The Liberating Loneliness Program: An Evidence-Informed Telehealth-Based Program for Addressing Loneliness Among Older Adults in Primary Care

Background
Loneliness is a prevalent health problem worldwide, and strongly associated with detrimental outcomes including premature mortality, functional impairments, re-hospitalization, depression, cognitive decline, and dementia. For many older adults, primary care providers are their only point of social contact, and therefore in a vital position to initiate services to address loneliness; however, loneliness is underassessed and undertreated due to appointment time constraints. The Liberating Loneliness program was created to fill this gap by providing an evidence-informed and client-centered protocol for occupational therapists (OTs) to seamlessly integrate into the primary care setting through interprofessional collaboration to address this significant need. This novel telehealth-based program involves active participation with geriatric primary care patients to create individualized action plans that embed strategies into daily routines to reduce loneliness in a format compatible with primary care service delivery. By completing sessions over the phone, the program recognizes a limiting factor to addressing loneliness among patients in primary care. Interprofessional collaboration is essential throughout the Liberating Loneliness program to support integrated services in the primary care setting.

Methodology
A modified Delphi method was utilized to obtain content validity of the Liberating Loneliness program manual among seven expert reviewers that comprehensively critiqued the program, prompting an iterative process of revisions.

Results
Two iterations were completed by expert reviewers. 12 out of 13 survey items received at least 85% agreement in the first round. Survey feedback prompted a revised second draft. In the second round, the remaining survey item was reassessed and received 100% agreement.

Conclusion
The expert reviewers’ consensus suggests the Liberating Loneliness program can be utilized to address this significant need and ultimately improve the health and wellbeing of geriatrics patients. This novel telehealth-based program provides another way to seamlessly integrate occupational therapy services into the primary care setting to promote interprofessional collaboration while meeting the needs of geriatric patients.

Reflections/lessons learned/implications
The Liberating Loneliness program demonstrates how interprofessional collaboration in primary care furthers opportunities to benefit patients and meet their needs. This program provides an opportunity to advance interprofessional collaboration in primary care by addressing loneliness among older adults via holistic, client-centered, and evidence-based occupational therapy protocol. By assessing and treating loneliness at the first—and for some, only point of contact—primary care practitioners could prevent and/or improve the negative health outcomes related to loneliness.