Findings from a Peer-Facilitated, Social Isolation Intervention in the Veterans Health Administration Healthcare System: A Mixed-Methods, Pilot Feasibility Study

• Published in: Journal of general internal medicine : JGIM 2023-12, Vol.38 (16), p.3460-3471
• Main Authors: Eliacin, Johanne, Patterson, Scott M., Mendez, Diana M., Burgess, Diana J., Traylor, Morgan H., Borden, Maria Y., Slaven, James E., Matthias, Marianne S.
• Format: Article
• Language: English
• Subjects: Acceptability; Bivariate analysis; Evaluation; Feasibility Studies; Health problems; Health risks; Humans; Internal Medicine; Intervention; Medicine; Medicine & Public Health; Mental disorders; Middle Aged; Mixed methods research; Original Research: Qualitative Research; Pilot Projects; Public health; Qualitative analysis; Social interactions; Social Isolation; Statistical analysis; Telemedicine; Veterans Health
• ISSN: 0884-8734; 1525-1497; 1525-1497
• DOI: 10.1007/s11606-023-08387-x

Background Social isolation is a global public health threat. Veterans are particularly at risk for social isolation due to high rates of comorbid physical and mental health problems. Yet, effective interventions are limited. Objectives Our primary objective was to assess the feasibility and acceptability of CONNECTED, a novel, transdiagnostic intervention to reduce social isolation that includes individual and group components and is delivered by peers via telehealth. Secondary objectives were to identify appropriate outcome measures and explore preliminary intervention effects. Methods This was a two-phase study. In Phase 1, to evaluate study feasibility, we surveyed 200 veterans to assess prevalence of social isolation and their interest in social connectedness interventions. In Phase 2, we employed a mixed-methods, pre-post study design in which we piloted CONNECTED with 19 veterans through 2 successive cohorts to further assess feasibility, to evaluate acceptability, and to explore preliminary effectiveness. Quantitative analyses involved descriptive and bivariate analyses as well as multivariate modeling. Qualitative interviews were analyzed using thematic analysis. Results For Phase 1, 39% of veterans surveyed were socially isolated. Participants who were ≤ 55 years old, caregivers, and those who experienced unmet social needs were more likely to report social isolation. Over 61% expressed interest in VA programs to reduce social isolation. For Phase 2, the pilot intervention, recruitment rate was 88% and the enrollment rate was 86%. Retention rates for the two cohorts were 80% and 50%, respectively, and satisfaction rates among intervention completers were 100%. Results also showed statistically significant improvements in social isolation (+ 5.91, SD = 4.99; p = .0028), social support (+ 0.74, SD = 1.09; p = .03), anxiety (-3.92, SD = 3.73; p = .003), and depression (-3.83, SD = 3.13; p = .001). Results for the other measures were not statistically significant. Conclusion CONNECTED is a feasible and acceptable intervention and is likely to be an effective tool to intervene on social isolation among veterans.