Health Promotion For Older Adults Research Articles

Nursing Students' Views on an e-Learning Activity About Health Promotion for Older Adults: A Cross-Sectional Study.

Nurses are graduating ill-prepared to work with older adults across care contexts. The education nursing students receive about older adults often focuses on managing illnesses rather than promoting health. To expand the education that nursing students receive regarding health promotion and older adults, we examined nursing students' perceptions of an e-learning activity on health promotion with older adults. We used a cross-sectional survey design. We included first-year baccalaureate nursing students (N = 260) at a Canadian university. Students were required to complete the module, but only those who wanted to participate in the study completed the survey (n = 167; response rate = 64.2%). We used a feedback survey to assess students' perceptions of the e-learning activity using four 5-point, Likert-type items. We also asked one open-ended question to solicit participants' feedback and suggestions for improving the e-learning activity. Descriptive statistics (frequency, mean [SD]) were used to summarize participants' perceptions and demographic characteristics. Content analysis was used to explore responses to the open-ended question. Participants reported that the module increased their knowledge about health promotion, as well as their perceptions and confidence in working with older adults. Participants also found the method of instruction interactive and enjoyable. Our e-learning activity on health promotion was perceived by nursing students as helpful in sensitizing them to their role in promoting health among older adults. [Journal of Gerontological Nursing, 50(3), 19-24.].

Interventions based on salutogenesis for older adults: An integrative review.

To synthesize the evidence of interventions based on salutogenesis for older adults. With the increasing tendency of global ageing and the progression of 'healthy ageing', salutogenesis has been adopted as a framework of health promotion for older adults. An integrative review following PRISMA guidelines. Seven databases including PubMed, Cochrane Library, Web of Science, Embase, Scopus, PsycINFO and CINAHL Plus were systematically searched on 29 September 2022 and updated on 18 July 2023. Eighteen eligible studies were included in this review. Salutogenic-based interventions fell into three main categories: dialogue-based, health education courses based, and goal setting and achievement based. The intervention doses: length ranged from 4 weeks to 2 years, with most (n = 12) within 12 weeks; the duration of each session ranged from 30 to 150 min, with the majority (n = 7) within 1 h; the frequency ranged from five times weekly to three times in 10 months, and in six studies was once a week. Intervention providers were mostly multidisciplinary teams, while in four studies were nurses only. Most of the studies reported that salutogenic-based interventions could improve older adults' sense of coherence, quality of life, self-efficacy, self-management, meaning of life and mental health. This review synthesized the interventions based on salutogenesis for older adults, including salutogenesis application, intervention and its doses, intervention settings and providers, and intervention effects. Future research on the effectiveness of the intervention, the optimal dose of the intervention and the underlying mechanisms are still necessary to understand salutogenic-based interventions. Not apply as it's a review paper. Salutogenic-based intervention is effective for older adults in different scenarios to improve their health outcomes. Nurses play a key role in salutogenic-based interventional programs and thus should be essential personnel as the intervention provider.

Intergeracionalidade e promoção da saúde: reflexões e desafios na atenção à pessoa idosa

Abstract Objective To discuss the promotion of health for older adults through intergenerationality, with an emphasis on intergenerational education within Intergenerational Programs, as a proposal for education fostering the protagonism of older adults and successful aging. Method Theoretical essay, reflective in nature with a qualitative approach. Grounded in the examination of documents emphasizing the increase in longevity and the concern for health promotion among older adults in Brazil, the aim is to contemplate intergenerationality in health promotion and the utilization of intergenerational education to foster successful aging through Intergenerational Programs. Results Organized into three topics: Health promotion for older adults: challenges for their protagonism; Understanding aging for intergenerational learning; Intergenerational program: protagonism for the health promotion of older adults. Conclusion Successful experiences in health, specifically within the realms of Primary Health Care, still appear to be limited or insufficiently recognized for the development of transformative education in health promotion for older adults. The challenge lies in fostering scientific research so that professionals, through continuous education, can enhance health education moments through intergenerational education. Thus, the establishment and implementation of Intergenerational Programs may represent this promising possibility.

Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study

ObjectivesThe purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.DesignA cross-sectional study.SettingThe study was conducted at...

The effects of regular physical activity on functional balance skills and life quality in elderly individuals

Objectives: The study aimed to investigate the effects of physical activity level (e.g., walking, simple exercises on sports equipment, and brisk walking) on functional balance and quality of life in elderly individuals. Patients and Methods: The study included 60 individuals (28 males, 32 females) over the age of 65 years who engaged in regular physical activity (Group 1, n=30) and sedentary individuals who did not engage in physical activity (Group 2, n=30) between January 2023 and July 2023. Mini Mental State Test (MMST), Fall Efficacy Scale (FES), Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Standing on One Leg (TAFS), and World Health Organization Quality of Life Scale-Elderly (WHOQOL-OLD) were applied to the individuals. Results: There was no statistically significant relationship between Group 1 and Group 2 when their MMST scores were compared (p=0.125). When the relationship between Group 1 and 2 and their balance status was examined, a significant difference was obtained when the results of FES (p=0.001), BBS (p=0.003), TUGT (p=0.014), and TAFS right/left (p=0.003/.004) were analyzed. When the quality of life of Group 1 and Group 2 was evaluated and the subparameters of the WHOQOL-OLD scale used for this purpose were compared, there was a significant difference in autonomy (p=0.001), past, present, and future activities (p=0.001), social participation (p=0.005), and closeness (p=0.013) scores. Conclusion: Regular physical activity was found to be the primary means of health promotion in older adults and an effective intervention to prevent falls, maintain balance, and improve quality of life.

Apathy as a determinant of health behaviors in older adults: Implications for dementia risk reduction.

Long-term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differentially associated with multiple health behaviors. In 1037 community-dwelling older adults without dementia (aged 70-90, 55% women), regression analyses examined apathy, depression, and fatigue as predictors of health behaviors (physical activity, diet, alcohol, smoking) and a behavioral risk index. Apathy was associated with reduced physical activity and alcohol use, and one or multiple behavioral risk factors. No or inconsistent relations were found between depression or fatigue and health behaviors. Apathy is relevant to multiple health behaviors and should be considered when designing health promotion for older adults, including interventions for dementia risk reduction. Findings highlight the importance of distinguishing apathy from comorbid symptoms. Novel theory-based perspective on behavioural risk factors for dementia.Higher apathy predicted less physical activity and alcohol use, and increased odds of lifestyle risk factors.Depressive symptoms were not associated with any health behavior.Apathy may be a determinant of multiple health behaviors in older adults, distinct from depression and fatigue.Considering apathy in precision prevention of dementia appears warranted.

Older adults' and service providers' experiences of a settings-based health promotion initiative in English football.

The study was undertaken to explore the experiences of older adults and service providers in a settings-based health promotion initiative in a football club. We conducted semi-structured interviews with 10 older adults attending an 'Extra Time Hub' (ETH) and two staff delivering the initiative. Our reflexive thematic analysis generated six themes. Findings revealed the brand of the sports club attracted some to join the ETH, but through partnerships with local agencies, the initiative was also successful in widening participation beyond older adults with an interest in football. Participants perceived that the ETH was beneficial for their mental health, helped them develop social connections, and promoted positive physical activity experiences. Moreover, the variety of pleasures derived from participation were also discussed. Our findings also illustrate the central role of staff in older adults' experiences of this form of health promotion. Overall, this study contributes to understandings of settings-based health promotion activities in sports clubs, and also demonstrates the potential for sports clubs to widen engagement with the local community through health promotion for older adults.

Development of a capacity-building program for older adults on health management and promotion for older adults in urban communities, Bangkok Metropolis

Development of a capacity-building program for older adults in health management and promotion is necessary for readiness for the complete-aged society in Thailand. Little is known about programs that reinforce older adults' capacities in health management and promotion in urban communities. This research and development design aimed to develop and determine the effects of a capacity-building program on health management and promotion for older adults in urban communities. A program was held in two sections totaling 90 hours, including coursework and practical sections. This program covered health education, chronic condition management, and health promotion for older adults. The program was evaluated for appropriateness and feasibility by five experts. Forty-four older adults met the criteria and were selected by simple random sampling from nine communities. Data were collected using questionnaires at baseline, post-intervention, and a 1-month follow-up after the end of the intervention. The instruments used for data collection included a demographic questionnaire, a self-assessment on the capacity of older adults, and a self-assessment competency questionnaire on health management and promotion. Descriptive statistics and paired sample t-test were used for the data analysis. After the intervention, the findings showed that the mean score of the capacity of older adults was significantly higher than before receiving the intervention (38.61 ± 4.03, p <.001). When comparing each dimension, the results found the mean scores for knowledge, attitude, and capacity for health management and promotion of older adults to be 11.77 ± 1.79, p <.001, 4.09 ± .39, p <.001, 3.72 ± .057, p <.001, respectively. The one-month follow-up revealed that most older adults had a moderate (53.3%) and high (46.5%) level of health management and promotion competency. This study indicates that the capacity-building program for older adults is effective and needs to be implemented in urban communities.

Determinants of new participation in sports groups among community-dwelling older adults: Analysis of a prospective cohort from The Otassha Study.

Participation in sports groups has health benefits for older adults, such as preventing functional limitations and social isolation. Encouraging participation in sports groups may be an important means of health promotion in older adults. However, there is insufficient research on the determinants of new participation in sports groups to consider effective interventions to promote participation in these groups. We investigated this using data from a 1-year prospective study. Data were obtained from “The Otassha Study” that assessed a cohort of community-dwelling older adults living in an urban area of Japan. Of 769 older adults who participated in a baseline health survey in 2018, 557 participated in a follow-up survey in 2019. We excluded 184 individuals who already participated in sports groups at baseline and 36 with missing data. Participation in sports groups was defined as that occurring more than once a week. Logistic regression analysis was used to identify the determinants of new participation in sports groups, with sociodemographic factors, lifestyle habits, physical functions, cognitive functions, psychological factors, and social factors as independent variables. Forty-one (12.2%) individuals participated in sports groups at follow-up. In the multiple adjusted logistic regression model, new participation in sports groups was significantly associated with female sex (odds ratio [OR] = 5.57, 95% confidence interval [CI]: 1.61‒19.26), engagement in regular exercise (OR = 2.23, 95%CI: 1.03‒4.84), and having a large social network (OR = 1.12, 95%CI: 1.04‒1.20). Physical functions were not associated with new participation. Determinants of new participation were lifestyle habits and social factors, rather than physical functions. Intervention through social networks may be effective in encouraging new participation in sports groups, which, in turn, may facilitate healthy aging.

Medicare's annual wellness visit: 10 years of opportunities gained and lost.

Medicare annual wellness visits (AWV) were initiated 10 years ago. Though AWVs emphasize on disease prevention and health promotion for older adults was a huge step forward, the current "one size fits all" approach does not adequately meet the wellness needs of a diverse population of older adults. Current AWVs do not sufficiently take into consideration the medical, psychological, functional, racial, cultural and socio-economic diversity of older adults. Updated AWVs should be tailored to meet the needs and priorities of older adults receiving them. Several geriatrics approaches to care, including geriatrics Glidepaths and the 4Ms of an Age-Friendly Health System, could help develop and guide a more patient-specific geriatrics focused approach to AWVs. Medicare's IPPE is an ideal time to advise new Medicare beneficiaries regarding what they should and should not do to maximize their ability to be healthy and functionally independent into their 80s, 90s, and 100s.

Relationship between oral health and social activity among community-dwelling older adults in Korea: Focusing on the mediating effect of depressive symptoms.

This study aimed to examine the relationship between oral health and social activity, and explore the mediating effect of depressive symptoms on the relationship between oral health and social activity among community-dwelling older adults in Korea. A total of 5033 community-dwelling older adults aged ≥65 years were included in the analysis. Data were obtained from the seventh wave (2018) of the Korean Longitudinal Study of Aging. Descriptive statistics, Pearson's correlation analysis and path analysis for mediation analysis were used. Path analysis showed that older adults with better oral health had more social activities (β=0.177, P < 0.001) and fewer depressive symptoms (β=-0.174, P < 0.001). Depressive symptoms had a mediating role partially in the relationship between oral health and social activity (β=0.014, P < 0.001). The results of in-depth exploration using oral health subdomains showed that physical oral function and oral pain or discomfort were directly related to the social activity (β=0.083 and β=0.149, respectively) and indirectly mediated by depressive symptoms (β=0.006 and β=0.004, respectively). However, psychosocial oral function only had an indirect effect on social activity mediated by depressive symptoms (β=0.006, P=0.005). Better oral health had a significant association with higher levels of social activities, which was partially mediated by decreased depressive symptoms. It is necessary to pay more attention to oral health promotion for older adults to decrease depressive symptoms and increase participation in social activities. Geriatr Gerontol Int 2022; 22: 766-772.

Meal Patterns of Older Adults: Results from the OUTDOOR ACTIVE Study.

Eating habits have a substantial effect on health, not only because of consumed foods and nutrients, but also because of the regularity of meals. This study investigates meal patterns in older adults. Data from 1198 adults (52.8% female) aged between 65 and 75 years, who resided in Bremen, Germany, were included in this cross-sectional study. Using a self-administered questionnaire, daily meals were assessed and categorised into three meal pattern types: ‘regular eaters’ (eating at least three meals a day), ‘meal skippers’ (skipping one meal a day), and ‘irregular eaters’ (skipping more than one meal a day). Descriptive analyses were carried out, stratified by sex and meal pattern types. Most women and men were regular eaters (51.5% and 51.7%, respectively), 33.8% of women and 33.3% of men were meal skippers, and 14.7% of women and 15.0% of men were irregular eaters. Differences between meal patterns were seen with regard to socioeconomic status; self-rated health; body-mass index; hypertension; consumption of self-prepared meals; and consumption of whole-grain products, green vegetables, meat, and alcohol. The results provide first insights into possible associations between meal patterns and sociodemographic and health factors, and can benefit disease prevention and health promotion in older adults.

Psycho-Social Factors in Older Adults’ Mental Health: A Narrative Review

Health promotion is a top priority worldwide. This includes mental health in older adults, who are at risk due to the ageing process, associated with deteriorating health status. Notwithstanding the importance of the topic, psycho-social factors are often neglected in the implementation or formulation of advanced age health promotion programs. In this context, it is imperative to reach a better understanding of the main psycho-social aspects involved in mental health promotion in older adults. The main objective of this narrative review was to identify documents that made a core contribution to the understanding of psycho-social factors related to mental health in community-dwelling older adults. To achieve this, a narrative review was carried out that included a total of 40 articles published between 2018 and 2022. This review was performed through an interpretive stance. Ethical approval was not required for this review. Three main categories were derived from thematic analysis: (i) mental health interventions; (ii) mental health and frailty in older adults, and (iii) social support in older adults. To conclude, understanding the main protective psycho-social factors involved in mental health in community-dwelling older adults is of paramount importance. Identifying the implications of the psycho-social factors in this population is vital to elaborate specific interventions, therefore enhancing their mental health.

Circle dance: integrative and complementary practice in the daily health promotion for older adults.

to understand circle dance as an integrative and complementary practice for health promotion in older adults' daily lives. an interpretive, qualitative study, based on Michel Maffesoli's Comprehensive Sociology of Everyday Life. There were 20 participants, 17 older adults and three focalizers in circles held in Basic Health Units in a municipality in southern Brazil. Data were collected through interviews and observation, between September 2016 and March 2017, and analyzed through preliminary analysis, ordering, key links, coding and categorization. three categories emerged that express the daily life of circle dance with older adults: circles that spin; challenges for new circles to spin; entering, being and staying in the circle. circle dance provided older adults with a feeling of belonging to a group, combined with pleasure and well-being, contributing to promotion of older adults' health.

Circle dance: integrative and complementary practice in the daily health promotion for older adults

RESUMO Objetivos: compreender a dança circular como uma prática integrativa e complementar para a promoção da saúde no quotidiano da pessoa idosa. Métodos: estudo interpretativo, qualitativo, fundamentado na Sociologia Compreensiva e do Quotidiano de Michel Maffesoli. Foram 20 participantes, 17 pessoas idosas e três focalizadoras em rodas realizadas em Unidades Básicas de Saúde de um município do Sul do Brasil. Os dados foram coletados por meio de entrevista e observação, entre setembro de 2016 e março de 2017, analisados pelos processos de análise preliminar, ordenação, ligações-chave, codificação e categorização. Resultados: emergiram três categorias, que expressam o quotidiano da dança circular com pessoas idosas: as rodas que giram; desafios para novas rodas girarem; o entrar, o estar e o permanecer na roda. Considerações Finais: a dança circular proporcionou às pessoas idosas a sensação de pertencimento a um grupo, aliada ao prazer e bem-estar, contribuindo para a promoção da saúde desta população.

An Integrative Approach to Promoting Wellness in Older Adults: An Online Undergraduate Course

As gerontology and geriatric programs look to grow their connections with health and allied health areas, examining emerging health care areas is important. Thus, this session will present key concepts and pedagogical strategies from an innovative online undergraduate course, An Integrative Approach to Promoting Wellness in Older Adults, that is taught in the Erickson School at the University of Maryland at Baltimore County. The course brings together a conventional western allopathic approach and a holistic, patient-centered, integrative approach which includes complementary therapies, to promote wellness in older adults. Specifically, the session will present a comparison of the philosophical premises of conventional western and integrative approaches to health promotion. It will present a holistic model of health, an overview of the effectiveness and safety of different complementary therapies, and examples of how an integrative approach with conventional western and complementary therapies can be used in to promote health in older adults with particular chronic conditions. Also, a discussion of the incorporation of diversity content in the course, an integrative approach to health promotion for underserved populations, and specific pedagogical strategies used to facilitate learning in synchronous and asynchronous online learning environments are included. Session presentation techniques include a PowerPoint presentation, demonstration of examples of conventional western and integrative approaches to health promotion in older adults through case studies, and audience participation.

10.P. Workshop: Mental health of older people

Abstract Due to a general health deterioration, decline in functional ability, accumulated stressful events related to loss and bereavement, and unfavorable socio-economic circumstances, older adults are known to be vulnerable to the development of mental health problems, sometimes leading to serious mental disorders. Approximately 20% of adults aged 60 and over, suffer nowadays from a mental or neurological disorder. This problem is possibly even more distinct in the context of the recent Covid-19 pandemic where health protecting measurements like restricting physical and social contact, disproportionally affect the mental health of older people who are already at higher risk of social isolation and loneliness. However, according to the WHO, mental health impairment in older people is still a highly under-identified, and under-estimated public health issue, often surrounded by shame and stigma, which hinders an adequate mental health promoting approach in this population. This workshop wants to contribute to new findings in the role that certain factors can play in protecting and promoting the mental health of older people. Research during circumstances of a crisis, like the Covid-19 pandemic, may reveal new insights in this context, although the long-term effects are not yet clear, and longstanding factors may not be overlooked. Dr Sunwoo Lee (Czech Republic) performed a large survey about mental health of older adults in 27 European countries and will discuss the important role that resilience and optimism can play in promoting mental health in older adults in the midst of a pandemic crisis. Dr. Cynthia Engels (France) investigated changes in daily activities and mental health of older adults during the lockdown period in France. She will report about the most important changes found and what it meant for peoples' wellbeing and social contacts. Prof. Patricia De Vriendt (Belgium) further focused on the daily activities of older men and women during the Covid lockdown in Belgium and discovered a significant gender difference in the extent to which they succeed to engage in meaningful activities during this crisis. She will discuss how crucial this meaning in activities is for older adults to maintain in good mental health. Finally, Prof. Jutta Lindert (Germany and US) will share the rather surprising findings of a large nationwide study in the United States among older adults showing how daily discrimination is related to impaired cognitive functioning in older men and women. She points to the importance of reducing discrimination, especially when the Covid-crisis is behind us, as an important factor in supporting mental health in this older population. Key messages Resilience, optimism and meaningful activities are important factors in mental health promotion for older adults. Discrimination has a negative impact on older adults' cognitive function.

Determinants of Continuance Intention to Use Health Apps among Users over 60: A Test of Social Cognitive Model.

Promoting healthy behavior among seniors is important in reducing the burden of care and healthcare expenses in a rapidly aging society. Health apps can play an important role in health promotion for older adults, but the level of user retention in health apps is low. To increase continued health app use among older adults, this study examined the factors influencing older users’ continuance intentions to use health apps. The research model was developed based on the social cognitive theory of health behavior, which integrates cognitive, environmental, and behavioral perspectives. To test the research model, an anonymous online survey was conducted among respondents aged 60 to 79 years who were using health apps. The measurement items in the questionnaire were developed based on validated scales from the literature. A total of 250 samples were analyzed. The assessment of the measurement model indicates that the reliability and validity of the items are satisfactory. The results of testing the structural model illustrate the determinants of health app continuance intention: health technology self-efficacy, self-evaluative outcome expectations, self-regulation, and privacy risk. The interrelationships among determinants are also investigated. Theoretical and practical implications are suggested to encourage older adults’ continued health app use and promote their health behavior over the long term.

Shifting to Primary Prevention for an Aging Population: A Scoping Review of Health Promotion Initiatives for Community-Dwelling Older Adults in Canada.

Older adults are healthier and living independently within our communities for longer. This demonstrates the need to build capacity in geriatric preventative services, with the potential to utilize health promotion to encourage successful aging. This scoping review examines the availability and potential of health promotion initiatives for community-dwelling older adults in Canada. Two research databases were searched for empirical articles published in Canada, in English, since 2000. A total of 17 articles met our inclusion criteria. The empirical literature demonstrates successful implementation of different primary prevention programs, with various facilitation methods used to address several health issues in late life. Most programs targeted falls prevention, often using education or exercise programming. Participants reported positive results in various biopsychosocial aspects of aging. Reported positive health outcomes and high engagement rates across examined programs may represent the ability for health promotion to successfully address the needs of older adults in the community, as well as meet the existing desire for participation in such initiatives. Further implementation and investment into health promotion for older adults can increase the accessibility of these programs across Canada, address new needs amongst this population, and alleviate the future healthcare burden posed by the growing aging demographic. The need for preventative services in gerontology is universal, thus the success seen in health promotion programs and policy, and the need for expansion, in Canada may also be relevant in countries with similar demographics.

Cost-effectiveness evidence of mental health prevention and promotion interventions: A systematic review of economic evaluations.

BackgroundThe prevention of mental disorders and promotion of mental health and well-being are growing fields. Whether mental health promotion and prevention interventions provide value for money in children, adolescents, adults, and older adults is unclear. The aim of the current study is to update 2 existing reviews of cost-effectiveness studies in this field in order to determine whether such interventions are cost-effective.Methods and findingsElectronic databases (including MEDLINE, PsycINFO, CINAHL, and EconLit through EBSCO and Embase) were searched for published cost-effectiveness studies of prevention of mental disorders and promotion of mental health and well-being from 2008 to 2020. The quality of studies was assessed using the Quality of Health Economic Studies Instrument (QHES). The protocol was registered with PROSPERO (# CRD42019127778). The primary outcomes were incremental cost-effectiveness ratio (ICER) or return on investment (ROI) ratio across all studies.A total of 65 studies met the inclusion criteria of a full economic evaluation, of which, 23 targeted children and adolescents, 35 targeted adults, while the remaining targeted older adults. A large number of studies focused on prevention of depression and/or anxiety disorders, followed by promotion of mental health and well-being and other mental disorders. Although there was high heterogeneity in terms of the design among included economic evaluations, most studies consistently found that interventions for mental health prevention and promotion were cost-effective or cost saving. The review found that targeted prevention was likely to be cost-effective compared to universal prevention. Screening plus psychological interventions (e.g., cognitive behavioural therapy [CBT]) at school were the most cost-effective interventions for prevention of mental disorders in children and adolescents, while parenting interventions and workplace interventions had good evidence in mental health promotion. There is inconclusive evidence for preventive interventions for mental disorders or mental health promotion in older adults. While studies were of general high quality, there was limited evidence available from low- and middle-income countries.The review was limited to studies where mental health was the primary outcome and may have missed general health promoting strategies that could also prevent mental disorder or promote mental health. Some ROI studies might not be included given that these studies are commonly published in grey literature rather than in the academic literature.ConclusionsOur review found a significant growth of economic evaluations in prevention of mental disorders or promotion of mental health and well-being over the last 10 years. Although several interventions for mental health prevention and promotion provide good value for money, the varied quality as well as methodologies used in economic evaluations limit the generalisability of conclusions about cost-effectiveness. However, the finding that the majority of studies especially in children, adolescents, and adults demonstrated good value for money is promising. Research on cost-effectiveness in low-middle income settings is required.Trial registrationPROSPERO registration number: CRD42019127778.