title: A social health services model to promote active ageing in Mexico: design and evaluation of a pilot programme.
abstract: The objective of the study was to design and evaluate a pilot programme aimed at promoting the active ageing of older adults at the Mexican Institute of Social Security. The study was conducted in three stages: (a) design; (b) implementation; and (c) before-after evaluation through analysis of changes in functional status, occupational functioning and health-related quality of life. To overcome the limitations of the study design, we evaluated the effect of 80 per cent adherence to the programme on the outcome variables using the generalised linear regression models (GLM). Two hundred and thirty-nine older adults agreed to participate, of whom 65 per cent completed the programme. Most were women; the average age was 77 years. Adherence to the programme was higher than 75 per cent for the group who completed active ageing services and less than 60 per cent for the drop-out group. Overall, 46 per cent of older adults reached an adherence level of 80 per cent or higher. Adherence was significantly associated with improved quality of life total score (coefficient 2.7,p<0.0001) and occupational functioning total score (coefficient 2.2,p<0.0001). Participation of older adults in an active ageing programme may improve their health-related quality of life and occupational functioning. It is necessary to identify the potential barriers and to implement strategies to improve the recruitment and retention rates during the intervention.
authors.affiliation: Division of Social Protection and Health , Inter-American Development Bank , Mexico City , Mexico .
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez-Cuevas
authors.affiliation: Epidemiology and Health Services Research Unit CMN Siglo XXI , Mexican Institute of Social Security , Mexico City , Mexico .
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Doubova
authors.affiliation: Center of Social Care for Older Adults , Mexican Institute of Social Security , Mexico City , Mexico .
authors.forename: Laura Angélica
authors.initials: LA
authors.lastname: Bazaldúa-Merino
authors.affiliation: Center of Health Systems Research , Mexican Institute of Public Health , Mexico City , Mexico .
authors.forename: Hortensia
authors.initials: H
authors.lastname: Reyes-Morales
authors.affiliation: Planet Media Mexico , Mexico City , Mexico .
authors.forename: David
authors.initials: D
authors.lastname: Martínez
authors.affiliation: Social Benefits Coordination , Mexican Institute of Social Security , Mexico City , Mexico .
authors.forename: Roberto
authors.initials: R
authors.lastname: Karam
authors.affiliation: Social Benefits Coordination , Mexican Institute of Social Security , Mexico City , Mexico .
authors.forename: Carlos
authors.initials: C
authors.lastname: Gamez
authors.affiliation: Research Division , Hospital Infantil de México Federico Gómez , Mexico City , Mexico .
authors.forename: Onofre
authors.initials: O
authors.lastname: Muñoz-Hernández
keywords: active ageing; health-related quality of life; occupational functioning; pilot programme