Social health changes in older Veterans following a multicomponent telerehabilitation program: A convergent mixed methods study

Abstract: Background and Purpose: Nearly half of older Veterans experience insufficient physical activity alongside feelings of loneliness or social disengagement. While in-person group rehabilitation interventions are known to alleviate loneliness and disengagement through peer social connections, it remains unclear whether similar effects can be achieved through telerehabilitation group sessions. The purpose of this study is to explore changes in social health (loneliness, social disengagement, and participation) as secondary outcomes of a multicomponent telerehabilitation program focused on physical function and activity. Methods: We conducted an embedded convergent mixed-method study. Fifty military veterans aged ≥60 years with ≥3 chronic medical conditions enrolled in the randomized study; 18 (36%) participated in semi-structured interviews after program completion. Quantitative data were collected via survey instruments (Berkman Social Disengagement Scale, 3-Item Loneliness, and Patient-Reported Outcomes Measurement Information System Short Form v2.0 Ability to Participate in Social Roles and Activities); outcomes were summarized and then analyzed with non-parametric tests. Qualitative data were analyzed using a hybrid inductive and deductive approach. Data pertaining to the same constructs (eg, social disengagement) were compared for mixed methods analysis. Results and Discussion: The mean (SD) age of participants was 62.9 (6.7) years. Most were male (64%), White (82%), and non-Hispanic (92%). We identified 3 key findings: (1) Participants described telehealth as a safe, engaging environment - both physically and psychologically. (2) Unique to the telerehabilitation program, participants reported meaningful connections with others, often facilitated more effectively through the virtual space compared to a physical location. (3) Despite no significant changes in the quantitative measures of social health, participants shared how they overcame social isolation through the program. Conclusions: Social health is under studied in physical therapy research. This study suggests that telerehabilitation can foster social health through mechanisms such as peer support and psychological safety, though these benefits were not reflected in the quantitative social health measures.