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Background <p>Homebound older adults often struggle with managing their health due to reduced mobility, limited social support, and fragmented access to healthcare services. These barriers can lead to poor self-care, delayed help-seeking, and diminished quality of life. Person-centred care (PCC), which emphasizes individualized support and active patient engagement, has demonstrated benefits in promoting self-management for chronic conditions. When delivered through mobile health (mHealth) technologies, PCC can be extended into the home environment, offering timely, tailored support. However, despite its potential, the effectiveness of PCC-based mHealth interventions for improving self-care among homebound older adults remains underexplored in real-world community settings.</p> Objective <p>This study aims to evaluate the clinical effectiveness and implementation outcomes of a PCC-based mHealth intervention in improving self-care among homebound older adults, compared to conventional provider-led care.</p> Methods <p>A hybrid type I effectiveness-implementation cluster-randomized controlled trial (cRCT) will be conducted, enrolling 130 participants from 26 community centres randomized (1:1) to either the intervention group (PCC-based mHealth program) or control group (usual care). Assessments at baseline, 3&#xa0;months, and 6&#xa0;months will evaluate primary outcomes of self-efficacy and instrumental activities of daily living (IADL). Secondary outcomes include quality of life, psychological distress, loneliness, functional mobility, sedentary behaviour, healthcare utilization, and perceived empowerment. The RE-AIM framework will guide the process evaluation, incorporating both quantitative and qualitative data to assess reach, adoption, implementation fidelity, and maintenance.</p> Discussion <p>This study will generate robust evidence on the effectiveness of integrating PCC principles with mHealth technologies to enhance self-management among homebound older adults. By combining clinical and implementation outcomes, the findings will inform scalable models of digitally enabled home-based care and support policy and service redesign to address the needs of aging populations in community settings. The intervention has the potential to reduce health disparities, promote autonomy, and improve overall health system responsiveness for a vulnerable and often overlooked population.</p> Trial registration <p>The study registered by ClinicalTrial.gov, NCT06879457. Registered on March 14, 2025.</p>

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Homebound older adults in self-care using a mobile health-assisted, person-centred care approach: study protocol for a hybrid effectiveness-implementation design

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月29日

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  • Arkers Kwan Ching Wong,
  • Frances Kam Yuet Wong,
  • Shamay Sheung Mei Ng,
  • Martin Chi Sang Wong,
  • Axel Wolf,
  • Andy Shu Kei Cheng,
  • Ka Wu,
  • Namkee G. Choi,
  • Paul Hong Lee,
  • Rick Yiu Cho Kwan,
  • Ruiyi Liu,
  • Yung Pong Leung,
  • Shun Yan Choi

摘要

Background

Homebound older adults often struggle with managing their health due to reduced mobility, limited social support, and fragmented access to healthcare services. These barriers can lead to poor self-care, delayed help-seeking, and diminished quality of life. Person-centred care (PCC), which emphasizes individualized support and active patient engagement, has demonstrated benefits in promoting self-management for chronic conditions. When delivered through mobile health (mHealth) technologies, PCC can be extended into the home environment, offering timely, tailored support. However, despite its potential, the effectiveness of PCC-based mHealth interventions for improving self-care among homebound older adults remains underexplored in real-world community settings.

Objective

This study aims to evaluate the clinical effectiveness and implementation outcomes of a PCC-based mHealth intervention in improving self-care among homebound older adults, compared to conventional provider-led care.

Methods

A hybrid type I effectiveness-implementation cluster-randomized controlled trial (cRCT) will be conducted, enrolling 130 participants from 26 community centres randomized (1:1) to either the intervention group (PCC-based mHealth program) or control group (usual care). Assessments at baseline, 3 months, and 6 months will evaluate primary outcomes of self-efficacy and instrumental activities of daily living (IADL). Secondary outcomes include quality of life, psychological distress, loneliness, functional mobility, sedentary behaviour, healthcare utilization, and perceived empowerment. The RE-AIM framework will guide the process evaluation, incorporating both quantitative and qualitative data to assess reach, adoption, implementation fidelity, and maintenance.

Discussion

This study will generate robust evidence on the effectiveness of integrating PCC principles with mHealth technologies to enhance self-management among homebound older adults. By combining clinical and implementation outcomes, the findings will inform scalable models of digitally enabled home-based care and support policy and service redesign to address the needs of aging populations in community settings. The intervention has the potential to reduce health disparities, promote autonomy, and improve overall health system responsiveness for a vulnerable and often overlooked population.

Trial registration

The study registered by ClinicalTrial.gov, NCT06879457. Registered on March 14, 2025.