Project Details

Background:

The global population of older adults is increasing (United Nations, 2022). Therefore, health promotion and prevention initiatives aimed at improving the health, quality of life, social participation and independent living of older people are becoming increasingly important (WHO, 2015, 2020). Many older people wish to age in place for as long as possible, even if they require support and care (Stula, 2012). However, access to services is often hindered by reduced mobility, lack of knowledge, and social isolation (Klein et al. 2021). Preventive Home Visit (PHV) is an intervention that aims to prevent care dependency, social isolation, and promote the health of older people in their homes. PHV provides a low-threshold service that includes information, counseling, guidance, and referral to assistance and support services (Renz and Meinck 2018). As part of the Bremen State Program “Lebendige Quartiere”, pilot regions will offer PHV for older people starting in 2023. PHV is an individual counselling service that provides information and referrals to community-based services. The aim is to prevent loneliness and care dependency for as long as possible, enabling older people to remain in their own homes. This pilot project will be scientifically accompanied by this research project.

Aim

The PhD project provides a theory-based formative evaluation of the PHV project in the state of Bremen using a mixed-methods design. The project is part of the research cluster "Healthy City Bremen: Interprofessional, digital, sustainable". The aim is to gain a better understanding of how PHV works and to identify factors that promote or hinder the implementation and effectiveness of PHV.

Methods

To develop a comprehensive theoretical understanding of the mechanisms of PHV and their effects, a programme theory (PT) will be developed. The initial PT will be developed deductively based on a literature-based realist syntheses. For the further development of the PT, an inductive approach will be used (expert interviews). The formative evaluation of the PHV in the state of Bremen will include an analysis of the questionnaire used to document the PHV. Individual interviews are conducted with older people who have received a PHV, as well with relevant stakeholders in the pilot project. Group interviews are also conducted with the visiting staff. A mixed methods approach is used to triangulate both quantitative and qualitative data.

Expected results

The results of the process evaluation should contribute to a better understanding of the effectiveness of the PHV in the state of Bremen. By identifying facilitating and hindering factors, decision-makers can be supported in adapting the intervention.