Active Approaches
Healthcare Utilisation Among the Elderly in Malaysia: The Mediating Role of Health Literacy
Paper Presentation in a Themed Session Noor'ain Mohamad Yunus
The relationship between the socio-demographic characteristics of the elderly and healthcare utilisation, is well established; however the process underlying this relationship is poorly understood. A cross-sectional study was conducted to examine the mediating effect of health literacy on the relationship between age and healthcare utilisation. Elderly (n=477) were recruited in 14 public hospitals in Malaysia. The findings reveal that the relationship between age and healthcare utilisation was mediated by health literacy. The findings from the present research help to improve the understanding of healthcare utilisation among the elderly people in Malaysia which are beneficial to the policy makers and practitioners.
Exploring the Feasibility of the Adapted Lifestyle-integrated Functional Exercise Programme: A Novel Approach to Fall Prevention Among Older Adults in Thailand
Paper Presentation in a Themed Session Sasiporn Ounjaichon
Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in older Thai adults and identify if modifications are necessary for this population. Qualitative methods were used to conduct focus groups and in-depth interviews with older adults and semi-structured interviews with stakeholders. Thematic analyses using Framework Approach were conducted. Findings of forty community-dwelling older adults and fourteen stakeholders (e.g. healthcare professionals) revealed positive views and identified four themes including: (a) individual factors, (b) perceptions of aLiFE, (c) recommendations for implementing aLiFE in Thailand, and (d) motivation. Older participants expressed interest in performing aLiFE in their daily activities, although some activities may need to be modified to fit the Thai cultural context. Stakeholders were concerned about how to motivate older Thai adults to adhere to aLiFE. Healthcare professionals and family members could play a major role to support older adults in uptake of aLiFE. Benefits (e.g. independence and fall prevention) may motivate older adults to engage in aLiFE. The aLiFE programme should be feasible and acceptable among older Thai adults. The aLiFE programme has been appropriately modified to be ‘Thai LiFE (TLiFE)’. A feasibility randomised controlled trial of the TLiFE programme has been conducted in older Thai adults.
Cohort Differences in the Role of Education, Occupation, and Income as Socioeconomic Determinants of Health
Paper Presentation in a Themed Session Almar Kok, Silvia Klokgieters, Marjolein Broese Van Groenou, Martijn Huisman
The persistence of socioeconomic inequalities in health (SEIH) might be explained by changes in the role of education, occupation, and income. Sociohistorical developments suggest that education’s role as a ‘gatekeeper' for access to higher skilled jobs and better financial rewards has become more important in recent decades. If this is the case, it is expected that the role of education has changed over time. Data from three birth cohorts aged between 55-64 years were collected in 1992, 2002, and 2012 and derived from the Longitudinal Aging Study Amsterdam. Multi-group mediation models with direct and indirect paths between education, occupation, income and physical functioning, physical performance, and depressive symptoms were examined. Absolute health inequalities in physical functioning, physical performance, and depression persisted across cohorts for all three socioeconomic indicators. The direct effect of occupation, but not education, was larger in later birth cohorts, whereas the effect of income was smaller in the later birth cohorts. However, the effect of income was not statistically significant in the youngest birth cohort. Socioeconomic inequalities in physical functioning, physical activity, and depression are indeed persistent over time, and they can partially be explained by the changing role of education. Education becomes more important in determining level of occupation and less important in determining the level of income. Hence the stability of SEIH might be explained by the fact that occupation partially substitutes education’s role in explaining SEIH. This suggests that credential inflation is the mechanism by which changes in SEIH occur.
