Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark.

Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.

Detect, trace and react: Danish senior centre staffs' awareness of and response to signs of deteriorating health or well-being among senior centre users - An ethnographic field study.

Senior centre staff members seemingly have an important organisational and administrative role, as well as engage in outreach activities, referral and follow-up in relation to health issues among senior centre users. However, their role in health promotion and illness prevention is easily overlooked and under researched. This study aimed to explore municipal senior centre staffs' awareness of and response to signs of deteriorating health or well-being among users. A multisite ethnographic field study was conducted at seven municipal senior centres in Denmark from November 2019 to February 2020. Data were obtained from participant observation and semi-structured individual interviews with 16 staff members. A thematic analysis strategy helped identify themes of importance. Senior centre staff followed a process of three steps when remaining aware of and responding to signs of deteriorating health and well-being among users: detecting, tracing and reacting. Three themes with corresponding subthemes were identified: Establishing close and trusting relationships, facilitating a community feeling and utilising joint collaboration. Each subtheme was linked to some or all of the three steps in the process. The municipal senior centre staff had a strong and explicit focus on detecting, tracing and reacting to signs of deteriorating health and well-being among senior centre users. This makes the senior centres a promising arena for illness prevention and health promotion.

Interventions to reduce preterm birth in pregnant women with psychosocial vulnerability factors-A systematic review.

OBJECTIVE: Pregnant women with psychosocial vulnerability factors face a higher risk of preterm birth, a heavier burden of perinatal morbidity and mortality and less social health equity. Prevention of preterm birth in this group has proved difficult, and more knowledge is needed to ensure evidence-based care and improve prevention. This study aimed to determine the effectiveness of preventive interventions to reduce preterm birth among pregnant women with psychosocial vulnerability factors. DESIGN: A systematic review of preventive interventions was conducted, searching the databases Cinahl, Cochrane Library, Embase, ProQuest, PsycInfo, PubMed and Scopus to identify RCT's. The search was completed on October 14, 2019. Using the Cochrane Collaboration tools, quality assessments were made, and independent single-data extraction was conducted. Due to heterogeneity in, e.g., participant characteristics, intervention content and duration, the data were synthesised qualitatively. Included studies were ranked in evidence-based hierarchical order, elucidating the risk of bias of each individual study, all of which were ranked as having a medium or low level of evidence. FINDINGS: We identified 1,562 articles, of which five focused on prevention of preterm birth, met our predefined criteria for inclusion and quality assessment, and were therefore included. Interventions consisted of home visits in two studies, group meetings in one study, phone calls in one study, and physical massage in the last study. Four transverse themes arose: intervention intensity, initiation, continuity of care, and the healthcare professionals' educational background. KEY CONCLUSIONS: The evidence base for interventions aiming to prevent preterm birth among pregnant women with psychosocial vulnerabilities is limited. Interventions based on ten antenatal group meetings initiated during the second trimester and facilitated by the same midwife have the greatest likelihood of being effective. Continuity in intervention delivery and healthcare professional's educational background may positively impact the efficiency of the intervention. Further research is needed to address questions about the impact of intervention initiation and intensity and its degree of continuity and mode of delivery.