Interrelation of Sport Participation, Physical Activity, Social Capital and Mental Health in Disadvantaged Communities: A SEM-Analysis Volunteer transitions among older adults: the role of human, social, and cultural capital in later life. Experience corps: Design of an intergenerational program to boost social capital and promote the health of an aging society Social Capital in the College Setting: The Impact of Participation in Campus Activities on Drinking and Alcohol-Related Harms Social capital and health: Does egalitarianism matter? A literature review Social capital and health-purely a question of context? Can social capital be intentionally generated? a randomized trial from rural South Africa. Workplace Social Capital and Mental Health among Chinese Employees: A Multi-Level, Cross-Sectional Study The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment. A prospective study of individual-level social capital and major depression in the United States Intergenerational interaction, social capital and health: results from a randomised controlled trial in Brazil. Low workplace social capital as a predictor of depression: the Finnish Public Sector Study. Happy@Work: protocol for a web-based randomized controlled trial to improve mental well-being among an Asian working population Is social capital a useful conceptual tool for exploring community level influences on HIV infection? An exploratory case study from South Africa Promoting mental health in small-medium enterprises: An evaluation of the "Business in Mind" program The effect of cognitive therapy on structural social capital: results from a randomized controlled trial among sexual violence survivors in the Democratic Republic of the Congo. The effect of Self-Help Groups on access to maternal health services: evidence from rural India INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness Effect of health literacy on the quality of life of older patients with long-term conditions: a large cohort study in UK general practice The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China: An Impact Evaluation The impact of group‐based Tai chi on health‐status outcomes among community‐dwelling older adults with hypertension An evaluation of the effectiveness of a community mentoring service for socially isolated older people: a controlled trial The impact and process of a community-led intervention on reducing environmental inequalities related to physical activity and healthy eating - a pilot study Case management in the context of capitation financing: an evaluation of the strengths model Postnatal depressive symptoms amongst women in Central Vietnam: a cross-sectional study investigating prevalence and associations with social, cultural and infant factors Capitation combined with pay-for-performance improves antibiotic prescribing practices in rural China.
Background The Health through Sport conceptual model links sport participation with physical , social and psychological outcomes and stresses the need for more underst and ing between these outcomes . The present study aims to uncover how sport participation , physical activity , social capital and mental health are interrelated by examining these outcomes in one model . Methods A cross-sectional survey was conducted in nine disadvantaged communities in Antwerp ( Belgium ) . Two hundred adults ( aged 18–56 ) per community were r and omly selected and visited at home to fill out a question naire on socio-demographics , sport participation , physical activity , social capital and mental health . A sample of 414 adults participated in the study . Results Structural Equation Modeling analysis showed that sport participation ( β = .095 ) and not total physical activity ( β = .027 ) was associated with better mental health . No association was found between sport participation and community social capital ( β = .009 ) or individual social capital ( β = .045 ) . Furthermore , only community social capital was linked with physical activity ( β = .114 ) , individual social capital was not ( β = -.013 ) . In contrast , only individual social capital was directly associated with mental health ( β = .152 ) , community social capital was not ( β = .070 ) . Conclusion This study emphasizes the importance of sport participation and individual social capital to improve mental health in disadvantaged communities . It further gives a unique insight into the functionalities of how sport participation , physical activity , social capital and mental health are interrelated . Implication s for policy are that cross-sector initiatives between the sport , social and health sector need to be supported as their outcomes are directly linked to one another OBJECTIVES We aim to underst and how human , social , and cultural capitals are associated with the volunteer process , that is , engagement ( starting ) , intensity ( number of hours ) , and cessation ( stopping ) , among older adults . METHOD Data from the 2000 through 2008 Health and Retirement Study and the 2001 through 2009 Consumption and Activity Mail Survey provide a sample of 4,526 respondents . R and om-effects pooled time series analyses incorporate not only the presence of various types of capital but also the quality of that capital . RESULTS Human and cultural capitals were positively associated with increased volunteer involvement . Effects of social capital ( relationships in the family , employment status , and the community ) depended on the quality of the relationships , not necessarily on their presence alone . DISCUSSION Results suggest that bolstering older adults ' capitals , particularly among lower socioeconomic status groups , can increase volunteer engagement and intensity and reduce cessation . Additionally , a variety of organizational policies including respite programs for caregivers and employer policies allowing employees to reduce their work hours might indirectly affect participation rates and commitment . Potential pools of volunteers exist in families , workplaces , and religious organizations , but more research is necessary to identify how to recruit and retain individuals in social networks where volunteer participatory rates are low Population aging portends a crisis of re sources and values . Desired solutions could include intergenerational strategies to harness the untapped potential of older adultsto address societal needs and to generate health improvements for older adults . Despite the desire of many older adults to remain socially engaged and productive , the creation of productive roles has lagged . This report describes the conceptual framework and major design features of a new model of health promotion for older adults  called Experience Corps ® . Experience Corps operates at , and leads to benefits , across multiple levels , including individuals , schools , and the larger community . At the individual level , we propose a model based on Erikson ’s concept of generativity to explain bow and why experience Corps works . At the level of schools , we propose a parallel model based on social capital . Experience Corps is a volunteer service program design ed to improve the lives of urban childre  and to yield health improvement for older persons . It illustrates how population aging creates new opportunities to address difficult social problems . This article explores how the linkage of concepts at multiple levels motivates a potentially cost-effective , feasible , and high-impact program Objective : The authors aim ed to replicate previous findings on social capital and harmful alcohol outcomes in the college setting and to ascertain the protective effects of additional indicators of social capital . Methods : Over 4 years ( 2000 - 2004 ) , the authors conducted annual  cross-sectional , r and om- sample student surveys at 32 US institutions of higher education ( N = 15,875 ) and constructed multilevel models to examine the association between individual- and campus-level participation in campus activities and harmful drinking outcomes . Results : At the individual level ,  community volunteerism was protective against harmful drinking outcomes . In contrast to past research , campus-level volunteerism was not significantly associated with the outcome measures . At both the individual and campus levels , participation in a religious organization  was protective . Greek membership and varsity athletic participation were risk factors at the individual level . Conclusions : Results did not corroborate previous findings and revealed mixed results for other measures of participation at the campus level . The influence of social capital on college alcohol consumption deserves further attention The aim of the paper is to critically review the notion of  social capital  and review empirical literature on the association between social capital and health across countries . The methodology used for the review includes a systematic search on electronic data bases for peer- review ed published literature . We categorize studies according to level of analysis ( single and multilevel ) and examine whether studies reveal a significant health impact of individual and area level social capital . We compare the study conclusions according to the country 's degrees of economic egalitarianism . Regardless of study design , our findings indicate that a positive association ( fixed effect ) exists between social capital and better health irrespective of countries degree of egalitarianism . However , we find that the between-area variance ( r and om effect ) in health tends to be lower in more egalitarian countries than in less egalitarian countries . Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country . Area level or context ual social capital may be less salient in egalitarian countries in explaining health differences across places Debate still surrounds which level of analysis ( individual vs. context ual ) is most appropriate to investigate the effects of social capital on health . Applying multilevel ecometric analyses to British Household Panel Survey data , we estimated fixed and r and om effects between five individual- , household- and small area-level social capital indicators and general health . We further compared the variance in health attributable to each level using intraclass correlations . Our results demonstrate that association between social capital and health depends on indicator type and level investigated , with one quarter of total individual-level health variance found at the household level . However , individual-level social capital variables and other health determinants appear to influence context ual-level variance the most While much descriptive research has documented positive associations between social capital and a range of economic , social and health outcomes , there have been few intervention studies to assess whether social capital can be intentionally generated . We conducted an intervention in rural South Africa that combined group-based microfinance with participatory gender and HIV training in an attempt to catalyze changes in solidarity , reciprocity and social group membership as a means to reduce women 's vulnerability to intimate partner violence and HIV . A cluster r and omized trial was used to assess intervention effects among eight study villages . In this paper , we examined effects on structural and cognitive social capital among 845 participants and age and wealth matched women from households in comparison villages . This was supported by a diverse portfolio of qualitative research . After two years , adjusted effect estimates indicated higher levels of structural and cognitive social capital in the intervention group than the comparison group , although confidence intervals were wide . Qualitative research illustrated the ways in which economic and social gains enhanced participation in social groups , and the positive and negative dynamics that emerged within the program . There were numerous instances where individuals and village loan centres worked to address community concerns , both working through existing social networks , and through the establishment of new partnerships with local leadership structures , police , the health sector and NGOs . This is among the first experimental trials suggesting that social capital can be exogenously strengthened . The implication s for community interventions in public health are further explored Background Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities , the evidence remains sparse on workplace social capital . To address this gap in the literature , we examined the association between  workplace social capital  and health status among Chinese employees in a large , multi-level , cross-sectional study . Methods By employing a two-stage stratified r and om sampling procedure , 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012 .  Workplace social capital was assessed using a vali date d and psychometrically tested eight-item measure , and the Chinese language version of the WHO-Five Well-Being Index ( WHO-5 ) was used to assess mental health . Control variables included sex , age , marital status , education level , occupation status , smoking status , physical activity , and job stress . Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status . Results In total , 34.9 % of workers reported poor mental health ( WHO-5<13 ) . After controlling for individual-level socio-demographic and lifestyle variables , compared to workers with the highest quartile of personal social capital , workers with the third , second , and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health , 1.39 ( 95 % CI : 1.10–1.75 ) , 1.85 ( 95 % CI : 1.38–2.46 ) and 3.54 ( 95 % CI : 2.73–4.59 ) , respectively . Corresponding odds ratios for workplace-level social capital were 0.95 ( 95 % CI : 0.61–1.49 ) , 1.14 ( 95 % CI : 0.72–1.81 ) and 1.63 ( 95 % CI : 1.05–2.53 ) for the third , second , and lowest quartiles , respectively . Conclusions  Higher workplace social  capital is associated with lower odds of poor mental health among Chinese employees . Promoting social capital at the workplace may contribute to enhancing employees ’ mental health in China AIMS This research examines adolescent perceptions of neighborhood disorganization and social capital to determine if they are associated with  adolescent alcohol or drug ( AOD ) use , AOD dependence  , and access to AOD treatment .  DESIGN This is a secondary analysis of data from the 1999 and 2000 National Survey on Drug Use and Health ( NSDUH ) . The NSDUH is a cross-sectional survey of a r and om sample of the non-institutionalized United States population and is conducted in respondents ' homes . PARTICIPANTS Youth between the ages of 12 and 17 , yielding a sample size of 38,115 respondents . MEASUREMENTS  Neighborhood disorganization  was self-reported by youth in response to eight items ; 10 items measured social capital . AOD use was also self-reported . AOD dependence was assessed by a series of questions regarding symptoms and impairment that is consistent with the criteria specified in the DSM-IV . RESULTS A little more than half of the youth reported never using alcohol or drugs ( 54.3 % ) , 41.1 % reported lifetime AOD use , and 4.6 % were AOD dependent . Two percent reported receiving AOD treatment . Medium and high levels of social capital were negatively associated with AOD use and dependence . Social capital was unrelated to access to AOD treatment . Neighborhood disorganization was positively associated with AOD use , dependence , and access to treatment . CONCLUSIONS After controlling for individual- and family-level characteristics , neighborhood disorganization and social capital were associated with AOD use and dependence . The findings suggest that subjective measures of social context may be an important component of the complex biopsychosocial model of adolescent AOD addiction and treatment utilization Study objective : To investigate prospect ively the associations between depression and cognitive social capital ( social trust , sense of belonging , mutual aid ) and structural social capital ( volunteer work and community participation ) . Methods : This was a prospect i ve study that was carried out in the USA . The participants were a nationally representative sample of 724 English-speaking non-institutionalised adults ( 25–74 years old ) who participated in the National Survey of Midlife Development in the United States ( MIDUS ) in 1995–6 and the MIDUS Psychological Experience Follow-Up study in 1998 . Main results : In multivariable adjusted logistic regression analyses , those who trusted their neighbours were less likely to develop major depression ( MD ) during follow-up than those who reported low levels of social capital on these dimensions ( adjusted OR of MD for high vs low trust = 0.43 ; 95 % CI 0.20 to 0.93 , adjusted for MD at baseline , age , gender , race , education , working status , marital status , physical health and extroversion traits ) . Structural dimensions of social capital were not associated with MD in adjusted models . Conclusions : Perceptions of higher levels of cognitive social capital ( trust of neighbours ) are associated with lower risks of developing MD during 2–3 year follow-up . However , after excluding participants with MD at the baseline , the association between trust and MD became non-significant . Structural dimensions were not associated with MD Recent years have seen a burgeoning of intergenerational programmes aim ing to improve the well being of participants . However , very few programmes have been formally evaluated . In this paper we report results from a r and omised controlled trial of a school-based intergenerational intervention undertaken in Brazil . R and omly selected sample s of 253 adolescents and 266 elders aged 60 and over resident in the school 's catchment area were administered a question naire including questions on cognitive components of social capital , family relationships , and self-rated health . Participants were then r and omly allocated to control and intervention groups . The intervention comprised participation in a 4 month programme of intergenerational activities in which the elders shared their memories with the students . At the end of the intervention the question naire was re-administered to the sample s. High proportions ( 85 - 95 % ) of both sample s completed the question naires but compliance with the intervention was low in the elderly group . In the analysis of results from the elderly sample , we therefore compared the control group with the group assigned to the intervention ( intention to treat analysis ) . Results showed that adolescents in the intervention group were nearly three times more likely to rate their health as good than those in the control group , but also more likely to judge that most people were selfish . In the elderly sample , those from the intervention group were over twice as likely as those from the control group to report positively on the helpfulness of neighbours ; judge most people to be honest or consider their family relationships as good . There were no significant differences between groups on other outcome measures . These results suggest that structured intergenerational activities may have positive effects on some aspects of social capital for both adolescents and elderly people , although further research is needed to eluci date the processes involved and the extent to which the findings are context specific . This study is the first to use a controlled trial design to evaluate this type of intervention and is valuable in showing that this design can be used in interventions of this kind , and also the difficulties involved In a prospect i ve cohort study of Finnish public sector employees , the authors examined the association between workplace social capital and depression . Data were obtained from 33,577 employees , who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000 - 2002 . Their risk of depression was measured with two indicators : recorded purchases of antidepressants until December 31 , 2005 , and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004 - 2005 . Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up . The odds for antidepressant treatment and physician-diagnosed depression were 20 - 50 % higher for employees with low self-reported social capital than for those reporting high social capital . These associations were not accounted for by sex , age , marital status , socioeconomic position , place of work , smoking , alcohol use , physical activity , and body mass index . The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress ( a proxy for undiagnosed mental health problems ) . Aggregate-level social capital was not associated with subsequent depression Background Mental health issues pose a serious concern in the workplace for the huge productivity loss and financial burden associated with it . Unlike the traditional ‘ fixing-what-is-wrong ’ approach , positive psychology offers a less-stigmatized way to promote mental health . Psychological capital , a concept originated from positive psychology , has been proven effective in improving mental well-being and work performance . However , little evidence exists for its implementation among Asian working population or its cost-benefit for organizations adopting such promotion strategy . The current study is design ed to assess the protective effects of a web-based psychology capital intervention among Hong Kong working population on individuals ’ mental health and work performance , as well as organizations ’ return-on-investment . Methods / Design A two-arm r and omized controlled trial design will be adopted . Eligible working adults will be r and omly allocated to either the intervention group or the waiting-list control group , with 177 participants in each arm . The intervention , which consists of four web-based training sessions , each targeting one of the psychological capital components ( hope , efficacy , optimism and resilience ) , will be implemented over a 4-week period . On-line surveys will assess the participants in each group at baseline , intervention completion , 1 and 3 months after the completion . The primary outcome is individuals ’ psychological capital level ; secondary outcomes include individuals ’ well-being , depressive symptoms , work engagement and productivity . Return-on-investment will be calculated from the employers ’ perspective based on productivity gain , savings in medical expenditure , as well as operation and time costs . Analysis will follow the intention-to-treat principle . Discussion This is the first experimental study that explores the applicability of psychological capital development among Asian population . Through investigating changes in individuals ’ work productivity from absenteeism and presenteeism , this will be one of the few studies that quantify productivity gains from any type of mental health promotion . By demonstrating effectiveness in improving mental well-being and a positive return-on-investment rate , the study may help convince more uptake of similar positive psychology interventions at workplace in Asia and elsewhere . Trail Registration Number ( assigned by Centre for Clinical Trials , Clinical Trials Registry , The Chinese University of Hong Kong ) : CUHK_CCT00396 . Registration Date : Abstract This paper reports on an exploratory study investigating links between sexual health and social capital in a South African mining community . In this study , social capital is defined in terms of people 's membership of voluntary community organizations ( e.g. church , residents ' associations , youth groups ) . Using biomedical and social survey data from a stratified r and om sample of 1,211 Carletonville residents , we tested the hypothesis that organizational members were less likely to have HIV . Multivariate analysis of variance sought to identify significant associations between nine organizational memberships and HIV infection , as well as three risk factors for infection ( casual partners , condom use with casual partners and alcohol consumption ) . Analysis yielded a range of significant results , but findings varied across age and gender , and were not all in the hypothesized direction . For example , young men and young women who belonged to sports clubs were less likely to be HIV-positive , and young women who belonged to sports clubs were more likely to use condoms with casual partners than non-members . Amongst members of stokvels ( voluntary savings clubs accompanied by social festivities ) , however , young men were more likely to be HIV-positive , women of all ages were more likely to have a casual partner , and both young men and young women were more likely to drink alcohol than non-members . While our exploratory study has produced sufficient evidence to justify the need for further research in this area , it also highlights that the interface between HIV infection and social capital is a complex area that defies easy generalization Background Workplace mental health promotion ( WMHP ) aims to prevent and effectively manage the social and economic costs of common mental illnesses such as depression . The mental health of managers and employees within small-medium enterprises ( SMEs ) is a neglected sector in occupational health research and practice , despite the fact that this sector is the most common work setting in most economies . The availability and propensity of SME staff to attend face-to-face training/therapy or workshop style interventions often seen in corporate or public sector work setting s is a widely recognised problem . The ' Business in Mind ' program employs a DVD mode of delivery that is convenient for SME managers , particularly those operating in regional and remote areas where internet delivery may not be optimal . The objective of the intervention program is to improve the mental health of SME managers , and examine whether employees of managers ' whose mental health improves , report positive change in their psychosocial work environment . The mechanisms via which we aim to improve managers ' mental health are through the development of their psychological capital ( a higher order construct comprised of hope , self efficacy , resilience and optimism ) and their skills and capacities for coping with work stress . Methods / Design The effectiveness of two versions of the program ( self administered and telephone facilitated ) will be assessed using a r and omised trial with an active control condition ( psychoeducation only ) . We aim to recruit a minimum of 249 managers and a sample of their employees . This design allows for 83 managers per group , as power analyses showed that this number would allow for attrition of 20 % and still enable detection of an effect size of 0.5 . The intervention will be implemented over a three month period and postal surveys will assess managers and employees in each group at baseline , intervention completion , and at 6 month follow up . The intervention groups ( managers only ) will also be assessed at 12 and 24 month follow-up to examine maintenance of effects . Primary outcomes are managers ' levels of psychological capital ( hope , resilience , self-efficacy and optimism ) , coping strategies , anxiety and depression symptoms , self-reported health , job satisfaction and job tension . Secondary outcomes are participating managers subordinates ' perceptions of manager support , relational justice , emotional climate and job tension . In order to provide an economic evaluation of the intervention , both employees and manager rates of absenteeism and presenteeism will also be assessed . Discussion The intervention being trialled is expected to improve both primary and secondary outcomes . If proven efficacious , the intervention could be disseminated to reach a much larger proportion of the business community . Trial registration Current controlled trials IS RCT N OBJECTIVES We evaluated changes in social capital following group-based cognitive processing therapy ( CPT ) for female survivors of sexual violence . METHODS We compared CPT with individual support in a cluster-r and omized trial in villages in South Kivu province , Democratic Republic of the Congo . Local psychosocial assistants delivered the interventions from April through July 2011 . We evaluated differences between CPT and individual support conditions  for structural social capital ( i.e. , time spent with nonkin social network , group membership and participation , and the size of financial and instrumental support networks ) and emotional support seeking . We analyzed intervention effects with longitudinal r and om effects models . RESULTS We obtained small to medium effect size differences for 2 study outcomes . Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages . CONCLUSIONS Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context Introduction The main challenge for achieving universal health coverage in India is ensuring effective coverage of poor and vulnerable communities in the face of high levels of income and gender inequity in access to health care . Drawing on the social capital generated through women ’s participation in community organizations like SHGs can influence health outcomes . To date , evidence about the impact of SHGs on health outcomes has been derived from pilot-level interventions , some using r and omised controlled trials and other rigorous methods . While the evidence from these studies is convincing , our study is the first to analyse the impact of SHGs at national level . Methods We analyzed the entire data set from the third national District Level Household Survey from 601 districts in India to assess the impact of the presence of SHGs on maternal health service uptake . The primary predictor variable was presence of a SHG in the village . The outcome variables were : institutional delivery ; feeding new-borns colostrum ; knowledge about family planning methods ; and ever used family planning . We controlled for respondent education , wealth , heard or seen health messages , availability of health facilities and the existence of a village health and sanitation committee . Results Stepwise logistic regression shows respondents from villages with a SHG were 19 per cent ( OR : 1.19 , CI : 1.13 - 1.24 ) more likely to have delivered in an institution , 8 per cent ( OR : 1.08 , CI : 1.05 - 1.14 ) more likely to have fed newborns colostrum , have knowledge ( OR : 1.48 , CI 1.39 – 1.57 ) and utilized ( OR : 1.19 , CI 1.11 – 1.27 ) family planning products and services . These results are significant after controlling for individual and village-level heterogeneities and are consistent with existing literature that the social capital generated through women ’s participation in SHGs influences health outcome . Conclusion The study concludes that the presence of SHGs in a village is associated with higher knowledge of family planning and maternal health service uptake in rural India . To achieve the goal of improving public health nationally , there is a need to underst and more fully the benefits of systematic collaboration between the public health community and these grassroots organizations Background For most people , home is the preferred place of care and death . Despite the development of specialist palliative care and primary care models of community based service delivery , people who are dying , and their families/carers , can experience isolation , feel excluded from social circles and distanced from their communities . Loneliness and social isolation can have a detrimental impact on both health and quality of life . Internationally , models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement . These models have not yet been subjected to rigorous evaluation . The aims of the study described in this protocol are : ( 1 ) to evaluate the feasibility , acceptability and potential effectiveness of The Good Neighbour Partnership ( GNP ) , a new volunteer-led model of social and practical care/support for community dwelling adults in Irel and who are living with advanced life-limiting illness ; and ( 2 ) to pilot the method for a Phase III R and omised Controlled Trial ( RCT ) . Design The INSPIRE study will be conducted within the Medical Research Council ( MRC ) Framework for the Evaluation of Complex Interventions ( Phases 0–2 ) and includes an exploratory two-arm delayed intervention r and omised controlled trial . Eighty patients and /or their carers will be r and omly allocated to one of two groups : ( I ) Intervention : GNP in addition to st and ard care or ( II ) Control : St and ard Care . Recipients of the GNP  will be asked for their views on participating in both the study and the intervention . Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before , during and after the intervention . The primary outcome is the effect of the intervention on social and practical need . Secondary outcomes are quality of life , loneliness , social support , social capital , unscheduled health service utilisation , caregiver burden , adverse impacts , and satisfaction with intervention . Volunteers engaged in the GNP will also be assessed in terms of their death anxiety , death self efficacy , self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers . Discussion The INSPIRE study addresses an important knowledge gap , providing evidence on the efficacy , utility and acceptability of a unique model of social and practical support for people living at home , with advanced life-limiting illness . The findings will be important in informing the development ( and evaluation ) of similar service models and policy elsewhere both nationally and internationally . Trial registration IS RCT N18400594 18th February 2015 Purpose The levels of health literacy in patients with long-term conditions ( LTCs ) are critical for better disease management and quality of life ( QoL ) . However , the impact of health literacy on QoL in older adults with LTCs is unclear . This study examined the association between health literacy and domains of QoL in older people with LTCs , investigating key socio-demographic and clinical variables , as confounders . Methods A prospect i ve cohort study was conducted on older adults ( n = 4278 ; aged 65 years and over ) with at least one LTC , registered in general practice s in Salford , UK . Participants completed measures of health literacy , QoL , multi-morbidity , depression , social support , and socio-demographic characteristics . Multivariate linear regressions were performed to examine the effects of health literacy on four QoL domains at baseline , and then changes in QoL over 12 months . Results At baseline , poor health literacy was associated with lower scores in all four QoL domains ( physical , psychological , social relationships and environment ) , after adjusting for the effects of multi-morbidity , depression , social support and socio-demographic factors . At 12-month follow-up , low health literacy significantly predicted declines in the physical , psychological and environment domains of QoL , but not in social relationships QoL. Conclusions This is the largest , most complete assessment of the effects of health literacy on QoL in older adults with LTCs . Low health literacy is an independent indicator of poor QoL older patients with LTCs . Interventions to improve health literacy in older people with LTCs are encouraged by these findings In China , health care providers have traditionally been paid fee-for-service and overprescribing and high out-of-pocket spending are common . In this study , township health centers in two counties were assigned almost r and omly to two groups : in one , fee-for-service was replaced by a global capitated budget ; in the other , by a mix of global capitated budget and pay-for-performance . Performance captured inter alia " irrational " drug prescribing ; 20 percent of the global capitated budget was withheld each quarter , points were deducted for failure to meet targets , and some of the withheld budget was returned in line with the points deducted . Outcomes included appropriate prescribing and prescription cost , data on which were obtained by digitizing prescriptions from a month just before the reform and from the same month a year later . Impacts were assessed via multivariate differences-in-differences with township health center fixed effects . To reduce bias from non-r and omness in assignment , the sample was trimmed by coarsened exact matching . Pay-for-performance reduced inappropriate prescribing significantly and substantially in the county where the initial level was above the penalty threshold , but end-line rates were still appreciable ; no effects were seen in the county where initial levels were around or below the threshold , or on out-of-pocket spending in either county Objectives : To test the effects of group‐based Tai chi on health‐status outcomes among older adults with hypertension . Background : A high‐ quality study exploring the effects of Tai chi on physical and psychosocial health for older adults with hypertension is needed in China . The long‐term effects of group‐based Tai chi in Chinese older adults with hypertension remain unclear . Methods : A r and omized controlled trial was conducted . The group‐based Tai chi training and practice were implemented in older adults over six‐month . Results : The  Tai chi ( TC ) group showed significantly lower blood pressure and body mass index than the usual care ( UC ) group . The TC group participants showed greater improvements in social support , quality of life , and reduction in depressive symptoms over a six‐month intervention than UC group . TC group showed significant group‐by‐time interactions in these variables . Conclusion : Group‐based Tai chi is effective in the enhancement of health‐status outcomes for older Chinese adults with hypertension Background Social isolation affects a significant proportion of older people and is associated with poor health outcomes . The current evidence base regarding the effectiveness of interventions targeting social isolation is poor , and the potential utility of mentoring for this purpose has not previously been rigorously evaluated . The purpose of this study was to examine the effectiveness of a community-based mentoring service for improving mental health , social engagement and physical health for socially isolated older people . Methods This prospect i ve controlled trial compared a sample of  mentoring service clients ( intervention group )  with a matched control group  recruited through general practice . One hundred and ninety five participants from each group were matched on mental wellbeing and social activity scores . Assessment s were conducted at baseline and at six month follow-up . The primary outcome was the Short Form Health Survey v2 ( SF-12 ) mental health component score ( MCS ) . Secondary outcomes included the SF-12 physical health component score ( PCS ) , EuroQol EQ-5D , Geriatric Depression Score ( GDS-10 ) , social activity , social support and morbidities . Results We found no evidence that mentoring was beneficial across a wide range of participant outcomes measuring health status , social activity and depression . No statistically significant between-group differences were observed at follow-up in the primary outcome ( p = 0.48 ) and in most secondary outcomes . Identifying suitable matched pairs of intervention and control group participants proved challenging . Conclusions The results of this trial provide no substantial evidence supporting the use of community mentoring as an effective means of alleviating social isolation in older people . Further evidence is needed on the effectiveness of community-based interventions targeting social isolation . When using non-r and omised design s , there are considerable challenges in the recruitment of suitable matches from a community sample .Trial registration SCIE Research Register for Social Care Background There is growing recognition that a sedentary lifestyle is being driven , at least in part , by environmental factors that affect individuals ' physical activity choices and health behaviours . In other words , the environments in which we live , and with which we interact , have become ones that encourage lifestyle choices that decrease physical activity and encourage over-consumption of foods . However , evidence from community-led interventions to change local neighbourhood environments to support physical activity and healthy eating is lacking . This article summarises the research protocol developed to evaluate a community-led intervention " My Health Matters " aim ed at reducing health inequalities relating to increasing physical activity and healthy eating as defined by community members themselves . Methods / Design This study includes three of the most deprived electoral wards in Stoke-on-Trent . In each of these areas , environmental factors including proximity of physical activity spaces , greenspace and leisure facilities , neighbourhood connectivity and walkability , l and -use-mix and population density , traffic , safety and crime , and food outlets will be mapped using Geographical Information Systems ( GIS ) . A community postal survey of r and omly selected addresses assessing environmental characteristics relating to physical activity , perceived health status , social capital , fruit and vegetable consumption and levels of physical activity will be undertaken ( baseline and at 2 year follow-up ) . Based on baseline findings an intervention will be design ed and implemented over a 2 year period that includes the following ; use of community participatory research to build effective community partnerships ; use of partnership consensus to identify , prioritise and design intervention(s ) related to specific health disparities ; recruitment of local residents to help with the delivery and sustainability of target intervention(s ) ; and the development of local systems for ongoing monitoring and evaluation of the intervention(s ) . Discussion A community-led and multidisciplinary approach to modifying environmental factors that support and reinforce healthful behaviours may be more successful than focusing on individual behaviour change as this approach does not exclusively rely upon individual will and capacity . Study findings will be collated in 2012 and , if successful in improving levels of physical activity and healthy eating , will help to inform the design of a larger area-based , cluster r and omized controlled trial to determine effectiveness Conclusions The results of the present evaluation strongly support the essential need for formal case management in providing community support for individuals with serious mental illness . When compared to a control condition in which consumers received CMHC-wide support from therapists , day treatment personnel , and residential staff , the Strengths case management program was considerably more effective in achieving three specific community support goals : increasing consumer personal incomes , providing needed social support , and maintaining consumer physical health . Surprisingly , the case management program was also found to be effective in achieving a goal that is usually not targeted by case management : consumers in the case management group improved in therapist-assessed psychiatric symptomatology more than control group consumers . Since the control and the case management groups had comparable increases in attendance at primary therapy and medication management over the study period , we conclude that the case management program was directly responsible for the improvements in psychiatric symptoms within its caseload . Whether these improvements in mood and cognitive processing are attributable to co-occuring improvements in quality of life variables ( i.e. , social support or personal income ) or whether psychiatric improvement is more directly attributable to case managerin vivo counseling must be decided by future research .While formal Strengths case management appears to be efficacious as a community support— and perhaps as a psychiatric rehabilitation — intervention , a formal program of case management does not appear to be essential to CMHC preparation for Medicaid capitated financing . The Valley Mental Health case management program significantly increased consumers ' residential autonomy and attendance at primary therapy , but improvements on these two Medicaid-related variables were nearly matched within the control group through the efforts of other program staff . Taken as a whole , the study findings demonstrate that a formal case management program can work effectively in league with other CMHC programs to achieve specific managed care-related administrative goals , but that these delineated administrative goals can also be attained through a CMHC-wide mobilization of dedicated front-line staff Background This study investigated the prevalence and socio-cultural correlates of postnatal mood disturbance amongst women 18–45 years old in Central Vietnam . Son preference and traditional confinement practice s were explored as well as factors such as poverty , parity , family and intimate partner relationships and infant health . Methods A cross-sectional study was conducted in twelve r and omly selected Commune Health Centres from urban and rural districts of Thua Thien Hue Province , Vietnam . Mother-infant dyads one to six months postpartum were invited to participate . Question naires from 431 mothers ( urban n = 216 ; rural n = 215 ) assessed demographic and family characteristics , traditional confinement practice s , son preference , infant health and social capital . The Edinburgh Postnatal Depression Scale ( EPDS ) and WHO5 Wellbeing Index indicated depressive symptoms and emotional wellbeing . Data were analysed using general linear models . Results Using an EPDS cut-off of 12/13 , 18.1 % ( n = 78 , 95 % CI 14.6 - 22.1 ) of women had depressive symptoms ( 20.4 % urban ; 15.8 % rural ) . Contrary to predictions , infant gender and traditional confinement were unrelated to depressive symptoms . Poverty , food insecurity , being frightened of family members , and intimate partner violence increased both depressive symptoms and lowered wellbeing . The first model accounted for 30.2 % of the variance in EPDS score and found being frightened of one ’s husb and , husb and ’s unemployment , breastfeeding difficulties , infant diarrhoea , and cognitive social capital were associated with higher EPDS scores . The second model had accounted for 22 % of the variance in WHO5 score . Living in Hue city , low education , poor maternal competence and a negative family response to the baby lowered maternal wellbeing . Conclusions Traditional confinement practice s and son preference were not linked to depressive symptoms among mothers , but were correlates of family relationships and wellbeing . Poverty , food insecurity , violence , infant ill health , and discordant intimate and family relationships were linked with depressive symptoms in Central Vietnam Pay-for-performance in health care holds promise as a policy lever to improve the quality and efficiency of care . Although the approach has become increasingly popular in developing countries in recent years , most policy design s do not permit the rigorous evaluation of its impact . Thus , evidence of its effect is limited . In collaboration with the government of Ningxia Province , a predominantly rural area in northwest China , we conducted a matched-pair cluster-r and omized experiment between 2009 and 2012 to evaluate the effects of capitation with pay-for-performance on  primary care providers ' antibiotic prescribing practice s , health spending , outpatient visit volume , and patient satisfaction . We found that the intervention led to a reduction of approximately 15 percent in antibiotic prescriptions and a small reduction in total spending per visit to village posts-essentially , community health clinics . We found no effect on other outcomes . Our results suggest that capitation with pay-for-performance can improve drug prescribing practice s by reducing overprescribing and inappropriate prescribing . Our study also shows that rigorous evaluations of health system interventions are feasible when conducted in close collaboration with the government
According to sufficiently reported outcomes , social capital interventions showed mixed effects on quality of life , well-being and self-perceived health and were generally ineffective on loneliness , mood and mortality .
Conclusions Our review highlights the lack of evidence and the diversity among trials , while supporting the potential of social capital interventions to reach comprehensive health effects in older adults
Background Observational studies show that social capital is a protective health factor .
Therefore , we aim to assess the currently unclear health impact of social capital interventions targeting older adults .