Harnessing the Power of Social Connection to Improve the Quality of Life of Older Adults with Multimorbidity

Johns Hopkins University, Baltimore MD

Investigators

Abstract

The long-term goal of this K23 Career Development Award is to prepare the PI (Mayra Sánchez González, PhD) for an independent research career to implement interventions to improve the quality of life of older adults with multimorbidity. Multimorbidity, having two or more concurrent chronic conditions, is becoming increasingly prevalent in older Hispanics and is associated with poor quality of life. Although multimorbidity disproportionally impacts individuals in low socioeconomic groups, evidence suggests that these groups (vs. high socioeconomic groups) benefit less from multimorbidity interventions. Individuals tend to manage their health better when they are socially connected, but living with multimorbidity often contributes to isolation and loneliness. Hispanics are vulnerable to social disconnection due to social stressors, which can put them at risk of lacking critical support to live well with multimorbidity. The risk for social disconnection may be complicated by aging in communities with limited support infrastructure and workforce to meet their needs. Therefore, this K23 proposal seeks to identify social connection factors associated with the optimal management of multimorbidity among older Hispanics (Aim 1), modify Positive Minds-Strong Bodies for older Hispanics (50+) with multimorbidity (Aim 2), and evaluate the modified intervention's implementation determinants and implementation outcomes (primary outcomes) and preliminary efficacy in improving quality of life (exploratory efficacy outcome) via a Pilot RCT of Healthier Together vs control in 50 older Hispanics (50+) with multimorbidity (2+ chronic conditions) (Aim 3). We will use a community-engaged approach to inform this project via a community advisory board (CAB) integrated by individuals with lived experience, caregivers, health navigators, and clinicians. We will conduct in-depth interviews with 30 Hispanics (50+) with multimorbidity. We will collaborate with the CAB to modify PMSB and create Healthier Together, focusing on strengthening social connections. Lastly, we will evaluate Healthier Together in a pilot RCT. The PI has brought together an exemplary team of content experts in aging, social connection, implementation science, community-engaged research, and qualitative methodology. The PI will achieve the following career goals through mentorship, didactic experiences, and professional development opportunities: (1) develop expertise in implementation science with an emphasis on aging research; (2) develop proficiency in community-engaged research with older adults; (3) develop expertise in qualitative research methodology to inform intervention modifications; (4) gain expertise in designing, implementing, and analyzing randomized clinical trials. Completing this K23 proposal will provide the necessary training and preliminary data for the PI to obtain independent grant funding and systematically pursue a line of research to improve outcomes for older adults with multimorbidity.