EMPOWERCARE: EMPOWERing individuals & communities to manage their own CARE

EMPOWERing individuals and communities to manage their own CARE (EMPOWERCARE) was a 3-year social innovation project involving 13 cross border European partners. EMPOWERCARE developed a holistic community asset approach to respond to current gaps in the care of people in the target group (those aged 65+ and those aged 50+ with at least one chronic condition). It aimed to address challenges facing our societies concerning the care of our ageing populations and when older people are not being involved in decisions concerning their own health and wellbeing.

The project ensured that older people are at the forefront of improved technology and better care from within their
communities. This sought to improve their situation but also tackle the financial issues of an ageing population and
improve social cohesion.

The main key messages from the evaluation of the project initiatives were:

• Self-efficacy – Across all sites, ‘inactive’ participants at baseline showed a statistically significant increase
in self-efficacy at the end of the initiatives. Qualitative data confirmed end-users’ increased levels of selfconfidence
and self-efficacy around taking action in relation to their own health.
• Emotional and social wellbeing - When considering all project sites, there was no significant decrease of
the level of reported loneliness, overall and by type (emotional and social), for participants who reported
feeling lonely at the start of the initiative. For participants from philosophically focused initiatives, who
reported being lonely at the start of the initiative, there was a slight decrease in emotional loneliness from
baseline, although this change was not statistically significant. Overall, there was no decrease, but for
initiatives that were philosophically focused there was a negative trend. Qualitative data evidenced the
positive impact initiatives had in tackling end-users’ loneliness.
• Digital literacy - When analysing survey responses from all sites, end-users reported internet healthseeking
behaviour did change at the end of initiatives. Nonetheless, for the sites focusing more on
technology, internet health-seeking behaviour increased from baseline to end of initiative, although the
positive change was not statistically significant. Qualitative data from end-users confirms the survey results
that those participating in the initiatives felt more digitally literate and confident in using technology for
their physical and mental health needs and to keep connected with their social networks.
• Internet health-seeking behaviour – There was no significant change in this area for end-users. This
could be explained by them receiving help in-person and therefore they felt less need to go online for help
with their health. For technology focused initiatives there was still no significant change, but there was
a positive trend for technology enthusiasm. Anxiety around technology use remained and the qualitative
data relating to this indicated there was room to build on technology skills.
• Person centred care - Across all sites, for those that had a baseline of below average person-centredness
or lower, mean scores increased from baseline to end of initiatives, and this improvement was statistically
significant, indicating that the project initiatives significantly increased workforce person-centeredness.
There were also similar significant improvements in the specific areas of this scale of Climate of Safety,
Climate of Everydayness, Climate of community and Climate of Comprehensibility, indicating that the
project initiatives significantly increased workforce feelings of whether the workplace is a place where the
patients are in safe hands, staff use language that the patients can understand, it is easy for patients to
talk to the staff and where the patients have someone to talk to if they so wish. Qualitative data reflected
these results, talking about the transformation in people’s lives that was possible through being focused
on the needs of the individuals and what matters to them.
• Workforce technology uptake - Across all sites, survey results from workforce attitudes towards
technology did not show any change from baseline to end of initiatives. Similarly, there was no difference
between workforce participants in technology-focused and philosophical initiatives. Qualitative data
from the workforce showed an understanding of the need to embrace technology in their work and that
some of the drive for that need came from the implementation of COVID-19 restrictions.
• Job satisfaction and workforce training embeddedness – for job satisfaction there was no significant
change, although there was a positive trend for those who started below the top 15%. The context of
working through COVID-19 may have had a negative impact on job satisfaction. Across all sites, there
were higher average scores on certain areas of efficacy in relation to workforce training in implementing,
embedding, and integrating a complex healthcare initiative, such as reflective monitoring and collective
action compared to coherence, and cognitive participation findings suggest that overall workforce
members showed they are willing to engage in reflexive monitoring and collective action across all sites
– so they were willing to self-monitor and take time to think about their behaviour and work together
to take action. The qualitative data indicated that embedding training has enabled the workforce to
understand the value of taking time, reflecting and connecting, which are some of the key person-centred
competencies and attributes you would want to see in a transformed workforce.

The Cost Benefit Analysis showed:
• Contingent Valuation Method (CVM) evaluation indicate that individuals are willing to pay (WTP) on average
€10.31 per month from their own out of pocket expenses to use and obtain the health benefits and wellbeing
effects of participating in the EMPOWERCARE initiatives.
• WTP is positively influenced by the value individuals place on the technically focused initiatives, willingness
to participate in an alternative initiative along with improvements gained in emotional and social loneliness
because of the EMPOWERCARE initiatives.
• The WTP estimates defined in this evaluation provide significant insights for decision makers and healthcare
commissioners on the value that previous participants place on the services provided through the
EMPOWERCARE initiatives in local communities.
• Insights from the ‘Good Ancestor’ principles in FGD promotes the deliberation of long-term thinking which
can lead to the power of change, reshaping decisions to take account of future generations, while promoting
and encouraging sustainability in respect for future generations.

The evaluation results provide some positive results on the success of the EMPOWERCARE initiatives across the
4 countries. More analysis has been done per site to understand the different aspects of the EMPOWERCARE
Strategy, Workforce Transformation Package and Technology Blueprint that made a positive difference to end-users
and members of the workforce. This further analysis will provide a more comprehensive picture of the
impact of the EMPOWERCARE initiatives, as well as inform the next stages of work.