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Health Promotion International Advance Access published online on January 10, 2009

Health Promotion International, doi:10.1093/heapro/dan042
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© The Author (2009). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

Impact of health education on health-related quality of life among elderly persons: results from a community-based intervention study in rural Bangladesh

A.K.M. Masud Rana1,2,*, Åke Wahlin1,3, Cecilia Stålsby Lundborg4,5 and Zarina Nahar Kabir1,2

1Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden 2BRAC, Dhaka, Bangladesh 3Department of Psychology, Stockholm University, Stockholm, Sweden and 4Department of Public Health Sciences, Division of International Health (IHCAR) Karolinska Institutet, Stockholm, Sweden 5Nordic School of Public Health and Apoteket, Göteborg, Sweden

* Corresponding author. E-mail: rana.akm.masud{at}ki.se


   Abstract

This study examines the change in health-related quality of life (HRQoL) among (≥60 years) elderly persons as a result of health education intervention. A community-based intervention study was performed in eight randomly selected villages (Intervention: n = 4; Control: n = 4) in rural Bangladesh. A total of 1135 elderly persons was selected for this study. The analyses include 839 participants (Intervention: n = 425; Control: n = 414) who participated in both baseline and post-intervention surveys. Participants in the intervention area were further stratified into compliant (n = 315) and non-compliant (n = 110) groups based on the reported compliance to the intervention activities. The intervention includes, for example, physical activity, advice on healthy food intake and other aspects of management. To create an enabling environment, social awareness was provided by means of information about the contribution of and challenges faced by elderly persons at home and the community, including information about elderly persons' health and health care. The intervention activities were provided to the elderly persons, caregivers, household members and community people for 15 months. The HRQoL was assessed using a multi-dimensional generic instrument designed for elderly persons. Multivariate analyses revealed that in the non-compliant group the probabilities of increased scores were less likely in overall HRQoL (OR 0.52, 95% CI 0.32–0.82). Among the Control group, increased scores were less likely in the physical (OR 73, 95% CI 0.54–0.99), social (OR 0.37, 95% CI 0.27–0.50), spiritual (OR 0.60, 95% CI 0.34–0.94), environment (OR 0.36, 95% CI 0.26–0.49) dimensions and overall HRQoL (OR 0.44, 95% CI 0.32–0.59) (adjusted for age, sex, literacy, marital status and economic status). This study concludes that provision of community-based health education intervention might be a potential public health initiative to enhance the HRQoL in old age.

Key words: Health-related quality of life; elderly; health education; Bangladesh; rural


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