Evaluating the health effects of a social intervention in older people using an experimental approach

  • Elizabeth Johnston

Student thesis: Doctoral ThesisDoctor of Philosophy


there is limited research to show that a social intervention such as increasing income improves health, especially as this relates to older people. It is known that poverty is a real problem for many older people in Northern Ireland. One reason for this is that older people often do not claim the financial benefits for which they are entitled. This is a randomised controlled study that sought to investigate the health effects of an increased uptake of social security benefits.

The aims of this study were to find out if an increase in income through the take up of unclaimed financial benefits lead to a significant improvement in the health status of older people and discover if this was maintained over a reasonable period of time. This was a randomised control trial based in the community. Patients were recruited from 11 general practices in South Down, Craigavon, Fermanagh and Tyrone. The intervention consisted of a benefit assessment followed by assistance completing the benefit application. The control group received the assessment but were not give assistance with the application. Instead they were given a list of agencies where help with the application could be found. A range of health, psycho-social and financial outcome was measured.

Of the 2180 patients who were sent invitation letters 300 agreed to a benefits assessment. 189 enrolled in the study and 149 were followed up at six months. A total of 89 patients received additional weekly benefits amounting to approximately £3277.19 per annum (£63 per week). A further 13 patients received one off payments totaling £5,731.01. All but two patients received their benefits within three months of assessment. While analysis showed trends suggesting greater improvements in social support and depression scores for the intervention group when compared with the controls the difference were not statistically significant. This is probably due to the following factors. The sample size in this study was small because of problems with the recruitment and screening of patients. More patients in the control group claimed benefits than had been anticipated and as a result it was difficult to detect differences between the two groups.

Valuable lessons have been leant and modifications to the study methodology have been suggested that will be of use to other researchers attempting to undertake similar studies in the UK.
Date of AwardJul 2008
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorDermot O'Reilly (Supervisor) & Michael Donnelly (Supervisor)


  • Financial benefits
  • Randomised control trial
  • Older people
  • Health outcomes
  • Social Intervention
  • Health Inequalities

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