Geriatric, Loneliness, Social Isolation
Conditions
Keywords
Loneliness, Social Isolation, Emergency Department, Geriatrics, Geriatric Psychiatry, Family Medicine, Randomized Clinical Trial
Brief summary
Social isolation and loneliness worsen older peoples' quality of life, risk of dementia, and contributes to 45,000 deaths/year in Canada - as much as smoking. Isolated people use the health care system more often, but have worse outcomes. Effective, inexpensive interventions exist but unfortunately they have not been implemented in Canada. We partnered with the Australian developer of HOW R U?, an effective and feasible intervention that uses specially trained, older, hospital volunteers to provide peer support to combat isolation and loneliness in isolated older peers. Little is known about older people's preferences for virtual care (telephone vs. video) nor their relative effectiveness. Thus we will compare two ways of delivering HOW R U: telephone support and a tested, secure user-friendly video conferencing app, aTouch Away® to a common control arm. We also partnered with Emergency Medicine, Family Medicine, Geriatrics and Psychiatry to identify people who will benefit from peer support; and with Volunteer Services to recruit volunteers.
Interventions
OTHERHOW R U? Intervention
HOW RU? intervention uses trained volunteer peers to provide strength-based support sessions weekly for 12 weeks.
Sponsors
Bolton Clarke Research Institute
Sunnybrook Research Institute
North York General Hospital
King's College London
University of Toronto
Mount Sinai Hospital, Canada
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
We will use intention-to-treat analysis for the primary outcome to further protect against selection bias. It is not feasible to blind participants to the intervention. Primary outcomes will be assessed after 12 weeks by a research assistant who has had no previous contact with participants and is blinded to the intervention group.
Intervention model description
This multi-centered, three-arm, outcome assessor blinded randomized clinical trial will follow CONSORT reporting guidelines and is part of a program of research that adheres to the ORBIT model for developing complex behavioural interventions. In this model, the previous study by Lowthian and colleagues established the proof of concept, and the current trial Phase IIb is adequately powered to test whether two versions of the HOW R U? intervention are effective compared to a common standard care wait-list arm.
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Any community-dwelling person 70 years of age and older receiving care from the ED, Family Medicine, or Geriatric clinics at our two participating sites (MSH and NYGH) will be eligible.
Exclusion criteria
* age less than 70 years; communication problems (critically ill, unconscious, language barrier, speech impairment or otherwise unable to provide consent), or admission to a hospital for \> 72 hours. Patients with severe cognitive impairment or those living in nursing homes who are dependent on others for their activity of daily living will be excluded. To target the intervention for older people with loneliness a baseline de Jonge loneliness scores of 2.0 will be required for participation in the trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in De Jong Gierveld Loneliness Scale at Baseline | This scale will be collected at baseline and at 12 weeks. | We will use the 6-item De Jong Gierveld loneliness scale as our primary outcome measure.The minimum value is 0 and the maximum value is 6. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Social Network | Baseline and at 12 weeks | Lubben's Social Network Scale |
| Change in Mood | Baseline and at 12 weeks | Geriatric Depression Scale |
| Change in Quality of life | Baseline and at 12 weeks | EQ-5D-5L survey |
| all-cause mortality | Follow-up phone call at 12 weeks | — |
Countries
Canada
Contacts
Primary ContactJacques Lee, MD
Backup ContactJoanna Yeung, HBSc
Outcome results
None listed