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Effective Health Care Program

Topic Suggestion Description

Date submitted: May 29, 2018

Describe your topic.
Questions: 1. What is the effectiveness of community and health system interventions (e.g., community health workers, peer support, transportation programs, time banking, etc.) that target social isolation and loneliness in older people? 2. What are the harms and costs associated with community and health system interventions (e.g., community health workers, peer support, transportation programs, time banking, etc) that target social isolation and loneliness in older people? PICOS: • Population: Adults 65+ • Intervention: Any intervention delivered in a health care or community setting, or IT intervention, that seeks to reduce social isolation, loneliness or their underlying causes. Examples include programs delivered by community health workers, peers, or health care practitioners, transportation programs, time banking, etc. • Comparator: Any comparator (pre-post, compared to control, or compared to another intervention) • Outcomes: o Health outcomes (e.g., chronic disease management, mental health outcomes, quality of life) o Health care utilization (e.g., Emergency Department visits, preventive care visits, missed appointments) o Harms o Costs
Describe why this topic is important.
Social isolation and loneliness in older people are major public health problems that have been associated with poor psychological and physical outcomes, as well as increased mortality.1,2 Social isolation is defined as the lack of meaningful and sustained connection to other people, while loneliness is defined as a perceived lack of interaction with others.3 There are complex social, psychological and physical reasons why older adults may become socially isolated, including visual and hearing disabilities, the desire to be independent, lack of mobility, loss of family and friends, and lack of transportation. In recent years, health systems have increasingly focused on addressing the upstream social determinants of health that contribute to poor health, rather than exclusively focusing on preventing and treating disease. Reducing social isolation in older adults has been identified as a priority issue and an area for potential collaboration between health systems, community organizations, public health departments and others.
Tell us why you are suggesting this topic.
See above. Target date: The target date for a review on non-IT interventions is mid-July 2018. The target date for a review on IT interventions is mid-Aug 2018. Completing the reviews by these deadlines would give sufficient time for Healthy Aging Summit partners to review results and assemble appropriate partners for discussions at the September 2018 meeting.
Target Date.
Describe what you are doing currently and what you are hoping will change because of a new evidence report.
evidence report In September 2018, a group of health systems, universities, community organizations, public health departments and others are coming together for a Healthy Aging Summit in Portland Oregon to discuss creating age friendly health systems. An evidence report that summarizes the interventions that effectively address social isolation and improve health outcomes would be used to inform which interventions will be adopted across these health systems. Given the increasing level of interest in this topic nationally, other health systems across the US have also indicated interest in the findings of this review.
How will you or your group use the information from a new evidence report?
See above.
How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
Findings of the evidence report would be disseminated nationally to health systems, research centers, and other groups working on reducing social isolation in older people. This list of contacts is being initially developed by the Kaiser Center for Health Research, and will be further refined through ongoing conversations with health systems and others in preparation for the Healthy Aging Summit. Findings would be disseminated via email, conferences, etc. as appropriate.
Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
Identified partners of the Healthy Aging Summit include Kaiser Permanente, Oregon Health and Science University, Adventist Health, Tuality Healthcare, and OCHIN.
Information About You: (optional)
Provide a description of your role or perspective.
Director, Kaiser Permanente Center for Health Research
If you are you making a suggestion on behalf of an organization, please state the name of the organization.
Please tell us how you heard about the Effective Health Care Program.