Suchergebnisse

BACKGROUND: Healthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups. METHODS/DESIGN: We designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation. DISCUSSION: This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform governmental authorities, professionals, academics, and NGOs with an estimate of resources necessary to achieve equitable access to physical activity programs for vulnerable older adults. TRIAL REGISTRATION: German Clinical Trials Register DRKS00009564 (Date of registration 03-11-2015)

In Anbetracht des wachsenden finanziellen Drucks auf die sozialen Sicherungssysteme drängt sich immer stärker die Frage auf, ob sich in Zukunft die Errungenschaften der modernen Medizin im Rahmen einer allgemeinen Gesundheitsversorgung bei weitgehend stabilen Beitragssätzen zur gesetzlichen Krankenversicherung (GKV) überhaupt noch finanzieren lassen. Die in den inzwischen zahlreich vorliegenden Untersuchungen formulierten Vorschläge für Maßnahmen zur Weiterentwicklung des Gesundheitssystems zielen überwiegend darauf ab, einerseits die Kosten im Gesundheitssystem zu begrenzen und andererseits die Eigenverantwortung der Patienten und Versicherten im Hinblick auf eine gesundheitsbewusste Lebensführung, individuelle Eigenvorsorge und Kostenbewusstsein zu stärken. Die Auswirkungen derartiger Maßnahmen auf die Versorgungssituation der Bürger werden im Einzelnen in der Regel nicht untersucht bzw. als bekannt angenommen. Insbesondere deren Akzeptabilität für die Patienten und Versicherten und damit auch ihre politische Umsetzbarkeit werden kaum thematisiert.