Medical Student Social Calls to Isolated Older Adults: A Pilot Study

INTRODUCTION: The COVID-19 pandemic has amplified social isolation and loneliness among older adults, a quarter of whom were considered socially isolated prior to the pandemic (Wu 2020). Inspired by a Columbia University student initiative (Nathanson et al. 2021), students at Hackensack Meridian School of Medicine [HMSOM] formed a new medical school volunteer club, the “Phone Pal Program.” The program matches medical student volunteers [MSV] with isolated seniors in the community to engage in social phone calls. Similar programs have been reported to have beneficial effects on both the participating older adults and volunteering students (Office et al. 2020). Ageism is a growing concern in our society, leading to poorer outcomes in older adults and highlighting gaps in medical school curricula (Mikton et. al, 2021). The MSVs and older adults engaged in phone calls for three months, and we collected data, including: (1) independent post-surveys of the participating MSVs and the older adults to assess their perception of the program, (2) pre and post ageism questionnaire replies completed by the MSVs, and (3) ageism questionnaire replies provided by a group of non-participating control students at the beginning and end of the project period. METHODS: Setup of the MSV club took over six months, with advising from faculty, student affairs leadership, and legal review. Once the program received formal approval, older adults reporting isolation or loneliness to their geriatric psychiatrist at participating outpatient clinics were invited to join the Phone Pal Program. HMSOM students were recruited as volunteers, and after undergoing a training course, were each matched with a consenting older adult. The MSVs and older adults engaged in bi-weekly social calls over three months. Volunteers submitted digital logs of their phone calls and were provided with feedback from faculty and student club leadership throughout the program period. The Phone Pal Program team was supported by a team including psychiatrists, social workers, and residents. A digital survey incorporating qualitative and quantitative elements, including questions about background experiences with older adults (e.g., home life, work experience), characterization of older adults, and the Ambivalent Ageism Scale [AAS] (Cary et. al, 2017), was administered before and after the three-month period to the MSVs and the non-participating control student group. Baseline data was compared using t-tests and Fisher's exact tests as appropriate and responses to the mixed and stratified ordinal regression analyses. RESULTS: After the formation of the Phone Pal Program as a MSV club, 30 students responded to the initial call for volunteers. 14 students joined the virtual interest meeting, and 13 committed to attending a training session. Four training sessions with faculty supervisors were held in February 2022, and all 13 volunteers completed the training program. Ultimately 12 volunteers established and maintained contact with their older adult, conducting a median of 3 calls per pair over the project period and averaging approximately 28 minutes per call. Both the MSV and non-participating control student groups were largely similar regarding age (P=0.48), sex (P=0.25), previous coursework in geriatrics (P=0.09), work with older adults (P = 0.08), volunteering with older adults (P=0.72), having lived with older adults (P=0.73), planning to live with older adults (P=1.0), and desire to work with older adults (P=0.30). The MSV group more frequently gave higher responses to AAS items 4 (P=0.04), 10 (P=0.02), and 11 (P=0.03) at baseline than the controls. After the intervention, however, no statistically significant differences were detected except for AAS item 1 (P<0.001), which was significantly lower for the intervention group. All MSVs completed a satisfaction survey at the end of the project period. About two thirds of the older adults agreed to complete a satisfaction survey. The survey results suggested that the majority of the MSVs found the program beneficial in fostering connection and appreciated the flexibility of the program. The majority of older adults endorsed feeling connected with their MSVs. CONCLUSIONS: The creation of the Phone Pal Program as a MSV club required a large time commitment from HMSOM student leaders, faculty mentors, and administrators. MSV retention and satisfaction was high, and the data collected suggests the majority of MSVs and older adults found the program beneficial. Although this was a small pilot study, we were still able to demonstrate a clear reduction on at least one item of the AAS. Further refinements to the training program may be helpful to further reduce ageism among our student and patient population. A larger scale study involving more participants is warranted, as a larger sample may reveal more beneficial effects that were missed in this pilot project. We hope that as the program grows, we can draw clearer conclusions regarding their experiences. THIS RESEARCH WAS FUNDED BY: None.