13. OPTIMIZING THE DESIGN AND MEASUREMENT OF A MULTI-MODULE GROUP INTERVENTION TO IMPROVE WELL-BEING IN OLDER ADULTS

Abstract

Introduction

Well-being is defined broadly, but typically includes promoting a combination of health, resilience, quality of life and connection. Positive psychological interventions move beyond the goal of simply decreasing symptoms and disorder rates and gravitate towards life enhancing and skill development. This psychological wellness group focuses on improving quality of life and skill development that aim to build resilience to life’s challenges, increase motivation to engage in positive self-care and drive to find purpose in engaging with and helping others. Our multi-modal well-being group targets a broad range of well-being dimensions including cognitive, behavioral, emotional, social, and physical health parameters. Group interventions harness the power of social connection while offering a cost effective and efficient means to reach a broad range of older patients that might otherwise be unable to access care. The overall aim of this project is to utilize an iterative process to continually improve and innovate a rotating psychological wellness group for older adults.

Methods

This program includes a psychological wellness group offering for older adults with 8 modules covering a collection of topics that support optimal psychological wellness and promote health and resilience (i.e. digital tools and mobile apps, value-based behavioral activation to improve your mood, eating for a healthy brain, caring for the caregiver, introduction to mindfulness, improving your sleep, physical activity and strategies for managing anxiety) that are held weekly, ranging in duration from 2-4 weeks, over a 7 month period. Well-being is broadly defined, including the existence of over 100 self-report measures to date, and our shift in measurement aims to provide clarity in definition and impact of our intervention. Having tried various well-being, loneliness, affect based, depression, anxiety, coping and resilience-based surveys, the team has worked to identify evidenced based measures that will capture our variables of interest and reflect change within the duration of the intervention. Evidence-based and lifestyle interventions target skill development, create opportunities for practice and provide expert feedback within the context of a socially engaged and supportive peer environment. Participants were referred from outpatient psychiatry clinics, geriatric medicine providers in medical centers and local community organizations servicing older adults. Inclusion criteria: Participants must be 65+ years old, English speaking, absent a diagnosis of dementia and open to group treatment.

Results

Older adults (N=19) were enrolled in the second wave of the psychological wellness group, including 9 males and 10 females with a mean age of 71. Summarized in Table One, the baseline (T1) and follow-up measures collected for T2 (6 weeks), T3 (12 weeks), T4 (18 weeks) and T5 (23 weeks) include PHQ-9, GAD-7, and PANAS-SF (both positive and negative affect scores). The results and qualitative findings (participant feedback), along with findings of the Valued Living Questionnaire (VLQ) will also be summarized and presented.

Conclusions

Positive psychiatry interventions have great potential to support and strengthen the psychological well-being of older adults who are faced with the myriad of challenges that come with increasing age. Considering the shortage of geriatric mental health providers and the ever-increasing demand, this program has improved access to psychiatric care. Program goals also include aims of boosting positive emotions, life satisfaction, purpose and meaning, along with decreasing loneliness, depression and anxiety. Continued collection of data across multiple cohorts has aided in the refinement of chosen assessments and fueled a better understanding of what benefits the group is having on participants.