PART VI. PROGRAM DESIGN AND IMPLEMENTATION

A project plan will be helpful in guiding and providing details to your Telewellness Program, and provide you with the content you’ll need to share with your team, partners, and potential funders.

Your project plan should include measurable outcomes, and include the following:

Clear objectives
Evaluation metrics with measurable results
A source to collect data and measure progress along the way

The table below offers some ideas and examples of what you may want to define as your objectives and how to get there:

Other objectives may include:

Reduced social isolation and high social engagement through the use of technology devices
Lower levels of anxiety among older adults and their caregivers experiencing stress
Increased perceptions of wellbeing
High satisfaction levels of engagement with the mental health service
High satisfaction levels with the device(s) used by the resident or community member

You can find a template of a project plan for a Telewellness Program at your community here, and see an example based on one of FPCIW’s earlier pilots here.

Establishing protocols and procedures

As you plan out your Telewellness Program, maintaining a system of protocols and procedures will be important to the orderly delivery of services to your community members, and assign specific roles and responsibilities to your team members. Having the procedures in place and ready to receive a potential client will help minimize confusion and disruption. A client referral and support procedure description outlines tasks, roles, and responsibilities—here is an example.

A workflow chart that visually describes the process of enrolling a client from recruitment to virtual therapy sessions to the completion of a case could be helpful in describing to the members of your team the steps involved in supporting a community member’s mental health services. In co-designing a workflow document with the various stakeholders of our project, we have found this tool to be an effective way to set up expectations—here is the document we created that you may use as a template.

Other important components of your protocols and procedures you may want to consider including:

A list of key partner and team member contact information
Telewellness session appointment reminders for residents (in the form of phone calls reminder cards the day before a virtual counseling appointment
Preparing an information and enrollment packet (that includes consent forms, instructions on operating the device that will be used for the virtual mental health sessions)

Among the challenges we faced in the enrollment of potential clients into counseling and therapy sessions was the burden of paperwork. Residents found the completion of forms exhausting and intimidating, especially when it involved research questions and consent—yet we believed that once a community member started counseling sessions, the services would be able to speak for themselves. We decided to test a new approach: to offer initial 15-min therapy sessions, no forms or signatures required. Soon after testing this model, we saw enrollments jump with additional and sustained mental health therapy. Our Telewellness Program is a continuously-evolving initiative that will require adjustments and changes to fit the unique needs of your community.

Kick-off event and community program awareness

Community awareness of the program or services you want to offer to your community is important to the success and adoption of services. The more that the members of a community learn, hear, and talk about mental health and wellness, the less stigma and fewer barriers they’ll encounter when seeking out the help they need. A kick-off event is an important and fun marker to celebrate the start of what could be a life-changing program for the members of your community.

The kickoff event can help community members normalize mental health, and welcome your Telewellness Program as an important step to serving the needs of residents–and caregivers–of the community. The event will be the starting point for promoting the Telewellness Program activities and the awareness of services with community partners. It may even be planned like a small health fair for seniors that includes basic screenings such as blood pressure, sugar level, and emotional wellness status with short questionnaires that measure wellbeing like the PHQ9. These screenings are opportunities to highlight the interventions your community will be immediately able to offer.

Invite your community service partners (social service organizations, community health workers). Your community partners can participate in the event to engage with potential clients in a fun environment. Residents can also get a chance to meet with clinicians and counselors and build rapport.
Create a festive atmosphere with snacks/refreshments, door prizes, and games. Raffles/Door prizes can be helpful for incentivizing them to be part of the event. During the event, it is recommended to share testimonies in-language.
Feature a live Zoom call with a counselor or therapist who’ll be participating in the delivery of mental health services. It could also helpful to play a series of videos for the introduction of the Telewellness Program, clinician introductions, and testimonies. If available, interactive small live Zoom conversation with counselors could provide a great snapshot for the services.

How we did it...

FPCIW deployed the Telewellness program at a California Bay Area community to test and validate the contents of this playbook. FPCIW first started by identifying the community, helping them set up an MOU, and assessed all community-based mental health resources. After assessing the demographics, language, and health needs of the community, we reached out to and partnered with a local social services provider, RAMS Inc., to provide mental health education webinars and host personal therapy sessions for residents.

For the first of the series of educational webinars, there was a kick-off event where all residents who attended received a “goodie bag” of items such as a reusable water bottle, reusable tote bag, and stress balls. Although we were talking about mental health, the event was marketed to feel light and exciting. We created colorful and in-language flyers and there were also refreshments ready for residents.

This type of kick-off event set the tone for future webinars that broadcasted mental wellness content, and sustained high attendance and excitement throughout the remainder of the program.

COVID social distancing barriers—and opportunities:

The COVID-19 crisis uncovered critical weaknesses in the health and social service fabric supporting older adult residents of affordable housing. Residents living in a community setting are at risk for isolation, depression, falls, poor medication adherence, and exacerbated chronic health conditions, in addition to greater risk of contracting COVID-19.

Technology-enabled devices, with appropriate training and support, provide important opportunities to reach our vulnerable older adults living on the other side of the digital divide. Some residents are particularly at risk because of limited or no access to digital tools that can help them with health care services, social services, or other critical information related to COVID education. A fundamental barrier for residents of our affordable housing community is that they disproportionately lack internet services and devices, technology-enabled interventions, and training in digital literacy.

The Telewellness Program offers a targeted response for vulnerable older adults through the development and implementation of a scalable program that provides telehealth, internet accessibility, and digital literacy training to improve access to health care services and communication. This program will ultimately lead to improved health, engagement, information, safety and well-being among residents.