Improving vision and health of elders in Nuwara Eliya district, Sri Lanka

The aim of our study is to improve the health, including eye health, and well-being of older people aged 60 years and above, through the establishment and support of Elders’ Clubs in Sri Lanka. Our objectives include:

Primary objective

To assess the effectiveness of community-based Elders’ Clubs (Intervention) compared to no Elders’ Club (Control group) on the quality of life of older people in Nuwara Eliya District in Sri Lanka.

Secondary objectives

1.  To assess the impact of participation in Elders’ Clubs on health, well-being, health related behaviour, and social and economic outcomes of older people in Nuwara Eliya District in Sri Lanka.
2. To describe key health and vision problems, health related behaviours, service access, social participation, care, and key demographic and socio-economic factors among older people to inform the planning and implementation of the Better Vision, Healthy Ageing Program and to assist policy makers.
3. To assess health seeking behaviour, and the barriers and enablers to access and uptake of health services.
4. To assess and explore feasibility, acceptability, costs and sustainability of introducing and supporting Elders’ Clubs.
5. To evaluate the effectiveness of the Program’s support to improve eye health care services in Nuwara Eliya district.

June 2012 - June 2016

The Elders’ Clubs are being introduced and supported in the Better Vision, Healthy Ageing (BVHA) Program area. The study is a cluster-randomized controlled trial (cRCT), nested in the BVHA Program. The cRCT will be conducted in randomly selected clusters within the Program area. Forty (40) clusters consisting of GN Divisions (local administrative divisions) have been randomly selected proportionate-to-size. These clusters will be randomly assigned to have community-based Elders’ Clubs introduced and supported after the baseline data collection (Intervention arm) or later after the endline data collection (Control arm).

Data will be collected to assess impact of Elders’ Club participation on health-related quality of life after 15 months. After that, Elders’ Clubs will also be introduced in the Control GN Divisions and supported for nine months until the end of the Program. In this way only 20 of the 93 GN divisions in the Program area will have the intervention delayed, and all the GN Divisions will have Elders’ Clubs introduced and supported within the Program period. The GNs will continue to support the Control arm Clubs after the Program ends, and efforts will be made to engage key stakeholders, such as estate management, to ensure ongoing support for the Elders’ Clubs.

The trial intervention is the establishment of, and support for, Elders’ Clubs at the community (village or tea estate) level. The intervention consists of Elders’ Clubs and Elders’ Committees (made up of one male and one female leader from each Elders’ Club). The intervention includes:

• Financial support to assist the set up and implementation of elders clubs
• Monthly phone calls or visits from program officers
• Loan of equipment or musical instruments etc
• Health information materials
• Visits by District Medical Officers and Estate Medical Assistants for health screening
• Social and cultural activities

It is expected that participants in the intervention group will have greater access to health services and improved self-reported quality of life.