Resilience of Diverse Older Adults during COVID-19: The Role of a Disability Prevention Intervention

Research Objectives To investigate whether Positive Minds Strong Bodies (PMSB), which was delivered before the COVID-19 pandemic by paraprofessionals to at-risk older adults, promoted resilience during the pandemic. Design Data for this study came from a previous RCT (PMSB) conducted between 25 May 2015 and 5 March 2019. Participants were re-contacted between 2 March 2021 and 18 July 2022. Setting Clinics and community-based organizations serving low-income racially and ethnically minoritized or immigrant older adult populations in four U.S. locations: Massachusetts, New York, Florida, and Puerto Rico. Participants Participants included adults 60 years and older, fluent in either English, Spanish, Mandarin, or Cantonese, with self-reported mild to severe depression or anxiety symptoms, and objectively evaluated as having minor to moderate disability (Alegría et al., 2019). Participants (N=307) were randomized to either PMSB (N=153) or enhanced usual care (EUC) conditions (N=154) on a one-to-one ratio for each two-person block within each site. Of the 307 participants, 44 were deceased prior to the follow-up and 17 were unable to participate due to medical reasons. Of the 263 eligible participants, 165 (PMSB=77, EUC=88) completed the follow-up assessment. Interventions PMSB is a combined psychosocial (10, one-hour individual sessions adapted from CBT delivered by a trained community health worker over six months), and exercise training intervention (three weekly group sessions of functional exercises delivered by a trained exercise trainer over a 12-to-14-week period). EUC consisted of calls to monitor mental health symptoms every two weeks for six months, and a NIH booklet on mental and physical self-care. Main Outcome Measures Anxiety, Depression, and Physical Functioning. Results Results showed that compared to EUC, participants who received PMSB reported fewer depression symptoms and greater physical functioning at the COVID-19 follow-up. No significant differences were observed between the PMSB and EUC groups on symptoms of anxiety during the pandemic. Conclusions These findings provide evidence that PMSB is a powerful intervention to promote enduring physical and mental health resilience even in the face of major life stressors associated with a global health crisis (e.g., COVID-19). Author(s) Disclosures None.