Exploring the Impact of Individualized Action Plans on Feelings of Loneliness and Self-Efficacy Among Older Adults in Primary Care

Background: Loneliness among older adults is a significant public health concern in the United States. Preliminary reports of the widespread impact of COVID-19 accentuate a mounting need within the U.S. healthcare system for routine assessment, intervention, and prevention efforts to address loneliness and associated negative outcomes in older adults.
Objectives: To evaluate the impact of an occupational therapy-led intervention of developing individualized action plans on feelings of loneliness and self-efficacy among older adults with chronic illness.
Method: Adults aged 60+ were recruited from a Philadelphia-area geriatric primary care clinic following their appointment. Participants collaborated with an occupational therapy doctoral student to develop an action plan to address self-management of chronic conditions and feelings of loneliness. Participants were contacted by telephone once a week for 4 weeks to discuss progress towards achieving action plan goals and make modifications as needed. Surveys were administered to determine the impact of the intervention on feelings of loneliness and self-efficacy for chronic disease management.
Results: Nine participants collaborated with an occupational therapy doctoral student over the telephone to create individualized action plans. Survey data indicated a statistically significant reduction in participants’ perception that their illness interfered with their daily role function. Additional data indicated decreased feelings of loneliness and increased confidence toward managing chronic illness among the sample, although these findings were not significant.
Conclusion: These findings support an occupational therapy-led intervention in geriatric primary care to help patients create a plan for behavior change and suggest a reduction in participants’ perception of illness intrusiveness on daily life.
Implications: With the expansion of occupational therapy services in the primary care setting, there is serendipitous opportunity for the assessment, intervention, and prevention of loneliness among older adults. These findings suggest that occupational therapists have a unique role on the interprofessional geriatric primary care team in supporting patients to incorporate healthy lifestyle modifications into daily routines through the use of individualized action plans. Within primary care, occupational therapists can collaborate with physicians and older adult patients to improve feelings of loneliness and self-efficacy and mitigate the impact of chronic illness on participation in daily life.