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FlourishCare Model of Integrated Care: The Validation of the Flourish Index-Revised.
- Source :
-
The Gerontologist [Gerontologist] 2024 Jul 01; Vol. 64 (7). - Publication Year :
- 2024
-
Abstract
- Background and Objectives: This study validates the Flourish Index-Revised (FI-R), a tool evaluating integrated healthcare models. The original Flourish Index (FI) was developed in 2018 and has been refined to align with the FlourishCare (FC) Model (Model) for geriatric primary care.<br />Research Design and Methods: The Model provides integrated biopsychosocial healthcare to older adults. The FI-R uses 25 quality-of-care indicators and 7 contextual community indicators. The FI-R was validated with Categorial Principal Components Analysis (CATPCA) using a sample of 949 patients 50+ who were mostly female (73%), non-Hispanic White (70%), living in urban areas (90%), and married (29%), single (22%), or divorced (19%). The mean age was 73.46 (standard deviation [SD] = 10.86) and mean years of education was 14.30 (SD = 2.14).<br />Results: CATPCA showed a 4-dimensional structure of biological, psychological, and 2 social determinants of health (SDOH) subdomains: health behaviors and community. Final selection of indicators was based on total variance accounted for >0.30, absolute values of item loadings >0.45, and not having cross-loadings >0.45 on 2 factors. Internal consistency (Cronbach's alpha) for the determinants were biological = 0.75, psychological = 0.76, SDOH:community = 0.70, SDOH:health behaviors = 0.50, and total FI-R = 0.95. Sensitivity to change was shown for the total FI-R, psychological determinants, and SDOH:health behaviors, but not for biological determinants.<br />Discussion and Implications: The validation of the FI-R shows promise for its usability to evaluate integrated healthcare models using existing measures in electronic health systems. More work is needed to improve the incorporation of SDOH:sociodemographics into the FI-R.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)
Details
- Language :
- English
- ISSN :
- 1758-5341
- Volume :
- 64
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The Gerontologist
- Publication Type :
- Academic Journal
- Accession number :
- 38721939
- Full Text :
- https://doi.org/10.1093/geront/gnae042