Novel Strategies to Reach and Engage Older Veterans During COVID-19

The COVID-19 pandemic and associated public health measures to prevent its spread have important implications for the health and wellbeing of older Veterans. Prior to the pandemic, social isolation was already recognized as a risk for older adults, contributing to increased risk of depression, physical inactivity, and mortality. Stay-at-home orders, social distancing, and transitions to new ways of delivering care have meant that many of the ways in which older Veterans connect with VA and others have changed. Older Veterans and Veterans with serious mental illness (SMI) are especially vulnerable to experience negative impacts from social isolation and loneliness. This symposium will present on four novel and adapted strategies for engaging with older Veterans during the COVID-19 pandemic and beyond: 1) VA Connection Plans, a whole health intervention to promote social connections for older Veterans with and without SMI (Peeples); 2) telehealth adaptations to PEER, an in-person, peer-delivered exercise intervention for older Veterans with SMI (Muralidharan); 3) VA Compassionate Contact Corps, a VA Voluntary Service program to connect older Veterans with friendly volunteers via telephone (Sullivan); and 4) group telehealth interventions to foster social connection among older Veterans and their families (Weiskittle). Kim Van Orden, geropsychologist and director of the Hope Lab (Helping Older People Engage) at the University of Rochester Medical Center, will serve as discussant.

Abstract P310: Impact of COVID-19 Pandemic on Stroke Care at the University of Rochester Medical Center

Introduction: The impact of the COVID-19 pandemic response on medical care for stroke is unknown. Methods: We used local “Get With The Guidelines” stroke data for patients with ischemic stroke (IS), transient ischemic attack (TIA), and intracerebral hemorrhage/subarachnoid hemorrhage (ICH/SAH) from March 20–April 14, 2020 (study period) and January 1–March 19, 2020 (control period #1) and March 20–April 14, 2019 (control period #2). We examined daily admission rates, transfers, tPA administration, thrombectomy, and time from last well to hospital arrival. Results: There were 349 patients (n=40 study period, n=225 control period #1, n=84 control period #2); 263 with IS, 37 with TIA, and 49 with ICH/SAH. Overall, 46% were female, 82% white, with median age 70 years (IQR 58-82 years). Daily admission rates were 1.4 IS/day for the study period compared to 2.1 IS/day (Incident rate ratio [IRR] 1.49 95% CI 1.05-2.13, p=0.027) and 2.2 IS/day (IRR 1.57 1.04-2.37, p=0.033) for control periods #1 and #2 ( Table ), respectively. There was only one admission for TIA in the study period compared to approximately one every 4 days in control period #1 (IRR 7.2 95% CI 1.0-53.7, p=0.053) and one every 2 days in control period #2 (IRR 14.0 95% CI 1.8-106.5, p=0.011). ICH/SAH admissions were fewer in the study period. Transfers were less common with approximately one transfer every four days in the study period compared to one each day of the control periods. Rates of tPA, thrombectomy, and time from last well to first hospital contact did not differ across the epochs. Conclusions: Our data suggest the COVID-19 pandemic response has led to reduced admission volumes for all stroke types in the University of Rochester Medical Center catchment area, partly due to decreases in hospital transfers. These data raise the question whether fewer patients sought care for stroke symptoms at the height of the COVID-19 pandemic.

M. Gabriela Sava Finalist of the 2020 MCDM Junior Researcher Best Paper Award

In April 2020, M. Gabriela Sava received the great news that her paper “An analysis of the sensitivity and stability of patients’ preferences can lead to more appropriate medical decisions,” published in Annals of Operations Research was selected as a finalist for the 2020 MCDM Junior Researcher Best Paper Award. The paper was in collaboration with Dr. Luis G. Vargas and Dr. Jerrold H. May from University of Pittsburgh and Dr. James G. Dolan from University of Rochester Medical Center. The award honors junior academic researchers and practitioners who work in the area of multi-criteria decision-making for their excellence, creativity and innovation. Gabriela was nominated for this prestigious award by the Associate Editor of the IJAHP, Dr. Birsen Karpak from Youngstown State University.