The purpose of this study is to investigate the program focus and contributing factors to program composition of five health promotion programs for seniors. The programs are selected using opportunistic sampling from five different local areas in metropolitan Vancouver. The five areas together constitute metropolitan Vancouver. A theoretical framework based on health promotion as a process which enables people to take control of their health promotion programming and recognizes that social, political, and organizational interventions are as important as individual actions, is used to support the purpose of this study. An ethnographic approach is used to collect observational, interview and documentary data on program focus, process and organization. The data are analyzed qualitatively to further the understanding of health promotion as a process central to individual and group empowerment in program focus and organization. The findings confirm that these programs focus predominantly on individual behaviour change efforts and only minimally on underlying environmental and community change factors. In the process of examining these health promotion programs for seniors, themes emerged which shed light on which factors most influence program composition. Program organization and process which involves multiple historical, theoretical and organizational factors are seen to most heavily influence program composition. / Graduate and Postdoctoral Studies / Graduate

A trend toward non-institutionalization of the elderly, in conjunction with the increasing size of the elderly population has resulted in the development of a variety of community programs and services to help meet their complex and diverse health care needs in the community setting. Although there is substantial documentation pertaining to the needs of the elderly in the community and the available services (Lifton, 1989; Padula, 1983; Starrett, 1986; Wallace, 1987), this documentation has been generated primarily by health care professionals and agencies, rather than from the perspectives of the elderly themselves. Adult Day Care [ADC] programs were established in the late 1960s as one means of attempting to meet the needs of the frail elderly in the community (Padula, 1983). On the surface, these programs appear to be effective in meeting the needs of clients through the provision of nursing services and a wide variety of therapeutic programs and social activities. This exploratory descriptive study was based on the premise that there exists a need to gain insight into the clients' perspectives regarding the ways in which ADC services are instrumental in meeting their perceived needs. Data were collected and analyzed to identify the self-perceived needs of ADC clients and their perceptions of how the ADC nursing services were instrumental in assisting them to meet these needs. Two interviews were conducted with each of the 11 ADC participants comprising the sample, using a semi-structured interview guide developed by the researcher. The two needs most commonly identified by participants included the need to cope with a range of concurrent and/or successive losses, and the need to establish new support systems. Participants identified the most significant components of the nursing role as those of the provision of emotional support through counselling, and the provision of health monitoring services. Participants viewed the overall ADC program as important in assisting them to meet their needs by providing access to social outings, individualized care, emotional support, and the opportunity to enhance their self-esteem, confidence, and feelings of belongingness. / Applied Science, Faculty of / Nursing, School of / Graduate