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A pragmatic trial of a group intervention in senior housing communities to increase resilience

  • Emily B. H. Treichler (a1) (a2) (a3), Danielle Glorioso (a1) (a2), Ellen E. Lee (a1) (a2) (a4), Tsung-Chin Wu (a2) (a5), Xin M. Tu (a1) (a2) (a6), Rebecca Daly (a1) (a2), Catherine O’Brien (a7), Jennifer L. Smith (a7) and Dilip V. Jeste (a1) (a2) (a8)...

Abstract

Background:

Aging is associated with numerous stressors that negatively impact older adults’ well-being. Resilience improves ability to cope with stressors and can be enhanced in older adults. Senior housing communities are promising settings to deliver positive psychiatry interventions due to rising resident populations and potential impact of delivering interventions directly in the community. However, few intervention studies have been conducted in these communities. We present a pragmatic stepped-wedge trial of a novel psychological group intervention intended to improve resilience among older adults in senior housing communities.

Design:

A pragmatic modified stepped-wedge trial design.

Setting:

Five senior housing communities in three states in the US.

Participants:

Eighty-nine adults over age 60 years residing in independent living sector of senior housing communities.

Intervention:

Raise Your Resilience, a manualized 1-month group intervention that incorporated savoring, gratitude, and engagement in value-based activities, administered by unlicensed residential staff trained by researchers. There was a 1-month control period and a 3-month post-intervention follow-up.

Measurements:

Validated self-report measures of resilience, perceived stress, well-being, and wisdom collected at months 0 (baseline), 1 (pre-intervention), 2 (post-intervention), and 5 (follow-up).

Results:

Treatment adherence and satisfaction were high. Compared to the control period, perceived stress and wisdom improved from pre-intervention to post-intervention, while resilience improved from pre-intervention to follow-up. Effect sizes were small in this sample, which had relatively high baseline resilience. Physical and mental well-being did not improve significantly, and no significant moderators of change in resilience were identified.

Conclusion:

This study demonstrates feasibility of conducting pragmatic intervention trials in senior housing communities. The intervention resulted in significant improvement in several measures despite ceiling effects. The study included several features that suggest high potential for its implementation and dissemination across similar communities nationally. Future studies are warranted, particularly in samples with lower baseline resilience or in assisted living facilities.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence should be addressed to: Dilip V. Jeste, University of California San Diego, 9500 Gilman Drive, Mail Code #0664, La Jolla 92093-0664, San Diego, CA, USA. Phone +858 534 4020. E-mail: djeste@ucsd.edu

Footnotes

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Emily B. H. Treichler and Danielle Glorioso are co-first authors and Jennifer L. Smith and Dilip V. Jeste are co-senior authors.

Footnotes

References

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Keywords

A pragmatic trial of a group intervention in senior housing communities to increase resilience

  • Emily B. H. Treichler (a1) (a2) (a3), Danielle Glorioso (a1) (a2), Ellen E. Lee (a1) (a2) (a4), Tsung-Chin Wu (a2) (a5), Xin M. Tu (a1) (a2) (a6), Rebecca Daly (a1) (a2), Catherine O’Brien (a7), Jennifer L. Smith (a7) and Dilip V. Jeste (a1) (a2) (a8)...

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