PMID- 37502365
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230729
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 10
DP  - 2023
TI  - Evaluating the design of the Integrated Care for Older People: a theory of change 
      approach.
PG  - 1166196
LID - 10.3389/fmed.2023.1166196 [doi]
LID - 1166196
AB  - INTRODUCTION: Given the progressive aging of the population, there is an urgent 
      need at the health system level to implement effective models to care for older 
      people (OP). Healthy aging is imperative to reach the Sustainable Development 
      Goals. The World Health Organization (WHO) developed the Integrated Care for 
      Older People (ICOPE) strategy to address this challenge. Implementing ICOPE 
      requires its adaption to a specific context. We propose a pathway for such 
      adaptation through an evaluation of the design of ICOPE; thus, we aim to describe 
      the Theory of Change (ToC) of ICOPE and evaluate it for its implementation in 
      Mexico City. METHODS: Based on the WHO and published literature documentation, we 
      drafted an initial ToC for ICOPE. Then, we validated the ToC with experts in 
      ICOPE, after which we evaluated and refined it by discussing the causal pathway, 
      intervention required to activate it, rationale, and assumptions in consecutive 
      workshops with 91 stakeholders and healthcare workers, using the nominal group 
      technique to reach a consensus. RESULTS: The resulting ToC has the potential to 
      contribute to healthy aging by three expected impacts: (1) prevention, reversal, 
      or delaying of the decline of intrinsic capacity (IC) in OP; (2) improvement of 
      the quality of life of OP; and (3) increase of disability-free life expectancy. 
      The ICOPE causal pathway had ten preconditions, including the availability of 
      resources, identifying at-risk individuals, available treatments, and evaluating 
      results. DISCUSSION: We adapted ICOPE to a specific implementation context by 
      evaluating its ToC in a participatory process that allows us to identify 
      challenges and address them, at least in terms of the guidelines to operate the 
      strategy. As ICOPE is an approach for a primary healthcare system, its adoption 
      in a community healthcare program is promising and feasible. Evaluation as a tool 
      could contribute to the design of effective interventions. The evaluation of the 
      design of ICOPE for its implementation contributes to the strength of its 
      potential to improve care for OP. This design for implementing ICOPE has the 
      potential to be applied to similar contexts, for example, in other 
      lower-middle-income countries.
CI  - Copyright (c) 2023 Gutierrez-Barreto, Sosa-Tinoco, Rojas-Calixto, Deniss-Navarro, 
      Avila-Avila and Gutierrez.
FAU - Gutierrez-Barreto, Samuel E
AU  - Gutierrez-Barreto SE
AD  - Master's and Doctorate Programs in Medical, Dental, and Health Sciences, National 
      Autonomous University of Mexico, Mexico City, Mexico.
FAU - Sosa-Tinoco, Eduardo
AU  - Sosa-Tinoco E
AD  - National Institute of Geriatrics, Mexico City, Mexico.
FAU - Rojas-Calixto, Oscar
AU  - Rojas-Calixto O
AD  - Ministry of Health, Mexico City, Mexico.
FAU - Deniss-Navarro, Zayda
AU  - Deniss-Navarro Z
AD  - Ministry of Health, Mexico City, Mexico.
FAU - Avila-Avila, Arturo
AU  - Avila-Avila A
AD  - National Institute of Geriatrics, Mexico City, Mexico.
FAU - Gutierrez, Juan Pablo
AU  - Gutierrez JP
AD  - Center for Policy, Population and Health Research, National Autonomous University 
      of Mexico, Mexico City, Mexico.
LA  - eng
PT  - Journal Article
DEP - 20230712
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC10368864
OTO - NOTNLM
OT  - ICOPE
OT  - community health services
OT  - design evaluation
OT  - older people
OT  - theory of change
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/07/28 06:42
MHDA- 2023/07/28 06:43
PMCR- 2023/07/12
CRDT- 2023/07/28 04:14
PHST- 2023/02/14 00:00 [received]
PHST- 2023/06/27 00:00 [accepted]
PHST- 2023/07/28 06:43 [medline]
PHST- 2023/07/28 06:42 [pubmed]
PHST- 2023/07/28 04:14 [entrez]
PHST- 2023/07/12 00:00 [pmc-release]
AID - 10.3389/fmed.2023.1166196 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2023 Jul 12;10:1166196. doi: 10.3389/fmed.2023.1166196. 
      eCollection 2023.