Take Charge of Your HealthProject Evaluation Report

March 2015

Project Description

New Horizons for Seniors Program (NHSP) • Funded a pilot project to educate and engage older volunteers as health

ambassadors in developing, implementing and evaluating a health literacy program for seniors on topics they identified as important to the quality of their daily lives.

• This project directly addresses a number of the NHSP funding priorities: • promoting volunteerism among seniors• engaging seniors in the community through mentoring of others• supporting the social participation and inclusion of seniors

Age-Friendly Ottawa

• overall aim of the of health literacy project is to “improve communications and access to available community resources” (Council on Aging of Ottawa, 2012).

Project Activities• Created a health literacy framework for older adults (March 2014)

• Completed a literature review (April 2014)

• Consulted with older adults to identify and prioritize topics (July and August 2014)

• Recruited and trained 16 volunteers as facilitators (September 2014)

• Developed the Take Charge of Your Health peer learning program (September 2014)

Project Activities

• Delivered and evaluated the Take Charge of Your Health program (October and November 2014)

• Conducted a formal evaluation including focus groups and key informant interviews (January and February 2015)

Project Background

Ottawa’s aging population

•Will 2X in next 20 years• 27% live alone

• 1 in 4 need support to remain independent• 20% are living with a disability • 7% of seniors live on low-income• Almost 30% were born in another country (City of Ottawa, 2012)

Health Literacy is an asset

• Health literacy is the ability to find, read, understand, and use information to make appropriate health decisions and follow instructions for treatment

Health Literacy Rates

All Canadians40%

Older Adults12%

? ??

? ? ?60%

? ??

? ? ?88%

? ??

(Rootman & Gordon-El-Bihbety, 2008)

Older adults are at risk

• Low literacy rates are associated with poorer health outcomes• Older adults experience unique

barriers accessing health information

• Yet, daily reading is a buffer(CCL, 2008; Rootman & Gordon El‐Bihbety, 2008; Gillespie & McNabb, 2012; Cornett, 2006)

Sources of information

• Doctors • Family Members • Friends•Media • Books • Internet

(CCL, 2008; Gillespie & McNabb, 2012; Veenhof & Timusk, 2009; Bugg & Xie, 2009)

Community-based approaches are best

Project Findings

Evaluation Methods

• Review of relevant background documents• Analysis participant feedback survey results • Two focus groups with participants • Interviews with the Program Director and the

Chair & Vice-Chair of the Health Issues Committee

Engagement

Take Charge of Your Health

• Staying Healthy• Talking to your Doctor• Dealing with the Unexpected• Dealing with Illness & Hospitalization• Choosing to Age at Home• Staying Social Connected

Retention & Satisfaction100% completed the program

100% would refer a friend

“It is very friendly and sharing of information is very useful.”

Facilitators felt prepared

94% > 60n=16

80% Prepared

100% Useful

Comfortable

Recruitment was challenging

• Only 20% of the 150 promised

•Majority were women• FSNA primary contact

Awareness & KnowledgeBetter Prepared/Decisions

100

94

94

88

65

94

95

94

81

88

94

100

79

95

64

83

94

37

94

43

83

84

88

53

100

72

88

6. Talking to your Doctor

5. Staying Social Connected

4. Staying Healthy*

3. Choosing to Age at Home

2. Dealing with the Unexpected*

1. Dealing with Illness & Hospitalization

New Useful Better Understanding Better Decisions Better Prepared

Ranked most useful at wrap up End of Session Results

* Did not ask all questions

Social connections

“I had the opportunity to find out that there are many others who have gone through the same

process as me or are going through it now, as I am.” “The chance to sound off and connect with a few

others who are in the same boat as me.”

Using new knowledge & skills

• Exercising more• Installing grab bars in the bathroom• Updating their will and power of attorney• Having conversations with their aging parents• Researching specific health information needs• Volunteering

Potential for social action

“You have me all fired up to help, but I want something concrete out of the program.”

“The project has allowed us to be closer to the community, more visible in the community drawing in

new faces, growing our reach. The ‘pool’ of participants will move this work forward.”

Summary of Results

EngagementFacilitator PreparednessRetention & SatisfactionAwareness & Knowledge

Better Prepared/DecisionsSocial ConnectionsKnowledge & Skills

UtilizationSocial Action

Recruitment

Our Recommendations

We recommend

• Refining program content and ‘branding’ • Scaling the program in neighbourhoods

with older adults from diverse backgrounds• Securing funding for a more rigorous

program evaluation • Capitalizing on the energy of current and

future participants to further engage on age-friendly initiatives

Questions?

ReferencesAgency for Healthcare Research & Quality (2011). Health Literacy Interventions and Outcomes: An Updated Systematic Review. US Department of Health & Human Sciences.

American Medical Association. (2000). Health literacy introductory kit. Chicago: American Medical Association.

Canadian Public Health Association. (2006). Health Literacy Interventions. Toronto, Ontario: CPHA.

Canadian Public Health Association. (2008). Priorities for Action: Outcomes from the National Symposium on Health Literacy. Ottawa: CPHA.

City of Ottawa. (2012). Older Adult Plan 2012-2014 Action Plan Summary.

Clement, S., Crichton, N., Ibrahim, S., Rowlands, G., Wolf, M. (2009). Complex interventions to improve the health of people with limited literacy: A systematic review. Patient Education Counseling, 75 (3), 340-51.

Council on Aging of Ottawa. (2012). Age-Friendly Ottawa Community Framework 2012-2014. Ottawa: Council on Aging of Ottawa.

Gillespie, J., McNab, J. (2012). Improving health literacy in seniors with chronic illness. Productive Ageing Centre. National Seniors Australia, 1, 1-24.

Kountz, D.S. (2009). Strategies for improving low health literacy. Postgrad Med, 5 (2), 171-7.

Nutbeam, D. (2009). The evolving concept of health literacy, Social Science & Medicine 67, 2072–2078.

ReferencesPeerson A, Saunders, M. (2009). Health literacy revisited: what do we mean and why does it matter? Health Promotion International, 4 (3), 285-96.

Rootman, I., Gordon-El-Bihbety, D. (2008). A Vision for a Health Literate Canada: Report of the Expert Panel on Health Literacy. Ottawa: Canadian Public Health Association.

The Canadian Council on Learning. (2008). Health Literacy in Canada: A Healthy Understanding. Ottawa, ON: CCL.

US Department of Health and Human Services. (2010). Toolkit for making written material clear and effective. Washington, DC: Centers for Medicare and Medicaid Services.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Quick Guide to Health Literacy.

Veenhof, B. & Timusk, P. (2009). Online activities of Canadian boomers and seniors, Canadian Social Trends, 88, 25-32. (Catalogue number 11-008-X). Statistics Canada: Ottawa.

World Health Organization. (1998). Health Promotion Glossary. WHO: Geneva.