0000000000006450
AUTHOR
Jorge Garcés-ferrer
The social engagement framework for addressing the chronic-disease-challenge
Abstract Background The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) intends to empower citizens to self-manage chronic conditions by combining mindfulness, social engagement and ICT support. This study evaluates effects in terms of perceived effectiveness, utility, efficiency, sustainability and satisfaction with SEFAC intervention. Methods A prospective cohort study with 6-month pre-post design was conducted in Croatia, Italy and the Netherlands. A total of 270 citizens ≥50 and at risk of or with a chronic condition were recruited. Self-reported effects of SEFAC intervention were assessed post-intervention using 5-point Likert scale [Strongly disagree -…
Guiding the development of community-based services for vulnerable migrants and refugees in Europe
Abstract The Mig-HealthCare roadmap & toolbox emphasize an approach that can be implemented at a local community level by local health professionals. The roadmap and toolbox were the main outcome of the project which combines evidence from original research and other information to present concrete steps in the provision of care to migrants and refugees at a community level. The vision of Mig-HealthCare for this roadmap & toolbox is to (1) Help the health professionals working primarily at the community health care level to familiarize themselves with the key areas of importance in refugee/migrant health (2) Provide health professionals with a valuable set of best practices and hand…
The Appraisal of Self-Care Agency Scale - Revised (ASA-R): Adaptation and Validation in a Sample of Spanish Older Adults.
AbstractSelf-care agency is an important determinant of healthy aging. The Appraisal of Self-care Agency Scale (ASA-R) (Sousa et al., 2010) is one of the main instrument to assess self-care capacity. The objectives of the study were: 1) to adapt and validate ASA-R scale for use in Spanish population; 2) to examine the dimensionality, validity and reliability; 3) and to establish the convergent validity of ASA-R using a self-reported health measure. The ASA-R Scale and the 12-item Short Form Health Survey (SF-12) were administered to 488 Spanish seniors aged 65 and over. Confirmatory Factor Analysis (CFA) was used to analyze the dimensionality, validity and reliability. Convergent validity w…
Pilot action within the framework of the Mig-HealthCare project - implementation of community-based pilot studies addressing health inequalities of migrants and refugees
Abstract In the framework of the Mig-HealthCare project, a roadmap to community-based health care was developed including a toolbox and an algorithm. The Mig-HealthCare partners piloted parts of the roadmap in 8 EU countries. Piloting included actions on health promotion issues for migrants/refugees, mental health issues, non-communicable diseases, screening for breast and cervical cancer and vaccination issues. Two recommended practices were also piloted among migrants/refugees namely the 'circle of health' and health mentors while the Greek partner tested the developed algorithm in various health settings. All pilots were evaluated using common and pilot specific indicators for (a) approp…
Reliability and Validity of the Tilburg Frailty Indicator in 5 European Countries
OBJECTIVES: To assess the internal consistency, convergent and divergent validity, and concurrent validity of the Tilburg Frailty Indicator (TFI) within community-dwelling older people in Spain, Greece, Croatia, the Netherlands, and the United Kingdom.DESIGN: Cross-sectional study.SETTING: Primary care and community settings.PARTICIPANTS: In total, 2250 community-dwelling older people (60.3% women; mean age = 79.7 years; standard deviation = 5.7).METHODS: We assessed the reliability and validity of the full TFI as well as its physical, psychological, and social domains. Baseline data of the Urban Health Centers Europe project were used. The internal consistency was assessed with the Cronbac…
Determinants of Refugee and Migrant Health Status in 10 European Countries: The Mig-HealthCare Project
In this study, we collect and synthesize information on the health status of the refugee/migrant population in ten European countries in order to map refugee/migrant health needs. With this information, we identify areas of intervention and healthcare system strengthening to provide the basis for future health planning and effective healthcare provision to migrants, asylum-seekers and refugees in the European Union (EU). Methods: 1407 migrants in ten European Union countries (consortium members of the Mig-HealthCare project) were surveyed on general health, mental health, and specific diseases using an interviewer-administered questionnaire. Descriptive statistics and multivariable linear r…
A coordinated preventive care approach for healthy ageing in five European cities: A mixed methods study of process evaluation components
To evaluate specific process components of the Urban Health Centres Europe (UHCE) approach; a coordinated preventive care approach aimed at healthy ageing by decreasing falls, polypharmacy, loneliness and frailty among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain.Mixed methods evaluation of specific process components of the UHCE approach: reach of the target population, dose of the intervention actually delivered and received by participants and satisfaction and experience of main stakeholders involved in the approach.The UHCE approach intervention consisted of a preventive assessment, shared decision-making on a care …
Policy Makers', NGO, and Healthcare Workers' Accounts of Migrants' and Refugees' Healthcare Access Across Europe : Human Rights and Citizenship Based Claims
Freely available healthcare, universally accessible to the population of citizens, is a key ideal for European welfare systems. As labor migration of the twentieth century gave way to the globalized streams of the twenty-first century, new challenges to fulfilling these ideals have emerged. The principle of freedom of movement, together with large-scale forced migration have led to large scale movements of people, making new demands on European healthcare systems which had previously been largely focused on meeting sedentary local populations' needs. Drawing on interviews with service providers working for NGOs and public healthcare systems and with policy makers across 10 European countrie…
Analysis of needs, expectations and capacities of health and social care professionals in order to provide culturally adapted care
Abstract The Mig-HealthCare consortium conducted a qualitative study of the health care needs of vulnerable migrants/refugees in Europe. The research was conducted between Fall 2017 and Spring 2018. In total, 20 focus group discussions or, where necessary individual interviews (19), were organised with health care professionals and service providers; policymakers; and representatives from Non-Governmental Organisations - NGOs. Thematic qualitative analysis was employed. The main results of the analysis show that: Health care provision for migrants is uneven throughout the EU and variations exist even within the same country. Health care providers and NGOs agree that health care for migrants…
Enhancing the SCIROCCO tool using quantitative and qualitative methods
Background: The SCIROCCO tool, developed as part of the SCIROCCO project, incorporates the Maturity Model for the adoption of Integrated Care developed by the European Innovation Partnership on Active and Healthy Ageing (B3 Action Group on Integrated Care). The online self-assessment tool can be used to facilitate scaling-up of integrated care across different health and care sectors, at different levels in health or care systems, and in a range of communities. Currently, more than 30 European regions are involved in testing the SCIROCCO tool. Since the project launch in April 2016, the tool underwent two iterations. Each of the iterations of the tool was followed by a round of refinement t…
Best practices addressing healthcare care access of migrants and refugees in European countries
Abstract Mig-healthCare has identified sources in the countries and languages of the consortium providing guidance for community-based healthcare for migrants and refugees. A total of 54 sources that refer to best practices in seven European countries were identified. Results were categorized along with the themes: organization, communication, training, education and facilities & services. Successful organizational measures were a close collaboration with different governmental authorities, NGOs, community organizations and various local service providers. Moreover, engagement with members from both the host community and the migrant/refugee community in the design and implementation ph…
Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults
Objectives: To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty. Design: Longitudinal cohort study. Setting: Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom. Participants: A total of 1735 participants (61.1% female ; mean age = 79.6 years ; SD = 5.5 years). Measurements: The frequency of self-reported moderate PA was measured and classified into two categories: "regular frequency" and "low frequency…
Predictions concerning the use of health care services in Europe by migrants/refugees and the Mig-HealthCare Roadmap & Toolbox
Abstract Based on the multiple levels of research conducted within the project the consortium developed a roadmap & toolbox which includes the following categories: Continuity of information, Language Culture & Communication, Mental Health, Vaccinations, Maternal/child health, Health promotion, Oral health/Dental Care and NCDs while the Toolbox contains tools on these categories in different languages. The roadmap & toolbox is accessible through the project website. In addition, different scenarios, giving a comprehensive picture of the foreseen situation and the evidence-based policies and actions needed to maximize the effective delivery and sensitivity in the service of care …
Strengthening Child-centred Health Systems response: what happens with migrant children?
Abstract Migrant children are especially vulnerable to the challenges experienced during the migratory process and its integration in the host country, even more, if they are unaccompanied. Child-centred Health Systems responses are needed, for that reason, the Erasmsus+ project EUVETCARE aims to strengthen the capacity of the professionals and systems to meet the specific needs of this population. A qualitative study allowed a needs assessment of the health and social care professionals in 5 EU countries (Cyprus, Germany, Greece, Italy and Spain). A total of 15 focus groups were carried out (99 participants). Focus groups discussions were transcribed verbatim in local languages and transcr…
Responsive and Minimalist App Based on Explainable AI to Assess Palliative Care Needs during Bedside Consultations on Older Patients
[EN] Palliative care is an alternative to standard care for gravely ill patients that has demonstrated many clinical benefits in cost-effective interventions. It is expected to grow in demand soon, so it is necessary to detect those patients who may benefit from these programs using a personalised objective criterion at the correct time. Our goal was to develop a responsive and minimalist web application embedding a 1-year mortality explainable predictive model to assess palliative care at bedside consultation. A 1-year mortality predictive model has been trained. We ranked the input variables and evaluated models with an increasing number of variables. We selected the model with the seven …
The Experiences and Views on Palliative Care of Older People with Multimorbidities, Their Family Caregivers and Professionals in a Spanish Hospital
The increasing prevalence of complex chronic diseases in the population over 65 years of age is causing a major impact on health systems. This study aims to explore the needs and preferences of the multimorbid patient and carers to improve the palliative care received. The perspective of professionals who work with this profile of patients was also taken into account. A qualitative study was conducted using semi-structured interviews with open-ended questions. Separate topic guides were developed for patients, careers and health professionals. We included 12 patients, 11 caregivers and 16 health professionals in Spain. The results showed multiple unmet needs of patients and families/caregiv…
Evaluation design of Urban Health Centres Europe (UHCE): preventive integrated health and social care for communitydwelling older persons in five European cities
BackgroundOlder persons often have interacting physical and social problems and complex care needs. An integrated care approach in the local context with collaborations between community-, social-, and health-focused organisations can contribute to the promotion of independent living and quality of life. In the Urban Health Centres Europe (UHCE) project, five European cities (Greater Manchester, United Kingdom; Pallini (in Greater Athens Area), Greece; Rijeka, Croatia; Rotterdam, the Netherlands; and Valencia, Spain) develop and implement a care template that integrates health and social care and includes a preventive approach. The UHCE project includes an effect and process evaluation.Meth…
The effectiveness of a coordinated preventive care approach for healthy ageing (UHCE) among older persons in five European cities: A pre-post controlled trial.
Abstract Background Older persons often have multiple health and social problems and need a variety of health services. A coordinated preventive approach that integrates the provision of health and social care services could promote healthy ageing. Such an approach can be organised differently, depending on the availability and organizational structures in the local context. Therefore, it is important to evaluate the effectiveness of a coordinated preventive care approach in various European settings. Objectives This study explored the effects of a coordinated preventive health and social care approach on the lifestyle, health and quality of life of community-dwelling older persons in five …
Co-created training program to promote active ageing in people with Down syndrome
Abstract Background Population ageing is a current challenge for the European society. Specifically, People with Down Syndrome (PDS) are living longer than before, reaching some of them around 60 years old. However, it is known that they show premature ageing that in some cases may be misled with Alzheimer first signs. Hence, it is crucial to promote an Active Ageing (AA) and healthy living in this specific population by keeping their cognitive, physical and emotional functions, and also promoting social activities such as community participation. In such way, their Quality of Life (QoL) will be increased. Objectives The main objective of this study was to co-design a Training Program (TP) …
Migrants' and refugees' health status and healthcare in Europe: A scoping literature review
Abstract Background There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes. Methods This review scoped 77 papers from nine European countries (Austria, Cyprus, France, Germany, Greece, Italy, Malta, Spain, and Sweden) in English and in country-specific languages i…
Digital and innovation skills in health care professionals in Europe
Abstract Background Rising life expectancy and ageing population are current phenomena that European society is facing and these are challenges for the European healthcare systems. To face them, several e-health solutions are already designed to optimize resources of the healthcare provider system. However, most of them are not being implemented or deployed. Some of the reasons are the lack of digital skills and innovation readiness in staff, and existing barriers to changing organizational practices. Objectives The DISH project (601008-EPP-1-2018-1-DK-EPPKA2-SSA) will develop 3 concepts to improve the digitalization of healthcare staff to help them in the use of e-health solutions already …