The Effectiveness of Peer-to-Peer Community Support to Promote Aging in Place

The investigators will accomplish the aims by conducting a longitudinal
comparative-effectiveness study in which at-risk older adult study participants in three
communities across the US are followed for 12-months. Using a quasi-experimental design,
investigators will compare outcomes in those receiving peer-to-peer community support to
those receiving standard community services.

At all three sites investigators will include 120 older adults in the peer-to-peer support
group and 120 in the standard community services group for a total intervention group size
of 360 (120 from each site) and 360 in the control group (120 from each site).

Study Outcomes & Measures To meet the first two aims investigators will (1) compare
annualized rates of hospitalization, ED use, and nursing home placement and (2) examine the
changes in self-reported health, depression, anxiety, and other measures of well-being in
the group receiving peer-to-peer support compared to the group receiving standard community
services from baseline to the end of study enrolment. The investigators describe each of our
outcomes and additional study measures in detail below. Measures have been translated and
used in Spanish and have been shown to be valid or have high reliability in Spanish

Inclusion Criteria:

- Overall

- ≥65 years of age

- Speaks English or Spanish

- Lives independently in their community year-round

- Meet the community defined criterion for receiving peer-to-peer support (at
least one of the following)

- Low income (at or below poverty level)

- On a fixed income that barely meets their living expenses

- Social and/or familial isolation

- Chronic Illness

- In need of frequent community services or resources. Peer-to-peer support
group (must meet the overall inclusion criteria as well as the following)

- Enrolled in the peer-to-peer support program and have an assigned peer volunteer

Exclusion Criteria:

- < 65

- Score ≤ 30 on the Telephone Interview of Cognitive Status (TICS) because they will
not have the ability to complete the survey

- State that it is unlikely that they will receive peer-to-peer support services for at
least a year. Individuals who are unlikely to receive at least a year of services
include those who need short-term help after a surgery and are likely to return to
full functioning and those planning to transition to nursing home care or move away.

- Currently receiving hospice services