Effect of Layperson-Delivered, Empathy-Focused Program of Telephone Calls on Loneliness, Depression, and Anxiety Among Adults During the COVID-19 Pandemic

Autor: Kahlon, Maninder K., Aksan, Nazan, Aubrey, Rhonda, Clark, Nicole, Cowley-Morillo, Maria, Jacobs, Elizabeth A., Mundhenk, Rhonda, Sebastian, Katherine R., Tomlinson, Steven
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: JAMA Psychiatry
ISSN: 2168-6238
2168-622X
Popis: Key Points Question Can a program of empathetic conversations delivered by laypeople via telephone reduce loneliness, depression, and anxiety in at-risk older adults? Findings In this randomized clinical trial of 240 older adults receiving services through a Meals on Wheels organization, a 4-week empathy-oriented telephone program delivered by rapidly trained lay callers during the coronavirus disease 2019 pandemic improved loneliness, depression, anxiety, and general mental health. Meaning In this study, loneliness, depression, and anxiety were rapidly reduced through layperson-delivered calls that focused on empathetic listening, suggesting a scalable approach to persistent mental health challenges of older adults.
Importance Loneliness is a risk factor for many clinical conditions, but there are few effective interventions deployable at scale. Objective To determine whether a layperson-delivered, empathy-focused program of telephone calls could rapidly improve loneliness, depression, and anxiety in at-risk adults. Design, Setting, and Participants From July 6 to September 24, 2020, we recruited and followed up 240 adults who were assigned to receive calls (intervention group) or no calls (control group) via block randomization. Loneliness, depression, and anxiety were measured using validated scales at enrollment and after 4 weeks. Intention-to-treat analyses were conducted. Meals on Wheels Central Texas (MOWCTX) clients received calls in their homes or wherever they might have been when the call was received. The study included MOWCTX clients who fit their service criteria, including being homebound and expressing a need for food. A total of 296 participants were screened, of whom 240 were randomized to intervention or control. Interventions Sixteen callers, aged 17 to 23 years, were briefly trained in empathetic conversational techniques. Each called 6 to 9 participants over 4 weeks daily for the first 5 days, after which clients could choose to drop down to fewer calls but no less than 2 calls a week. Main Outcomes and Measures Primary outcome was loneliness (3-item UCLA Loneliness Scale, range 3-9; and 6-item De Jong Giervald Loneliness [De Jong] Scale, range 0-6). Secondary outcomes were depression (Personal Health Questionnaire for Depression), anxiety (Generalized Anxiety Disorder scale), and self-rated health (Short Form Health Survey Questionnaire). Results The 240 participants were aged 27 to 101 years, with 63% aged at least 65 years (n = 149 of 232), 56% living alone (n = 135 of 240), 79% women (n = 190 of 240), 39% Black or African American (n = 94 of 240), and 22% Hispanic or Latino (n = 52 of 240), and all reported at least 1 chronic condition. Of 240 participants enrolled, 13 were lost to follow-up in the intervention arm and 1 in the control arm. Postassessment differences between intervention and control after 4 weeks showed an improvement of 1.1 on the UCLA Loneliness Scale (95% CI, 0.5-1.7; P
This randomized clinical trial examines whether a layperson-delivered, empathy-focused program of telephone calls could rapidly improve loneliness, depression, and anxiety in at-risk adults.
Databáze: OpenAIRE
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