Evaluation of A Community-based Health Promotion Program for Older Adults — Take Communities in Nantou as An Example

Background: ""Successful Aging"" is currently a goal for aging societies. Taiwan is moving toward an aged society. The risk of disability will increase as the population aging and may result in a heavy financial burden for Taiwanese government, society, and families. A health promotion program implemented by Nantou YMCA (The Young Men''s Christian Association) in Nantou county are based on the experiences of disability prevention programs from Osaka YMCA in Japan, which emphasized on developing the concept of fun, safe and effective disability prevention programs. The program emphasizes on both physical and mental health for the elderly with the goal of enabling them to live independently, and hopefully to build a successful aging society. Objectives: The objective of the study was to investigate the effect of a community-based 10-week health promotion and disability prevention courses provided by Nantou YMCA regarding change of fitness, exercise self-efficacy expectation, exercise outcome expectation, and quality of life among older people. Methods: The study design was a quasi-experimental design. The subjects of this study were older adults participanting in Nantou YMCA health promotion courses (intervention group, n = 42) and olders adults from other Nantou communities (control group, n = 31). The health promotion and disability prevention courses provided by Nantou YMCA conbined health education, physical training and group activity. Physical training focused on increasing lower-body strength, balance and flexibility. The study conducted pre-test and post-test to investigate the changes of two groups’ fitness, exercise self-efficacy expetation, exercise outcome expetation and quality of life before and after the courses. Results: The older adults participanted Nantou YMCA health promotion courses showed significant improvement in the fitness tests of time up and go (p < 0.001) and the 30-second chair stand (p < 0.05) than older adults in the control group. Older adults in the intervention group also gained significant increases in the score of exercise self-efficacy expetation (p < 0.001) and the score of quality of life in role physical (p < 0.05), bodily pain (p < 0.05), general health (p < 0.05), sum of physical health (p < 0.05) and vatility (p < 0.05) scales than older adults in the control group. Conclusions and Recommendations: This study indicated that the health promotion program implemented by Nantou YMCA, orginated from Japan, after localizing for rural communities in Nantou county, were effective on helping community dwelling older adults to improve their physical function, physical and mental quality of life, and their confidence of exercise regularly, after revising the program to fit the culture in Nantou county. Futher study may compare with the effect of health promotion program in urban area, and find suitable strategy of health promotion in older adult in different area.