A Technology Training Program to Alleviate Social Isolation and Loneliness Among Homebound Older Adults: A Community Case Study

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.

Assessing community health research capacity across stakeholders: adapting a tool

Multi-sectoral collaborative approaches with strong community engagement are essential for addressing health disparities. A valid tool for assessing organizational research and capacity for community health research stakeholders could help strengthen organizational capacity for engagement in such collaborations. This study was conducted to validate an innovative tool for assessing research activity and capacity of a spectrum of stakeholder organizations to provide support for strengthening community health research capacity in Bhutan. In-person interviews with academics (n = 10), clinicians (n = 10), government staff (n = 10), consultants (n = 2) and management of health-related civil society organizations (CSOs; n = 12 interviews/organizations, 13 individuals) were recorded and transcribed. Questions covered individual and organizational research activity and capacity, research networks and an international version of the Community Research Assessment Tool (CREAT-I). Almost all participants (84%) had participated in community health research projects. Social network analysis showed a large, interconnected cluster with a few key individuals linking across sectors. CREAT-I responses identified the highest capacity in organizational support for research among academic participants, while clinical and CSO participants reported highest capacity in practical research experiences and government participants reported highest capacity in research specific experiences. The CREAT-I tool showed strong internal reliability (Cronbach's α = 0.91) and validity. Limited money, time and skilled staff were identified as barriers to research. The CREAT-I assesses community health research capacity of organizations, and such a tool could be useful in identifying research capacity needs, monitoring impact of research capacity-building activities and contributing to a greater capacity for multi-sectoral collaborative approaches to community health research in international settings.