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Journal of the American Geriatrics Society ; 69(SUPPL 1):S255-S256, 2021.
Article in English | EMBASE | ID: covidwho-1214910


Background: Social isolation has detrimental consequences for older adults, including decreased life-space mobility, quality of life, cardiovascular function, increased anxiety and accelerated cognitive decline. This interdisciplinary model aims to assess the effects of a holistic telehealth delivered group exercise program, Veteran's Video Connect-Balance, Exercise, and Stability Training (VVC BEST). Method: This prospective quality improvement project was completed in two cycles of ten weeks from April-September 2020. Geriatricians and geriatric nursing staff screened and medically cleared older veterans. Geriatric physical therapists assigned individuals to a sitting or standing group based on functional level. The course structure entailed two telehealth classes per week of one-hour duration. Each week highlighted a different area of fitness: aerobic conditioning, flexibility, strengthening, and balance training. Interventions were modified based on participant's cognitive, auditory, and/or visual impairments. Veterans were referred to in-person chiropractor or acupuncture services for musculoskeletal pain management to minimize polypharmacy. Veterans demonstrating low attendance were referred to telehealth psychology services for motivational interviewing. Primary outcome measures included performance on the modified Berg Balance Scale (mBBS). Secondary outcomes included patient satisfaction and self-reported activity level. Results: Twelve participants Mage = 85.7 (6.9) years (n=7 in sitting, n=5 in standing) completed an average of 27.8 (19.5) telehealth sessions. Veterans demonstrated a significant improvement in their mBBS scores, t(9) = -5.79, p < 0.001 and self-reported physical activity, χ2 (4, n = 9) = 11.14, p = 0.025. All participants reported satisfaction and would recommend VVC BEST. Technology constraints limited participation to seven individuals per class. Conclusions: High program satisfaction coupled with objective improvements in balance and increased self-reported physical activity demonstrate the acceptability and preliminary benefits of this telehealth interdisciplinary program. This program remains ongoing while older veterans continue to shelter-in-place due to COVID-19 restrictions.

Journal of the American Geriatrics Society ; 69(SUPPL 1):S50, 2021.
Article in English | EMBASE | ID: covidwho-1214877


Background: During the COVID-19 pandemic, older adults are missing routine care appointments despite increasing availability of telehealth video visits. We conducted a needs assessment of two Residential Care Facilities for the Elderly (RCFE) in Northern California as a first step to improving access to telehealth visits for older community dwelling individuals. Methods: We conducted voluntary surveys of the independent community dwelling adults of two RCFEs. Site A houses residents who are mostly Caucasian and middle and upper middle class. Site B provides subsidized senior housing and serves a large group of residents who are non-English speakers. Surveys ascertained residents' preferred devices as well as comfort level, support, and barriers regarding telephonic and video visits. Results: Of the 700 surveys distributed, 249 surveys were completed and returned (36%). The average age of participants was 84.6 (SD = 6.6) and 77% were female. At site A, 89% of participants had a bachelor's degree or beyond and 99% listed English as their preferred language. At Site B, 43% had a bachelor's degree or beyond, and 13% preferred English while 73% preferred Mandarin. Regarding remote visits, 37% of all participants felt comfortable connecting with their healthcare team through video visits with computer being the most preferred device (23%) followed by smartphone (19%) and iPad/tablet (11%). Regarding perceived barriers, there were substantial differences depending on the site. Participants at Site A reported not knowing how to connect to the platform (24%), not being familiar with the technology (22%), and difficulty hearing (14%) as the top three barriers, whereas for the participants at Site B, the top three barriers were not being able to speak English well (55%), lack of interest in seeing provider outside of clinic (35%), and not knowing how to connect to the platform (35%). Conclusions: Significant barriers exist for older adults in RCFEs with telehealth visits with their care team. The largest barriers include difficulty with technology or using the video visit platform, language barriers, and lack of desire to see provider outside of clinic. Due to site specific differences in reported telemedicine barriers, any intervention to improve access should be tailored to the specific needs of that site.

Journal of the American Geriatrics Society ; 69(SUPPL 1):S48, 2021.
Article in English | EMBASE | ID: covidwho-1214808


Background: The VA has developed mobile applications (apps) to support mental health self-management. Older Veterans can likely benefit from these apps but may need assistance to learn how to operate them. The Geri-Mobile Health Program offers personalized training to older Veterans interested in learning to use these apps to address their well-being goals. Here we examine the program's initial effects on mobile device proficiency, quality of life (QoL), usage of and comfort with apps, and acceptability. Methods: Veterans are referred by VA providers or may selfrefer to the Geri-Mobile Health program. Mental health clinicians conduct individual sessions to teach basics about devices and introduce VA mental health apps. Participants complete initial assessments of mobile device proficiency (Mobile Device Proficiency Questionnaire;MDPQ), QoL, the number of days per week they use apps, and their comfort with apps (1: “not at all”;5: “extremely comfortable”). At post-treatment, initial assessments were repeated including the Client Satisfaction Questionnaire to examine program acceptability. Results: Twenty-five referrals have been received with 18 Veterans enrolled (M age: 72.92;SD=5.99). To date, 11 participants have completed treatment, 3 are in treatment, 3 are on hold due to COVID, and 1 began to use apps independently after an initial session. On average, participants (n=11) completed 8.18 sessions (SD = 3.37). Significant improvements in MDPQ scores were observed at post-treatment (t(10)= -2.77, p= .009). Nonsignificant improvements were seen in QoL. Participants increased the number of days apps were used from 1.09 to 2.9 days per week at post-treatment. Additionally, they reported increased average comfort using apps to manage their health (Pre=3.18;Post=4), high overall satisfaction with the program (82% very satisfied), and that 100% would definitely recommend the program/return if they were to seek help again. Conclusion: Analyses suggested that the Geri-Mobile Health program increases older adults' mobile device proficiency and is highly acceptable. Larger studies should examine the program's clinical impact on mental health symptoms and quality of life. Programs such as this serve as an example of how to equip older adults with the knowledge necessary to manage their mental health symptoms using apps.