Dataset Information

Increasing Social Connectedness for Underserved Older Adults Living With Depression: A Pre-Post Evaluation of PEARLS.

ABSTRACT:

Objective

To evaluate PEARLS effectiveness for increasing social connectedness among underserved older adults with depression.

Design

Multisite, pre-post single-group evaluation.

Setting

Community-based social service organizations (N = 16) in five U.S. states, purposively sampled for maximum variation of participants and providers.

Participants

A total of 320 homebound older adults (mean(SD) age 72.9(9.6), 79% female, 44% people of color, 81% low-income, 61% living alone, average four chronic conditions) with clinically significant depression (PHQ-9 mean(SD) 12.7(4.6)).

Intervention

Four to 6 month home-based depression care management model delivered by trained front-line providers.

Measurements

Brief validated social connectedness scales: Duke Social Support Index 10-item (DSSI-10), PROMIS-Social Isolation (6-item), UCLA-Loneliness (3-item); sociodemographic and health measures.

Results

At baseline, PEARLS participants overall and with ≥1 of the following characteristics were less socially connected: younger (50-64), white, LGBTQ+, not partnered, not caregiving, living alone, financial limitations, chronic conditions, and/or recently hospitalized. Six-months post-PEARLS enrollment, participants significantly increased social interactions and satisfaction with social support (DSSI-10 t[312] = 5.2, p <0.001); and reduced perceived isolation (PROMIS t[310] = 6.3, p <0.001); and loneliness (UCLA t[301] = 3.7, p =0.002), with small to moderate effect sizes (Cohen's d DSSI-10: 0.28, PROMIS-SI: 0.35, UCLA: 0.21). Increased social connectedness was associated with reduced depression. Improvements in social connectedness (except social interactions) persisted during early COVID-19. Being Latino and/or having difficulty paying for basic needs was associated with less improvement in post-PEARLS social connectedness.

Conclusion

PEARLS has potential to improve social connectedness among underserved older adults, though additional supports may be needed for persons facing multiple social determinants of health. Further research is needed to establish causality.

SUBMITTER: Steinman L

PROVIDER: S-EPMC7564120 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Increasing Social Connectedness for Underserved Older Adults Living With Depression: A Pre-Post Evaluation of PEARLS.

Steinman Lesley L Parrish Amanda A Mayotte Caitlin C Bravo Acevedo Perla P Torres Eva E Markova Mariana M Boddie Margaret M Lachenmayr Sue S Montoya Carol Nohelia CN Parker Libby L Conton-Pelaez Edrei E Silsby Joscelyn J Snowden Mark M

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 20201016 8

<h4>Objective</h4>To evaluate PEARLS effectiveness for increasing social connectedness among underserved older adults with depression.<h4>Design</h4>Multisite, pre-post single-group evaluation.<h4>Setting</h4>Community-based social service organizations (N = 16) in five U.S. states, purposively sampled for maximum variation of participants and providers.<h4>Participants</h4>A total of 320 homebound older adults (mean(SD) age 72.9(9.6), 79% female, 44% people of color, 81% low-income, 61% living ...[more]

PMID: 33187883

Similar Datasets

Project description:BackgroundThe overall impact of social connectedness on health outcomes in older adults living in nursing homes and assisted living settings is unknown. Given the unclear health impact of social connectedness for older adults in congregate long-term care settings worldwide, a comprehensive systematic review is required to evaluate the overall relationship between social connectedness and health outcomes for them.ObjectivesThe purpose of this article was to synthesize the literature regarding the health impact of social connectedness among older adults living in nursing homes or assisted living settings.MethodsUsing PRISMA guidelines, we identified eligible studies from Scopus, MEDLINE, PsycINFO, CINAHL and Cochrane databases (1990-2021). Bias and quality reporting assessment was performed using standardized criteria for cohort, cross sectional and qualitative studies. At each stage, ≥ 2 researchers conducted independent evaluations.ResultsOf the 7350 articles identified, 25 cohort (follow-up range: 1 month-11 years; with two also contributing to cross sectional), 86 cross sectional, eight qualitative and two mixed methods were eligible. Despite different instruments used, many residents living in nursing homes and assisted living settings had reduced social engagement. Quantitative evidence supports a link between higher social engagement and health outcomes most studied (e.g. depression, quality of life). Few studies evaluated important health outcomes (e.g. cognitive and functional decline). Most cohort studies showed that lack of social connectedness accelerated time to death.ConclusionsSocial connectedness may be an important modifiable risk factor for adverse health outcomes for older adults living in nursing homes and assisted living facilities. Most studies were cross sectional and focused on quality of life and mental health outcomes. Longitudinal studies suggest that higher social engagement delays time to death. Evidence regarding other health outcomes important to older adults was scant and requires further longitudinal studies.

Project description:BackgroundOlder adults are at risk for loneliness, and interventions to promote social connectedness are needed to directly address this problem. The nature of interventions aimed to affect the distinct, subjective concepts of loneliness/social connectedness has not been clearly described. The purpose of this review was to map the literature on interventions and strategies to affect loneliness/social connectedness for older adults.MethodsA comprehensive scoping review was conducted. Six electronic databases were searched from inception in July 2015, resulting in 5530 unique records. Standardized inclusion/exclusion criteria were applied, resulting in a set of 44 studies (reported in 54 articles) for further analysis. Data were extracted to describe the interventions and strategies, and the context of the included studies. Analytic techniques included calculating frequencies, manifest content analysis and meta-summary.ResultsInterventions were described or evaluated in 39 studies, and five studies described strategies to affect loneliness/social connectedness of older adults or their caregivers in a qualitative descriptive study. The studies were often conducted in the United States (38.6%) among community dwelling (54.5%), cognitively intact (31.8%), and female-majority (86.4%) samples. Few focused on non-white participants (4.5%). Strategies described most often were engaging in purposeful activity and maintaining contact with one's social network. Of nine intervention types identified, the most frequently described were One-to-One Personal Contact and Group Activity. Authors held divergent views of why the same type of intervention might impact social connectedness, but social contact was the most frequently conceptualized influencing factor targeted, both within and across intervention types.ConclusionsResearch to test the divergent theories of why interventions work is needed to advance understanding of intervention mechanisms. Innovative conceptualizations of intervention targets are needed, such as purposeful activity, that move beyond the current focus on the objective social network as a way to promote social connectedness for older adults.

Project description:BackgroundWith the intensification of aging, depression among the older adults has become a significant global health challenge, especially in developing countries where the problem is particularly severe. This study aims to explore the association between living arrangements and depression, with a specific focus on examining the mediating role of social support in rural northwest China.MethodsData were collected from 501 individuals aged 60 and above in rural Shaanxi Province, northwest China. Living arrangements were assessed based on co-residing family members. Depression was measured using the Geriatric Depression Scale-30, and social support was evaluated with the Social Support Rating Scale. Ordinary Least Squares Regression, Quantile Regression, Generalized Linear Regression, and Ordered Regression analyzed the association between living arrangements and depression. Hierarchical multiple linear regression examined the mediating role of social support. A heterogeneity analysis by gender and socio-economic status was also conducted.ResultsThe depression rates were 51.84% for non-empty nests, 67.92% for individuals living alone, and 46.80% for individuals only living with a spouse. The regression analysis did not reveal a significant difference in depressive between empty nests compared to non-empty nests. However, older adults living alone exhibited a higher susceptibility to depression symptoms (β = 2.594, P < 0.05). The mediating analysis showed that empty nesters living alone experience higher rates of depression due to receiving less social support compared to those living with a spouse or in non-empty nest arrangements, particularly concerning subjective social support (β = 0.481, P < 0.05). Heterogeneity analysis identified specific vulnerable groups among older adults, emphasizing the higher susceptibility to depressive symptoms among those living alone, especially among male older adults or those from non-poor families.ConclusionsOur findings emphasize a significant prevalence of depression among older adults in rural areas, particularly highlighting the vulnerability of those living alone. This underscores the urgent need for government attention to address the mental health challenges faced by the older adults. Future interventions should focus on improving social support networks to mitigate the impact of living alone on depression symptoms among this population.

Project description:BackgroundSocial disconnection is a public health concern among rural Australian older adults. While research suggests technology can enhance social wellbeing and protect against social disconnection, many older adults are not digitally literate, and little is known as to why and how technology adoption could be promoted in rural contexts. This study aimed to (1) explore the barriers and facilitators of technology adoption among rural older adults and (2) determine the potential utility of technology to promote social connectedness in the aged population. The Theoretical Domains Framework and the Behaviour Change Wheel (BCW) were employed to gain a comprehensive understanding of the digital and social behaviours of rural Australian older adults.MethodsSemi-structured interviews were conducted with a convenience sample of 33 rural older adults aged between 65 and 87 years. Interviews were conducted over the phone, audio-recorded, and transcribed. Interview transcripts were coded and analysed using thematic analysis and the BCW.ResultsNumerous barriers and facilitators of technology adoption were identified, with the most prominent being knowledge, perceived value, perceived self-efficacy, and social support. Findings suggest that older adults' technology adoption is not simply a technical matter, but influenced by various individual, social, and environmental contexts. Consideration of these factors during development, marketing, training and implementation may facilitate technology adoption among older adults. With regard to social connectedness, several rural barriers emerged, including low population density, geographic isolation, limited community opportunities and poor public transport infrastructure.ConclusionTechnology was consistently identified as a facilitator of the social experience, indicating that technology is a promising tool to enhance social connectedness among older adults, particularly those living in rural areas. Future research should focus on enhancing the capability, opportunity and motivation of older adults in technology adoption, with reference to the rural contexts.

Dataset Information

Increasing Social Connectedness for Underserved Older Adults Living With Depression: A Pre-Post Evaluation of PEARLS.

Objective

Design

Setting

Participants

Intervention

Measurements

Results

Conclusion

Publications

Increasing Social Connectedness for Underserved Older Adults Living With Depression: A Pre-Post Evaluation of PEARLS.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets