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:

https://www.hss.edu/health-video-library.asp

https://www.youtube.com/playlist?list=PLDps2oOp60a7TEfDWuePJkarYGkS2ReQv

The award 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, according to the APHA. The organization notes that minimizing health disparities and improving access to health and long-term care services are important issues for minority populations in the United States.

HSS is the award recipient for its manuscript titled, "Utilizing Alternative Strategies to Keep Underserved and Vulnerable Communities Socially Connected.” Bonnie McGrath, first author and program assistant, Regional Markets Education & Outreach at HSS, accepted the award virtually at the APHA Aging and Public Health Section Awards Ceremony on October 25.

“When the pandemic started, it was essential for us to continue to provide services to our underserved and vulnerable populations, including older adults,” explained McGrath. “Working closely with our community partners, the HSS team assessed the community’s needs and identified strategies to implement programs that individuals could access from home. It is truly an honor to have our work recognized by the APHA.”

HSS successfully transitioned many in-person programs to telephone conference calls or video conferences with Zoom. New programs, on-demand videos and offerings in a safe outdoor space with social distancing were added as time went on. Focus groups, phone interviews and surveys were used to assess program effectiveness, McGrath explained. Data collection indicated that the offerings enabled participants to feel calmer and more relaxed; they valued the opportunity to connect with others; and they gained skills to cope with stress and anxiety.

“Our ability to adapt and be innovative has allowed us to implement new program formats to reach the diverse communities we serve, offering support, an opportunity for physical activity and social connections,” said Sandra Goldsmith, assistant vice president, HSS Education Institute. “The communities we serve were open to these changes, and it is gratifying to have the opportunity to play a continued role in supporting their health.”

Moderator Melinda Stevens reports that HSS has implemented a pain and stress management program catered to those living with chronic musculoskeletal conditions. 

"Rheumatology patients often have conditions that lead to stiff joints and muscles, and many other clinic patients are on some type of pain medication to help mitigate their pain associated with their condition," said Weisel. "Studies show that one-third of patients with RA [rheumatoid arthritis] are being prescribed opioids as part of a treatment plan and one in ten use opioids chronically during the course of their disease."

The HSS program aims to give patients alternative strategies to help cope with pain and has multiple components including workshops and weekly phone calls all aimed to meet patients' needs.

"We implemented additional aspects to our program so it not only focuses on the breath... but we also added in some aspects of movement as well,"  said Wimmer. "Patients engage in mindful breathing techniques as well as seated yoga poses ending with a deep relaxation session that tie together both the movement with the breath."

Listen to the full podcast at consultant360.com.