# Improving Physical and Psychosocial Functioning in Underserved Older Adults During the COVID-19 Pandemic: A Community Health Worker-Led Intervention

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $505,720

## Abstract

Project Summary
The heightened vulnerability to COVID-19 of African American older adults in Detroit, Michigan and other
marginalized communities is linked to systemic racism experienced over the life course. Structural inequities
also magnify the pandemic's impact on older adults' physical and psychosocial functioning. For example, social
isolation is exacerbated by widespread digital exclusion, and closures of community centers leave few safe
options for physical activity. Hence, many older adults in Detroit, burdened by poor health even before the
pandemic, face a downward spiral of increased distress, reduced physical and social activity, and physical
deconditioning. Timely intervention is critical to prevent or slow this decline. “Positive STEPS” is a self-
management and resilience-building intervention led by community health workers (CHWs) at the Detroit
Health Department (DHD). CHWs have a unique ability to reach underserved groups, provide culturally
congruent care, and form a bridge to formal services; yet they have been vastly underutilized during the
pandemic. This intervention targets individual (self-management, resilience), interpersonal (social support) and
community (enhanced DHD capacity) levels. The long-term goal of this research is to build an evidence base
for engaging the CHW workforce to mitigate the pandemic's impact on vulnerable groups. The project's
objective is to assess the impact of Positive STEPS on functional outcomes. The central hypothesis is that
Positive STEPS, delivered via a synchronous group telephone platform, asynchronous podcast series, and
activity trackers, will improve psychosocial and physical functioning at 2 and 8 months. In an ongoing
randomized pilot trial, a version of Positive STEPS has been well-received and delivered by CHWs with high
fidelity. In analysis to date of post-program outcomes, the intervention group (n=16) has shown clinically
significant improvements of 2 to 5 points across PROMIS domains of physical functioning, anxiety, depression,
fatigue and pain interference, while controls (n=18) are unchanged or worse. The DHD will work with other City
of Detroit units to recruit participants with elevated physical or psychological symptoms. Specific aims are: 1)
With input from a Community Advisory Board, modify Positive STEPS for group delivery and add pandemic
content; conduct a mini-pilot (n=10). 2) Conduct an RCT to assess its impact (vs. COVID education/telephone
wellness check) on PROMIS-29 Psychosocial Score (a weighted combination of distress, fatigue, pain, social
participation and sleep) among 456 primarily African American older adults. 3) Using qualitative data from
participants and other stakeholders, conduct mixed-methods analyses to provide context for Aim 2 findings,
assess community impact, and inform a dissemination toolkit. This project is significant in that it will rigorously
test a scalable model for addressing sequelae of the pandemic among older adults in a deepl...

## Key facts

- **NIH application ID:** 10865117
- **Project number:** 5R01NR020442-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Mary Rose Janevic
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $505,720
- **Award type:** 5
- **Project period:** 2021-09-24 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865117

## Citation

> US National Institutes of Health, RePORTER application 10865117, Improving Physical and Psychosocial Functioning in Underserved Older Adults During the COVID-19 Pandemic: A Community Health Worker-Led Intervention (5R01NR020442-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10865117. Licensed CC0.

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