Connecting During COVID-19: A Protocol of a Volunteer-Based Telehealth Program for Supporting Older Adults' Health

Elena Dikaios, Harmehr Sekhon, Alexandre Allard, Blanca Vacaflor, Allana Goodman, Emmett Dwyer, Paola Lavin-Gonzalez, Artin Mahdanian, Haley Park, Chesley Walsh, Neeti Sasi, Rim Nazar, Johanna Gruber, Chien-Lin Su, Cezara Hanganu, Isabelle Royal, Alessandra Schiavetto, Karin Cinalioglu, Christina Rigas, Cyrille Launay, Olivier Beauchet, Emily McDonald, Dallas Seitz, Sanjeev Kumar, Vasavan Nair, Marc Miresco, Marie-Andrée Bruneau, George Alexopoulos, Karl Looper, Ipsit Vahia, Soham Rej, Syeda Nayab Bukhari, Elena Dikaios, Harmehr Sekhon, Alexandre Allard, Blanca Vacaflor, Allana Goodman, Emmett Dwyer, Paola Lavin-Gonzalez, Artin Mahdanian, Haley Park, Chesley Walsh, Neeti Sasi, Rim Nazar, Johanna Gruber, Chien-Lin Su, Cezara Hanganu, Isabelle Royal, Alessandra Schiavetto, Karin Cinalioglu, Christina Rigas, Cyrille Launay, Olivier Beauchet, Emily McDonald, Dallas Seitz, Sanjeev Kumar, Vasavan Nair, Marc Miresco, Marie-Andrée Bruneau, George Alexopoulos, Karl Looper, Ipsit Vahia, Soham Rej, Syeda Nayab Bukhari

Abstract

Introduction: Social-distancing due to COVID-19 has led to social isolation, stress, and mental health issues in older adults, while overwhelming healthcare systems worldwide. Telehealth involving phone calls by trained volunteers is understudied and may be a low-cost, scalable, and valuable preventive tool for mental health. In this context, from patient participatory volunteer initiatives, we have adapted and developed an innovative volunteer-based telehealth intervention program for older adults (TIP-OA). Methods and analysis: To evaluate TIP-OA, we are conducting a mixed-methods longitudinal observational study. Participants: TIP-OA clients are older adults (age ≥ 60) recruited in Montreal, Quebec. Intervention: TIP-OA volunteers make weekly friendly phone calls to seniors to check in, form connections, provide information about COVID-19, and connect clients to community resources as needed. Measurements: Perceived stress, fear surrounding COVID-19, depression, and anxiety will be assessed at baseline, and at 4- and 8-weeks. Semi-structured interviews and focus groups will be conducted to assess the experiences of clients, volunteers, and stakeholders. Results: As of October 15th, 2020, 150 volunteers have been trained to provide TIP-OA to 305 older clients. We will consecutively select 200 clients receiving TIP-OA for quantitative data collection, plus 16 volunteers and 8 clinicians for focus groups, and 15 volunteers, 10 stakeholders, and 25 clients for semi-structured interviews. Discussion: During COVID-19, healthcare professionals' decreased availability and increased needs related to geriatric mental health are expected. If successful and scalable, volunteer-based TIP-OA may help prevent and improve mental health concerns, improve community participation, and decrease healthcare utilization. Clinical Trial Registration: ClinicalTrials.gov NCT04523610; https://ichgcp.net/clinical-trials-registry/NCT04523610?term=NCT04523610&draw=2&rank=1.

Keywords: COVID-19; anxiety; depression; geriatrics; older adults; telehealth.

Conflict of interest statement

DS is a site investigator on a clinical trial sponsored by Hoffmann La Roche. VN receives research funding from Brain Canada, Eli Lilly, as well as Merck & Biogen Pharmaceutical companies (project completed). He declares no influence or impact on the project under consideration. SK receives research support from Brain and Behavior Foundation, National Institute on Aging, BrightFocus Foundation, Brain Canada, Canadian Institute of Health Research, Center for Aging and Brain Health Innovation, Center for Addiction and Mental Health, University of Toronto. He also receives equipment support from Soterix Medical. GA served on the Advisory Board of Eisai and of Janssen Pharmaceuticals. He also served on the Speakers Bureaus of Allergan, Otsuka, and Takeda-Lundbeck and his work was supported by P50 MH113838. SR receives a junior investigator salary award from the Fonds de Recherche Quebec–Santé and an investigator-initiated research grant from Satellite Healthcare (Dialysis Company) for an unrelated project. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Dikaios, Sekhon, Allard, Vacaflor, Goodman, Dwyer, Lavin-Gonzalez, Mahdanian, Park, Walsh, Sasi, Nazar, Gruber, Su, Hanganu, Royal, Schiavetto, Cinalioglu, Rigas, Launay, Beauchet, McDonald, Seitz, Kumar, Nair, Miresco, Bruneau, Alexopoulos, Looper, Vahia, Rej and Bukhari.

References

    1. World Health Organization WHO Health Topics – Coronavirus. (2020). Available from: (accessed June 6, 2020).
    1. Center for Systems Science and Engineering (CSSE) at John Hopkins University COVID-19 Dashboard. (2020). Available from: (accessed October 5, 2020).
    1. D'Adamo H, Yoshikawa T, Ouslander JG. Coronavirus Disease 2019 in geriatrics and long-term care: the ABCDs of COVID−19. J Am Geriatr Soc. (2020) 68:912–7. 10.1111/jgs.16445
    1. Center for Disease Control CDC - Coronavirus - People at Higher Risk. (2020). Available from: (accessed October 5, 2020).
    1. Public Health Agency of Canada Physical Distancing: How to Slow the Spread of COVID-19. (2020). Available from: (accessed October 5, 2020).
    1. Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Health Soc Care Commun. (2015) 25:799–812. 10.1111/hsc.12311
    1. Domènech-Abella J, Mundó J, Haro JM, Rubio-Valera M. Anxiety, depression, loneliness and social network in the elderly: longitudinal associations from The Irish Longitudinal Study on Aging (TILDA). J Affect Disord. (2019) 246:82–8. 10.1016/j.jad.2018.12.043
    1. Vigo D, Patten S, Pajer K, Krausz M, Taylor S, Rush B, et al. . Mental Health of Communities during the COVID-19 Pandemic. Can J Psychiatry. (2020) 65:681–7. 10.1177/0706743720926676
    1. Mental Health Commission of Canada Making the Case for Investing in Mental Health in Canada. (2013). Available online at: (accessed October 5, 2020).
    1. Vasiliadis HM, Dionne PA, Préville M, Gentil L, Berbiche D, Latimer E. The excess healthcare costs associated with depression and anxiety in elderly living in the community. Am J Geriatr Psychiatry. (2013) 21:536–48. 10.1016/j.jagp.2012.12.016
    1. Shoukat A, Wells CR, Langley JM, Singer BH, Galvani AP, Moghadas SM. Projecting demand for critical care beds during COVID-19 outbreaks in Canada. Can Med Assoc J. (2020) 192:E489–96. 10.1503/cmaj.200457
    1. Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Int Med. (2018) 178:745. 10.1001/jamainternmed.2018.1314
    1. Osenbach JE, O'Brien KM, Mishkind M, Smolenski DJ. Synchronous telehealth technologies in psychotherapy for depression: a meta-analysis. Depress Anxiety. (2013) 30:1058–67. 10.1002/da.22165
    1. Rees CS, Maclaine E. A systematic review of videoconference-delivered psychological treatment for anxiety disorders. Aust Psychol. (2015) 50:259–64. 10.1111/ap.12122
    1. Preston C, Moore S. Ringing the changes: the role of telephone communication in a helpline and befriending service targeting loneliness in older people. Aging Soc. (2018) 39:1528–51. 10.1017/S0144686X18000120
    1. Noone C, McSharry J, Smalle M, Burns A, Dwan K, Devane D, et al. . Video calls for reducing social isolation and loneliness in older people: A rapid review. Cochr Database Syst Rev. (2020) 5:CD013632. 10.1002/14651858.CD013632
    1. Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur Psychiatry. (2020) 63:e32. 10.1192/j.eurpsy.2020.35
    1. Robertson FC, Lippa L, Broekman MLD. Editorial. Task shifting and task sharing for neurosurgeons amidst the COVID-19 pandemic. J Neurosurg. (2020) 17:1–3. 10.3171/2020.4.JNS201056
    1. Xu S, Li Y. Beware of the second wave of COVID-19. Lancet. (2020) 395:1321–2. 10.1016/S0140-6736(20)30845-X
    1. Dias A, Azariah F, Anderson SJ, Sequeira M, Cohen A, Morse JQ, et al. . Effect of a lay counselor intervention on prevention of major depression in older adults living in low- and middle-income countries: a randomized clinical trial. JAMA Psychiatry. (2019) 76:13–20. 10.1001/jamapsychiatry.2018.3048
    1. Hargittai E, Dobransky K. Old dogs, new clicks: digital inequality in skills and uses among older adults. Can J Commun. (2017) 42:195–212. 10.22230/cjc.2017v42n2a3176
    1. Neves B, Amaro F. Too old for technology? How the elderly of Lisbon use perceive ICT. J Commun Inform. (2012) 8:1–2.
    1. Pachis JA, Zonneveld KLM. Comparison of prompting procedures to teach internet skills to older adults. J Appl Behav Anal. (2018) 52:173–87. 10.1002/jaba.519
    1. Park MM, Zafran H, Stewart J, Salsberg J, Ells C, Rouleau S, et al. . Transforming mental health services: a participatory mixed methods study to promote and evaluate the implementation of recovery-oriented services. Implement Sci. (2014) 9:119. 10.1186/s13012-014-0119-7
    1. Walsh C, Côté-Olijnyk M, Park M. Touching Lives: Changing Public Perspectives of Mental Illness Through a Volunteer-In-Partnership Program. Quebec, QC: Canadian Psychiatric Association; (2019).
    1. Culo S. Risk assessment and intervention for vulnerable older adults. Br Columbia Med J. (2011) 53:421–5.
    1. Canadian Coalition for Seniors' Mental Health (2006) National Guidelines for Seniors' Mental Health: The Assessment of Suicide Risk and Prevention of Suicide. Available from: (accessed October 5, 2020).
    1. Ezzati A, Jiang J, Katz MJ, Sliwinski MJ, Zimmerman ME, Lipton RB. Validation of the perceived stress scale in a community sample of older adults. Int J Geriatr Psychiatry. (2014) 29:645–52. 10.1002/gps.4049
    1. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: development and initial validation. Int J Mental Health Addict. (2020) 27:1−9. 10.1007/s11469-020-00270-8
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Int Med. (2001) 16:606–13. 10.1046/j.1525-1497.2001.016009606.x
    1. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Int Med. (2006) 166:1092. 10.1001/archinte.166.10.1092
    1. Fan U, Li R. Variable selection in linear mixed effects models. Ann Statist. (2012) 40:2043–68. 10.1214/12-AOS1028
    1. Houghton C, Murphy K, Meehan B, Thomas J, Brooker D, Casey D, et al. . From screening to synthesis: using nvivo to enhance transparency in qualitative evidence synthesis. J Clin Nurs. (2017) 26:873–81. 10.1111/jocn.13443
    1. Peckham SB, Ionson E, Nassim M, Ojha K, Palaniyappan L, Gati J, et al. . Sahaj Samadhi meditation vs a Health Enhancement Program in improving late-life depression severity and executive function: study protocol for a two-site, randomized controlled trial. Trials. (2019) 20:605. 10.1186/s13063-019-3682-z
    1. Huang Y, Zhao N. Mental health burden for the public affected by the COVID-19 outbreak in China: Who will be the high-risk group? Psychol Health Med. (2020) 14:1–12. 10.1080/13548506.2020.1754438
    1. Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. (2019) 6:211–24. 10.1016/S2215-0366(18)30511-X
    1. Chan SM, Chiu FK, Lam CW, Leung PY, Conwell Y. Elderly suicide and the 2003 SARS epidemic in Hong Kong. Int J Geriatr Psychiatry. (2006) 21:113–8. 10.1002/gps.1432
    1. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. (2004) 10:1206–12. 10.3201/eid1007.030703
    1. Lu T-H, Chou Y-J, Liou C-S. Impact of SARS on healthcare utilization by disease categories: implications for delivery of healthcare services. Health Policy. (2007) 83:375–81. 10.1016/j.healthpol.2007.03.001
    1. Plomecka MB, Gobbi S, Neckels R, Radziński P, Skórko B, Lazerri S, et al. Mental Health Impact of COVID-19: A global study of risk and resilience factors. medRxiv. (2020). 10.1101/2020.05.05.20092023
    1. Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci USA. (2013) 110:5797–801. 10.1073/pnas.1219686110
    1. Halvorson MA, Humphreys K. A review of the nature and impact of exclusion in depression treatment outcome research. Ann Depress Anxiety. (2015) 2:1058.
    1. Goldstein-Piekarski AN, Williams LM, Humphreys K. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders. Transl Psychiatry. (2016) 6:e847. 10.1038/tp.2016.108
    1. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. (2011) 199:445–52. 10.1192/bjp.bp.110.083733
    1. Briscoe J, Orwin D, Ashton L, Burdett J. Being there: a peer support service for older adults with mental illness. Health Research Council of New Zealand (2005).
    1. Chapin RK, Sergeant JF, Landry S, Leedahl SN, Rachlin R, Koenig T, et al. . Reclaiming joy: pilot evaluation of a mental health peer support program for older adults who receive medicaid. Gerontologist. (2012) 53:345–52. 10.1093/geront/gns120
    1. Chen YH, Lin YH, Hung CS, Huang CC, Yeih DF, Chuang PY, et al. . Clinical outcome and cost-effectiveness of a synchronous telehealth service for seniors and nonseniors with cardiovascular diseases: quasi-experimental study. J Med Int Res. (2013) 15:87. 10.2196/jmir.2091
    1. Office EE, Rodenstein MS, Merchant TS, Pendergrast TR, Lindquist LA. Reducing social isolation of seniors during COVID-19 through medical student telephone contact. J Am Med Direct Assoc. (2020) 21:948–50. 10.1016/j.jamda.2020.06.003

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다