Lebenswerte Lebenswelten
   für ältere Menschen final version 20.05.06

Ein Modellprojekt im Auftrag des Fonds Gesundes Österreich
durchgeführt vom Institut für Sozialmedizin der Medizinischen Universität Graz
im Zeitraum von März 2003 bis März 2006


Promoting Healthy Ageing in Rural and Semi-Urban Communities in Austria


Authors: Karin Reis-Klingspiegl, Petra Plunger, R. Horst Noack, Maria Schmidt-Leitner

Background

“Lebenswerte Lebenswelten für ältere Menschen” is a best-practice model of community-based health promotion for the elderly commissioned by the Austrian Health Promotion Foundation. The three-year-project’s aim is to develop, explore and evaluate innovative approaches or policies for community-development and empowerment of elderly population groups to improve their health-related quality of life. The project started in March 2003 in 13 Styrian communities located in two districts. These districts differ in two criteria: population income and percentage of elderly people.

Strategies

Developing a Salutogenic Culture and Capacity Building

A community sharing a salutogenic culture tends to value health as an important public good and to facilitate active ageing by empowering people to develop health-promoting capacities. Both approaches – developing a salutogenic culture and capacity building for active ageing - are essential strategies of community development at all stages of a health promotion project addressing the elderly population.

Cohort-study

We started in autumn 2003 with a survey (n=1.400) on biopsychosocial determinants of health, lifestyle, health communication and social cohesion in our communities. Moreover we interviewed stakeholders and key persons in the regions to find out health-related needs and demands of our target-group.

Local Project-Teams

After presenting the findings to community-administrations and to the general public we started to form project-teams made up of volunteers. These teams link elderly individuals with people, who either work with elderly persons (e.g. nurses in social services) or have frequent contact with elderly people at their associations and clubs (e.g. at church or at senior clubs). These teams are empowered to take over planning, organizing, realizing and reflecting interventions according to perceived needs of the target group.

Project-Fund

A tool called project-fund supports the forming of project-teams. It is expected to give “cash and coaching”: “Cash” for funding local mini-projects (e.g. initiating a regular get-together; working on everyday life topics, such as work and festivities) and “coaching” to help implement these mini-projects professionally. The project-fund is financed by the Austrian Health Promotion Foundation and the 13 communities, which participate in the best-practice model.

Furthermore, lectures, courses, workshops and walking-tours organized by the local project-teams or the community-administration, addressing health-related needs and demands are offered.

Results

Developing a Salutogenic Culture and Capacity Building

Community interventions focus on three areas of structural and strategic capacity building:

  • Incorporating the concepts of health and health promotion into the community administration (e.g. identifying with and communicating health targets; linking NGOs, associations and clubs in the community; budgeting health-promotion activities)

  • Developing leadership (e.g. competent and active teams accepted by the administration and target groups; social and communication skills; free time to invest)

  • Developing health-supporting community resources (e.g. knowledge, management, finances, competence, time schedules)

Cohort-study

So far, we have completed the baseline-interviews. A thousand persons of the cohort will be interviewed again in autumn 2005. The hypothesis of the coherence of well-being and life-quality on the one hand and population income and percentage of elderly people on the other hand is confirmed. Furthermore, a shortage of medical care (malsupply), in particular for the elderly, was discovered. Therefore, we plan another project linking health promotion and primary care in communities.

Local Project-teams

At the moment in five of our 13 communities project-teams are formed – all very different from each other. The five teams are located either in larger rural communities or in semi-urban areas. It has become evident that the teambuilding-process is easiest in communities between 3.000 and 4.000 inhabitants.

Project Fund

Our project-fund for 2004 and 2005 is endowed with a total amount of € 54.000. So far, we support 16 subprojects in 11 participating communities. Currently € 25.107 have been invested. This amount equals 42% of the total subproject costs. We found that providing partial funding usually guarantees that the rest of the required money can be raised directly in the communities.

Conclusion

Successful health promotion interventions in community settings require sufficient time, substantial efforts and appropriate capabilities to use very limited resources most efficiently. To assess and evaluate changes it is critical to use sensitive and reliable criteria and indicators of success. These tools are not only crucial in guiding the implementation process but may also be helpful at an early stage to decide whether a certain community health project is worth being started and continued, respectively.

We are interested in discussing our findings in capacity-building with other community-interventions.

Contact

Karin Reis-Klingspiegl

Email: reis@utanet.at