HSS Shares Successful Strategies to Support the Health of Older Adults at American Public Health Association Symposium
The COVID-19 pandemic has taken a toll on mental health, and older adults, most at risk of severe illness from the virus, have been especially vulnerable, according to Robyn Wiesel, director of Community Education & Outreach at Hospital for Special Surgery (HSS). According to the Centers for Disease Control and Prevention, loneliness and social isolation pose serious public health risks and affect a significant number of people in the United States.
When the pandemic forced the closure of its onsite programs, Community Education & Outreach staff quickly set out to transition their offerings to virtual and conference call formats. “It was important for us to continue to promote an atmosphere of support for our older adult population,” explained Wiesel. “Our goal was to continue to deliver high-quality education, exercise and support programs to promote health, activity and connectivity.”
HSS staff shared their strategies and successes at a virtual symposium titled, “Fostering Social, Emotional and Physical Connectivity in Older Adults during the Pandemic and Beyond” at the annual meeting of the American Public Health Association (APHA) on October 26.
Utilizing Alternative Strategies to Keep Underserved and Vulnerable Communities Socially Connected
A presentation that focused on implementing new and creative program formats to better reach diverse communities was honored with the APHA Betty J. Cleckley Minority Issues Research Award. It recognizes individuals in aging and public health research who have made a significant impact on the lives of older people who are members of minority groups.
To foster social connectedness and promote well-being during the pandemic, HSS adapted its in-person programs to continue to reach underserved and vulnerable populations, including older adults whose primary language was not English.
Working closely with community partners, Bonnie McGrath, program assistant, Regional Markets Education & Outreach, and her colleagues conducted a needs assessment and identified alternative strategies to successfully pivot programs, including Pilates mat and Tai Chi classes to be offered via conference call, videoconference via Zoom or in a safe outdoor space in a socially distanced manner.
HSS offered 586 programs reaching 5,902 participants from March 2020 to August 2021. Surveys indicate that the program enabled participants to feel calmer and more relaxed; many experienced less pain; they valued the opportunity to connect with others; and they gained skills to cope with stress and anxiety. The online programs are ongoing and continue to evolve and improve based on participant feedback.
Aging with Dignity: Connection and Support to Reduce Isolation
“Aging with Dignity” was a monthly in-person support group led by a social worker designed to establish connections, provide guidance and reduce feelings of isolation in vulnerable communities. At the start of the pandemic, HSS staff quickly adapted to a remote format to continue the support group through frequent telephone conference calls.
Linda Roberts, LCSW, assistant manager of the Greenberg Academy for Successful Aging at HSS, says the telephone format made participation easier for those without easy access to the Internet or who were not as comfortable with an online format.
The group is ongoing and has been running for 63 weeks since the pandemic began in March 2020, with more than two-thirds of participants ages 70 and older. Program evaluations indicate that the weekly calls are effective in reducing their feelings of loneliness by establishing a sense of empowerment and community with other group members.
Improving Quality of Life and Fostering Connectivity Through Virtual Exercise Programs in Older Adults
When in-person exercise classes were no longer an option, HSS implemented biweekly live virtual classes, including Pilates, yoga and Tai Chi, as well as on-demand videos, tailored to improve musculoskeletal health for older adults while fostering social connectivity. The offerings were designed for different levels of ability.
According to Claudia Zurlini, senior coordinator, Community Education & Outreach, since the COVID-19 onset, HSS has reached more than 3,600 participants through live virtual exercise classes and 1.5 million people through on-demand exercise videos. Participant surveys indicate that the virtual offerings helped improve mobility, physical activity level and quality of life, while reducing the negative impact of isolation.
Best Practices and Lessons Learned in Evaluating Virtual Programs for Older Adults
Program evaluation is a crucial process that assesses the impact and quality of public health programs. Prior to COVID-19, HSS used a mixed-method approach with an emphasis on distributing paper surveys in person. With the shift to virtual programs, HSS adopted a new strategy to ensure effective assessment. In-person surveys were transitioned to an online system. However, due to low response rates of online surveys, HSS expanded the strategy to include a three-pronged qualitative approach – focus groups via Zoom, phone interviews and open-ended survey questions.
Bertilia Trieu, MPH, senior coordinator, Outcomes & Data Analytics, says the new approach helped foster social connectivity by allowing older adults to share feedback in spaces that virtually connected them to classmates and evaluation staff. It also created an opportunity to reach older adults who were uncomfortable with technology or did not have access.
HSS Virtual Offerings Here to Stay
“The expansion of our online programs, webinars, classes and on-demand content has demonstrated tremendous reach outside of our physical geographic area. Our content has been accessed by people throughout the country and around the world," says Wiesel, who adds that the expansion of online offerings will continue.
“At HSS, our data has shown that our programs are just as effective, if not more effective, in the virtual space," she adds. "Our reach numbers have increased considerably. Since January 2021, our on-demand content alone has received close to 3 million views.”
To access the extensive programming on the HSS website, as well as a YouTube playlist, visit:
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 12th consecutive year), No. 4 in rheumatology by U.S. News & World Report (2021-2022), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2021-2022). HSS is ranked world #1 in orthopedics by Newsweek (2021-2022). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 130 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.