Abstract

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 (n = 2), volunteers (n = 3), and participants (n = 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.

Highlights

  • Social isolation and loneliness are significant threats to physical and mental health, among older adults

  • In response to physical distancing orders enacted to mitigate the spread of coronavirus 2019 (COVID-19), organizations and researchers alike seek to develop and deliver solutions to combat social isolation and loneliness among older adults, who are at outsized risk of complications caused by COVID-19 [13, 14]

  • We describe facilitators, barriers, and lessons learned of Talking Tech implementation from the Meals on Wheels Rhode Island (MOWRI) perspective, as identified from interviews with Talking Tech participants, volunteers, and MOWRI program staff (Table 2)

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Summary

Introduction

Social isolation and loneliness are significant threats to physical and mental health, among older adults. Meals on Wheels America (MOWA), the leadership organization that supports the national network of Meals on Wheels (MOW) programs, aims to alleviate social isolation and loneliness among homebound MOW clients. Formal efforts currently delivered through MOW programs to address isolation and loneliness lack strong evaluation and have not been scaled widely [12] To bridge this gap, researchers worked with MOWA and a MOW program in Rhode Island to pilot an intervention aimed at alleviating social isolation and loneliness through technology. ICT interventions can aid homebound, isolated older adults in socialization by allowing them to engage with others from within their home [18, 19] Barriers, such as lack of technology knowledge, support, broadband availability, and cost, limit the adoption of ICT among older adults [23, 24]. If tailored to meet the needs of homebound older adults, ICT interventions could fill the gap in needed social isolation and loneliness programs for this population

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