Stress management education for the elderly: a social marketing approach to program development and evaluation

Abstract

The present study examined a social marketing approach to a health promotion program in stress management education that combined various aspects of large scale mass-market campaigns and individually tailored interventions. The study was conducted in two major phases using two groups from the main population of retired university faculty members. The intervention was a series of stress management seminars which was presented in each phase. Program evaluation took place at several intervals throughout the study.

The first phase of the study served to assess the retirees' needs and to develop the program content and delivery style by using the target population's administrative committee. This committee became the focus group. The presentation of the stress management seminars to the focus group was specifically tailored to the group through frequent interactions and participation by the group members. On evaluation, the program was shown to be effective on a number of dimensions, but it was also labor intensive.

A second phase was conducted on a larger sample from the target population of retirees. The sample was found to be equivalent to the focus group on demographic variables, stress levels, and stress management practices. This phase utilized the same program content that was developed in the first phase, but further examined program delivery. Two styles of program delivery were compared. The first was a didactic, lecture-style frequently used in large scale educational campaigns; the second was an interactive, discussion style, used more frequently in individual interventions.

Overall, the program participants from both phases improved in their abilities to identify their stress symptoms, stress management strategies that they felt they would use, and increased their levels of perceived control over their stress. Factor analysis was one method used to evaluate program effectiveness and to replicate the factor structure of coping strategies from another study. The utility of factor analysis as an assessment procedure was developed and supported.

No major significant differences between delivery styles were found. Thus, indirect tailoring of the program for the target population through the representative focus group was as effective as directly tailoring the program with the target population. Both the interactive and didactic approaches can be integrated into a single educational program to obtain an optimal combination of cost-effectiveness and informativeness. Once the program content was developed through the intensive process of tailoring in the first phase, the more efficient didactic delivery style could be used equally successfully with a matched population. Clinically, the study served as a cost-effective prototype of a stress-management education program for the mass-market.