A Pilot and Feasibility Study of the Aging Together Anti-Ageism Peer Support Program

Abstract

Although the theory of relational ageism describes how ageism is reinforced through interpersonal interactions, it remains unknown whether peer support programs may help reduce ageism and enhance older adults’ well-being. We conducted a pilot and feasibility study of a manualized anti-ageism peer support program facilitated by trained older adults called “Aging Together.” Key components include peer support, education about ageism and health, and “tell your story of aging.” Six small groups of five-to-eight participants (N = 48 total) met for ten, weekly, in-person (60–90 minute) sessions in a U.S. Midwest city. Results indicate the program was feasible and acceptable overall (attendance rate = 88.91%, attrition rate = 6.25%, M acceptability score = 4.23/5). Wilcoxon signed rank tests (N = 28) indicated a significant decrease in relational ageism (M = 2.73/6 to 2.19/6; p ≤ .01) and depressive symptoms (M = 8.61/30 to 6.57/30; p ≤ .01). Future research should scale this program across diverse, geographical settings and explore potential mediating relationships between internalized/relational ageism and psychosocial well-being.

Keywords

ageism education psychosocial intervention

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References

Adler

N. E.

Epel

E. S.

Castellazzo

Ickovics

J. R.

(2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, White women. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 19(6), 586–592. https://doi.org/10.1037//0278-6133.19.6.586

Bandura

(1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122–147. https://doi.org/10.1037/0003-066X.37.2.122

Beutel

M. E.

Klein

E. M.

Brahler

Reiner

Junger

Matthias

Wiltink

Wild

P. S.

Munzel

Lackner

K. J.

Tibubos

A. N.

(2017). Loneliness in the general population: Prevalence, determinants and relations to mental health. BMC Psychiatry, 17(1), Article 97. https://doi.org/10.1186/s12888-017-1262-x

Björgvinsson

Kertz

S. J.

Bigda-Peyton

J. S.

McCoy

K. L.

Aderka

I. M.

(2013). Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment, 20(4), 429–436. https://doi.org/10.1177/1073191113481998

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Breitenstein

S. M.

Fogg

Garvey

Hill

Resnick

Gross

(2010). Measuring implementation fidelity in a community-based parenting intervention. Nursing Research, 59(3), 158–165. https://doi.org/10.1097/NNR.0b013e3181dbb2e2

Breitenstein

S. M.

Gross

Garvey

C. A.

Hill

Fogg

Resnick

(2010). Implementation fidelity in community-based interventions. Research in Nursing & Health, 33(2), 164–173. https://doi.org/10.1002/nur.20373

Burnes

Sheppard

Henderson

Jr., C. R.

Wassel

Cope

Barber

Pillemer

(2019). Interventions to reduce ageism against older adults: A systematic review and meta-analysis. American Journal of Public Health, 109(8), e1–e9. https://doi.org/10.2105/AJPH.2019.305123

Chambers

D. A.

Glasgow

R. E.

Stange

K. C.

(2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science: IS, 8, Article 117. https://doi.org/10.1186/1748-5908-8-117

10.

Chang

Kannoth

Levy

Wang

Lee

J. E.

Levy

B. R.

(2020). Global reach of ageism on older persons’ health: A systematic review. PLoS One, 15(1), Article e0220857. https://doi.org/10.1371/journal.pone.0220857

11.

Chrisler

J. C.

Barney

Palatino

(2016). Ageism can be hazardous to women’s health: Ageism, sexism, and stereotypes of older women in the healthcare system. Journal of Social Issues, 72(1), 86–104. https://doi.org/10.1111/josi.12157

12.

Conover

W. J.

(1999). Practical nonparametric statistics (3rd ed.). John Wiley & Sons, Inc.

13.

Coudin

Alexopoulos

(2010). ‘Help me! I’m old!’ How negative aging stereotypes create dependency among older adults. Aging & Mental Health, 14(5), 516–523. https://doi.org/10.1080/13607861003713182

14.

de Jong Gierveld

Van Tilburg

(2006). A 6-item scale for overall, emotional, and social loneliness: Confirmatory tests on survey data. Research on Aging, 28(5), 582–598. https://doi.org/10.1177/0164027506289723

15.

Fong

T. G.

Fearing

M. A.

Jones

R. N.

Shi

Marcantonio

E. R.

Rudolph

J. L.

Yang

F. M.

Kiely

D. K.

Inouye

S. K.

(2009). Telephone interview for cognitive status: Creating a crosswalk with the mini-mental state examination. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 5(6), 492–497. https://doi.org/10.1016/j.jalz.2009.02.007

16.

Gaggioli

Scaratti

Morganti

Stramba-Badiale

Agostoni

Spatola

C. A.

Molinari

Cipresso

Riva

(2014). Effectiveness of group reminiscence for improving wellbeing of institutionalized elderly adults: Study protocol for a randomized controlled trial. Trials, 15, Article 408. https://doi.org/10.1186/1745-6215-15-408

17.

Bailey

D. E.

Jr. Dong

(2017). Social support, social strain, and cognitive function among community-dwelling U.S. Chinese older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 72(suppl_1), S16–S21. https://doi.org/10.1093/gerona/glw221

18.

Geffen

L. N.

Kelly

Morris

J. N.

Howard

E. P.

(2019). Peer-to-peer support model to improve quality of life among highly vulnerable, low-income older adults in Cape Town, South Africa. BMC Geriatrics, 19(1), Article 279. https://doi.org/10.1186/s12877-019-1310-0

19.

Gendron

Camp

Amateau

Iwanaga

(2024). Internalized ageism as a risk factor for suicidal ideation in later life. Aging & Mental Health, 28(4), 701–705. https://doi.org/10.1080/13607863.2023.2271870

20.

Gendron

Camp

Amateau

Mullen

Jacobs

Inker

Marrs

(2024). The next critical turn for ageism research: The intersections of ageism and ableism. The Gerontologist, 64(2), gnad062. https://doi.org/10.1093/geront/gnad062

21.

Gendron

Inker

J. K.

Andricosky

Zanjani

(2020). Development of the relational ageism scale: Confirmatory test on survey data. International Journal of Aging and Human Development, 90(3), 281–296. https://doi.org/10.1177/0091415019836956

22.

Gendron

Van Aartrjik

Carpenter

Backer

Applewhite

(2022). Ageism Interventions: The need for an ecological perspective. Journal of Aging & Social Policy, 36(5), 1–12. https://doi.org/10.1080/08959420.2022.2132803 (Advance online publication).

23.

Gendron

T. L.

Inker

Welleford

E. A.

(2018). A theory of relational ageism: A discourse analysis of the 2015 White House conference on aging. The Gerontologist, 58(2), 242–250. https://doi.org/10.1093/geront/gnw155

24.

Gendron

T. L.

Welleford

E. A.

Inker

White

J. T.

(2016). The language of ageism: Why we need to use words carefully. Gerontologist, 56(6), 997–1006. https://doi.org/10.1093/geront/gnv066

25.

Jeste

D. V.

Lee

E. E.

Cacioppo

(2020). Battling the modern behavioral epidemic of loneliness: Suggestions for research and interventions. JAMA Psychiatry, 77(6), 553–554. https://doi.org/10.1001/jamapsychiatry.2020.0027

26.

Kang

Kim

(2022). Ageism and psychological well-being among older adults: A systematic review. Gerontology & Geriatric Medicine, 8, Article 23337214221087023. https://doi.org/10.1177/23337214221087023

27.

Kelly

M. E.

Duff

Kelly

McHugh Power

J. E.

Brennan

Lawlor

B. A.

Loughrey

D. G.

(2017). The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: A systematic review. Systematic Reviews, 6(1), Article 259. https://doi.org/10.1186/s13643-017-0632-2

28.

Kim

Thyer

B. A.

Munn

J. C.

(2019). The relationship between perceived ageism and depressive symptoms in later life: Understanding the mediating effects of self-perception of aging and purpose in life, using structural equation modeling. Educational Gerontology, 45(2), 105–119. https://doi.org/10.1080/03601277.2019.1583403

29.

Kim

S. H.

(2012). Effects of a volunteer-run peer support program on health and satisfaction with social support of older adults living alone. Journal of Korean Academy of Nursing, 42(4), 525–536. https://doi.org/10.4040/jkan.2012.42.4.525

30.

Levy

(2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18(6), 332–336. https://doi.org/10.1111/j.1467-8721.2009.01662.x

31.

Levy

B. R.

Hausdorff

J. M.

Hencke

Wei

J. Y.

(2000). Reducing cardiovascular stress with positive self-stereotypes of aging. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55(4), P2015–P2213. https://doi.org/10.1093/geronb/55.4.P205

32.

Levy

B. R.

Pilver

Chung

P. H.

Slade

M. D.

(2014). Subliminal strengthening: Improving elders’ physical function over time through an implicit-age-stereotype intervention. Psychological Science, 25(12), 2127–2135. https://doi.org/10.1177/0956797614551970

33.

Levy

B. R.

Pilver

C. E.

Pietrzak

R. H.

(2014). Lower prevalence of psychiatric conditions when negative age stereotypes are resisted. Social Science & Medicine, 119, 170–174. https://doi.org/10.1016/j.socscimed.2014.06.046

34.

Levy

B. R.

Slade

M. D.

(2023). Role of positive age beliefs in recovery from mild cognitive impairment among older persons. JAMA Network Open, 6(4), Article e237707. https://doi.org/10.1001/jamanetworkopen.2023.7707

35.

Levy

B. R.

Slade

M. D.

Kunkel

S. R.

Kasl

S. V.

(2002). Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology, 83(2), 261–270. https://doi.org/10.1037//0022-3514.83.2.261

36.

Levy

B. R.

Slade

M. D.

Pietrzak

R. H.

Ferrucci

(2018). Positive age beliefs protect against dementia even among elders with high-risk gene. PLoS One, 13(2), Article e0191004. https://doi.org/10.1371/journal.pone.0191004

37.

Lyons

Alba

Heywood

Fileborn

Minichiello

Barrett

Hinchliff

Malta

Dow

(2018). Experiences of ageism and the mental health of older adults. Aging & Mental Health, 22(11), 1456–1464. https://doi.org/10.1080/13607863.2017.1364347

38.

Lyons

Cooper

Lloyd-Evans

(2021). A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions. BMC Psychiatry, 21(1), Article 315. https://doi.org/10.1186/s12888-021-03321-z

39.

Mogic

Rutter

E. C.

Tyas

S. L.

Maxwell

C. J.

O’Connell

M. E.

Oremus

(2023). Functional social support and cognitive function in middle- and older-aged adults: A systematic review of cross-sectional and cohort studies. Systematic Reviews, 12(1), Article 86. https://doi.org/10.1186/s13643-023-02251-z

40.

National Academies of Sciences, Engineering, and Medicine . (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. The National Academies Press. https://doi.org/10.17226/25663

41.

Nozari

Mo’tamedi

Eskandari

Ahmadivand

(2019). Narrative group therapy to improve aging perceptions and reduce thanatophobia (death anxiety) in older adults. Elderly Health Journal, 5(2), 117–123. https://doi.org/10.18502/ehj.v5i2.2158

42.

Perissinotto

C. M.

Stijacic Cenzer

Covinsky

K. E.

(2012). Loneliness in older persons: A predictor of functional decline and death. Archives of Internal Medicine, 172(14), 1078–1083. https://doi.org/10.1001/archinternmed.2012.1993

43.

Russell

D. W.

(1996). UCLA loneliness scale (version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66(1), 20–40. https://doi.org/10.1207/s15327752jpa6601_2

44.

Schwarzer

Jerusalem

(1995). Generalized self-efficacy scale. In Weinman

Wright

Johnston

(Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Nfer-Nelson.

45.

Schwei

R. J.

Amesoudji

A. W.

DeYoung

Madlof

Zambrano-Morales

Mahoney

Jacobs

E. A.

(2020). Older adults’ perspectives regarding peer-to-peer support programs and maintaining independence. Home Health Care Services Quarterly, 39(4), 197–209. https://doi.org/10.1080/01621424.2020.1778594

46.

Shiovitz-Ezra

Erlich

Ayalon

(2023). Short- and medium-term effects of ageism on loneliness experienced during the COVID-19 pandemic. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 42(6), 1255–1266. https://doi.org/10.1177/07334648231159372

47.

Shiovitz-Ezra

Shemesh

McDonnell/Naughton

(2018). Pathways from ageism to loneliness. In Ayalon

Tesch-Römer

(Eds.), Contemporary perspectives on ageism. International Perspectives on Aging (Vol. 19, pp. 131–147). Springer. https://doi.org/10.1007/978-3-319-73820-8_9

48.

Steward

(2021). Toward interventions to reduce internalized ageism. Journal of Human Behavior in the Social Environment, 32(3), 336–355. https://doi.org/10.1080/10911359.2021.1898516

49.

Steward

Hasche

(2024). Do internalized age stereotypes mediate the relationship between volunteering and self-efficacy for adults 50+ years of age? International Journal of Aging and Human Development, 98(2), 135–158. https://doi.org/10.1177/00914150231183139

50.

Steward

A. T.

Hasche

Laser

J. A.

(2022). Do internalized age stereotypes mediate the relationship between volunteering and social connectedness for adults 50+? Journal of Aging Studies, 61, Article 101031. https://doi.org/10.1016/j.jaging.2022.101031

51.

Sun

Yin

Liu

Sun

(2022). Stigma and peer-led interventions: A systematic review and meta-analysis. Frontiers in Psychiatry, 13, Article 915617. https://doi.org/10.3389/fpsyt.2022.915617

52.

World Health Organization . (2021). Ageism is a global challenge: UN. Ageism is a global challenge: UN (who.int).

53.

Yanos

P. T.

Roe

Lysaker

P. H.

(2011). Narrative enhancement and cognitive therapy: A new group-based treatment for internalized stigma among persons with severe mental illness. International Journal of Group Psychotherapy, 61(4), 577–595. https://doi.org/10.1521/ijgp.2011.61.4.576

54.

Zelenka

A. T.

(2011). Modeling social participation as predictive of life satisfaction and social connectedness: Scale or index? (Unpublished doctoral dissertation). Morgridge College of Education, University of Denver.