Bullet points from PMS Report - Evaluation - Upstream

Bullet points from PMS Report

Verbal feedback. From N=26 (18 interviews, focus group)

• Psychological and social benefits
  
  • Reductions in depression and loneliness
  • Increased alertness / cognitive awareness / well-being / optimism
  • Less dwelling on concerns / worries, better sleep
  • Increased social interaction and community involvement
  • Increased sense of self-worth and willingness to engage in life
    
• Health behaviour and health benefits
  
  • Improved physical activity, diet and drinking
  • Less health visits, reduced medication use
  • Potentially reduced risk of falls (due to alertness effect)
  • Facilitated rehabilitation of co-ordination / mobility post-stroke
    
• Transformational change
  
  • Around a quarter of cases reported profound life-changes
  • Re-engagement with society, renewed optimism about life
  • Dramatic lifestyle changes
    
• No significant negative outcomes (1 shoulder strain after exercise).
• Discussion with mentors confirmed that from their perspective, for all engaged participants (N ~200) - around 80-90% derived noticeable positive benefits, and about 20-30% underwent dramatic transformations in mood and behaviour.
• The questionnaire data confirmed clinically meaningful changes (2 points on SF-12) in mental well-being for around 60% of participants, with 30% experiencing dramatic positive changes (a shift of 25 population centiles or 6.1 SF-12 points).

Sample Characteristics (N=172)

• 76% female, average age 77 (52 to 96), 25% with financial pressures
• Health: Participants have poor physical and psychological health, commensurate with high levels of loneliness /social isolation
  
  • 74% at least one longstanding health impairment which limits activities
  • SF12 health quality of life scores significantly lower than norms for UK over-75s and UK population (both mental and physical health)
  • 53% with clinical levels of depression, based on GDS scores
• 64% widowed, 73% living alone, 93% retired (N=45 here)
  

6 Month Follow-up Data (health measures) N =71
Survey is ongoing. Measures taken at entry into Upstream and (mean) 5.5 months’ later.  Data for larger numbers will be available as time goes on.

• Statistically significant increase in SF12 mental health component (Mean Diff: 3.0 points, p < 0.005)
• The change in SF12 scores (effect size 0.30SD) is clinically meaningful (the consensus is that 2-3 points is meaningful)
  
• No significant increase or decrease in SF12 physical health component
• Statistically significant reduction in depressive mood (Diff=0.60, p < 0.02)
  
• The above change (effect size 0.31SD) is also clinically meaningful. The number with clinical levels of depression fell from 32(45%) to 25(35%)
• Slight increase in proportion engaging in physical activity from 67% to 78%

12 Month Follow-up Data (health measures) N =51

Survey is ongoing, and data for larger numbers will be available as time goes on. Measures taken at entry into Upstream and (mean) 12.0 months’ later.

• Improvements in depression scores were maintained (Mean Diff=0.57, p<0.05)
• The size of the difference in SF12 mental component scores decreased (Mean improvement=0.71 points, n.s)
• SF12 physical component scores now showed a strong trend towards improvement (Mean Diff=1.57, p=0.06)
• The overall health utility index (which combines SF12 mental and physical components) improved significantly (Mean Diff=0.027, p<0.05)
• Social support scores (MOS Social Support Scale) also improved significantly (Mean Diff=0.20, p<0.05, effect size =0.34).