Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study
Abstract
BACKGROUND AND OBJECTIVES: Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020-December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. RESEARCH DESIGN AND METHODS: This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. RESULTS: The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. DISCUSSION AND IMPLICATIONS: HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.
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Other interventions delivered through phone calls or videoconferencing often focus on peer support or empathy-based approaches without consistently employing structured, evidence-based frameworks.
“Others emphasize interventions delivered through phone calls or videoconferencing, often focusing on peer support or empathy-based approaches without consistently employing structured, evidence-based frameworks [e.g., (69–71)].”
From Telephone-based group mental health support for older adults in central Canada: pilot acceptability and effectiveness findings of The CONNECT Program (2025) · cites this paper as [71]
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- Authors
- Robinson, E., Dickins, M., Lad, L., Beard, S., McGill, D., Hayes, J., Fabri, A. M., Wade, H., Meyer, C., & Lowthian, J. A.
- Affiliations
- Bolton Clarke Research Institute , Melbourne, Victoria , Australia
- Monash Health (AU)
- Bolton Clarke , Melbourne, Victoria , Australia
- Northern Health (AU)
- Monash University (AU)
- Corresponding author
- Robinson, Elizabeth
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-04-24
- Volume
- 64
- Issue
- 6
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- OpenAlex
- W4395081388
- Cited by
- 2
- References
- 39
- Citations by year
- 2025: 2
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Gerontologist (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Better Care Victoria (IF19122)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- social isolation, loneliness, depression, older adults, COVID-19 pandemic, program adaptation, implementation evaluation, implementation fidelity, social connectedness, elderly care, community-based care
- MeSH terms
- COVID-19, SARS-CoV-2, Aged, Australia, Depression, Female, Humans, Loneliness, Male, Social Isolation, Social Support, Telephone, Volunteers, Program Evaluation, Pandemics
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