Homebound, Mobile Health, Older Adults, Person-Centred Care, Self-Care
Conditions
Brief summary
The aim of the study is to evaluate the effectiveness and implementation of the mobile health (mHealth)-assisted, person-centred care (PCC) self-care support programme for homebound older adults. The researcher will compare PCC approach to a conventional care provider-led model. Participants (n = 130) will receive the intervention of six bi-weekly WhatsApp video call sessions over three months with nurse case managers (NCMs).
Detailed description
This hybrid effectiveness-implementation, cluster-randomized controlled trial evaluates a mHealth-assisted, PCC self-care support programme for homebound older adults in Hong Kong. Participants (n = 130) receive six bi-weekly WhatsApp video call sessions with NCMs over three months. The study compares a PCC-based approach with a conventional provider-led model. Effectiveness outcomes include self-efficacy, functional independence, and psychosocial well-being. Implementation is assessed using the RE-AIM framework. Findings will inform scalable, digital health interventions for aging populations, improving functional independence, self-care engagement, and healthcare accessibility for homebound older adults.
Interventions
BEHAVIORALPCC-based mHealth-assisted self-care support intervention
Participants receive six bi-weekly WhatsApp video call sessions with a NCM over three months, using a person-centred care (PCC) approach.
BEHAVIORALProvider-led mHealth-assisted self-care support intervention
Participants receive six bi-weekly WhatsApp video call sessions with a NCM over three months, based on the conventional provider-led model.
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged 60 years or older; * Unable to leave home more than twice per week due to physical or functional health problems; * Own and have basic proficiency in using a smartphone; * Speak Cantonese; * Indicate sufficient cognitive ability; and * Be moderately frail or below.
Exclusion criteria
* Unable to hear, see, or communicate effectively; * Be completely bed-bound; or * Reside in an area without stable internet coverage.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in self-efficacy assessed using the Chinese version of the General Self-Efficacy Scale | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean score on self-efficacy. |
| Change in instrumental activities of daily living assessed using the Chinese version of the Lawton Instrumental Activities of Daily Living Scale | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean score on instrumental activities of daily living. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in perceived loneliness assessed using the Chinese version of the UCLA 3-item Loneliness Scale | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean score on perceived loneliness. |
| Change in functional mobility assessed using the Timed Up and Go Test | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Time in seconds. |
| Change in sedentary behaviour assessed using the Chinese version of the Sedentary Behaviour Questionnaire for Elderly | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean hours per day. |
| Change in frequency of healthcare utilization assessed using the self-reported healthcare utilization survey | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Number of visits. |
| Participant reach and recruitment success measured by recruitment records | At baseline. | Unit of Measure: Percentage of eligible enrollment. |
| Change in quality of life assessed using the Chinese version of the 12-item Short Form Health Survey version 2 | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean score on quality of life. |
| Service provider acceptability and adoption of person-centred care approach measured by focus group interview | At 3 months post-intervention. | Unit of Measure: Thematic analysis of interview records. |
| Implementation fidelity and adherence to person-centred care principles measured by session recordings and fidelity checklist | Ongoing monitoring during intervention. | Unit of Measure: 1). Number and reasons for missed sessions; 2). Percentage of sessions meeting fidelity criteria. |
| Long-term maintenance and retention of participants measured by cost-effectiveness analysis and retention and dropout records | At 6 months post-intervention. | Unit of Measure: 1). Incremental cost-effectiveness ratio (ICER) per additional quality adjusted life year (QALY) gained; 2). Number and reasons of dropout. |
| Barriers and Facilitators to the intervention measured by focus group interview | At 3 months post-intervention. | Unit of Measure: Thematic analysis of interview records. |
| Participant satisfaction with the intervention assessed using the Chinese version of four-dimension Client Satisfaction Questionnaire | At 3 months post-intervention and 6 months post-intervention. | Unit of Measure: Mean score on satisfaction. |
| Change in psychological distress assessed using the Chinese version of 21-item Depression Anxiety Stress Scale | At baseline, 3 months post-intervention , and 6 months post-intervention. | Unit of Measure: Mean score on psychological distress. |
Countries
Hong Kong
Contacts
Primary ContactProf. Arkers Wong
Outcome results
None listed