Social Isolation in Older Adults
Conditions
Keywords
Older adults, Social Support, Technology uptake
Brief summary
The focus of the study is to evaluate the expanded version of PRISM 1.0 for a broad array of seniors with different needs and circumstances. The aims of the study are to: 1) obtain information on perceptions of the usefulness and usability of PRISM 2.0 and interface design issues; 2) examine the impact of access to PRISM 2.0 on social connectivity, engagement, social support, and perceived loneliness; 3) examine the impact of access to PRISM 2.0 on perceived isolation, well-being, and quality of life; 4) examine the impact of access PRISM 2.0 on computer attitudes, self-efficacy, technology proficiency and technology uptake; 5) gather data on usefulness of system features and if these vary by living condition; and 6) examine, in our statistical models, the influence of factors such as age, cognitive abilities, ethnicity, education on system use and outcomes.
Detailed description
This study is part of the CREATE center. The focus of the study is to evaluate the expanded version of PRISM 1.0 for a broad array of seniors with different needs and circumstances. The aims of the study are to: 1) obtain information on perceptions of the usefulness and usability of PRISM 2.0 and interface design issues; 2) examine the impact of access to PRISM 2.0 on social connectivity, engagement, social support, and perceived loneliness; 3) examine the impact of access to PRISM 2.0 on perceived isolation, wellbeing, and quality of life; 4) examine the impact of access PRISM 2.0 on computer attitudes, self-efficacy, technology proficiency and technology uptake; 5) gather data on usefulness of system features and if these vary by living condition; and 6) examine, in our statistical models, the influence of factors such as age, cognitive abilities, ethnicity, education on system use and outcomes. The design of the PRISM 2.0 is well grounded and the chosen features will be based on: 1) the findings from the PRISM 1.0 trial; 2) the cognitive, human factors and engineering; 3) emerging findings in aging (e.g., findings related to technology acceptance, social isolation, social networks, life engagement); 4) existing theories of aging (e.g., Stress-Process Model; Active Theory; Social Isolation/Engagement; 5) findings regarding the benefits of technology for seniors; 6) findings from previous work from CREATE regarding interface design, training, provision of environmental support, and the needs of older adults; 7) recent findings regarding Internet use among older adults; 8) findings from our prior focus groups on barriers to access of technology and technology preferences; 9) findings from our technology-based community intervention programs with older adults; 10) existing models of technology adoption and diffusion; 11) the literature on implementation science our planned focus groups and pilot testing of PRISM 2.0.
Interventions
BEHAVIORALPRISM 2.0 Condition
Access to the PRISM 2.0 program
BEHAVIORALTablet Condition
Access to the tablet
Sponsors
National Institute on Aging (NIA)
Weill Medical College of Cornell University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age 65+ years * Able to read English at the 6th grade level * Passing score of Social Isolation Screening * Passing score of brief Technology Proficiency Screen * Passing score of Telephone Interview for Cognitive Status (TICS) * Passing score of Woodcock Johnson Reading Comprehension (Spanish equivalent) * Passing score of Fuld Object Memory Evaluation
Exclusion criteria
* Blind or deaf * Has terminal Illness or severe motor impairment * Significant use of computer/Internet/email in the home or elsewhere * Working for a paid more than 5 hours/week * Participate as formal volunteer more than 5 hours/week * Attend senior center or another formal organization for than 10 hours/week
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | Baseline, 6 month follow-up and 9 month follow-up | Higher score means better functional health/well-being. A lower score reflects poorer health. Range (0-1400) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | Baseline, 6 month follow-up and 9 month follow-up | Higher score indicates a greater degree of loneliness. A lower score reflects a lower degree of loneliness. Range (0-80) |
Countries
United States
Participant flow
Recruitment details
Participants were recruited based on response to study recruitment efforts (e.g., flyers, mailings, etc.) at 3 research centers between April 2017 and March 2020.
Participants by arm
| Arm | Count |
|---|---|
| PRISM 2.0 Condition Exposing participants to the PRISM 2.0 interface.
PRISM 2.0 Condition: Access to the PRISM 2.0 program | 125 |
| Tablet Condition Exposing participants to the regular computer/tablet
Tablet Condition: Access to the tablet | 120 |
| Total | 245 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 8 | 3 |
| Overall Study | Investigator Decision | 1 | 1 |
| Overall Study | Lost to Follow-up | 7 | 11 |
| Overall Study | Withdrawal by Subject | 24 | 9 |
Baseline characteristics
| Characteristic | Tablet Condition | PRISM 2.0 Condition | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 117 Participants | 125 Participants | 242 Participants |
| Age, Categorical Between 18 and 65 years | 3 Participants | 0 Participants | 3 Participants |
| Age, Continuous | 75 years | 76 years | 76 years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 21 Participants | 23 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 115 Participants | 100 Participants | 215 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 3 Participants | 4 Participants | 7 Participants |
| Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure | 865 units on a scale | 855 units on a scale | 857.5 units on a scale |
| Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings | 39 units on a scale | 39 units on a scale | 39 units on a scale |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 20 Participants | 26 Participants | 46 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 5 Participants | 7 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants | 10 Participants | 14 Participants |
| Race (NIH/OMB) White | 94 Participants | 84 Participants | 178 Participants |
| Region of Enrollment United States | 120 participants | 125 participants | 245 participants |
| Sex: Female, Male Female | 89 Participants | 100 Participants | 189 Participants |
| Sex: Female, Male Male | 31 Participants | 23 Participants | 54 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 8 / 128 | 3 / 120 |
| other Total, other adverse events | 9 / 128 | 7 / 120 |
| serious Total, serious adverse events | 5 / 128 | 3 / 120 |
Outcome results
Primary
Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being.
Higher score means better functional health/well-being. A lower score reflects poorer health. Range (0-1400)
Time frame: Baseline, 6 month follow-up and 9 month follow-up
Population: Eleven participants in the PRISM 2.0 arm and 5 participants in the Tablet arm at baseline, 13 participants in the PRISM 2.0 arm and 14 participants in the Tablet arm at the 6-month time point, and 10 participants in the PRISM 2.0 arm and 11 participants in the Tablet arm at 9-month did not complete this measure.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| PRISM 2.0 Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | Baseline | 855 units on a scale |
| PRISM 2.0 Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | 6-month | 900 units on a scale |
| PRISM 2.0 Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | 9-month | 860 units on a scale |
| Tablet Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | Baseline | 865 units on a scale |
| Tablet Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | 6-month | 870 units on a scale |
| Tablet Condition | Change in Functional Health/Well-being as Measured by Modified SF-36, a Self-report Measure of Functional Health and Well-being. | 9-month | 857.5 units on a scale |
Secondary
Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation.
Higher score indicates a greater degree of loneliness. A lower score reflects a lower degree of loneliness. Range (0-80)
Time frame: Baseline, 6 month follow-up and 9 month follow-up
Population: Data is unavailable for 8 participants in the PRISM 2.0 arm and 2 participants in the Tablet arm at baseline as they did not complete this measure. Missing data is due to normal attrition and special circumstances associated with the COVID-19 pandemic.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| PRISM 2.0 Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | Baseline | 39 units on a scale |
| PRISM 2.0 Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | 6 month | 37 units on a scale |
| PRISM 2.0 Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | 9 month | 35 units on a scale |
| Tablet Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | Baseline | 39 units on a scale |
| Tablet Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | 6 month | 36 units on a scale |
| Tablet Condition | Change in Loneliness as Measured by Loneliness Scale, a 20-item Scale to Measure One's Subjective Feelings of Loneliness and Feelings of Social Isolation. | 9 month | 33 units on a scale |