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Table 1 Effectiveness strategies in the intervention group

From: A community-based health–social partnership program for community-dwelling older adults: a hybrid effectiveness–implementation pilot study

Theories

Content

Strategies

The Omaha system

Problem classification scheme

▪ Assess four domains, namely, environmental, psychosocial, physiological, and health-related behavior

Intervention scheme

▪ Set contract goals and formulate an individual care plan with the participants

▪ Provide information about health-promoting and self-care activities

Problem-rating scale for outcomes

▪ Evaluate knowledge, behavior, and status after implementing the intervention

Bandura’s social cognitive theory

Mastery experience

▪ Explore past successful experiences of handling health care issues

▪ Remind them of helpful strategies

Vicarious experience

▪ Show pictures, newspaper clips, or videos of celebrities who have successfully adhered to self-care behavior

Social and verbal persuasion

▪ Provide verbal encouragement

Physiological and affective states

▪ Monitor and note the physiological status, i.e., vital signs, regularly in a booklet

▪ Encourage the participants to state their concerns about work

Gittell’s relational coordination theory

Routines

▪ Formulate a standardized protocol

Information systems

▪ Create referral forms and records

Meetings

▪ Conduct bimonthly case conferences (frequency can be adjusted)

Boundary spanner

▪ The nurse case manager can provide strong leadership and help to integrate the work of others