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Good Aging in Lahti Region (GOAL) Regional research and development project

Good Aging in Lahti Region (GOAL) Regional research and development project. Raisa Valve, Head of Development, University of Helsinki, Palmenia Centre for Continuing Education. Lifelong Physical activity, 22.2.2011, RV.

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Good Aging in Lahti Region (GOAL) Regional research and development project

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  1. Good Aging in Lahti Region (GOAL)Regional research and development project Raisa Valve, Head of Development, University of Helsinki, Palmenia Centre for Continuing Education Lifelong Physical activity, 22.2.2011, RV

  2. GOAL = GOod Ageing in Lahti region (international name)Ikihyvä Päijät-Häme 2002-2012 (national name) Collaborators • University of Helsinki, Palmenia and Faculty of Social Sciences • National Institute for Health and Welfare • Joint Authority for Päijät-Häme Social and Health Care and its 15 municipalities • Lahti University of Applied Sciences

  3. Goals • To empower both professionals and population in health promotion • To increase welfare, diminish morbidity, and improve quality of life among ageing, and thereby to increase attractiveness of the region

  4. 0 10 20 30 40 50 60 70 80 90 2800 2800 2600 2600 2400 2400 2200 2200 2000 2000 1800 1800 1600 1600 1400 1400 1200 1200 1000 1000 800 800 600 600 400 400 200 200 0 0 0 10 20 30 40 50 60 70 80 90 AGE Care and servicecostsaccording to age (€ per month)

  5. Health and social expenditures and their predicted change in Finland, 1975–2050 38 36 36 34 ilman tuottavuutta 32 32 30 28 28 Increasing productivity 26 24 24 22 20 20 Increasing productivity + postponing of serv.needs 18 16 16 14 12 12 10 8 8 6 4 4 2 0 0 1975 1985 1995 2005 2015 2025 2035 2045

  6. Technological innovations are needed in order to improve productivity. • Social innovations are needed in order to postpone the needs for and use of services. Antti Karisto

  7. Social innovations • All innovations are social in the sense that they come into existence through the interaction between producers and users • Doing new things, doing things in a new way • Challenging the customary way of thinking and acting • Also minor novelties may satisfy criteria of innovativeness. • Innovations are not disseminated in an uniform and mechanistic way. Antti Karisto

  8. Societies are rapidly ageing, and there is a strong need for new innovative working practices in health promotion as well as for new kinds of alliances and co-operation in old age care. Photo by Iiris Salomaa Antti Karisto

  9. Goals • To increase welfare, diminish morbidity, and improve quality of life among ageing, and thereby to increase attractiveness of the region • The project goals have been defined by the representatives from the hospital district, the province, municipalities, national and local research and education institutions, non-governmental organizations

  10. Goals • To empower both the professionals and the population in health promotion • Main entry point to the municipalities is via the social and health care sector • Professionals are overburdened and need practices that will clarify responsibilities between different professionals and between patients and professionals

  11. Three parts of GOAL • 10-year cohortstudy (2002-2012) • Three birth cohorts will be followed, those born in1946-50 (the baby boomers), 1936-40 and 1926-30 • needsassessment • general programevaluation • Community-basedinterventions • evidence-based • implementationstudies • development of policies and practicies • CommunityDiagnoses • Combining data fromcohortstudy, statisticalreports and policydocumentsfromeachmunicipality.

  12. GOAL program design 2002 N=4274 2005 N=3997 2008 N=2817 2012 F-0 n=2815 F-1 n=2415 F-2 n=2050 F-3 Interventions Community diagnoses Community diagnoses Community diagnoses Interventions Evaluation F = Follow-up

  13. GOAL model GOAL group Municipal administration Sensitivity to emerging intervention needs Community-based interventions Interventions support each other ideologically, structurally and methodologically Lifestyle counseling T2DM Promotion of functional capability in elderly Evaluation and cohort study

  14. Lifestyle counselling process Where, How, Who

  15. Intention formation Planning Action Theory-base I:The Health Action Process Approach Perceived self-efficacy Outcome expectancies Intention Planning Initiative Maintenance Disengagement Recovery Risk perception Action Barriers and resources Schwarzer, R., Fuchs, R. (1996). Self-efficacy and health behaviors. In M. Conner & P. Norman (eds.): Predicting health behaviour: Research and practice with social cognition models (pp. 163-196). Buckingham, UK: Open University Press.

  16. Community-based intervention 2009-2012:Intervention on promotion offunctional capability in elderly LOCAL HEALTH CARE CENTER THIRD SECTOR ORGANIZATION • KEY WORDS • TO CREATE A SYSTEMATIC MODEL • CO-OPERATION WITH THE PUBLIC AND THE THIRD SECTOR • DOING THINGS IN A NEW WAY • PREVENTIVE ACTION • HOLISTIC HEALTH • Group-based interventions • Contents • Physical exercise progam • Nutrition • Social networks At an early stage identify those who are in a risk of losing their functional capacity ≥ 70 years of age Directed to the group-based intervention Directed to the local health care center (follow-up measurements and marking the results

  17. group-based (GB) at the gym home-based (HB) GB+ goal setting HB+goal setting information group Research setting study participant recruitmentover 70 years of age, no severe dementia, mental illness, cancer treatment or other ”fatal” disease, Short functional capacity test (Guralnik,SPPB) (home care personnel) more comprehensive tests (the Berg, TOIMIVA) (physiotherapist) interview (researcher) strenght and balance training Short functional capacity test (Guralnik,SPPB) (home care personnel) more comprehensive tests (the Berg, TOIMIVA) (physiotherapist) interview (researcher) follow-up 3 mo 9 mo 15 mo Short functional capacity test (Guralnik,SPPB) (home care personnel) Short functional capacity test (Guralnik,SPPB) (home care personnel) more comprehensive tests (the Berg, TOIMIVA) (physiotherapist) interview (researcher)

  18. SPPB -test1. balance • a) semi-tandem • b) the side-by-side • c) Tandem

  19. Funding - Municipalities 2001-2012 2002-2007 2008-2012 • Academy of Finland 2002-2004 • The Social Insurance Institution of Finland 2004- • Ministry of Social affairs and Health, National Health Project 2004-2007

  20. Toconclude about GOAL • Initial focus was on population level • Emphasis shifted towards development of social and health care services as primary targets • Sensitivity to emerging intervention needs • Interventions support each other ideologically, structurally and methodologically • Doing new things, doing in a new way • Group-based lifestyle counseling • How to measure and promote functional capacity in a systematic way • Several national and international publications • GOAL could be seen as a research and developmental resource in Paijat-Hame • http://www.palmenia.helsinki.fi/ikihyva/

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