Effect of an eHealth intervention on older adults’ quality of life and health-related outcomes: a randomized clinical trial

David H. Gustafson, Rachel Kornfield, Marie Louise Mares, Darcie C. Johnston*, Olivia J. Cody, Ellie Fan Yang, David H. Gustafson, Juwon Hwang, Jane E. Mahoney, John J. Curtin, Alexander Tahk, Dhavan V. Shah

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: By 2030, the number of US adults age ≥65 will exceed 70 million. Their quality of life has been declared a national priority by the US government. Objective: Assess effects of an eHealth intervention for older adults on quality of life, independence, and related outcomes. Design: Multi-site, 2-arm (1:1), non-blinded randomized clinical trial. Recruitment November 2013 to May 2015; data collection through November 2016. Setting: Three Wisconsin communities (urban, suburban, and rural). Participants: Purposive community-based sample, 390 adults age ≥65 with health challenges. Exclusions: long-term care, inability to get out of bed/chair unassisted. Intervention: Access (vs. no access) to interactive website (ElderTree) designed to improve quality of life, social connection, and independence. Measures: Primary outcome: quality of life (PROMIS Global Health). Secondary: independence (Instrumental Activities of Daily Living); social support (MOS Social Support); depression (Patient Health Questionnaire-8); falls prevention (Falls Behavioral Scale). Moderation: healthcare use (Medical Services Utilization). Both groups completed all measures at baseline, 6, and 12 months. Results: Three hundred ten participants (79%) completed the 12-month survey. There were no main effects of ElderTree over time. Moderation analyses indicated that among participants with high primary care use, ElderTree (vs. control) led to better trajectories for mental quality of life (OR=0.32, 95% CI 0.10–0.54, P=0.005), social support received (OR=0.17, 95% CI 0.05–0.29, P=0.007), social support provided (OR=0.29, 95% CI 0.13–0.45, P<0.001), and depression (OR= −0.20, 95% CI −0.39 to −0.01, P=0.034). Supplemental analyses suggested ElderTree may be more effective among people with multiple (vs. 0 or 1) chronic conditions. Limitations: Once randomized, participants were not blind to the condition; self-reports may be subject to memory bias. Conclusion: Interventions like ET may help improve quality of life and socio-emotional outcomes among older adults with more illness burden. Our next study focuses on this population. Trial Registration: ClinicalTrials.gov; registration ID number: NCT02128789

Original languageEnglish (US)
JournalJournal of general internal medicine
DOIs
StateAccepted/In press - 2021

Keywords

  • depression
  • eHealth
  • older adults
  • quality of life
  • telemedicine

ASJC Scopus subject areas

  • Internal Medicine

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