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Culturally sensitive care for elderly immigrants through ethnic community health workers: the Voice of the the Elderly Immigrants
ISRCTN ISRCTN89447795
DOI 10.1186/ISRCTN89447795
ClinicalTrials.gov identifier
EudraCT number
Public title Culturally sensitive care for elderly immigrants through ethnic community health workers: the Voice of the the Elderly Immigrants
Scientific title Culturally sensitive care for elderly immigrants through ethnic community health workers: development and effectstudy of a community based intervention programme in the Netherlands.
Acronym VOICE
Serial number at source 11-138/C
Study hypothesis We developed an intervention programme in which ethnic community health workers act as liaisons between elderly immigrants and local health care and social welfare services.
In this study we evaluate the effectiveness and the implementation of this intervention programme.
We expect to find an increase in use of health care and social welfare facilities consumption, increase in perceived quality of life and decrease in reported number of functional limitations of elderly immigrants in the Netherlands.
Lay summary Background and study aims
In our study, ethnic community health workers will act as liaison between elderly immigrants and local health care and social welfare services to make sure that treatment and care is more accessible for elderly immigrants. The aim is to find our how well this approach works. When we have evidence that this works well, the community health worker function can be further integrated into the existing local health care and welfare system.

Who can participate?
Elderly people meeting the following inclusion criteria: (1) aged 55 years and over, (2) living independently (alone or with others), (3) born in Turkey, Morocco, Moluccan Islands or descendant of Moluccan immigrants born in the Netherlands and who lived in one of the Moluccan ‘camps’.

What does the study involve?
Our study aims to recruit 194 elderly immigrants. They will be randomly allocated to one of two groups: 97 to the ‘intervention group’ and 97 to the control group.
Participants in the ‘intervention group’ are invited by community health workers to participate in the intervention programme that consists of four steps. (1) Participants participate in home visits conducted by community health workers in order to examine their health problems, barriers to health care and social welfare services and needs for adequate care. (2) Participants participate in problem focused working groups organized by community health workers to discuss commonly shared problems based on the home visits.(3) Participants co-operate with community health workers and providers of health care and social welfare services in finding solutions, creating and conducting improvement programmes (concrete initiatives necessary for providing care and social welfare services that meet the participants’ health and social welfare needs). (4) Participants are involved in the implementation of the improvements programmes in the community. Participants are invited to face to face interviews at two points in time: a baseline interview within two weeks after the home visit by the community health worker and a follow-up interview 18 months after the baseline interview.
Participants in the ‘control group’ do not receive the visit of community health workers.

What are the possible benefits and risks of participating?
Our study can contribute to the improvement of care for elderly immigrants by developing culturally sensitive care in which elderly people actively participate. No risks are involved for elderly participants.

Where is the study run from?
Our study has been set up by the University Medical Center Utrecht. We are carrying out the study in three (semi) urban residential areas in the Netherlands which all have a community of immigrants (Turks, Moroccans and Moluccans).

When is the study starting and how long is it expected to run for?
The recruitment started in October 2011. The study will be expected to be completed in December 2013.

Who is funding the study?
ZonMw, the Netherlands Organization for Health Research and Development.

Who is the main contact?
Professor Niek de Wit
N.J.dewit@umcutrecht.nl
Ethics approval We submitted our study protocol to the Medical Ethics Committee of the University Medical Center Utrecht (UMCU) if this study falls under the Medical Research Involving Human Subjects Act (WMO). The committee judged that our study does not meet the WMO criteria and therefore is not subject to the WMO.
Study design Quasi experiment with a pre-post test design with an intervention group and control group in three (semi) urban residential areas
Countries of recruitment Netherlands
Disease/condition/study domain Use of health care and social welfare facilities
Participants - inclusion criteria 1. Aged 55 years and over
2. Living independently (alone or with others)
3. Born in Turkey, Morocco, Moluccan Islands or descendant of Moluccan immigrants born in the Netherlands and lived in one of the Moluccan 'camps'
Participants - exclusion criteria Elderly people using care for severe psychiatric disorders are excluded from the study.
Anticipated start date 01/10/2011
Anticipated end date 01/12/2013
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants We need a total of 194 elderly people.
Interventions Our study aims to recruit 194 elderly immigrants (97 for the invention group and 97 for the control group). The intervention group consists of Turks, Moroccans and Moluccans recruited by community health workers at three (semi) urban residential areas in the Netherlands. Controls are a matched group comparable in size and composition and live outside the three intervention sites. To assess the effectiveness of the intervention, the intervention group is compared with a group where no community health workers are introduced (no community health worker involvement is provided to controls). Data are collected at two points in time: a baseline assessment and a follow-up assessment 18 months after baseline assessment. The assessments are structured face-to-face interviews in the preferred language of the respondent (Dutch, Turkish, Malay, Moroccan-Arabic or Moroccan-Berber) performed by trained interviewers with a similar ethnic background as the participants.
Primary outcome measure(s) Use of health care and social welfare facilities is measured by self-reported care consumption at baseline and 18 months after baseline.
Secondary outcome measure(s) 1. Perceived quality of life and is measured using the Short Form-12 (SF-12) and the EQ-5D+C.
2. Functional limitations are measured using the Katz-15.
Secondary outcomes are measured at baseline and 18 months after baseline.
Sources of funding This study is funded by a grant from ZonMW, the Netherlands Organization for Health Research and Development.
Trial website http://www.stem-nuzo.nl/
Publications 1. 2013 protocol in http://www.ncbi.nlm.nih.gov/pubmed/23497392
Contact name Prof  Niek  de Wit
  Address UMC Utrecht, div. Julius Centrum
Correspondence Str. 6.131
PO Box 85500
3508 GA Utrecht
The Netherlands
  City/town Utrecht
  Zip/Postcode 3508 GA
  Country Netherlands
  Tel +31(0)88 75 682 47
  Email N.J.dewit@umcutrecht.nl
Sponsor The National Care for the Elderly Programme - ZonMw (Netherlands)
  Address The Netherlands Organisation for Health Research and Development
Laan van Nieuw Oost Indië 334
2593 CE The Hague
P.O. Box 93245
  City/town The Hague
  Zip/Postcode 2509 AE
  Country Netherlands
  Tel +31 (0)70 349 51 11
  Fax +31 (0)70 349 51 00
  Email Duijn@zonmw.nl
  Sponsor website: http://www.nationaalprogrammaouderenzorg.nl
Date applied 31/01/2013
Last edited 19/03/2013
Date ISRCTN assigned 27/02/2013
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