Improving physical and psychosocial functioning in underserved older adults during the covid-19 pandemic: a community health worker-led intervention

Active Project Grant Awarded Last action

Award ID
R01NR020442
Recipient
Awarding agency
Obligated
$5,271,972

Award facts

Assistance listing
93.361 Nursing Research
Completion date 89% complete
Originally
Funding
  • $4,559,437.00 Federal
  • $712,535.00 Non-federal
Place of performance
Ann Arbor, MI 48109, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
The heightened vulnerability to covid-19 of african american older adults in detroit, michigan and other marginalized communities is linked to systemic racism experienced over the life course. Structural inequities also magnify the pandemic's impact on older adults' physical and psychosocial functioning. For example, social isolation is exacerbated by widespread digital exclusion, and closures of community centers leave few safe options for physical activity. Hence, many older adults in detroit, burdened by poor health even before the pandemic, face a downward spiral of increased distress, reduced physical and social activity, and physical deconditioning. Timely intervention is critical to prevent or slow this decline. "positive steps" is a self- management and resilience-building intervention led by community health workers (CHWS) at the detroit health department (DHD). CHWS have a unique ability to reach underserved groups, provide culturally congruent care, and form a bridge to formal services; yet they have been vastly underutilized during the pandemic. This intervention targets individual (self-management, resilience), interpersonal (social support) and community (enhanced DHD capacity) levels. The long-term goal of this research is to build an evidence base for engaging the CHW workforce to mitigate the pandemic's impact on vulnerable groups. The project's objective is to assess the impact of positive steps on functional outcomes. The central hypothesis is that positive steps, delivered via a synchronous group telephone platform, asynchronous podcast series, and activity trackers, will improve psychosocial and physical functioning at 2 and 8 months. In an ongoing randomized pilot trial, a version of positive steps has been well-received and delivered by CHWS with high fidelity. In analysis to date of post-program outcomes, the intervention group (N=16) has shown clinically significant improvements of 2 to 5 points across promis domains of physical functioning, anxiety, depression, fatigue and pain interference, while controls (N=18) are unchanged or worse. The DHD will work with other city of detroit units to recruit participants with elevated physical or psychological symptoms. Specific aims are: 1) with input from a community advisory board, modify positive steps for group delivery and add pandemic content; conduct a mini-pilot (N=10). 2) conduct an RCT to assess its impact (VS. Covid education/telephone wellness check) on promis-29 psychosocial score (a weighted combination of distress, fatigue, pain, social participation and sleep) among 456 primarily african american older adults. 3) using qualitative data from participants and other stakeholders, conduct mixed-methods analyses to provide context for aim 2 findings, assess community impact, and inform a dissemination toolkit. This project is significant in that IT will rigorously test a scalable model for addressing sequelae of the pandemic among older adults in a deeply disadvantaged setting. IT is innovative in that IT tests a unique blend of CHW support with broadly-accessible mobile health tools. Last, IT has potential for broad impact, given the model's transferability to other vulnerable populations.

Transactions

Action Federal Non-federal Date
Amendment $0 $0
Amendment Improving physical and psychosocial functioning in older adults: a community health worker-led intervention - : many older adults, especially following… $528,071 $0
Amendment $505,720 $0
Amendment $518,802 $0
Amendment $518,802 $0
Amendment $531,486 $0
Amendment $531,486 $0
Amendment $712,535 $0
Original award $712,535 $712,535

Subawards

Subrecipient Amount Awarded
City Of Detroit-Health Department For our subcontract with the University of Michigan for the study, Improving Physical and Psychosocial Functioning in Underserved Older Adults During the… $147,711
City Of Detroit-Health Department $244,533

Quick answers

Who received award R01NR020442?

R01NR020442 was awarded to Regents Of The University Of Michigan by National Institute of Nursing Research (National Institutes of Health) on September 24, 2021.

How much is award R01NR020442 worth?

$5,271,972 has been obligated on R01NR020442: $4,559,437 in federal funding and $712,535 in non-federal funding.

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