Abstract
Background: Approximately one in three older Canadians are at risk of social isolation, and social isolation is associated with various negative health outcomes, including mortality. Thus, social isolation represents a major unmet public health need. A potential population-level solution involves innovative programming integrating the health, social care and community sectors. We describe a novel initiative involving partnerships among recreation therapy (RT), county adult day programs (ADPs) and a community gardening centre to improve health and wellbeing for older adults living with frailty across the region. This initiative encompasses several pillars of integrated care, including population health, new alliances, developing capacity and evaluating impact.
Approach: The target audience for the program were clients of the Simcoe-Muskoka district ADPs. ADPs are run by Ontario Home and Community Care Support Services, with a mandate to provide social, recreational and support services for older adults living with frailty or cognitive impairment in the community. The current initiative was led by the North Simcoe Muskoka Specialized Geriatric Services (NSMSGS) RT, who partnered with adult day program and garden centre staff to develop a year-long series of five seasonal gardening workshops tailored to the needs of frail older adults. Workshops were conducted at each of the five ADPs across the region, facilitated by staff from a local community gardening centre. During the workshops, ADP clients constructed planters with a kit containing seasonal plants.The evaluation (approved by the local institutional review board) involved a mixed-methods study with the aim of elucidating the impact of the initiative. Descriptive data were collected via workshop tracking forms, and quantitative data were collected via a questionnaires and surveys evaluating collaboration and sense of person-centred care (ADP and garden centre staff), as well as satisfaction surveys and a visual analog scale evaluating mood pre- and post- workshop (participants). Quantitative data will be analyzed via descriptive and comparative analyses. Qualitative data were collected via individual interviews and focus groups conducted with purposefully selected workshop participants and staff. Data from the personal interviews and focus groups will be analyzed using reflexive thematic analysis. Mixed-methods integration will be done via a triangulation process for data analysis and interpretation.
Results: Twenty-five workshops were run across all participating ADPs. Four hundred clients participated. Program evaluation data collection is complete, but analysis is ongoing, and will be presented in detail at the time of the conference. Preliminary findings collected from surveys demonstrate that 00% of participants rated their level of satisfaction with the workshops as either 4 or 5 out of 5 (where 5 is most satisfied). Participants also expressed experiencing enjoyment out of the workshops and finding them meaningful, with one participant stating it was nice to connect with people. We all enjoyed it. It was over too soon, though.
Implications: This initiative provides a model for integrated care for a vulnerable population across health, social and community sectors. Our evaluation of the program implementation and effectiveness will allow the current program to be optimized, and ultimately will provide a roadmap for similar programs to be adapted across regions and settings.