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Health assets in older age: a systematic review.

ABSTRACT: BACKGROUND:Finding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual's health assets-internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as health assets within personal, social, economic and environmental domains. METHODS:Systematic searches of databases were conducted for literature published in peer-reviewed journals between January 2000 and November 2016. Selection criteria included community dwelling populations aged 65 years and over and publications written in English. Data on study population, design, measures of health status, factors within the four previously stated domains and results were extracted. Study quality was independently assessed using an appraisal instrument. RESULTS:Twenty-three publications, including 78?422 participants, from more than 13 different countries were identified for inclusion in this review. There was strong evidence that higher scores of self-rated health, psychological well-being and life satisfaction were associated with better health in older age. Social network and contact with family and friends, and engagement in leisure and social activities were important support mechanisms. Education and financial resources consistently proved to be key economic health assets for older adults. CONCLUSIONS:Implementing an asset-based approach to health promotion uncovers the skills, knowledge, connections and potential of the individual and the community. This approach is an ideal opportunity for government health bodies and their partners to respond to the challenges faced by global ageing.Factors are often interdependent and cumulative, suggesting the potential for an instrument to measure the accumulated effect of health assets on health status in older adults.

SUBMITTER: Hornby-Turner YC

PROVIDER: S-EPMC5777471 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Health assets in older age: a systematic review.

Hornby-Turner Yvonne Claire YC Peel Nancye May NM Hubbard Ruth Eleanor RE

BMJ open 20170517 5

<h4>Background</h4>Finding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual's health assets-internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as h ...[more]

PMID: 28515182

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Project description:ObjectiveTo provide an up-to-date overview of health assets in a global context both from a theoretical perspective and its practical applications to address health inequalities and achieve sustainable health.DesignA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesA comprehensive search, including 10 electronic bibliographic databases and hand searches, was undertaken to capture the wide range of terms associated with 'health assets' and 'asset-based approaches to health'.Eligibility criteriaAny peer-reviewed published and grey literature in English related to 'health assets' or 'assets' in a 'health' context was included without any date, country or study design restrictions and the quality of evidence was appraised according to the Oxford Level of Evidence.OutcomesA broad consideration of all outcome measures including clinical outcomes, patient-level, community-level and population-level impacts and costs, was adopted.Results478 publications were included. Health assets were researched in 40 countries, predominantly in the West such as the USA and the UK. A number of broad health assets were identified including community and individual assets. Even though research was conducted in a number of different settings, most occurred in the community, clinical, care or educational settings. A wide variety of interventions and approaches were implemented, most commonly related to education and/or training, asset mapping or asset approaches.ConclusionsGlobally, authors most often referred to general 'health assets', 'assets' or some form of 'community asset' in relation to health. Overall, the idea of health assets is framed within a positive paradigm focusing on health creation rather than curative approaches. The sustained credibility of the global 'health assets' literature depends on future research on definitional, theoretical and evaluative issues in order to convince policy-makers and service commissioners of its necessity and added value to the traditional deficit approach.

Project description:Background:The National Action Plan to Improve Health Literacy makes the case that a wide range of organizations and professionals must work together to improve health information and services to achieve a health literate society. The context and framework for this collaboration and action, however, have yet to be well-articulated. We report on our use of a community health needs assessment model to describe county and state health literacy activities, gaps, assets, and opportunities. This approach combines the public health best practice of learning about communities through systematic assessments and the emerging health literacy best practice of studying organizational behaviors. Brief description of activity:A community health literacy assessment was implemented from January 2018 to April 2018. The purpose was to collect information about county and state-level health literacy activities, gaps, assets, and opportunities. We used this information to characterize the status of health literacy in Maryland and establish an initial baseline for county and state strategic planning work and future collaboration. Implementation:An environmental scan of each county in Maryland identified health indicators, community resources, and health organizations or professionals. Organizational representatives participated in interviews about their health literacy work. Interviews were analyzed to identify themes as well as summarize and quantify perspectives by county. We convened a forum, disseminated preliminary findings, and performed member checking to assess agreement with the results. Results:The team interviewed 56 individuals from 49 organizations. Themes of health literacy definitions as well as organizational ranking on the use of health literacy best practices are discussed in this article. Forty public health professionals, including 10 interview participants, attended the forum. Member checking assessed interview participants' agreement with results and interpretations, which were found to be accurate portrayals of their responses. Lessons learned:Lessons learned include being flexible with the interview approach, performing member checking, and allowing participants to self-define health literacy. Our experience shows a small team can perform a large-scale assessment that provides actionable information at state and county-levels. The results can influence future interventions, inform strategic planning and collaboration, and lead us toward a health literate society. [HLRP: Health Literacy Research and Practice. 2019;3(4):e216-e226.]. Plain Language Summary:A systematic community health needs assessment framework was used to collect information about health literacy activities, assets, gaps, and opportunities at the state and county level. Participant feedback showed the team accurately captured the activities, assets, gaps, and opportunities to improve health literacy practices. A needs assessment framework is feasible for describing community health literacy.

Project description:BackgroundInnovation ecosystems are an important driver of regional economic growth and development. STEM assets connected to universities may play an important role in such ecosystems.ObjectiveTo systematically review the literature relating to the effect of university STEM assets on regional economies and innovation ecosystems, providing a better understanding of how the impact is generated and constrained, as well as identifying any gaps in knowledge.MethodsKeyword and text word searches using the Web of Science Core Collection (Clarivate), Econlit (EBSCO) and ERIC (EBSCO) were performed in July 2021 and February 2023. Papers were double screened on abstract and title, and were included if there was consensus that they fulfilled the inclusion criteria of: (i) relating to an OECD country; (ii) having been published between 1 January 2010 and 28 February 2023; and (iii) concerning the impact of STEM assets. Data extraction was undertaken for each article by a single reviewer and checked by a second reviewer. Due to the heterogeneity of the study designs and outcome measures used, it was not possible to perform a quantitative synthesis of results. A narrative synthesis was subsequently undertaken.ResultsOf the 162 articles identified for detailed review, 34 were accepted as being sufficiently relevant to the study to be included for final analysis. Three important features identified were that the literature: i) is predominately concerned with supporting new businesses; ii) describes a high level of involvement with a university in providing that support; and iii studies economic impacts at local, regional and national levels.DiscussionThe evidence points to a gap in the literature relating to looking at the broader impact of STEM assets and any corresponding transformational, system-level effects that go beyond narrowly defined, short to medium-term outcomes. The main limitation of this review is that information on STEM assets in the non-academic literature is not captured.

Project description:OBJECTIVE:Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time. METHOD:A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857). RESULTS:Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism). CONCLUSION:The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

Project description:Background/objectivesThe number of older adults with complex health needs is growing, and this population experiences disproportionate morbidity and mortality. Interventions led by community health workers (CHWs) can improve clinical outcomes in the general adult population with multimorbidity, but few studies have investigated CHW-delivered interventions in older adults.DesignWe systematically reviewed the impact of CHW interventions on health outcomes among older adults with complex health needs. We searched for English-language articles from database inception through April 2020 using seven databases. PROSPERO protocol registration CRD42019118761.SettingAny U.S. or international setting, including clinical and community-based settings.ParticipantsAdults aged 60 years or older with complex health needs, defined in this review as multimorbidity, frailty, disability, or high-utilization.InterventionsInterventions led by a CHW or similar role consistent with the American Public Health Association's definition of CHWs.MeasurementsPre-defined health outcomes (chronic disease measures, general health measures, treatment adherence, quality of life, or functional measures) as well as qualitative findings.ResultsOf 5671 unique records, nine studies met eligibility criteria, including four randomized controlled trials, three quasi-experimental studies, and two qualitative studies. Target population and intervention characteristics were variable, and studies were generally of low-to-moderate methodological quality. Outcomes included mood, functional status and disability, social support, well-being and quality of life, medication knowledge, and certain health conditions (e.g., falls, cognition). Results were mixed with several studies demonstrating significant effects on mood and function, including one high-quality RCT, while others noted no significant intervention effects on outcomes.ConclusionCHW-led interventions may have benefit for older adults with complex health needs, but additional high-quality studies are needed to definitively determine the effectiveness of CHW interventions in this population. Integration of CHWs into geriatric clinical settings may be a strategy to deliver evidence-based interventions and improve clinical outcomes in complex older adults.

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Health assets in older age: a systematic review.

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Health assets in older age: a systematic review.

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