Background

Seniors are the most susceptible group to COVID-19 infection and at highest risk for severe disease and death. Accessible and understandable information on COVID-19 is lacking in the community and misinformation is widespread.  Seniors anecdotally have been foregoing doctor visits and prescription medications. Research is needed on how to best support at-risk seniors in their homes during COVID-19. 

Methodology

The study is exploring the feasibility of partnering with a trusted entity – Meals on Wheels to deploy senior kits during the COVID-19 shutdown. Seniors were pre-assigned into treatment or control arms using simple randomization at the time of kit distribution.  The kit included a study flyer, COVID-19 educational flyer with hot-line numbers, kit introduction, home fall assessment guide, DVD with simple fall-prevention, chair exercises, and a senior health book (written at the 5^th-6^th grade reading level).  

Upon consent the senior was enrolled into their pre-assigned group; control assigned seniors were interviewed for survey at the start of the study and again 3-4 months later, and treatment assigned seniors additionally received ongoing telephone support between the initial and final surveys.

This prospective, quasi-experimental control study aims to determine engagement factors in enrolled seniors living in the community; and pre-post rates of change for COVID-19 knowledge and behaviors, on-line accessibility, telehealth doctor visits, self-care, loneliness, and fall prevention exercises. All results will be analyzed by health literacy (measured by the Brief Health Literacy Screen).  Focus groups will be held the first week in June.

Results

208 educational kits were distributed via Meals on Wheels over 16 weeks; 98 seniors were successfully enrolled (47.1%).  Baseline results found equivalency between treatment and control groups on observed variables including clinical risk, health literacy, COVID-19 knowledge, internet use, loneliness, and exercise pre-pandemic.  Statistically significant differences in baseline measures were found by inadequate and marginal health literacy. 

Conclusions

The study is ongoing through June 2021. This proposed study will inform new practice and community approaches for maintaining health, function and social connectedness among at-risk culturally diverse seniors during a pandemic.  It is also testing a low-touch, literacy and language appropriate intervention.