Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
J Gen Intern Med. 2023 Dec;38(16):3460-3471. doi: 10.1007/s11606-023-08387-x. Epub 2023 Sep 18.
Social isolation is a global public health threat. Veterans are particularly at risk for social isolation due to high rates of comorbid physical and mental health problems. Yet, effective interventions are limited.
Our primary objective was to assess the feasibility and acceptability of CONNECTED, a novel, transdiagnostic intervention to reduce social isolation that includes individual and group components and is delivered by peers via telehealth. Secondary objectives were to identify appropriate outcome measures and explore preliminary intervention effects.
This was a two-phase study. In Phase 1, to evaluate study feasibility, we surveyed 200 veterans to assess prevalence of social isolation and their interest in social connectedness interventions. In Phase 2, we employed a mixed-methods, pre-post study design in which we piloted CONNECTED with 19 veterans through 2 successive cohorts to further assess feasibility, to evaluate acceptability, and to explore preliminary effectiveness. Quantitative analyses involved descriptive and bivariate analyses as well as multivariate modeling. Qualitative interviews were analyzed using thematic analysis.
For Phase 1, 39% of veterans surveyed were socially isolated. Participants who were ≤ 55 years old, caregivers, and those who experienced unmet social needs were more likely to report social isolation. Over 61% expressed interest in VA programs to reduce social isolation. For Phase 2, the pilot intervention, recruitment rate was 88% and the enrollment rate was 86%. Retention rates for the two cohorts were 80% and 50%, respectively, and satisfaction rates among intervention completers were 100%. Results also showed statistically significant improvements in social isolation (+ 5.91, SD = 4.99; p = .0028), social support (+ 0.74, SD = 1.09; p = .03), anxiety (-3.92, SD = 3.73; p = .003), and depression (-3.83, SD = 3.13; p = .001). Results for the other measures were not statistically significant.
CONNECTED is a feasible and acceptable intervention and is likely to be an effective tool to intervene on social isolation among veterans.
社会孤立是一个全球性的公共卫生威胁。由于患有多种躯体和精神健康问题的比率较高，退伍军人尤其面临社会孤立的风险。然而，有效的干预措施却很有限。
我们的主要目标是评估 CONNECTED 的可行性和可接受性，CONNECTED 是一种新颖的、针对多种疾病的干预措施，可减少社会孤立，包括个体和群体组成部分，并通过远程医疗由同龄人提供。次要目标是确定适当的结果测量指标并探讨初步的干预效果。
这是一项两阶段研究。在第 1 阶段，为了评估研究的可行性，我们对 200 名退伍军人进行了调查，以评估社会孤立的发生率以及他们对社会联系干预的兴趣。在第 2 阶段，我们采用了混合方法的前后测设计，通过 2 个连续队列对 19 名退伍军人进行了 CONNECTED 的试点研究，以进一步评估可行性、可接受性，并探讨初步效果。定量分析包括描述性和双变量分析以及多变量建模。定性访谈采用主题分析。
在第 1 阶段，39%的退伍军人被调查者处于社会孤立状态。年龄在 55 岁及以下、照顾者以及有未满足的社会需求的参与者更有可能报告社会孤立。超过 61%的参与者表示有兴趣参加退伍军人事务部的项目以减少社会孤立。在第 2 阶段，试点干预的招募率为 88%，入组率为 86%。两个队列的保留率分别为 80%和 50%，干预完成者的满意度为 100%。结果还表明，社会孤立（+5.91，SD=4.99；p=.0028）、社会支持（+0.74，SD=1.09；p=.03）、焦虑（-3.92，SD=3.73；p=.003）和抑郁（-3.83，SD=3.13；p=.001）均有统计学显著改善。其他测量指标的结果则无统计学意义。
CONNECTED 是一种可行且可接受的干预措施，很可能是一种针对退伍军人社会孤立问题的有效干预工具。
