The Effectiveness of Peer-to-Peer Community Support to Promote Aging in Place

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

456 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-31

Study Completion Date

2017-12-31

Brief Summary

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The investigators' overall objective is to evaluate the effectiveness of peer-to-peer support programs in preventing the necessity of acute health care and nursing home services for older adult populations and in promoting their health and wellness. The investigators' Specific Aims are:

1. To compare the effectiveness of peer-to-peer community support in preventing hospitalization, emergency department (ED) use, and nursing home placement in an at-risk older adult population relative to standard community services.
2. To compare the effect of peer-to-peer community support on intermediary measures of health and wellness such as self-rated health, depression, and anxiety relative to standard community services.

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Detailed Description

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The investigators will accomplish the aims by conducting a longitudinal comparative-effectiveness study in which at-risk older adult study participants in three communities across the US are followed for 12-months. Using a quasi-experimental design, investigators will compare outcomes in those receiving peer-to-peer community support to those receiving standard community services.

At all three sites investigators will include 120 older adults in the peer-to-peer support group and 120 in the standard community services group for a total intervention group size of 360 (120 from each site) and 360 in the control group (120 from each site).

Study Outcomes \& Measures To meet the first two aims investigators will (1) compare annualized rates of hospitalization, ED use, and nursing home placement and (2) examine the changes in self-reported health, depression, anxiety, and other measures of well-being in the group receiving peer-to-peer support compared to the group receiving standard community services from baseline to the end of study enrolment. The investigators describe each of our outcomes and additional study measures in detail below. Measures have been translated and used in Spanish and have been shown to be valid or have high reliability in Spanish

Conditions

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Wellness Programs Hospitalization Emergency Room

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Peer-to-peer support (non-randomized)

225 older adults that are currently receiving peer-to-peer support

Group Type EXPERIMENTAL

Peer-to-Peer Support

Intervention Type BEHAVIORAL

All three data collection sites run peer-to-peer community support programs. Core program elements include the same program objective, standard definition of who qualifies for peer-to-peer support, the mechanism by which older adults are referred for consideration for peer-support, core elements of training programs for the older adults who volunteer to provide the peer support, and monthly in-service trainings for all volunteers once trained, weekly hours that volunteers spend providing support, and provision of small stipends for volunteers.As they find their role very rewarding, there is very little peer turn-over; the vast majority of peers volunteer for years in this role, until they themselves start requiring services.

Standard Services (non-randomized)

225 older adults will continue receiving standard community services

Group Type ACTIVE_COMPARATOR

Standard Community Services

Intervention Type BEHAVIORAL

All three data collection sites will continue to provide standard community services to the older adults that are not enrolled in the peer-to-peer support program

Interventions

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Peer-to-Peer Support

All three data collection sites run peer-to-peer community support programs. Core program elements include the same program objective, standard definition of who qualifies for peer-to-peer support, the mechanism by which older adults are referred for consideration for peer-support, core elements of training programs for the older adults who volunteer to provide the peer support, and monthly in-service trainings for all volunteers once trained, weekly hours that volunteers spend providing support, and provision of small stipends for volunteers.As they find their role very rewarding, there is very little peer turn-over; the vast majority of peers volunteer for years in this role, until they themselves start requiring services.

Intervention Type BEHAVIORAL

Standard Community Services

All three data collection sites will continue to provide standard community services to the older adults that are not enrolled in the peer-to-peer support program

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Overall

* ≥65 years of age
* Speaks English or Spanish
* Lives independently in their community year-round
* Meet the community defined criterion for receiving peer-to-peer support (at least one of the following)

* Low income (at or below poverty level)
* On a fixed income that barely meets their living expenses
* Social and/or familial isolation
* Chronic Illness
* Enrolled in the peer-to-peer support program and have an assigned peer volunteer

Exclusion Criteria

* \< 65
* Score ≤ 30 on the Telephone Interview of Cognitive Status (TICS) because they will not have the ability to complete the survey
* State that it is unlikely that they will receive peer-to-peer support services for at least a year. Individuals who are unlikely to receive at least a year of services include those who need short-term help after a surgery and are likely to return to full functioning and those planning to transition to nursing home care or move away.

* Currently receiving hospice services

Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes