Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, United States.
Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, United States.
Front Public Health. 2021 Nov 18;9:750609. doi: 10.3389/fpubh.2021.750609. eCollection 2021.
Despite substantial evidence of the negative health consequences of social isolation and loneliness and the outsized impact on older adults, evidence on which interventions are most effective in alleviating social isolation and loneliness is inconclusive. Further complicating the translation of evidence into practice is the lack of studies assessing implementation and scalability considerations for socialization programs delivered by community-based organizations (CBOs). Our primary objective was to describe the implementation barriers, facilitators, and lessons learned from an information and communication technology (ICT) training program aimed at reducing social isolation and loneliness for homebound older adults in a home-delivered meals program. Participants received in-home, one-on-one ICT training lessons delivered by volunteers over a 14-week period with the goal of increasing social technology use. To assess implementation facilitators and barriers, 23 interviews were conducted with program staff ( = 2), volunteers ( = 3), and participants ( = 18). Transcripts were analyzed using thematic analysis. Aspects that facilitated implementation included the organization's existing relationship with clientele, an established infrastructure to deliver community-based interventions, alignment of intervention goals with broader organizational aims, and funding to support dedicated program staff. Challenges to implementation included significant program staff time and resources, coordinating data sharing efforts across multiple project partners, participant and volunteer recruitment, and interruptions due to COVID-19. Implications of these facilitators and barriers for scalability of community-based ICT training interventions for older adults are described. Lessons learned include identifying successful participant and volunteer recruitment strategies based on organizational capacity and existing recruitment avenues; using a targeted approach to identify potential participants; incorporating flexibility into intervention design when working with the homebound older adult population; and monitoring the participant-volunteer relationship through volunteer-completed reports to mitigate issues. Findings from this formative evaluation provide insight on strategies CBOs can employ to overcome challenges associated with implementing technology training programs to reduce social isolation and loneliness for older adults, and thus improve overall well-being for homebound older adults. Recommendations can be integrated into program design to facilitate implementation of ICT programs in the community setting.
尽管有大量证据表明社交孤立和孤独对健康有负面影响,而且对老年人的影响更大,但哪些干预措施最能有效缓解社交孤立和孤独感的证据尚无定论。进一步使证据转化为实践复杂化的是,缺乏评估社区组织(CBO)提供的社交计划实施和可扩展性考虑的研究。我们的主要目标是描述一项信息和通信技术(ICT)培训计划实施的障碍、促进因素和经验教训,该计划旨在减少居家送餐计划中居家老年人的社交孤立和孤独感。参与者在 14 周的时间内接受志愿者提供的一对一家庭 ICT 培训课程,目标是增加社交技术的使用。为了评估实施的促进因素和障碍,对项目工作人员(=2)、志愿者(=3)和参与者(=18)进行了 23 次访谈。使用主题分析对记录进行了分析。促进实施的方面包括组织与客户的现有关系、提供基于社区的干预措施的既定基础设施、干预目标与更广泛的组织目标保持一致,以及支持专职项目工作人员的资金。实施面临的挑战包括大量的项目工作人员时间和资源、协调多个项目合作伙伴的数据共享工作、参与者和志愿者的招募以及因 COVID-19 而中断。描述了这些促进因素和障碍对基于社区的 ICT 培训干预措施扩大规模的影响。得出的经验教训包括根据组织能力和现有招募途径确定成功的参与者和志愿者招募策略;使用有针对性的方法来确定潜在参与者;在与居家老年人群体合作时,将灵活性纳入干预设计中;以及通过志愿者完成的报告监测参与者-志愿者关系,以减轻问题。这项形成性评估的结果提供了有关 CBO 可以采用的策略的见解,这些策略可以克服与实施技术培训计划相关的挑战,以减少老年人的社交孤立和孤独感,从而提高居家老年人的整体幸福感。建议可以纳入方案设计,以促进社区环境中 ICT 方案的实施。