Presenter:

Mary T. Hynes, University of Toronto, Canada

Abstract

Background
Improving modifiable health risk factors (such as: diet, physical activity, social engagement) can reduce morbidity, potentially improving physical and cognitive function and delaying health decline.  Clinician-led SMART (Specific-Measurable-Attainable-Realistic-Time based) goal setting has been explored with older adults; however, the potential of a completely older adult driven SMART goal intervention is under-explored.  A proof-of-concept study conducted by the first author in 2019, demonstrated the potential for older adults to create and follow through with a self-created SMART goal for one month.  The current study is exploring the potential to scale this peer-led SMART goal model to groups of older adults, in the context of the COVID-19 pandemic.

Method 
This completely older adult program led by an older adult researcher comprises three phases: 1. Rapid scoping review of older adults involvement in creating, facilitating or evaluating participation of older adults’ groups in health care; 2. Survey of attitudes and intentions of older adults across Ontario regarding attending group activities and preferred learning opportunities for long term change during and following the COVID-19 pandemic; 3. RCT examining the impact of older adults meeting in peer groups to create and engage with SMART goals to develop self-efficacious management of physical, psychological and/or social health risks.

Older adults will be recruited virtually from Ontario Health Centres across Ontario to form groups for a three armed study  ̶  (1) three groups with a SMART goal setting session followed by six monthly meetings where goal attainment and modification data will be collected, (2) an information session on SMART goal setting for three groups and (3) usual care. Additionally, participants from all arms of this mixed methods study will complete the New General Self-Efficacy Scale and the SF-36 health survey initially, at 6 months and 6 months later.  All sessions will be conducted by older adult facilitators, with facilitators for new groups recruited from group participants in a continuous on-going iterative process.

Results
This completely peer-led project will evaluate a new model for behavior change and in doing so tackle current practice where non-seniors tell seniors what they need to do. Rather than burdening the health system, older adults will demonstrate their ability to maintain or improve their management of their physical, psychological and/or social health.

Discussion
If the years gained through increased longevity are lived in as good health as possible the ability of older adults to do the things they value, will have few limits.