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A research study was conducted to determine public opinion in Alberta, a Canadian province, on the controversial topic of death hastening. Questions on the right to hastened death, end-of-life plans and end-of-life experiences were included in the Population Research Laboratory's annual 2010 health-care telephone survey, with 1203 adults providing results relatively representative of Albertans. Of all 1203, 72.6% said yes to the question: 'Should dying adults be able to request and get help from others to end their life early, in other words, this is a request for assisted suicide'? Among all who provided an answer, 36.8% indicated 'yes, every competent adult should have this right' and 40.6% indicated 'yes, but it should be allowed only in certain cases or situations'. Over 50% of respondents in all but one socio-demographic population sub-group (Religious-other) were supportive of the right to hastened death. However, multinomial regression analysis revealed that the experiences of deciding to euthanise a pet/animal and developing or planning to develop an advance directive predicted support, while self-reported religiosity predicted non-support. Finding majority public support for death hastening suggests that legalisation could potentially occur in the future; but with this policy first requiring a careful consideration of the model of assisted suicide or euthanasia that best protects people who are highly vulnerable to despair and suffering near the end of life. [ABSTRACT FROM AUTHOR]

Health counselling is an evidence-based behavioural medicine approach and the most commonly reported form of faith-based health interventions. Yet, no research has explored the factors influencing the implementation of faith-based health counselling. Therefore, this study examined individual, organisational and environmental factors associated with offering/not offering faith-based health counselling programmes within faith-based organisations. A national, internet-based, opt-in, cross-sectional survey of faith leaders ( N = 676) was conducted (March-December 2009) to assess faith leaders' demographic information, health status, fatalism, health-related attitudes and normative beliefs, attitudes towards health counselling, institutional and occupational information, and perceptions of parent organisation support for health and wellness interventions. Most faith leaders reported offering some type of health counselling in the past year [ n = 424, 62.7%, 95% CI (59.0, 66.3)]. Results of a multivariate logistic regression showed that faith leaders reporting greater proxy efficacy (OR = 1.40, P = 0.002), greater comfort in speaking with church members about health (OR = 1.25, P = 0.005), greater perceived health (OR = 1.27, P = 0.034), and who worked at larger churches (OR ≥ 3.2, P ≤ 0.001) with greater parent organisation support (OR = 1.33, P = 0.002) had significantly higher odds of offering faith-based health counselling. Church size and parent organisation support for faith-based health interventions appear to be important factors in the presence of faith leader health counselling. The content of faith leader health counselling training should aim to increase faith leaders' confidence that church members will successfully change their health behaviours as a result of the health counselling and increase faith leaders' comfort in speaking with church members about health. Future research is needed to examine efficacious and effective dissemination methods such as the use of internet trainings, CD ROM materials and incorporating health counselling into seminary school. [ABSTRACT FROM AUTHOR]

This study assesses the Urban Breakaway Project, a collaborative project offering a structured vacation in the countryside of the province of Quebec intended for homeless (or street) youths. The objective of this study was to document participants' perspectives regarding this project by examining their satisfaction, intention to change following their stay and perceived improvement with respect to their life situation. Another goal of this research was to investigate the relationship between satisfaction level and perceived improvement of participants. One hundred and seven individuals participated in the study, during Urban Breakaway's first year of operation. Satisfaction with the project, assessed with the global Client Satisfaction Questionnaire-3 score, revealed a positive relationship with global scores of perceived improvement, as measured by the Perceived Improvement Questionnaire [PIQ; r = 0.37 (67), 95% CI (0.15; 0.56)]. Regarding intention to change, the data indicated that 95% of participants had moderate-to-definite intentions to do something to change their lives. Participants reported an improvement for most items covered by the PIQ. They experienced the greatest changes in relation to mood, leisure, appetite, physical condition and self-esteem. Results indicate that the Urban Breakaway Project reaches not only street youths but also an older homeless population. Participants, regardless of their age, were found to be very satisfied with services obtained, and their satisfaction was significantly correlated with the perceived improvement in their situation. Qualitative data indicate that characteristics of the programme, such as the countryside setting, the focus on basic needs, the climate and the opportunity for socialisation, peer support (or belonging) and personal growth were appreciated. [ABSTRACT FROM AUTHOR]

Glycaemic control is an essential component in diabetes management. There is growing attention on the protective effects of social capital on health, where social capital comprises features of society that facilitate co-operation for mutual benefit. The aim of this study was to investigate its role as a social determinant of health in the glycaemic control of diabetes mellitus. A cross-sectional study was conducted in a diabetes care charity institute, Isfahan, Iran from July 2010 to September 2010. Based on the level of HbA1c, all patients were divided into two groups: HbA1c level ≤ 7 as controlled diabetes and HbA1c level > 7 as uncontrolled diabetes. Sixty patients were randomly selected from each group (controlled diabetes and uncontrolled diabetes) and all agreed to participate. Social capital was measured using the Integrated Questionnaire for the Measurement of Social Capital (SC-IQ). The mean age of participants in the controlled diabetes group was 51.3 (SD: 7.8) years and 50.1(SD: 7.2) in the uncontrolled group. The mean social capital score was 185.1 (CI 95% 181.4-188.6) in the controlled group and 175.4 (CI 95% 171.8-178.8) in the uncontrolled group. There was a significant negative correlation between empowerment and political action and trust and solidarity dimensions and the level of HbA1c. In multiple regression analysis, trust and solidarity and empowerment and political action were significant predictors of the HbA1c. The results of this study suggest that social participation, trust, and empowerment and political action may determine how effectively the patient's diabetes has been managed. This initial finding warrants subsequent experimental investigations designed to identify strategies that can be used to foster the creation of social capital to improve diabetes control. [ABSTRACT FROM AUTHOR]

A randomised controlled trial was conducted to test the effectiveness of the Home Independence Program (HIP), a restorative home-care programme for older adults, in reducing the need for ongoing services. Between June 2005 and August 2007, 750 older adults referred to a home-care service for assistance with their personal care participated in the study and received HIP or 'usual' home-care services. Service outcomes were compared at 3 and 12 months. Subgroups of 150 from each group were also compared on functional and quality of life measures. Data were analysed by 'intention-to-treat' and 'as-treated'. The intention-to-treat analysis showed at 3 and 12 months that the HIP group was significantly less likely to need ongoing personal care [Odds ratio (OR) = 0.18, 95% CI = 0.13-0.26, P < 0.001; OR = 0.22, 95% CI = 0.15-0.32, P < 0.001]. Both subgroups showed improvements on the individual outcome measures over time with the only significant differences being found at 12 months for Instrumental Activities of Daily Living (IADL) in the as-treated analysis. Contamination of the control group by an increased emphasis on independence across the home-care agency involved, together with other methodological problems encountered, is thought to account for the few differences between groups in individual outcomes. Despite no difference between the groups over time in their overall ADL scores, a significantly smaller proportion of the HIP group required assistance with bathing/showering, the most common reason for referral, at 3 and 12 months. The results support earlier findings that participating in a short-term restorative programme appears to reduce the need for ongoing home care. The implementation of such programmes more broadly throughout Australia could substantially offset the projected increase in demand for home care associated with the five-fold projected increase in numbers of the oldest old expected over the next 40 years. [ABSTRACT FROM AUTHOR]

World Health Organization and United Nations International Children's Emergency Fund have strongly recommended a sustained coverage of universal immunisation among all children against tuberculosis, polio, diphtheria, pertussis, tetanus and measles. In India, these vaccines under the universal immunisation programme are made available absolutely free of cost to all children through the public health system. Information regarding immunisation coverage among HIV exposed children in India is still very limited. The objective of this study was to estimate the proportion of children of people living with HIV who had been completely immunised by the age of 12 months and to find predictors of complete immunisation. A community-based cross-sectional survey was conducted in the Kolkata Metropolitan Area between 15 June and 14 September 2009 using a pre-structured interview schedule. Data were analysed from 256 care-givers of children (85.5% response rate) whose parents were randomly selected from the Bengal Network of HIV-positive people. Multiple logistic regression was used to estimate and test associations of predictors with complete immunisation. The percentage of children of people living with HIV completely immunised at the age of 12 months was 73.0% (67.3% to 78.1%), which was not significantly different from that for all children at 12 months. Mothers having received antenatal care [OR (odds ratio): 7.29; 95% confidence intervals (CI): 2.39-22.25], mothers having postprimary education (OR: 3.37; 95% CI: 1.45-7.81), children of Hindu and Christian religion (OR: 3.74; 95% CI: 1.63-8.62), children not belonging to scheduled castes, tribes and 'other backward classes' (OR: 2.08; 95% CI: 1.02-4.25) were significant independent predictors of complete immunisation status of these children. This emphasises the imperative need for up-scaling of antenatal care among the pregnant mothers to ensure complete immunisation among their children. A special focus on girl child education should also be implemented to empower future mothers for a sustained improvement of child immunisation in the long-run. The current national immunisation programme should focus on the children from the Muslim community and those belonging to scheduled castes, tribes and other backward classes to improve coverage. [ABSTRACT FROM AUTHOR]

This research explores the relationship between support worker utilisation and patient- and team-level characteristics using a prospective longitudinal study of 20 older people's community rehabilitation teams. Between January and September 2009, 462 Whole Time Equivalent Staff and 1913 patients participated in the study. Patient dependency, health status (Therapy Outcome Measures, EQ-5D and Levels of Care tool) and demographic data were collected alongside detailed staff activity data for patients during the recruitment period. Multivariate analyses were used to determine the relationship between the proportion of care delivered by support workers team and patient variables. Support workers delivered up to 36% of direct patient care and spent less time per patient contact (36.0 minutes, SD 37.7, range 0-600) than qualified professionals (mean time per contact 75.8 minutes, SD 32.9, range 0-334). Less-dependent and female patients had a greater proportion of support worker input, with a 4.9% increase in face-to-face support worker time for every 0.1 unit increase in EQ-5D (95% CI 0.3-9.6, P = 0.038), while females had an additional 5.1% of their total contact time with support workers compared with males (95% CI 1.9-8.4, P = 0.002). In an analysis without EQ-5D, older patients had a greater proportion of support worker time ( P = 0.006). Other factors associated with support worker input include the referral source, intensity of care, usual living arrangements and proportion of support staff in a team. Results indicate that patient- and team-level factors are a determinant in the proportion of support worker care delivered to older people in the community, suggesting that it may be appropriate to introduce a more explicit targeted deployment of support workers based on patient-level characteristics, which may facilitate a more effective use of qualified practitioner time for more complex, dependent patients. [ABSTRACT FROM AUTHOR]

Due to the ageing population, there is an increased demand for home care services. Restorative care is one approach to improving home care services, although there is little evidence to support its use in the community setting. The objective of this trial was to evaluate the impact of a restorative home care service for community-dwelling older people. The study was a cluster randomised controlled trial undertaken at a home care agency in New Zealand. The study period was from December 2005 to May 2007. Older people were interviewed face-to-face at baseline, four and 7 months. A total of 186 older people who received assistance from a home care agency participated in the study, 93 received restorative home care and 93 older people received usual home care. The primary outcome measure was change in health-related quality of life (measured by the Short Form 36 [SF36] Health Survey). Secondary outcomes were the physical, mental, and social well-being of older people (Nottingham Extended Activities of Daily Living, Timed Up and Go, Mastery scale, Duke Social Support Index). Findings revealed that compared with usual care, the intervention demonstrated a statistically significant benefit in health-related quality of life (SF36) at 7 months for older people (mean difference 3.8, 95% CI −0.0 to 7.7, P = 0.05). There were no changes in other scale measurements for older people in either group over time. There was a statistically significant difference in the number of older people in the intervention group identified for reduced hours or discharge (29%) compared with the control group (0%) ( P < 0.001). In conclusion, a restorative home care service may be of benefit to older people, and improves home care service efficacy. [ABSTRACT FROM AUTHOR]

There is limited knowledge on the relationship between the living conditions of community-dwelling older people and their quality of life (QOL) considered in all its specific domains. The purpose of this study was to determine (1) which dimensions of QOL were independently associated with living alone and (2) the independent correlates of these dimensions of QOL amongst older outpatients. We conducted a cross-sectional survey of 239 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric medicine clinic in Italy between June and November 2009 (response rate 93%). Subjects underwent a comprehensive geriatric assessment including QOL, which was evaluated by using the Older People's QOL questionnaire. In multivariate logistic regression analyses, living alone was associated with the lowest score-based tertile of two specific dimensions of QOL out of seven, namely 'social relationships and participation' [odds ratio (OR) 2.73, 95% confidence interval (CI) 1.08-6.91] and 'home and neighbourhood' (OR 4.96, 95% CI 1.75-14.07), independently of the main demographic, social, functional and clinical characteristics of the subjects. Amongst the 107 subjects living alone, independent correlates of these dimensions of QOL were depression, having no caregiver and having never been married. Depression, having no caregiver and having never been married could provide a valuable means of identifying older people living alone who are at greater risk of a poor QOL and who would most benefit from effective social and medical interventions. [ABSTRACT FROM AUTHOR]

Community support services (CSSs) have been developed in Canada and other Western nations to enable persons coping with health or social issues to continue to live in the community. This study addresses the extent to which awareness of CSSs is structured by the social determinants of health. In a telephone interview conducted in February-March 2006, 1152 community-dwelling older adults (response rate 12.4%) from Hamilton, Ontario, Canada were made to read a series of four vignettes and were asked whether they were able to identify a CSS they may turn to in that situation. Across the four vignettes, 40% of participants did name a CSS as a possible source of assistance. Logistic regression was used to determine factors related to awareness of CSSs. Respondents most likely to have awareness of CSS include the middle-aged and higher-income groups. Being knowledgeable about where to look for information about CSSs, having social support and being a member of a club or voluntary organisations are also significant predictors of awareness of CSSs. Study results suggest that efforts be made to improve the level of awareness and access to CSSs among older adults by targeting their social networks as well as their health and social care providers. [ABSTRACT FROM AUTHOR]

People, along with their families, feel the impact of chronic illness in many areas of their lives. It has been known that those with chronic illness leave the workforce earlier than their peers, have lower incomes and often need additional support to manage their health and lives. However, limited information is available about whether chronic illness is already present prior to retirement, or has developed subsequently. Similarly, we know little about what personal and household assistance is needed by people with chronic illness. In this study, a random sample of 10 000 members of National Seniors Australia, stratified by age and state of residence, were surveyed by post between August and September 2009 and asked about their chronic illnesses along with their age at diagnosis. In addition, participants were asked about their need for assistance with everyday household tasks and personal care. Responses were received from 4574 respondents, a response rate of 45.7%. Of those responding, 82.2% reported having at least one chronic illness at the time of the survey. The study confirms that ill health leads to earlier retirement from the workforce, and those who are sickest require more assistance with their household tasks and personal care. Each additional chronic illness present at age 50 reduced working life by a year, and each present at age 60 by 0.7 years. Diabetes, arthritis and depression were significantly related to earlier retirement. The impact was greatest for both continued workforce participation and need for assistance for those suffering from depression or anxiety. The relationships between health, workforce participation and need for assistance in daily activities are complex. Further research is required to uncover this complexity; nevertheless, the findings highlight the need to review the adequacy of current social and health policy for this particular population. [ABSTRACT FROM AUTHOR]

Equity of access to health services is a major concern as it is an important precondition for positive health outcomes. However, inequities in use of health services among immigrant populations persist. Despite the increasing research in the field, patterns of healthcare seeking among immigrant populations and its associated factors are not fully understood. This study aimed to investigate healthcare-seeking patterns among immigrants in Portugal and identify factors associated with utilisation of health services. A cross-sectional study was conducted between October 2008 and May 2009 with a sample of 1375 immigrants residing in the Lisbon region. Data were collected through a structured questionnaire applied by trained interviewers. Two stepwise logistic regressions were conducted to identify which factors were associated with utilisation of the National Health Service (NHS) and with healthcare seeking for the first time in Portugal at the Primary Health Care service, estimated by calculating odds ratios and 95% confidence intervals. Among participants, around 77% reported having used the NHS; 50% sought health-care for the first time at the Primary Health Care service and 33% at the emergency room. Lower odds of having used the NHS were associated with being male, Brazilian or eastern European compared with being African, and undocumented. Lower odds of having sought health-care for the first time at the Primary Health Care service were associated with being male and undocumented. These results suggest that further efforts are needed to tackle inequalities in access to care and promote the utilisation of health services, particularly among the more vulnerable immigrant groups. Increasing appropriate utilisation of health services, including the primary and preventive care services, may lead to better health outcomes. Immigrants' involvement and participation should be incorporated into the development of health strategies to improve access and utilisation of healthcare services. [ABSTRACT FROM AUTHOR]

There is strong evidence suggesting ethnic variations in mental health service use and disproportionate numbers of people of black ethnic origin being admitted to hospital. The objective of this study was to establish whether people of black ethnic origin had equal access to home treatment in a mental health crisis. Using a case-control design, we selected a random sample of 240 inpatient episodes and compared them with a sample of 77 home treatment episodes over a 12-month period (1 April 2008-31 March 2009). We found no difference in the proportion of people of black ethnic origin being home treated in comparison to receiving an inpatient admission, although they experienced longer hospital admissions than people of other ethnic origin. Diagnosis, housing status and source of referral were found to be significant in influencing the choice of intervention in our multivariate analysis. People of black ethnic origin were found to use home treatment to the same extent as other ethnic groups in a mental health crisis, but further research is required for the early discharge function of home treatment teams to evaluate whether this aspect of care is experienced differently by different ethnic groups. [ABSTRACT FROM AUTHOR]

Volunteers and staff of women's organisations who are highly active in engaging and providing community service can be recruited to motivate female smokers to quit. We described the knowledge and attitudes regarding tobacco control and smoking cessation among these affiliates in Hong Kong and identified factors associated with the practices of cessation interventions. Eight of 14 women's organisations joining the Women Against Tobacco Taskforce agreed to participate. All staff, volunteers, and members of the eight organisations were invited to complete a self-administered anonymous questionnaire during July and August 2006. A total of 623 out of 771 (80.8%) affiliates responded. Their knowledge on smoking and health (mean = 3.91, SD = 1.44 on a range of 0-7), smoking related diseases (mean = 2.91, SD = 0.97 on a range of 0-4), and women-specific diseases (mean = 2.93, SD = 1.87 on a range of 0-6), was considered to be inadequate. They had positive attitudes towards tobacco control (mean = 3.31, SD = 0.55) and their own role in smoking cessation counselling (mean = 3.19, SD = 0.56) on a 4-point Likert scale and 39.3% reported had attempted to offer quitting advice. Logistic regression analysis found that participants having direct contact with smokers who had a positive attitude towards their own role in smoking cessation counselling (OR = 2.57; 95% CI = 1.67-3.95) and better knowledge of smoking and smoking-related diseases (OR = 1.35; 95% CI = 1.06-1.71) were more likely to provide cessation counselling after controlling for gender; knowledge on smoking and health, and women-specific diseases; attitude towards tobacco control, negative and positive attitudes towards female smokers, and perceived self-efficacy in smoking cessation counselling. Women's organisations showed limited support towards tobacco control and their affiliates had a limited knowledge on smoking and health but had positive attitudes. Appropriate training, capacity building and establishing rapport with women's organisations are needed to promote smoking cessation and to support tobacco control in the community. [ABSTRACT FROM AUTHOR]

In order to promote new human papillomavirus (HPV) prevention and detection methods effectively in Mexico, it is important to understand how much the population knows about the virus. This study aimed to determine the demographic and behavioural factors associated with HPV awareness and knowledge in a population of Mexican college students. With a response rate of 77%, data were collected from 1109 college students aged 17-25 years old at the Autonomous University of the State of Morelos in 2006. Students completed a questionnaire that assessed demographic and behavioural characteristics along with questions about HPV. A small percentage (16.9%) of the college students had never heard about HPV. Characteristics associated with not having heard about HPV included being male, not having running water, not having health insurance and not having sexual experience. Students had a median score of 5 out of 10 on an HPV knowledge index based on 10 yes/no questions about HPV developed for this study. Students had higher HPV knowledge scores if they studied health science, or science and engineering, were a fourth year student, had running water at home, had health insurance, or were a female who had had a previous Pap smear. Although most of these Mexican college students had heard of HPV, they had limited knowledge about the virus and prevention strategies. Further research in Mexican college students is needed to explain the variations in HPV knowledge to create appropriate health education programmes. [ABSTRACT FROM AUTHOR]

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported 'initiation and/or advice' smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with 'initiation and/or advice' were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China. [ABSTRACT FROM AUTHOR]

Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994-2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89-1.94, females OR: 1.14, 95% C.I.: 0.78-1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73-2.23, females OR: 1.23, 95% C.I.: 0.64-2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17-0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00-1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population. [ABSTRACT FROM AUTHOR]

Migrant workers are increasingly important to the care sector in England as well as in other developed countries. The profile of migrants is likely to continue changing due to reforms in immigration policy and legislation limiting the range of jobs open to migrants from non-EU countries while facilitating migration from the new European Union accession countries. This article reports on detailed secondary analysis of newly available data on the characteristics of migrants working in the care sector as their first job. The analysis was undertaken in 2009 as part of research investigating the contribution made by migrant care workers in England. The sample was identified from the new National Minimum Data Set for Social Care (NMDSSC), which is completed by social care employers in England. Workers whose ethnicity was identified as not White British and who had their previous job abroad were used as a proxy of recent migrants. The analysis shows that this group of workers has a significantly different profile compared with other workers. Recent migrants in the care sector were significantly younger and held higher qualifications relevant to social care; however, there were no significant gender differences. They were also significantly concentrated in the private and voluntary sectors and in direct care work. There were variations between recent migrants' ethnicity and their job roles, with Asian workers more prevalent in senior care positions. These findings have a number of possible implications for social care workforce and providers, particularly within the current context of changing migration rules and social care reforms. [ABSTRACT FROM AUTHOR]

Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3) a letter with encouragement to phone the visitor for appointment (letter without a proposed date). Covariates included sex, age, experience with preventive interventions, functional ability, self rated health, social relations and psychosocial characteristics. Statistical analyses included chi-square tests, and bi- and multivariable logistic regression analyses. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to 'letter with a proposed date', men had an odds ratio of 1.78 (95% CI: 1.16-2.74) for declining visits when 'telephone call' was used and an odds ratio 2.81 (95% CI: 1.79-4.40) when 'letter without a proposed date' was used as the invitational procedure. In women the odds ratios were 1.23 (95% CI: 0.91-1.68) and 1.87 (95% CI: 1.37-2.55), respectively. [ABSTRACT FROM AUTHOR]

The main objective of the study was to apply the recently developed Index of Capability (ICECAP-O) instrument to measure and value the quality of life of a representative sample of the older South Australian population (aged ≥ 65 years) according to carer status. A Health Omnibus survey including the ICECAP-O instrument, carer status (informal carer vs. non-carer) and several socio-demographic questions was administered in 2009 as a face-to-face interview to 789 individuals aged 65 years or older in their own homes. A total of 671 individuals (85%) characterised themselves as a non-carer and 115 individuals (15%) characterised themselves as an informal carer. In general, carers exhibited relatively high quality of life as measured by the ICECAP-O, with carers having comparable mean ICECAP-O scores to non-carers in the general population [carers: mean (SD) 0.848 (0.123), non-carers: mean (SD) 0.838 (0.147)]. The results of the multivariate regression model for the total sample indicated statistically significant variations in overall ICECAP-O scores according to age (with younger participants tending to have slightly higher scores on average), country of birth (with those participants who were born in Australia having higher scores on average than those who were born elsewhere) and household income (with participants with higher income levels having higher scores on average). The results of the multivariate regression model differentiated by carer status also indicated some important differences. Specifically, average ICECAP-O scores were noticeably lower for carers who are separated or divorced and for carers who lived alone and these differences were statistically significant. The study findings provide support for the existence of process utility in informal care-giving. The provision of informal care may be associated with a positive impact upon quality of life for many caregivers, which may mediate the negative aspects arising from the burden associated with informal care-giving. [ABSTRACT FROM AUTHOR]