Community-based intervention for promoting healthy habits through MAHA mobile application in Basque elderly population.

Abstract

Background: Population over 65 years of age in EU is increasing, rising costs in health and social care systems and making changes in biological, physiological, and psychosocial field. Promoting healthy ageing has become a key to improve the lifelong health and wellbeing of ageing population. Health technologies and eHealth tools can be an effective instrument to address the challenge of ageing. They provide an opportunity to improve the health and well-being of older people, and to prevent, treat and ensure the sustainability of health systems.
 Digital technologies aimed at promoting active ageing enable access to greater knowledge, better communication and a better relationship with people's environment, if they are designed in a person-centred way. They open up a range of new possibilities and resources that represent a way to reduce the generation gap and bring older people closer to the rest of the community.
 Methods: The Basque Country region has implemented a community-based intervention to promote active and healthy ageing through the use of a self-managed mobile MAHA App within Gatekeeper European project (H2020, nº857223). MAHA app developed in a co-creation process involving end-users and professionals from community settings is available in Google Play and App Store for iOS. The tool offers activities and materials to reinforce socialization and, promote healthy, meaningful, creative and fulfilling lives among elderly people.
 This quasi-experimental and longitudinal study is targeted at 10,000 older people and/or their caregivers from the Basque Country (Spain). The community-based intervention in the Basque Country has been designed to involve Primary Health Care services and key agents from different sectors at the community level that can influence the well-being and health of the elderly population. The Support Network created for the intervention has the participation of 39 community organisations and entities belonging to the Basque Health Ecosystem.
 Results: A mixed methods approach to evaluation will be carried out, using quantitative techniques, through validated questionnaires and usage metrics to assess effectiveness; and qualitative techniques, to collect user experience. An analysis of the implementation process has been executed, to identify the determinants, factors, and aspects that impact the intervention, and the commitment, adherence and dropout rate towards user engagement. The intermediate data shows that the actions implemented are effective, as the intervention has been widely disseminated and many people have been contacted. Although more than half have accepted to participate in the intervention, only 3% finally registered in the application. This intervention also shows low adherence to the intervention and a high level of dropout, as it is understood that once the user accepted to participate, they do not follow the study protocol. 
 Discussion and Conclusions: The community-based intervention implemented will contribute to generating awareness and new data on research into the intention-to-treat, adherence and attrition rate of the use of self-managed eHealth applications by the elderly. Likewise, a tool with these characteristics can be considered an effective health asset for improving elderly people's health, making healthy options more accessible and incorporating new habits in this population.