Evidence and Policy
PMS Summary and Report
Key Points
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.
- 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
Measures taken at entry into Upstream and (mean) 5.5 months’ later.
- 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. 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).
