females living 5.4 years longer than males (National Center for Health Statistics 2005). Further, upon attaining 65 years of age, adults have an average life expectancy of greater than 18 additional years (Arias 2006) and an increased risk for the development of chronic disease and disability (Centers for Disease Control and Prevention 2005). In general, a healthy lifestyle and early disease detection health behaviors are associated with preventing chronic diseases, such as heart disease, cancer, diabetes, and stroke, which have an increased incidence in older adults. Potential consequences of not preventing or managing chronic disease are hospitalization, disability, dependence on others for care, and care in a nursing home (Goulding 2003). A further impact of the additional years and chronic disease is healthcare expenses for older adults that are twice those of the general population (Administration on Aging 2004). Sound decisions about diet, physical activity, and healthcare are necessary to achieving a healthy lifestyle.
Health education programs provide older adults with information to assist in making informed decisions about health and lifestyle behaviors. One such program is Journey to Healthy Aging, a community based health education program for older adults and their families. The Journey to Healthy Aging in group setting provides information on normative aging changes, chronic diseases with increased risk in older age and prevention strategies. On a monthly basis different speakers provide one-hour programs on health topics of interest to older adults. Principles of adult learning, group support and humor guide the format of the Journey to Healthy Aging programs. The programs provide an opportunity for older adults to gain knowledge and ask questions in a non-threatening environment among a group of peers.
The purpose of this study was to determine if community based health education programs had a significant impact on knowledge and health behavior in older adults. …