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  • 1. Barenfeld, E.
    et al.
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Göteborg, Sweden.
    Wallin, L.
    Dahlin-Ivanoff, S.
    Supporting decision-making by a health promotion programme: Experiences of persons ageing in the context of migration2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1337459Article in journal (Refereed)
    Abstract [en]

    This study is part of the Promoting Aging Migrants’ Capabilities programme that applied person-centred group meetings and one individual home visit to prolong independence in daily activities among people ≥70 years who had migrated to Sweden from Finland or the Western Balkan region. With the purpose to understand programme outcomes, the study aimed to explore the participants’ everyday experiences of using health-promoting messages exchanged during the programme. Using a grounded theory approach, 12 persons aged 70- 83 years were interviewed six months to one year after their participation in the programme. The participants experienced how using health-promoting messages was a dynamic process of how to make decisions on taking action to satisfy health-related needs of oneself or others immediately or deferring action. Five sub-processes were also identified: gaining inner strength, meeting challenges in available resources, being attentive to what is worth knowing, approaching health risks, and identifying opportunities to advocate for others. The results suggest that the programme could develop personal skills to support older people who have migrated to overcome health-related challenges. They further demonstrate the importance of supporting their health literacy before personal resources hinder action, and call for research on programmes to overcome environmental barriers to health.

  • 2. Barenfeld, E.
    et al.
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
    Wallin, L.
    Dahlin-Ivanoff, S.
    Understanding the "black box" of a health-promotion program: Keys to enable health among older persons aging in the context of migration2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, no 1, article id 29013Article in journal (Refereed)
    Abstract [en]

    Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researchercommunity partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration. 

  • 3. Barenfeld, Emmelie
    et al.
    Dahlin-Ivanoff, Synneve
    Wallin, Lars
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health—AgeCap, University of Gothenburg, Gothenburg, Sweden.
    Promoting aging migrants' capabilities: A randomized controlled trial concerning activities of daily living and self-rated health2018In: AIMS Public Health, ISSN 2327-8994, Vol. 5, no 2, p. 173-188Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the 6-month and 1-year effects of a person-centered group-based health-promoting intervention on independence in daily activities and self-rated health. The study was an RCT with follow-ups at 6 months and 1 year. A total of 131 independent living people (70+) who have migrated to Sweden from Finland or Western Balkan region were included. Participants were independent in activities of daily living and cognitively intact. They were randomized to an intervention group receiving four weekly group-meetings and a follow-up home visit, or a control group (no intervention). An overall chi-squared test was performed and the odds ratio calculated. A high proportion of the participants maintained independence in activities of daily living and improved or maintained self-rated health. However, no significant differences were found between the groups. The result indicates that the intervention was offered too early in the aging process to be able to detect effects. Methodological challenges were met during both the recruitment and implementation phases. In response to lessons learned, a multicenter design is recommended for future research in order to strengthen the findings. Furthermore, this study has contributed with experiences on both opportunities and challenges in terms of research with and about older people aging in the context of migration, as is discussed.

  • 4. Behm, L.
    et al.
    Eklund, K.
    Wilhelmson, K.
    Zidén, L.
    Gustafsson, Susanne
    Institute of Neuroscience and Physiology/Occupational Therapy, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg,Sweden.
    Falk, K.
    Dahlin-Ivanoff, S.
    Health Promotion Can Postpone Frailty: Results from the RCT Elderly Persons in the Risk Zone2016In: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 33, no 4, p. 303-315Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Very old persons (80+) are often described as "frail", implying that they are particularly vulnerable to adverse health outcomes. Elderly Persons in the Risk Zone was designed to determine whether a preventive home visit or multiprofessional senior group meetings could postpone deterioration in frailty if the intervention is carried out when the person is not so frail. DESIGN AND SAMPLE: The study was a RCT with follow-ups at 1 and 2 years. A total of 459 persons (80+), still living at home, were included. Participants were independent in activities of daily life and cognitively intact. MEASURES: Frailty was measured in two complementary ways, with the sum of eight frailty indicators and with the Mob-T Scale measuring tiredness in daily activities. RESULTS: Both interventions showed favorable effects in postponing the progression of frailty measured as tiredness in daily activities for up to 1 year. However, neither of the two interventions was effective in postponing frailty measured with the sum of frailty indicators. CONCLUSIONS: The results in this study show the potential of health promotion to older persons. The multiprofessional approach, including a broad spectrum of information and knowledge, might have been an important factor contributing to a more positive view of aging. 

  • 5. Behm, L.
    et al.
    Gustafsson, Susanne
    Göteborgs universitet.
    Hälsofrämjande och sjukdomsförebyggande insatser för de allra äldsta2017In: Hemsjukvård / [ed] Eva Drevenhorn, Lund: Studentlitteratur AB, 2017, 2, p. 133-148Chapter in book (Other academic)
  • 6. Berglund, H.
    et al.
    Gustafsson, Susanne
    The Frail Elderly Research Support Group (FRESH), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Ottenvall Hammar, I.
    Faronbi, J.
    Dahlin-Ivanoff, S.
    Effect of a care process programme on frail older people’s life satisfaction2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 1097-1104Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to analyse the effects of a full-scale implementation of a care process programme on life satisfaction among frail older people, as compared with those receiving usual care. Design: The study includes participants from a full-scale care process programme (N = 77) and participants from a historical control group (N = 66). The care process programme establishes a comprehensive continuum of care through components including case management, interprofessional teamwork and care-planning meetings in the older people's own homes. Methods: Questionnaires were used and data were collected at baseline, with follow-ups at three, six and 12 months. Results: The implementation of the full-scale care process programme had a positive effect on life satisfaction among frail older people. From 6-month–12-month follow-ups, a higher proportion of participants in the care process programme had positive life satisfaction outcomes, as compared with the historical control group. 

  • 7. Dahlin-Ivanoff, S.
    et al.
    Eklund, K.
    Wilhelmson, K.
    Behm, L.
    Häggblom-Kronlöf, G.
    Zidén, L.
    Landahl, S.
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Sahlgrenska Academy at the University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden; Institute of Neuroscience and Physiology, University of Gothenburg Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    For whom is a health-promoting intervention effective?: Predictive factors for performing activities of daily living independently2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 171Article in journal (Refereed)
    Abstract [en]

    Background: Health-promoting interventions tailored to support older persons to remain in their homes, so-called “ageing in place” is important for supporting or improving their health. The health-promoting programme “Elderly Persons in the Risk Zone,” (EPRZ) was set up for this purpose and has shown positive results for maintaining independence in activities of daily living for older persons 80 years and above at 1- and 2 year follow-ups. The aim of this study was to explore factors for maintaining independence in the EPRZ health-promoting programme. Methods: Total of 459 participants in the original trial was included in the analysis; 345 in the programme arm and 114 in the control arm. Thirteen variables, including demographic, health, and programme-specific indicators, were chosen as predictors for independence of activities of daily living. Logistic regression was performed separately for participants in the health promotion programme and in the control arm. Results: In the programme arm, being younger, living alone and self-rated lack of tiredness in performing mobility activities predicted a positive effect of independence in activities of daily living at 1-year follow-up (odds ratio [OR] 1.18, 1.73, 3.02) and 2-year, (OR 1.13, 2.01, 2.02). In the control arm, being less frail was the only predictor at 1-year follow up (OR 1.6 1.09, 2.4); no variables predicted the outcome at the 2-year follow-up. Conclusions: Older persons living alone - as a risk of ill health - should be especially recognized and offered an opportunity to participate in health-promoting programmes such as “Elderly Persons in the Risk Zone”. Further, screening for subjective frailty could form an advantageous guiding principle to target the right population when deciding to whom health-promoting intervention should be offered. Trial registration: The original clinical trial was registered at ClinicalTrials.gov. Identifier: NCT00877058 , April 6, 2009. 

  • 8. Ehrenborg, C.
    et al.
    Gustafsson, Susanne
    Department Occupational Therapy, Rehabilitation Clinic, Södra Älvsborgs Hospital, Borås, Sweden; Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Institute of Neuroscience and Physiology/Occupational Therapy, Gothenburg, Sweden.
    Archenholtz, B.
    Long-term effect in ADL after an interdisciplinary rehabilitation programme for WAD patients: A mixed-method study for deeper understanding of participants' programme experiences2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 12, p. 1006-1013Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate long-term effects in self-perceived occupational performance and satisfaction in Activities of Daily Living (ADL) for patients with Whiplash Associated Disorders (WAD) with chronic pain in an interdisciplinary rehabilitation programme, and investigate patients' opinions of programme effects. Method: A mixed-method with sequential explanatory design was used. Fifty-three patients with WAD were followed-up 12 months after discharge. The Canadian Occupational Performance Measure was used to evaluate the change in ADL and the Multidimensional Pain Inventory for psychosocial functioning. Telephone interviews, based on five structured questions about the perceived impact of the rehabilitation programme, were made. Results: The 12-month follow-up showed significant ADL improvement (p<0.001). There was less interference in daily activities due to pain (p<0.01), and life control increased. More people were back to work. Interviews revealed the programme's environment as strengthening and safe, and participants felt they were met with respect. Key success factors were to be treated with respect to being part of the social context and to obtain new knowledge. Conclusions: The interdisciplinary rehabilitation programme had initiated a process of change towards a more active life for the participants. They had found a new way of managing their lives. Despite the absence of pain reduction, they managed ADL in a better way, had more life control and returned to work to a higher degree.Implications for RehabilitationChronic pain after WAD effects the entire life for many people.Long-term effects on activities of daily living, life control and work ability have shown positive results after an interdisciplinary rehabilitation programme based on behavioural and cognitive principles.The key success factors were to be treated with respect to being a part of a social context and to obtain new knowledge. 

  • 9. Faronbi, Joel Olayiwola
    et al.
    Gustafsson, Susanne
    The Frail Elderly Research Support Group (FRESH), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Sweden; The Gothenburg University Centre for Ageing and Health (Age Cap), Sweden.
    Berglund, Helene
    Ottenvall Hammar, Isabelle
    Dahlin-Ivanoff, Synneve
    Social Network and Support, Self-Rated Health, and Loneliness as Predictors of Risk for Depression Among pre-Frail and Frail Older People in Sweden2017In: Open Access Journal of Gerontology & Geriatric Medicine, E-ISSN 2575-8543, Vol. 2, no 5Article in journal (Refereed)
    Abstract [en]

    Introduction: Family and social network are indispensable to the well-being of the older people. However, little has been documented about benefits of the social network and support in reducing the risk for depression among older persons in Sweden. This study aims to examine the relationship between social network and social support, loneliness, and self-rated health among older Swedish people and to determine the ability of these variables (and personal characteristics) to predict the risk for depression among pre-frail and frail older people.

    Methodology: This study analysed aggregated data from three randomised controlled studies, which included pre-frail and frail older Swedish adults age 65 years and above. Analyses were done using chi-square, ANOVA, and multiple regressions (in Stata v14).

    Results: Findings from the analysis revealed that out of 737 respondents included in this study, 27.5% were at risk for depression (CI: 24.31, 30.78), 54.8% were living alone and 12.5% had no children. Furthermore, factors that statistically predicted the risk for depression include having a confidant (β=1.32, p;=0.006) loneliness (β=11.47,p=0.000, self-rated health (β=-2.60, p=0.000), changes in loneliness (β=-10.16, p=0.000), number of children (β=0.78, p=0.000), number of confidant (β=-0.19, p=0.068) and living alone (β=-0.61, p=0.005).

    Conclusion: This study concluded that a large number of the older adults in this population is at risk for depression and factors that predict risk for depression include having a confident, living-alone, number of children, loneliness and poorer self-rated health. Therefore, health- promoting activities that encourage interaction and communication among the older adults should be implemented to promote their well-being.

  • 10.
    Fransson, Amanda
    et al.
    Hälso- och Sjukvårdsorganisationen, Karlskrona kommun, Sweden.
    Björklund Carlstedt, Anita
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Gustafsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    Older adults' occupations in heat waves: A scoping review2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 7, p. 1000-1015Article, review/survey (Refereed)
    Abstract [en]

    Background

    Heat waves impact the health of older adults, and occupations are important for health. An overview of research focussed on older adults' occupations in heat waves can be useful for occupational therapy practice.

    Objective

    To identify what the literature shows about older adults' experience and performance of, and participation in, occupations in heat waves.Material and methodThis scoping review included a literature search in five academic databases, four databases for grey literature, and a manual search. Literature in English regarding older adults 60+ and their occupations in heat waves were eligible.

    Findings

    Twelve studies were included. Findings showed that older adults adapt their occupations using bodily, environmental, and social interaction strategies and by changing their daily routines. Personal, environmental, social, and economic factors facilitate and maintain occupations in heat waves.

    Conclusion

    Older adults adapt their occupations in heat waves and different factors impact how they can be adapted. Future research is needed to explore how older adults experience their occupations in heat waves, and to deepen the knowledge about their heat-adaptive strategies.

    Significance

    The findings support the role of occupational therapists in the design and practice of interventions managing the impact of heat waves in daily life.

  • 11.
    Gustafsson, Susanne
    Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation Centre for Ageing and Health (Agecap), Gothenburg University, Sweden.
    Evaluation of an Interactive Showroom to Increase Knowledge about Welfare Technology and its Potential in Municipal Care Settings2021Conference paper (Refereed)
    Abstract [en]

    Background: Welfare Technology (WT) can contribute to occupational justice. The implementation of WT products and services therefore needs to be promoted in order to benefit end-users.

    Objective: To evaluate an interactive showroom of WT.

    Material and method: Municipal employees (n=217) filled in a questionnaire before and after they visited an interactive showroom of WT - an occupational therapist-led group intervention

    Findings: The number of participants confirming WT’s potential to contribute to municipal operation areas increased in seven out of eight areas after their visits (p<0.05). A statistically significant increase was also found regarding knowledge of and confidence in WT, and its potential value. Fifty-six percent indicated they had no plan for a follow-up after their visit.

    Conclusion: A visit to the interactive showroom increased the perceived knowledge and appreciated value of WT. The perception of the possibility of implementing WT in various municipal operation areas also increased, which may contribute to the pursuit of occupational justice.

  • 12.
    Gustafsson, Susanne
    University of Gothenburg, Gothenburg, Sweden.
    Health-Promoting Interventions for Persons Aged 80 and Older are Successful in the Short Term – Results from the Randomized and Three-Armed Elderly Persons in the Risk Zone Study2012Conference paper (Refereed)
  • 13.
    Gustafsson, Susanne
    Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, Centre for Ageing and Health (Agecap), Gothenburg University, Sweden.
    Life filming – en ny metod för att delaktiggöra äldre personer i utformningen av en åldersvänlig stadsmiljö2019Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Möjligheten att påverka utformningen av sin lokala miljö är särskilt viktig för äldre personer eftersom åldersrelaterade problem, i kombination med en mindre stödjande miljö, kan förhindra utförandet av meningsfulla aktiviteter. Det är oklart hur man bäst går tillväga för att delaktiggöra äldre personer i utformningen av deras lokala miljö. Digitala verktyg kan vara en möjlig metod att främja delaktighet. Life filming genom att använda surfplatta användes som metod i ett WHO-projekt där målet var att förbättra åldersvänligheten i stadsmiljön. Syfte: Att beskriva Life filming som metod för att delaktiggöra äldre personer i utformningen av deras lokala miljö. Material och metod: En beskrivande fallstudie. Data samlades in genom observationer, samtal och nedskrivna erfarenheter samt sammanställdes genom tematisk analys. Deltagarna i WHO-projektet har validerat resultaten. Resultat: Analysen resulterade i fem teman vilka beskriver centrala aspekter av Life filmning i det givna sammanhanget: Förankring av begreppet delaktighet, Praktisk tillämpning av Life filming, Filmen som produkt, Att göra verklig skillnad och En identitet som kapabel äldre person. Slutsats: Life filming gynnade delaktighet i WHO-projektet, både som en process och ett resultat. Metoden hade fördelar på flera nivåer: för personen själv, för äldre personer som grupp och för kommunen/samhället. Life filming kan utgöra ett användbart digitalt verktyg i praktiken när delaktighet för äldre personer i utformningen av deras lokala miljö eftersträvas.

  • 14.
    Gustafsson, Susanne
    University of Gothenburg, Gothenburg, Sweden.
    Äldre personer i riskzon – Hälsofrämjande åtgärder för hemmaboende äldre personer är verksamma2013Conference paper (Other academic)
  • 15.
    Gustafsson, Susanne
    et al.
    Frail Elderly Research Support Group (FRESH), Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Sweden; Gothenburg University Centre for Ageing and Health (AgeCap), Sweden.
    Berglund, H.
    Faronbi, J.
    Barenfeld, E.
    Hammar, I.
    Minor positive effects of health-promoting senior meetings for older community-dwelling persons on loneliness, social network, and social support2017In: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 12, p. 1867-1877Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate the 1-year effect of the health-promoting intervention “senior meetings” for older community-dwelling persons regarding loneliness, social network, and social support. Methods: Secondary analysis of data was carried out from two randomized controlled studies: Elderly Persons in the Risk Zone and Promoting Aging Migrants’ Capabilities. Data from 416 participants who attended the senior meetings and the control group at baseline and the 1-year follow-up in the respective studies were included. Data were aggregated and analyzed with chi-square test and odds ratio (OR) to determine the intervention effect. Results: The senior meetings had a positive effect on social support regarding someone to turn to when in need of advice and backing (OR 1.72, p=0.01). No positive intervention effect could be identified for loneliness, social network, or other aspects of social support. Conclusion: Health-promoting senior meetings for older community-dwelling persons have a minor positive effect on social support. The senior meetings might benefit from a revision to reinforce content focused on loneliness, social network, and social support. However, the modest effect could also depend on the lack of accessible social resources to meet participants’ identified needs, a possible hindrance for a person’s capability. This makes it necessary to conduct further research to evaluate the effect of the senior meetings and other health-promoting initiatives on social aspects of older community-dwelling people’s lives, since these aspects are of high importance for life satisfaction and well-being in old age.

  • 16.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Edberg, Anna-Karin
    Kristianstad University, Kristianstad, Sweden.
    Dahlin-Ivanoff, Synneve
    Gothenburg and Lund University, Sweden.
    Swedish health care professionals' view of frailty in older persons2012In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 31, no 5, p. 622-640Article in journal (Refereed)
    Abstract [en]

    There is a paucity of research literature concerning frailty in older persons from the health care professionals' perspective. Consequently, the purpose of this study was to elucidate health care professionals' view of frailty in older persons. An explorative, qualitative design was selected and four focus groups comprising 21 health care professionals were conducted, audiotaped, transcribed verbatim, and analyzed. Frailty was found to consist of seven dimensions: "being bodily weak and ill," "being negatively influenced by personal qualities," "lacking balance in everyday activities," "being dependent in everyday life," "not being considered important," "being hindered by the physical milieu and defective community service," and "having an inadequate social network." The results showed that health care professionals' view of frailty in older persons differed from the current state of knowledge on frailty. This implies that the seven dimensions found to constitute frailty could contribute to a more comprehensive understanding of the concept.

  • 17.
    Gustafsson, Susanne
    et al.
    Institute of Neuroscience and Physiology/Occupational Therapy, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Edberg, Anna-Karin
    The Vårdal Institute, The Swedish Institute for Health Science, University of Gothenburg, Gothenburg, Sweden; Department of Health Sciences, Lund University, Lund, Sweden.
    Johansson, Boo
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Dahlin-Ivanoff, Synneve
    Institute of Neuroscience and Physiology/Occupational Therapy, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; The Vårdal Institute, The Swedish Institute for Health Science, University of Gothenburg, Gothenburg, Sweden.
    Multi-component health promotion and disease prevention for community-dwelling frail elderly persons: A systematic review2009In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 6, no 4, p. 315-329Article in journal (Refereed)
    Abstract [en]

    The objective was to investigate definitions of frailty used in studies of multi-component health promotion and disease-preventive (HPDP) intervention programmes for community-dwelling frail elderly persons and to review the content, organisation and effects of HPDP interventions. A systematic review of 19 articles was made, and the International Classification of Functioning, Disability and Health (ICF) was used as a structural framework for the analysis. The result shows that a consensus was reached on including various aspects of impairments in body functions and structures as an integral part of the frailty concept, with the exception of one subgroup: mental/cognitive functions. Additionally, opinions varied quite consistently regarding aspects of activity limitations and participation restrictions, personal and environmental factors. Ten of the 14 HPDP programmes covered various intervention elements referring to all four ICF components. Eleven programmes involved registered personnel only, while a more divergent pattern was seen in the remaining organisational aspects of the interventions: length of interventions and location plus age segments, participatory approach and contextual information, as well as the theoretical foundation of the interventions. Measures of body functions and structures were significantly improved in 5 out of 17 (29%) targeted aspects. For activity and participation, 12 out of 32 (38%) targeted aspects were positively changed, while the score for environmental factors was 7 out of 22 (32%), and for personal factors 8 out of 22 (36%). Our review suggests that further research is needed to explore and disentangle the complex interrelationships between various interventions and outcomes. 

  • 18.
    Gustafsson, Susanne
    et al.
    Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology/Occupational Therapy, University of Gothenburg, Göteborg, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Gothenburg/Lund, Sweden; Södra Älvsborgs Sjukhus, Borås, Sweden.
    Eklund, K.
    Wilhelmson, K.
    Edberg, A. -K
    Johansson, B.
    Kronlöf, G. H.
    Gosman-Hedström, G.
    Dahlin-Ivanoff, S.
    Long-term outcome for ADL following the health-promoting RCT-Elderly persons in the risk zone2013In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 53, no 4, p. 654-663Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine independence in activities of daily living (ADL) at the 1- and 2-year followups of the health-promoting study Elderly Persons in the Risk Zone. Design and Method: A randomized, three-armed, single-blind, and controlled study. A representative sample of 459 independent and community-dwelling older adults, 80 years and older, were included. A preventive home visit was compared with four weekly multiprofessional senior group meetings including a follow-up home visit. Results: Analysis showed a significant difference in favor of the senior meetings in postponing dependence in ADL at the 1-year follow-up (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.19-3.10) and also in reducing dependence in three (OR = 0.52, 95% CI = 0.31-0.86) and four or more ADL (OR = 0.40, 95% CI = 0.22-0.72) at the 2-year follow-up. A preventive home visit reduced dependence in two (OR = 0.40, 95% CI = 0.24-0.68) and three or more ADL (OR = 0.37, 95% CI = 0.17-0.80) after 1 year. Implications: A long-term evaluation of Elderly Persons in the Risk Zone showed that both senior meetings and a preventive home visit reduced the extent of dependence in ADL after 1 year. The senior meetings were superior to a preventive home visit since additional significant effects were seen after 2 years. To further enhance the long-term effects of the senior meetings and support the process of self-change in health behavior, it is suggested that booster sessions might be a good way of reinforcing the intervention.

  • 19.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Eklund, Kajsa
    Wilhelmson, Katarina
    Johansson, Boo
    Häggblom Kronlöf, Greta
    Gosman-Hedström, Gunilla
    Dahlin-Ivanoff, Synneve
    Long-Term Outcome for ADL Following the Health-Promoting RCT—Elderly Persons in the Risk Zone2014Conference paper (Refereed)
  • 20.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Eklund, Kajsa
    Wilhelmson, Katarina
    Johansson, Boo
    Häggblom Kronlöf, Greta
    Gosman-Hedström, Gunilla
    Dahlin-Ivanoff, Synneve
    Long-Term Outcome for ADL Following the Health-Promoting RCT—Elderly Persons in the Risk Zone2014Conference paper (Refereed)
  • 21.
    Gustafsson, Susanne
    et al.
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    Falk, C.
    Tillman, S.
    Holtz, L.
    Lindahl, L.
    Life filming as a means of participatory approach together with older community-dwelling persons regarding their local environment2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 5, p. 347-357Article in journal (Refereed)
    Abstract [en]

    Background: The potential to influence the design of one’s local environment is especially important to older people since age-related problems, in combination with a less supportive environment, can prevent the performance of meaningful activities. It is unclear how best to tailor a participatory approach to support the task of collaborating with older persons about their local environment. Life filming was used in such a project. Objective: To describe Life filming as a means of participatory approach in relation to older community-dwelling persons and the design of their local environment. Material and method: A descriptive single case study. Data were generated through field notes and memos, and analyzed utilizing thematic analysis. Participants have validated the findings. Findings: Five themes describe central aspects of Life filming in the given context: Anchoring the concept of participation, Practical application of Life filming, The film as a product, Making a real difference, and An identity as a capable older person. Conclusion: Life filming supported participation, both as a process and an outcome. It had benefits on multiple levels: for the individual person, for older persons as a group, and for the municipality. Life filming could constitute a useful digital tool for practice when a participatory approach is desired. 

  • 22.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Hörder, H.
    The ICECAP-O measure2022In: A Multidisciplinary Approach to Capability in Age and Ageing / [ed] H. Falk Erhag, U. Lagerlöf Nilsson, T. Rydberg Sterner & I. Skoog, Cham: Springer, 2022Chapter in book (Refereed)
    Abstract [en]

    This chapter presents the ICECAP-O, a measure of capability tailored for older people. It briefly presents the original version of the ICECAP-O. In addition, it describes the work that has been done concerning the translation and cross-cultural adaptation of the ICECAP-O to the Swedish context. Finally, the chapter contains arguments for the use of the Swedish version of the ICECAP-O in health and social care, and in the evaluation of interventions and longitudinal research studies where older people’s capabilities are a focus.

  • 23.
    Gustafsson, Susanne
    et al.
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy; Centre for Ageing and Health (AgeCap), Sweden.
    Hörder, Helena M
    Ottenvall Hammar, Isabelle
    Skoog, Ingmar
    Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons2018In: Health Psychology Research, E-ISSN 2420-8124, Vol. 6, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICECAP- O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons.

  • 24.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Hörder, Helena M.
    Rydberg, Therese
    Ottenvall Hammar, Isabelle
    Skoog, Ingmar
    Waern, Margda
    A Cross-Cultural Adaptation of the ICECAP-O: Reliability and Validity in Swedish 70-Year-Old Persons2017Conference paper (Refereed)
  • 25.
    Gustafsson, Susanne
    et al.
    Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Section for Health and Rehabilitation, Gothenburg, Sweden; University of Gothenburg Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    Lood, Q.
    Wilhelmson, K.
    Häggblom-Kronlöf, G.
    Landahl, S.
    Dahlin-Ivanoff, S.
    A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: Promoting aging migrants' capabilities implementation and RCT study protocol2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 10Article in journal (Refereed)
    Abstract [en]

    Background: There are inequities in health status associated with ethnicity, which may limit older foreign-born persons' ability to age optimally. Health promotion for older persons who have experienced migration is thus an area of public health importance. However, since research related to this issue is very limited, the study 'Promoting Aging Migrants' Capabilities' was initiated to improve our understanding. The study aims to implement and evaluate a linguistically adapted, evidence-based, health-promoting intervention with a person-centred approach for two of the largest groups of aging persons who have migrated to Sweden: persons from Finland and persons from the Balkan Peninsula. Methods/Design: This study has a descriptive, analytical, and experimental design. It is both a randomised controlled trial and an implementation study, containing the collection and analysis of both qualitative and quantitative data. The setting is an urban district in a medium-sized Swedish city with a high proportion of persons who were born abroad and whose socio-economic status is low. The intervention comprises four group meetings ('senior meetings') and one follow-up home visit made by a multi-professional team. For the randomised controlled trial, the plan is to recruit at least 130 community-dwelling persons 70 years or older from the target group. Additional persons from involved organisations will participate in the study of the implementation. Both the intervention effects in the target group (outcome) and the results of the implementation process (output) will be evaluated. Discussion: The results of this forthcoming randomised controlled trial and implementation study may be useful for optimising implementation of person-centred, health-promoting initiatives for older persons who have experienced migration. It is also hoped that this combined study will show that the capabilities for optimal aging among older persons born in Finland and the Balkan countries can be improved in the Swedish healthcare context. Trial registration: The trial was registered at ClinicalTrials.gov April 10, 2013, identifier: NCT01841853. 

  • 26.
    Gustafsson, Susanne
    et al.
    Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation Centre for Ageing and Health (Agecap), Gothenburg University, Sweden.
    Rydberg, Therese
    Research within Global Health at the University of Gothenburg2014Conference paper (Other academic)
  • 27.
    Gustafsson, Susanne
    et al.
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    Sandsjö, L.
    Evaluation of an interactive showroom to increase general knowledge about welfare technology and its potential in municipal care settings2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 8, p. 591-600Article in journal (Refereed)
    Abstract [en]

    Background: Welfare Technology (WT) can promote participation in activity. Thus, initiatives to support the implementation of WT products and services in municipality care settings needs to be developed and evaluated to benefit end-users. Objective: To evaluate an interactive showroom of WT. Material and method: Municipal employees (n = 217) filled in a questionnaire before and after they visited an interactive showroom of WT. Findings: The number of participants confirming WT’s potential to contribute to municipal operation areas increased in seven out of eight areas after their visits (p < 0.05). A statistically significant increase was also found regarding general knowledge of and confidence in WT and its potential value. Conclusion: A visit to the interactive showroom increased the perceived general knowledge and appreciated value of WT. The perception of the possibility of implementing WT in various municipal operation areas also increased, which may contribute to the implementation of WT in municipal care settings.

  • 28.
    Gustafsson, Susanne
    et al.
    Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation Centre for Ageing and Health (Agecap), Gothenburg University, Sweden.
    Sandsjö, Leif
    Implementing Welfare Technology in the municipality - Evaluation of an interactive showroom2019Conference paper (Refereed)
  • 29.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Sjöström, Manuela
    Livslots Angered – Implementering av en evidensbaserad personcentrerad hälsofrämjande intervention för äldre personer födda utomlands2014Conference paper (Refereed)
  • 30.
    Gustafsson, Susanne
    et al.
    Centre for Ageing and Health (Agecap), Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, Gothenburg University, Sweden.
    Sjöström, Manuela
    Berglund, Helene
    Tailored implementation of evidence-based practice in the community care for the aged - initial experiences in a collaborative project in the city of Gothenburg, Sweden2015Conference paper (Refereed)
    Abstract [en]

    Background: Evidence-based practice (EBP) appears promising in order to strengthen both interprofessional team work and the client´s involvement in his/her care processes. It is therefore of interest to implement EBP in the community care for the aged. But implementation is not always a simple and straightforward process; it may face resistance or difficulties. Factors such as usability, adaptations, barriers, fidelity, and anticipated impact need to be studied when implementing EBP in a new context. Aim: To evaluate the implementation of EBP in community health and social care for the aged in a Swedish setting. This includes the study of the implementation process as well as the impact of EBP on interprofessional teamwork and the care receivers' experiences of care quality. Methods: An explanatory case study in two urban districts in the city of Gothenburg, Sweden, where the implementation of EBP is delivered as a collaborative project with a tailored multifaceted implementation strategy. Data will be collected through documentary information, observations, focus groups, interviews, and a survey, and analyzed using both qualitative and quantitative methods. Results: The collaborative project is on-going with three facilitators using a multifaceted implementation strategy including cooperation between researchers and users, education/learning, and facilitation. Data collection has commenced. Initial experiences reveal that the introductory phase, containing time for persons involved in the collaborative project to get to know each other, each other's areas of expertise and respective organizations, took longer than expected. Also, different care-professions have experienced thus far conducted educational activities in different ways, and some express limited ability to prioritize project activities. Conclusion: The future results of this explanatory case study may be useful for gaining knowledge of and understanding the implementation of EBP in community care for the aged, and to improve the quality of care, support and rehabilitation of older persons.

  • 31.
    Gustafsson, Susanne
    et al.
    Department of Occupational Therapy, Rehabilitation Clinic, Borås Hospital.
    Sunnerhagen, Katharina S.
    Faculty of Neuroscience-Rehabilitation Medicine, Sahlgrenska Academy at Göteborg University.
    Dahlin-Ivanoff, Synneve
    Institute of Occupational Therapy and Physiotherapy, Sahlgrenska Academy at Göteborg University; Vårdal Institute, The Swedish Institute for Health Science, Göteborg University.
    Occupational therapists' and patients' perceptions of ABILHAND, a new assessment tool for measuring manual ability2004In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, no 3, p. 107-117Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe how occupational therapists (OTs) and patients perceived ABILHAND, a new assessment tool for measuring manual ability, in order to evaluate it in terms of content validity and clinical utility in stroke rehabilitation in Sweden. Three main steps were followed to achieve the study goal. First, ABILHAND was translated, and second OTs used ABILHAND with patients admitted for occupational therapy intervention. Finally, in the third step, which aimed to evaluate the content validity and clinical utility of ABILHAND, focus-group interviews were used as a qualitative method of research. The results indicate that ABILHAND might benefit from adjustments to improve content validity. The results also show that standardization for clinical administration is necessary, the production of a manual is essential and the development of a user-friendly computer program for processing data is desirable. An additional finding in this study is an insight into the clinical reasoning of the OTs, which resulted in two conclusions. First, OTs need to discuss and learn more about central concepts in occupational therapy, and second they need to learn more about standardized assessment and how tests are developed and used.

  • 32.
    Gustafsson, Susanne
    et al.
    Vårdalinstitutet, Swedish Institute for Health Sciences, Sweden; Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden; Hospital of Södra Älvsborg, Borås, Sweden.
    Wilhelmson, K.
    Eklund, K.
    Gosman-Hedström, G.
    Zidén, L.
    Kronlöf, G. H.
    Højgaard, B.
    Slinde, F.
    Rothenberg, E.
    Landahl, S.
    Dahlin-Ivanoff, S.
    Health-promoting interventions for persons aged 80 and older are successful in the short term-results from the randomized and three-armed elderly persons in the risk zone study2012In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 60, no 3, p. 447-454Article in journal (Refereed)
    Abstract [en]

    Objectives

    To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up.

    Design

    Randomized, three-armed, single-blind, controlled trial performed between November 2007 and May 2011.

    Setting

    Two urban districts of Gothenburg, Sweden.

    Participants

    Four hundred fifty-nine community-living adults aged 80 and older not dependent on the municipal home help service.

    Intervention

    A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit.

    Measurements

    Change in frailty, self-rated health, and ADLs between baseline and 3-month follow-up.

    Results

    Both interventions delayed deterioration of self-rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12-3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated.

    Conclusion

    Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.

  • 33.
    Gustafsson, Susanne
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Wilhelmson, Katarina
    Eklund, Kajsa
    Gosman-Hedström, Gunilla
    Zidén, Lena
    Häggblom Kronlöf, Greta
    Rothenberg, Elisabeth
    Landahl, Sten
    Dahlin-Ivanoff, Synneve
    ”Elderly persons in the Risk Zone” – Health promoting interventions for older adults are successful in the short term2012Conference paper (Refereed)
  • 34.
    Gustafsson, Susanne
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Wilhelmson, Katarina
    Gosman-Hedström, Gunilla
    Zidén, Lena
    Häggblom Kronlöf, Greta
    Slinde, Frode
    Rothenberg, Elisabeth
    Landahl, Sten
    Dahlin-Ivanoff, Synneve
    Health-Promoting Interventions for Persons Aged 80 and Older are Successful in the Short Term – Results from the Randomized and Three-Armed Elderly Persons in the Risk Zone Study2014Conference paper (Refereed)
  • 35. Hammar, Isabelle Ottenvall
    et al.
    Berglund, Helene
    Dahlin-Ivanoff, Synneve
    Faronbi, Joel
    Gustafsson, Susanne
    The Frail Elderly Research Support Group, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; The Gothenburg University Centre for Ageing and Health, Gothenburg, Sweden.
    Risk for depression affects older people's possibilities to exercise self-determination in using time, social relationships and living life as one wants: A cross-sectional study with frail older people2018In: Health Psychology Research, ISSN 2420-8124, Vol. 6, no 1, article id 7577Article in journal (Refereed)
    Abstract [en]

    Exercising self-determination in daily life is highly valued by older people. However, being in the hands of other people may challenge the older people's possibilities to exercise self-determination in their daily life. Among frail older people living in Sweden, risk for depression is highly predominant. There is a knowledge gap regarding if, and how having a risk of depression affects older people's self-determination. The objective was, therefore, to explore if, and in that case how, frail older people's self-determination is affected by the risk of depression. In this cross-sectional, secondary data analysis, with 161 communitydwelling frail older people, simple logistic regression models were performed to explore the association between self-determination, the risk of depression and demographic variables. The findings showed that risk for depression and reduced self-determination were significantly associated in the dimensions: use of time (P=0.020), social relationship (P=0.003), help and support others (P=0.033), and the overall self-determination item (P=0.000). Risk for depression significantly affected self-determination in use of time (OR=3.04, P=0.014), social relationship (OR=2.53, P=0.011), and overall self-determination (OR=6.17, P=0.000). This point out an increased need of strengthening healthcare professionals' perspectives, and attitudes towards a self-determined, friendly, and person-centred dialogue.

  • 36. Hörder, Helena
    et al.
    Gustafsson, Susanne
    Division of Occupational and Physical Therapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health—Agecap, University of Gothenburg, Gothenburg, Sweden.
    Rydberg, Therese
    Skoog, Ingmar
    Waern, Margda
    A Cross-Cultural Adaptation of the ICECAP-O: Test–Retest Reliability and Item Relevance in Swedish 70-Year-Olds2016In: Societies, E-ISSN 2075-4698, Vol. 6, no 4, article id 30Article in journal (Refereed)
    Abstract [en]

    Background: While there is a plethora of Quality of Life (QoL) measures, the Investigating Choice Experiments for the Preferences of Older People—CAPability index (ICECAP-O) is one of the few that taps into the concept of capability, i.e., opportunities to 'do' and 'be' the things that one deems important in life. We aimed to examine test–retest reliability of the ICECAP-O in a Swedish context and to study item relevance.

    Methods: Thirty-nine 70-year-olds who took part in a population-based health study completed the Swedish version of the ICECAP-O on two occasions. We analyzed the test–retest reliability for the index and for the individual items. Participants also rated the relevance of each item on a visual analogue scale (0–100).

    Results: Test–retest reliability for the index score was in good agreement with an ICC of 0.80 (95% CI 0.62–0.90). However, Kappa was low for each item and ranged from 0.18 (control) to 0.41 (role). For attachment, we found a systematic disagreement with lower ratings at the second test occasion. Participants gave their highest relevance rating to attachment and lowest to enjoyment.

    Conclusion: The Swedish version of the ICECAP-O had good test–retest agreement, similar to that observed for the English version. Item level agreement was problematic, however, highlighting a need for future research.

  • 37. Johannesson, J.
    et al.
    Rothenberg, E.
    Gustafsson, Susanne
    Sahlgrenska Academy at University of Gothenburg, Department of Internal Medicine and Clinical Nutrition, Sweden; Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), Department of Health Sciences, Lund University, Sweden; University of Gothenburg, Centre for Ageing and Health (AgeCap), Sweden.
    Slinde, F.
    Meal frequency and vegetable intake does not predict the development of frailty in older adults2019In: Nutrition and Health, ISSN 0260-1060, Vol. 25, no 1, p. 21-28Article in journal (Refereed)
    Abstract [en]

    Background: Frailty is considered highly prevalent among the aging population. Fruit and vegetable intake is associated with positive health outcomes across the life-span; however, the relationship with health benefits among older adults has received little attention. Aim: The aim was to examine if a relationship exists between meal frequency or frequency of vegetable intake and the development of frailty in a population of older adults. Methods: A total of 371 individuals, 80 years or older, from the study ‘Elderly Persons in the Risk Zone’ were included. Data was collected in the participants’ home by face-to-face interviews up to 24 months after the intervention. Baseline data were calculated using Chi2-test; statistical significance was accepted at the 5% level. Binary logistic regression was used for the relationship between meal frequency or vegetable intake and frailty. Results: Mean meal frequency was 4.2 ± 0.9 meals per day; women seem to have a somewhat higher meal frequency than men (p=0.02); 57% of the participants had vegetables with at least one meal per day. No significant relationship was found between meal frequency or vegetable intake and frailty at 12 or 24 months follow-ups. Conclusions: Among this group of older adults (80+), meal frequency was slightly higher among women than men, and just over half of the participants had vegetables with at least one meal a day. The risk of developing frailty was not associated with meal frequency or vegetable intake. The questions in this study were meant as indicators for healthy food habits. 

  • 38.
    Johannesson, Julie
    et al.
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Health Sciences, Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), Lund University, Lund, Sweden; Centre for Ageing and Health (AgeCap), University of Gothenburg, Mölndal, Sweden.
    Gustafsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Centre for Ageing and Health (AgeCap), University of Gothenburg, Mölndal, Sweden.
    Slinde, Frode
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Food and Nutrition and Sports Science, University of Gothenburg, Gothenburg, Sweden.
    Rothenberg, Elisabet
    Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.
    Exploring meal frequency and vegetable intake among immigrants 70 years or older in Sweden: Secondary analysis of data from the Promoting Aging Migrants Capabilities study2021In: Journal of Ethnic Foods, ISSN 2352-6181, E-ISSN 2352-619X, Vol. 8, no 1, article id 39Article in journal (Refereed)
    Abstract [en]

    Background

    Earlier research regarding immigrants has shown that lifestyle and environmental factors are of importance for the risk of developing certain diseases. Food habits are one of these factors. As there is little research concerning immigrants and food habits, the aim of the present paper was to explore food habits operationalised as meal frequency and vegetable intake among a group of older immigrants in Sweden. Specifically, the following questions were explored: changes in food habits when migrating, missing food from the native country, gender differences in food habits and association between food habits and self-rated health and well-being.

    Method

    A total of 131 persons from the health-promoting study “Promoting Aging Migrants’ Capabilities” (PAMC) conducted in Gothenburg, Sweden, 2011–2014, were included in this exploratory secondary analysis of questionnaire data. Participants were 70 years or older, cognitively intact, and living in ordinary housing. They had all migrated to Sweden from Finland or the Western Balkan Region (Bosnia-Herzegovina, Croatia, Montenegro and Serbia). Descriptive statistics as well as binary logistic regression were used to answer the research questions.

    Results

    Forty-eight percent of the participants in PAMC reported that they had changed their food habits when migrating, and 17% considered that they missed certain foods from their native country. Most of the participants migrated to Sweden more than 20 years ago. There was a significant difference in self-rated health in favour of the male participants (p = 0.02), but food habits, operationalised as meal frequency and vegetable intake, were not associated with self-rated health or life satisfaction.

    Conclusion

    Men rated their health as better than women did, but food habits operationalised as meal frequency or vegetable intake, were not associated with self-rated health or life satisfaction. Results from this secondary analysis were affected by methodological shortcomings. Further studies to understand the role of food habits in relation to health in a migration context are desired.

  • 39. Lood, Q.
    et al.
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center of Ageing and Health - Agecap, University of Gothenburg, Gothenburg, Sweden.
    Dahlin Ivanoff, S.
    Bridging barriers to health promotion: A feasibility pilot study of the 'Promoting Aging Migrants' Capabilities study'2015In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 21, no 4, p. 604-613Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives

    Improving the possibilities for ageing persons to take control over their health is an increasingly important public health issue. Health promotion has previously been visualized to succeed with this goal, but research has primarily focused on ageing persons who are native-born, leaving the generalizability to persons who are foreign-born unexplored. Therefore, as part of the development of a larger health promotion initiative for ageing persons who have experienced migration, this study aimed to assess the feasibility of an adapted protocol. The specific feasibility objectives were to assess recruitment procedure, retention rates, study questionnaire administration and variability of collected data.

    Method

    Forty persons who were ≥70 years, and who had migrated from Finland, Bosnia and Herzegovina, Croatia, Montenegro or Serbia to Sweden were randomly allocated to a health promotion programme or a control group. The programme was linguistically adapted with regard to translated information material, bilingual health professionals and evaluators, and a person-centred approach was applied to both programme development and provision. The data analysis was explorative and descriptive.

    Results

    The results visualized structural and linguistic barriers to recruitment and study questionnaire administration, and describe strategies for how to bridge them. Retention rates and data variability were satisfying.

    Conclusions

    Calling for iterative and pragmatic programme design, the findings describe how to move towards a more inclusive health care environment. Person-centred and bilingual approaches with attention to the possibilities for building authentic relationships between participants and providers are emphasized, and a structured methodology for developing study questionnaires is suggested. 

  • 40.
    Mac Innes, Hanna
    et al.
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Dunér, Anna
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Gustafsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lindahl, Lisbet
    Department of Research and Development (FoU i Väst), The Gothenburg Region Association of Local Authorities (GR), Gothenburg, Sweden.
    Older migrants' perceptions of places to meet: Insights for social work practice2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 11, article id e0292730Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore the experiences of older migrants' (70+) access to and participation in different meeting places. Qualitative interviews were conducted with participants originating from Finland and four countries in the Western Balkans: Bosnia- Herzegovina, Croatia, Montenegro, and Serbia. The participants used everyday places in the neighborhood, which were not primarily meant to be meeting places, to create and uphold social contacts. These meeting places contributed to experiences of community and trust. Both everyday meeting places and organized meeting places were used to establish and develop relationships that could result in an exchange of both practical and emotional support. Perceptions of "not belonging", limited proficiency in Swedish, and a strained financial situation created barriers to accessing some meeting places. The results of this study demonstrate the significance of meeting places that are not purposefully aimed at older people in general or older people from a specific country.

  • 41. Zidén, L.
    et al.
    Häggblom-Kronlöf, G.
    Gustafsson, Susanne
    Vårdalinstitutet, Swedish Institute for Health Sciences, University of Gothenburg, Sweden; Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Lundin-Olsson, L.
    Dahlin-Ivanoff, S.
    Physical function and fear of falling 2 years after the health-promoting randomized controlled trial: Elderly persons in the risk zone2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no 3, p. 387-397Article in journal (Refereed)
    Abstract [en]

    Purpose of the study: To investigate the effects of 2 different health-promoting interventions on physical performance, fear of falling, and physical activity at 3-month, 1-year, and 2-year follow-ups of the study Elderly Persons in the Risk Zone. Design and Methods: A randomized, three-armed, single-blind, and controlled study in which 459 independent and community-dwelling people aged 80 years or older were included. A single preventive home visit including health-promoting information and advice and 4 weekly senior group meetings focused on health strategies and peer learning, with a follow-up home visit, were compared with control. Functional balance, walking speed, fear of falling, falls efficacy, and frequency of physical activities were measured 3 months, 1 year, and 2 years after baseline. Results: There were no or limited differences between the groups at the 3-month and 1-year follow-ups. At 2 years, the odds ratio for having a total score of 48 or more on the Berg Balance scale compared with control was 1.80 (confidence interval 1.11-2.90) for a preventive home visit and 1.96 (confidence interval 1.21-3.17) for the senior meetings. A significantly larger proportion of intervention participants than controls maintained walking speed and reported higher falls efficacy. At 1 and 2 years, a significantly higher proportion of intervention participants performed regular physical activities than control. Implications: Both a preventive home visit and senior meetings reduced the deterioration in functional balance, walking speed, and falls efficacy after 2 years. The long-term effects of both interventions indicate a positive impact on postponement of physical frailty among independent older people. 

  • 42. Zingmark, M.
    et al.
    Norström, F.
    Lindholm, L.
    Dahlin-Ivanoff, S.
    Gustafsson, Susanne
    Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
    Modelling long-term cost-effectiveness of health promotion for community-dwelling older people2019In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 16, no 4, p. 395-404Article in journal (Refereed)
    Abstract [en]

    The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For each intervention and a no-intervention control group, we calculated the accumulated quality-adjusted life years (QALYs) and societal costs over 4 years. Sensitivity analyses included higher intervention costs, lower intervention effects and additional intervention costs and effects related to booster sessions. The results of all analyses indicated that health promotion implemented for community-dwelling older people in the format of senior meetings or a preventive home visit was cost-effective. Both interventions lead to QALY gains and reduce societal costs at any follow-up over 4 years, and thus, resources can be used to implement other interventions. The most important factor for the magnitude of QALY gains and cost savings was the intervention effect. Yearly booster sessions implemented for those persons who maintained their level of functioning extended the intervention effects adding additional QALYs and further reducing societal costs. 

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