Effects of a 'social activity program that encourages interaction' on rural older people's psychosocial health: Mixed-methods research

Background: We developed a program that encourages interaction among older people living at home by combining face-to-face and online activities and examined its effects on older adults' psychosocial health.Methods: In this mixed-methods study, we recruited 11 women and 6 men (Mage = 79.5 +/- 6.4 years), who lived in a rural community and participated in a senior citizen club. The intervention was conducted for 13 months, comprising monthly face-to-face group and social media activities. For the program process evaluation, we collected focus-group interview data on participants' perceptions of their personal lives, club membership, and community post-intervention. For the outcome evaluation, we collected six outcome measures pre- and post-intervention: loneliness, subjective health, subjective well-being, self-esteem, social support and social activity satisfaction. Finally, through the integration of the process-outcome evaluation, we inferred what effects the program had on participants' psychosocial health.Results: In the process evaluation, we identified four themes: 'Stimulation brought about by relationships with peers,' 'Realization as to where they feel they belong,' 'Rethinking of oneself in the community,' and 'Awareness of attachment to and coexistence with the community.' In the outcome evaluation, the outcome measures were maintained without significant decline post-intervention.Conclusion: Through the integration of the process-outcome evaluation, we deduced three effects of the program on psychosocial health: (1) fulfilment of subjective health, (2) maintenance and assurance of moderate distance connectedness and (3) orientation toward aging in place.Implications for practice: This study offers a promising opportunity for further development and research into community-based preventive nursing care intervention strategies to maintain the psychosocial health of homebound older people in communities with social activity groups.