Integrating the ecological approach in health promotion for older adults: a survey of programs aimed at elder abuse prevention, falls prevention, and appropriate medication use.

This study assesses the extent of integration of the ecological approach in disease prevention and health promotion (DPHP) programs for older adults in a sample of organisations offering such programming in Québec, Canada. Following from our previous work, the study used a model identifying intervention settings, targets, and strategies as independent dimensions of ecological programming. As a first step, public health units, local community health centres and seniors' day centres were surveyed to identify DPHP programs for older adults. In a second phase, detailed data were obtained about programs in the theme areas of elder abuse prevention, falls prevention, and appropriate medication use. Overall, 132 programs were investigated including 17 public health unit programs, 72 local community health centre programs, and 43 day centre programs. All data were obtained through telephone interviews. The DPHP programs for these organisations tended to be situated in organisational (especially health organisation) and community settings, with individual clients and organisations as main intervention targets. Assessment of the level of integration of the ecological approach showed it to be relatively low, especially in the local community health centres and seniors' day centres.