Rate of Social Isolation by Geographic Location Among Older Adults: AAA LongROAD Study

Lynch, Laura; Mielenz, Thelma J.; Li, Guohua; Eby, David W.; Molnar, Lisa J.; Betz, Marian E.; DiGuiseppi, Carolyn; Hill, Linda; Jones, Vanya; Strogatz, David

doi:10.3389/fpubh.2021.791683

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Social isolation will be measured using the Patient-Reported Outcomes and Measures Information System-Social Isolation (PROMIS-SI 8a). This measure has been used extensively in older adults with chronic health conditions and depression [48][49][50]. This 8-item measure uses a 5-point Likert scale with responses ranging from "always" to "never."…”

Section: Methodsmentioning

confidence: 99%

Layperson-Facilitated Internet-Delivered Cognitive Behavioral Therapy for Homebound Older Adults With Depression: Protocol for a Randomized Controlled Trial

Kayser¹,

Wang²,

Wu³

et al. 2023

JMIR Res Protoc

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Background Depression in older adults has serious biological, psychological, and social consequences. Homebound older adults experience a high burden of depression and significant barriers to accessing mental health treatments. Few interventions to address their specific needs have been developed. Existing treatment modalities can be challenging to scale up, are not tailored to unique population concerns, and require significant staffing support. Technology-assisted, layperson-facilitated psychotherapy has the potential to overcome these challenges. Objective The aim of this study is to assess the efficacy of a layperson-facilitated internet-delivered cognitive behavioral therapy program tailored for homebound older adults. The novel intervention, Empower@Home, was developed based on user-centered design principles and partnerships between researchers, social service agencies, care recipients, and other stakeholders serving low-income homebound older adults. Methods This 2-arm, 20-week pilot randomized controlled trial (RCT) with a waitlist control crossover design aims to enroll 70 community-dwelling older adults with elevated depressive symptoms. The treatment group will receive the 10-week intervention immediately, whereas the waitlist control group will cross over and receive the intervention after 10 weeks. This pilot is part of a multiphase project involving a single-group feasibility study (completed in December 2022). This project consists of a pilot RCT (described in this protocol) and an implementation feasibility study running in parallel with the pilot RCT. The primary clinical outcome of the pilot is the change in depressive symptoms after the intervention and at the 20-week postrandomization follow-up. Additional outcomes include acceptability, adherence, and changes in anxiety, social isolation, and quality of life. Results Institutional review board approval was obtained for the proposed trial in April 2022. Recruitment for the pilot RCT began in January 2023 and is anticipated to end in September 2023. On completion of the pilot trial, we will examine the preliminary efficacy of the intervention on depression symptoms and other secondary clinical outcomes in an intention-to-treat analysis. Conclusions Although web-based cognitive behavioral therapy programs are available, most programs have low adherence and very few are tailored for older adults. Our intervention addresses this gap. Older adults, particularly those with mobility difficulties and multiple chronic health conditions, could benefit from internet-based psychotherapy. This approach can serve a pressing need in society while being cost-effective, scalable, and convenient. This pilot RCT builds on a completed single-group feasibility study by determining the preliminary effects of the intervention compared with a control condition. The findings will provide a foundation for a future fully-powered randomized controlled efficacy trial. If our intervention is found to be effective, implications extend to other digital mental health interventions and populations with physical disabilities and access restrictions who face persistent disparities in mental health. Trial Registration ClinicalTrials.gov NCT05593276; https://clinicaltrials.gov/ct2/show/NCT05593276 International Registered Report Identifier (IRRID) PRR1-10.2196/44210

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Section: Methodsmentioning

confidence: 99%

Layperson-Facilitated Internet-Delivered Cognitive Behavioral Therapy for Homebound Older Adults With Depression: Protocol for a Randomized Controlled Trial

Kayser¹,

Wang²,

Wu³

et al. 2023

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

“…However, loneliness, defined as a form of “chronic impaired belongingness” (Stillman & Baumeister, 2009, p. 250), may be an even more potent predictor of suicide outcomes than objective social isolation (Cacioppo et al, 2009) because it relates to the construct of thwarted belongingness (i.e., social rejection), a necessary component for suicide according to the interpersonal–psychological theory of suicide (Joiner, 2007). Although social isolation and loneliness are pervasive among older veterans (Edberg et al, 2010), these factors appear unrelated to rural residence (Gurewich et al, 2023; Henning-Smith et al, 2019; Lynch et al, 2021), suggesting the interplay of more complex factors in the increased suicide rates for rural veterans compared with those living in urban settings.…”

Section: Ky Veteran Suicidementioning

confidence: 99%

Kentucky veteran and nonveteran suicide 2010–2019: A feasible solution algorithm test of perfect storm theory.

Schuman,

Seals,

Stromberg

et al. 2024

Journal of Rural Mental Health

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Veteran suicide remains a pressing public health problem in Kentucky (KY) and the United States. Perfect storm theory (PST) suggests that human behavior arises from the intensity of interactions between instigating, impelling, and disinhibiting forces and could be used to study the effects of interacting factors related to catastrophic behaviors such as self-directed violence. Suicide data were obtained from the KY Violent Death Reporting System for 2010-2019. Subgroups of veteran (n = 1,203, 17.8%) and nonveteran (n = 5,559, 82.2%) decedents were categorized by suicide characteristics, and Feasible Solution Algorithm was used to test the main proposition of PST. KY male veterans differed from nonveteran decedents in that they were significantly more likely to have been White, older, married, educated beyond high school, used a firearm, left a note, lived in a rural area, and had physical health problems. A three-way interaction, χ 2 (1) = 5.01, p = .0252, supported the main proposition of PST for veterans who were rural and older, in the presence of one or more of the following disinhibiting factors: alcohol found at the scene, recent death/suicide of a friend or family member, traumatic anniversary, blood alcohol content ≥.08, or a positive drug test. The identified interactions contribute to a better understanding of the complex nature of suicide and confirm that PST could be used to guide further research on the antecedents of veteran suicide and its prevention.This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

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Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study

Tanguay,

Nadeau,

Brousseau

et al. 2024

Heliyon

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Rate of Social Isolation by Geographic Location Among Older Adults: AAA LongROAD Study

Cited by 4 publications

References 21 publications

Layperson-Facilitated Internet-Delivered Cognitive Behavioral Therapy for Homebound Older Adults With Depression: Protocol for a Randomized Controlled Trial

Layperson-Facilitated Internet-Delivered Cognitive Behavioral Therapy for Homebound Older Adults With Depression: Protocol for a Randomized Controlled Trial

Kentucky veteran and nonveteran suicide 2010–2019: A feasible solution algorithm test of perfect storm theory.

Nonmedical problems among older adults visiting the emergency department for low acuity conditions: A prospective multicentre cohort study

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