Raisa Valve, Head of Development, University of Helsinki, Palmenia Centre for Continuing Education Good Aging in Lahti Region (GOAL) Regional research

Raisa Valve, Head of Development,

University of Helsinki,

Palmenia Centre for Continuing Education

Good Aging in Lahti Region (GOAL)Regional research and development project

Lifelong Physical activity, 22.2.2011, RV

GOAL = GOod Ageing in Lahti region (international name)

Ikihyvä Päijät-Häme 2002-2012 (national name)

Collaborators• University of Helsinki, Palmenia and Faculty of Social Sciences• National Institute for Health and Welfare• Joint Authority for Päijät-Häme Social and Health Care and its

15 municipalities• Lahti University of Applied Sciences

Goals

• To empower both professionals and population in health promotion

• To increase welfare, diminish morbidity, and improve quality of life among ageing, and thereby to increase attractiveness of theregion

Figure 2. The occurred and predictable changes in absolute sizes of different age groups in

1900–2050 (in millions)

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[email protected]

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Care and service costs according to age (€ per month)

Health and social expenditures and their predicted change in Finland, 1975–2050

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ilman tuottavuutta

Increasing productivity + postponing of serv.needs

Increasing productivity

Technological innovations are needed in order to improve productivity.

Social innovations are needed in order to postpone the needs for and use of services.

Antti Karisto

Social innovations

All innovations are social in the sense that they come into existence through the interaction between producers and users

Doing new things, doing things in a new way Challenging the customary way of thinking and

acting Also minor novelties may satisfy criteria of

innovativeness. Innovations are not disseminated in an uniform and

mechanistic way.

Antti Karisto

Societies are rapidly

ageing, and there is a

strong need for

new innovative working

practices in health

promotion as well as

for new kinds of

alliances and co-operation

in old age care.

Photo by Iiris Salomaa

Antti Karisto

Goals

To increase welfare, diminish morbidity, and improve quality of life among ageing, and thereby to increase attractiveness of the region The project goals have been defined by the representatives from

the hospital district, the province, municipalities, national and local research and education institutions, non-governmental organizations

Goals

To empower both the professionals and the population in health promotion Main entry point to the municipalities is via the social and health

care sector Professionals are overburdened and need practices that will clarify

responsibilities between different professionals and between patients and professionals

Three parts of GOAL

1) 10-year cohort study (2002-2012) Three birth cohorts will be followed, those born in 1946-50 (the

baby boomers), 1936-40 and 1926-30 needs assessment general program evaluation

2) Community-based interventions evidence-based implementation studies development of policies and practicies

3) Community Diagnoses Combining data from cohort study, statistical reports and policy

documents from each municipality.

F-0 n=2815

GOAL program design

F-1n=2415

F-2n=205

0

F-3

Communitydiagnoses

Interventions

Evaluation

2002N=4274

2005N=3997

20122008N=2817

Communitydiagnoses

Interventions

F = Follow-up

Communitydiagnoses

GOAL model

GOAL groupMunicipal

administration

Community-based interventions

Lifestyle counselingT2DM

Evaluation and cohort study

Promotion offunctional

capability in elderly

Interventions support each other ideologically, structurally and methodologically

Sensitivity to emerging intervention needs

Identification ofthose who may be

at higher risk

Lifestylecounselling

Follow-up,evaluation

Lifestyle counselling process

Where, How, Who

Intention formation ActionPlanning

Intention Planning Initiative Maintenance

Recovery

Perceived self-

efficacy

Outcome expectanci

es

Risk perceptio

n

Dis

en

gag

em

en

t

Action

Barriers and resources

Theory-base I:The Health Action Process Approach

Schwarzer, R., Fuchs, R. (1996). Self-efficacy and health behaviors. In M. Conner & P. Norman (eds.): Predicting health behaviour: Research and practice with social cognition models (pp. 163-196). Buckingham, UK: Open University Press.

Community-based intervention 2009-2012:Intervention on promotion offunctional capability in elderly

LOCAL HEALTH CARE CENTERTHIRD SECTOR ORGANIZATION

KEY WORDS TO CREATE A SYSTEMATIC MODEL CO-OPERATION WITH THE PUBLIC AND THE THIRD SECTORDOING THINGS IN A NEW WAY PREVENTIVE ACTION HOLISTIC HEALTH

Group-based interventions

Contents• Physical exercise progam • Nutrition• Social networks

At an early stage identify those who are in a risk of losing their functional capacity

≥ 70 years of age

Directed to the group-based intervention

Directed to the local health care center (follow-up measurements and marking the results

Research setting

study participant recruitment over 70 years of age, no severe dementia, mental illness, cancer treatment or other ”fatal” disease,

Short functional capacity test (Guralnik,SPPB) (home care personnel)more comprehensive tests (the Berg, TOIMIVA) (physiotherapist)

interview (researcher)

group-based (GB) at the gym

home-based (HB)

GB+ goal setting HB+goal setting informationgroup



follow-up3 mo

9 mo

15 mo

Short functional capacity test (Guralnik,SPPB) (home care personnel)



strenght and balance training

SPPB -test1. balance

• a) semi-tandem

• b) the side-by-side

• c) Tandem

Funding

- Municipalities 2001-2012

2002-2007

2008-2012

•Academy of Finland 2002-2004•The Social Insurance Institution of Finland 2004-•Ministry of Social affairs and Health, National Health Project 2004-2007

To conclude about GOAL

Initial focus was on population level Emphasis shifted towards development of social and health care

services as primary targets Sensitivity to emerging intervention needs Interventions support each other ideologically, structurally and

methodologically Doing new things, doing in a new way

Group-based lifestyle counseling How to measure and promote functional capacity in a systematic way

Several national and international publications GOAL could be seen as a research and developmental resource in

Paijat-Hame

http://www.palmenia.helsinki.fi/ikihyva/

Documents

Raisa Valve, Head of Development, University of Helsinki, Palmenia Centre for Continuing Education Good Aging in Lahti Region (GOAL) Regional research