Abstract
BackgroundSupporting older adults’ health and wellbeing in the community is an important policy goal that can be supported by health promotion. Despite widespread acceptance of the biopsychosocial model of health and its relation to health, many health promotion programs fail to realize this model in program design. Further, there is limited evidence to support program design targeting social determinants of health such as social isolation or connectedness. To fill this gap, we aimed to understand older adult’s experiences participating in cardiovascular health promotion program in a subsidized residential building to capture unintended ‘spin-off’ psychosocial effects.MethodsThis study took a constructivist, ethnographic approach utilizing participant observation and semi-structured interviews with participants of the program to understand participant’s lived experiences of a health promotion program. In total, we conducted eighty hours of field work and fifteen semi-structured interviews with participants of the program. Thematic analysis was used to analyze the data.ResultsFour themes emerged. First, the health promotion program filled a perceived gap caused by a constrained and impersonal health care system. Secondly, the program connected older adults with resources and provided regular and secure access to health information and support. Third, for some residents, the program facilitated social relationships between older adults, leaving participants feeling more socially connected to other residents. Lastly, a paradox of loneliness emerged where older adults talked openly about feelings of loneliness, however not in relation to themselves, but rather regarding their peers.ConclusionsPsychosocial aspects of health, such as loneliness, social connectedness, and social support may be of equal value as the physical health benefits to the older adults who participate in health promotion programs. Incorporating these elements into programming is a complex goal, and the complexity of targeting social determinants of health such as social loneliness or connectedness should not be under-estimated. Given the benefits of targeting social determinants of health, future research should be considered that measure both the objective and subjective aspects of social isolation, loneliness and connectedness in health promotion programming.
Highlights
Supporting older adults’ health and wellbeing in the community is an important policy goal that can be supported by health promotion
The biopsychosocial model of health implies that health promotion programs should target both biomedical and psychosocial factors related to health and wellbeing [12]
Raymond et al, who reviewed interventions targeting the social participation of seniors, suggest that interventions should be located in close proximity to the target population, that interests, culture, and beliefs of older adults be incorporated into the program scheme, and that interventions aim to support the meaningful development of older adults social relationships and roles [8]
Summary
Supporting older adults’ health and wellbeing in the community is an important policy goal that can be supported by health promotion. There is limited evidence to support program design targeting social determinants of health such as social isolation or connectedness. To fill this gap, we aimed to understand older adult’s experiences participating in cardiovascular health promotion program in a subsidized residential building to capture unintended ‘spin-off’ psychosocial effects. The biopsychosocial model of health implies that health promotion programs should target both biomedical and psychosocial factors related to health and wellbeing [12] There is both weak and limited evidence of the efficacy of health promotion programs in targeting specific social problems amongst older adults, such as social isolation, loneliness, and social participation. Raymond et al, who reviewed interventions targeting the social participation of seniors, suggest that interventions should be located in close proximity to the target population, that interests, culture, and beliefs of older adults be incorporated into the program scheme, and that interventions aim to support the meaningful development of older adults social relationships and roles [8]
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