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The Role of Social Reinforcement in the Maintenance of Short-Term Effects after a Self-Management Intervention for Frail Housebound Seniors with Arthritis*

Published online by Cambridge University Press:  09 May 2012

Sophie Laforest ,
Kareen Nour ,
Monique A.M. Gignac ,
Lise Gauvin  and
Manon Parisien
Sophie Laforest*
Affiliation:
Department of Kinesiology, University of Montréal Institut de recherche en santé publique de l’Université de Montréal (IRSPUM) Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire
Kareen Nour
Affiliation:
Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire Direction de santé publique de la Montérégie
Monique A.M. Gignac
Affiliation:
Health Care and Outcomes Research, University Health Network Dalla Lana School of Public Health, University of Toronto
Lise Gauvin
Affiliation:
Department of Social and Preventive Medicine, University of Montréal CRCHUM-Centre de recherche du Centre Hospitalier de l’Université de Montréal
Manon Parisien
Affiliation:
Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Sophie Laforest, Ph.D. Department of Kinesiology Université de Montréal P.O. Box 6128 Downtown Station Montréal, QC H3C 3J7 (sophie.laforest@umontreal.ca)
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Abstract

Following the program I’m Taking Charge of My Arthritis!, study participants reported fewer functional limitations, less helplessness, and better coping effectiveness than did controls. This study examined the maintenance of these effects and the role of social reinforcement in maintaining benefits eight months post-intervention. The study collected information (1) at baseline (n=125); (2) two months later, before randomization (pre-intervention); (3) two months post-randomization (post-intervention 1); and (4) ten months post-randomization (post-intervention 2) (n=80). We conducted a randomized controlled trial comparing three groups: a control group, intervention group without social reinforcement, and intervention group with social reinforcement after the program. A multilevel analysis revealed that intervention participants with social reinforcement following the program continued to report significantly fewer functional limitations and greater coping effectiveness compared to intervention group participants without social reinforcement. This research provides preliminary evidence for the value of additional contact with frail housebound seniors post-intervention for maintaining the intervention benefits.

Résumé

Une étude a montré que le programme Mon arthrite, je m’en charge! pouvait réduire la perception des limitations fonctionnelles des participants du groupe expérimental, réduire leur sentiment d’impuissance et améliorer leur perception de gestion de la maladie. La présente étude examine le maintien de ces bénéfices et le rôle du renforcement social sur ce maintien, huit mois après l’intervention. Les mesures ont été prises à quatre temps: 1) mesure de base (n=125); 2) deux mois plus tard, avant randomisation (pré-intervention); 3) deux mois post randomisation (post-intervention) et 4) dix mois après la randomisation (post-intervention 2) (n=80). Un devis expérimental randomisé a été utilisé pour comparer trois groupes: le groupe témoin, le groupe expérimental sans renforcement social et le groupe expérimental avec renforcement social post-intervention (i.e., téléphones mensuels par un bénévole). Les analyses multiniveaux ont révélé que les participants du groupe expérimental avec renforcement social ont continué à rapporter moins de limitations fonctionnelles (p= 0.05) et une meilleure perception de gestion de la maladie (p=0.07) que les participants du groupe expérimental sans renforcement social. Cette étude fournit des preuves préliminaires sur la valeur ajoutée des renforcements post-intervention pour maintenir les effets d’un programme d’autogestion chez des aînés frêles, confinés à domicile.

Keywords

autogestionarthriteinterventionaînes frèlesl’entretien des effetsself-managementarthritisinterventionfrail older adultsmaintenance of effects
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 2 , June 2012 , pp. 195 - 207
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

This research was funded by the Canadian Health Institute of Research Grant #MOP-42547. We thank the study’s participants, Richard Goudreault of the Direction de santé publique de Montréal, collaborating at local Community Health Services Centers CLSCs, and members of the Advisory Committee for their contributions to this research.

KN and SL jointly conceptualized the research project, participated in the design of the study and wrote the article. KN further developed the ideas and the statistical analysis and coordinated the gathering of data. SL, as principal researcher of the project I’m Taking Charge of My Arthritis!, undertook the project’s general supervision and actively participated in each step. LG primarily guided the statistical analysis and contributed to the write-up of the manuscript. MG was involved in the original design of the research and made a significant contribution to writing of the article, through a critical review of the intellectual content. MP made a significant contribution to writing of the article and supervised the program offering. All authors read and approved the final manuscript.

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