Can We Borrow Your Intervention? Randomized Controlled Trial of an Older Adult Telehealth Wellness Promotion Program...

The widespread availability of evidence-based, community-embedded health promotion programs for older adults represents a major achievement in gerontology. Many of these programs may also be suitable for younger adults with early-acquired disability, creating an opportunity to leverage existing resources and networks. However, the evidence base supporting these programs has often excluded people with early-acquired or long-term disability.

This project represented a "bridging" partnership among a group of academic disability researchers and a community service organization serving older adults. The team identified an existing health coaching program for older adults (EnhanceWellness), engaged in a formal adaptation process, and conducted a 3-arm randomized controlled trial in 505 middle-aged adults with long-term, physical disability. Participant-reported outcomes (mood, community participation, and self-efficacy) were assessed at baseline, mid-intervention (3 months), postintervention (6 months), and 12 months, utilizing PROMIS measures. EnhanceWellness was compared to health education or treatment as usual.

Participants were middle-aged (M = 55.8 years) and primarily women (79%), who had lived with a disability-associated health condition for an average of 23 years. Linear mixed-effects modeling suggested superiority of EnhanceWellness in increasing participation outcomes, and effects were maintained at the 12-month follow-up. Intervention effects were partially mediated by improvements in disease management self-efficacy. There were no significant treatment effects on depression.

Results emphasize the potential for adaptation as a strategy to extend the existing network of older adult interventions to serve those living with long-term disability.