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Crews DC, Delaney AM, Walker Taylor JL, et al. Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study. Kidney Med. 2019;1(1):13-20doi: 10.1016/j.xkme.2018.12.001.
Crews, D. C., Delaney, A. M., Walker Taylor, J. L., Cudjoe, T. K. M., Nkimbeng, M., Roberts, L., Savage, J., Evelyn-Gustave, A., Roth, J., Han, D., Boyér, L. L., Thorpe, R. J., Roth, D. L., Gitlin, L. N., & Szanton, S. L. (2019). Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study. Kidney medicine, 1(1), 13-20. https://doi.org/10.1016/j.xkme.2018.12.001
Crews, Deidra C, et al. "Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study." Kidney medicine vol. 1,1 (2019): 13-20. doi: https://doi.org/10.1016/j.xkme.2018.12.001
Crews DC, Delaney AM, Walker Taylor JL, Cudjoe TKM, Nkimbeng M, Roberts L, Savage J, Evelyn-Gustave A, Roth J, Han D, Boyér LL, Thorpe RJ, Roth DL, Gitlin LN, Szanton SL. Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study. Kidney Med. 2019 Jan 24;1(1):13-20. doi: 10.1016/j.xkme.2018.12.001. eCollection 2019. PMID: 32734179; PMCID: PMC7380338.
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Kidney Med. 2019 Jan 24;1(1):13-20. doi: 10.1016/j.xkme.2018.12.001. eCollection 2019.

Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living with ESRD (SOCIABLE) Study.

Kidney medicine

Deidra C Crews, Alice M Delaney, Janiece L Walker Taylor, Thomas K M Cudjoe, Manka Nkimbeng, Laken Roberts, Jessica Savage, Allyson Evelyn-Gustave, Jill Roth, Dingfen Han, LaPricia Lewis Boyér, Roland J Thorpe, David L Roth, Laura N Gitlin, Sarah L Szanton

Affiliations

  1. Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore.
  2. Johns Hopkins University School of Nursing, Johns Hopkins Medical Institutions, Baltimore.
  3. Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore.
  4. Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore.
  5. Clinical Center, National Institutes of Health, Bethesda.
  6. Division of Geriatrics, Department of Medicine, Baltimore, MD.
  7. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
  8. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  9. Drexel University College of Nursing and Health Professions, Philadelphia, PA.

PMID: 32734179 PMCID: PMC7380338 DOI: 10.1016/j.xkme.2018.12.001

Abstract

RATIONALE & OBJECTIVE: Older adults with end-stage kidney disease have increased morbidity, fatigue, and decreased physical function, which can inhibit self-care and social engagement. We pilot tested a home-based program to improve physical and social functioning of low socioeconomic status older adults treated with hemodialysis (HD).

STUDY DESIGN: Qualitative study and randomized waitlist control intervention.

SETTING & PARTICIPANTS: Older adult HD patients in Baltimore, MD.

INTERVENTIONS: We identified functional needs and home environmental barriers to social engagement through focus groups; mapped findings onto aspects of an established program, which includes home visits with an occupational therapist, nurse, and handyman to provide ≤$1,300 worth of repairs, modifications, and devices; and piloted the program (Seniors Optimizing Community Integration to Advance Better Living with ESRD [SOCIABLE]) among 12 older adult HD patients. We delivered the services over 5 months in a staggered fashion.

OUTCOMES: Feasibility and acceptability of the intervention and change in disability scores.

RESULTS: Focus group themes included fatigue, lack of social support, and desire to live independently. SOCIABLE pilot participants were recruited from 2 dialysis units and all were African American (50% men); mean age was 69 years. At baseline, the mean disability score for activities of daily living (ADLs) was 4.4 and for instrumental ADLs (IADLs) was 6.3 (both out of a possible 16). Among the 9 participants alive at follow-up, there was 100% intervention completion and outcomes assessment. All treated participants improved a mean score of 2.3 for ADL and 2.6 for IADL disability, and social support and social network scores improved by 4.8 and 4.6, respectively.

LIMITATIONS: Small sample size; all participants were African American.

CONCLUSIONS: A home-based intervention addressing physical and social functioning of low socioeconomic status older adults on HD therapy was feasible and acceptable.

© 2019 The Author(s).

Keywords: Disability; activities of daily living; dialysis; home environment; older adults; qualitative study; social engagement; socioeconomic status

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