Xuxi Zhang

Health promotion for people with chronic conditions 5. What are the effects of peer support on glycemic control for adults with type 2  diabetes (T2DM) and the characteristics of effective peer support?  (Step 3 of Public  Health Framework)  6. What are the effects of interventions targeting modifiable risk factors on diabetic  retinopathy (DR) for adults with T2DM and the characteristics of effective  interventions?  (Step 3 of Public Health Framework) 7. Could the Social Engagement Framework for Addressing the Chronic‐disease‐ challenge (SEFAC) intervention be effective to promote the self‐management of  chronic conditions and a healthy lifestyle?  (Step 4 of Public Health Framework) Outline of this thesis  Table 1.2.1 provides an overview of the six studies presented in this thesis. The research focus  of these studies can be divided into two topics related to health promotion of healthy ageing.  Part 1 of this thesis consists of studies on health promotion for people with frailty. In Chapter  2 , the associations between physical, psychological and social frailty and HRQoL among  community‐dwelling older people are studied. In  Chapter 3 , the longitudinal associations  between frequency of moderate physical activity (PA) and overall, physical, psychological and  social frailty among community‐dwelling older people are studied. In addition, the  associations between a 12‐month change in frequency of moderate PA and overall, physical,  psychological and social frailty are studied. In Chapter 4 , the internal consistency, convergent  and divergent validity and concurrent validity of the TFI within community‐dwelling older  people in Spain, Greece, Croatia, the Netherlands and the United Kingdom (UK) are studied.  In Chapter 5 , specific process components of a coordinated preventive care approach on fall  risk, appropriate medication use, loneliness and frailty (UHCE approach, more details are  described in the next paragraph) aimed to promote healthy ageing among older adults are  studied to evaluate how the approach is implemented, which persons are reached and what  their experience is with this approach.  Part 2  of this thesis consists of studies on health  promotion for people with chronic conditions. In  Chapter 6 , the effects of different kinds of  peer support on glycemic control, in terms of providers, types of support, intervention  duration and effect duration, are studied to find out how to achieve better effects of peer  support on glycemic control among adults with T2DM. In  Chapter 7 , the effects of different  interventions targeting modifiable risk factors on DR are studied to find out how to perform  better interventions to prevent and control DR among adults with T2DM. In  Chapter 8 , the  evaluation design of SEFAC project aimed to empower citizens at risk of or with T2DM and/or  cardiovascular disease to self‐manage their chronic conditions through the SEFAC  intervention is described. Finally, in  Chapter 9 , an overall discussion, including  recommendations and implications for future research, policy and practice, is provided.  18 Chapter 1