Older adults in Canada are experiencing increasing levels of social isolation,
loneliness, and mental health challenges, including anxiety and depression - trends that
have worsened during and following the COVID-19 pandemic. Research consistently shows
that loneliness and social isolation are associated with poorer mental and physical
health outcomes, increased risk of dementia, and increased mortality. At the same time,
social connection has a strong protective impact on health and well-being.
Community-based programs that promote both social engagement and psychological support
are urgently needed, particularly since older adults are less likely to access formal
mental health services.
Approximately 3-11% of older adults meet diagnostic criteria for mood or anxiety
disorders each year, with even more experiencing elevated symptoms that greatly influence
quality of life. Subsyndromal depression in late life is estimated to occur two to three
times more often than major depressive disorder. Despite these needs, up to 70% of older
adults with anxiety or mood disorders do not access psychological services, often due to
low mental health literacy or practical barriers to care. At the same time, participation
in community activities is associated with improved emotional well-being, greater social
support, and lower rates of depression and anxiety.
To bridge this need for support, our team developed and pilot-tested The CONNECT Program
- a group-based mental health intervention for adults 55 years and older, delivered via
telephone or virtually. The CONNECT Program is grounded in Acceptance and Commitment
Therapy (ACT), self-compassion, and theories of successful aging, and aims to improve
psychological flexibility; reduce loneliness, social isolation, and co-occurring symptoms
of depression and anxiety. A Manitoba pilot study (N = 34) demonstrated promising
outcomes in terms of feasibility, acceptability, and preliminary effectiveness with the
telephone-based group intervention.
The current trial will evaluate the implementation and effectiveness of The CONNECT
Program in four Canadian provinces (British Columbia, Manitoba, New Brunswick,
Saskatchewan), using an implementation-effectiveness hybrid design and a crossover
randomized controlled trial. This study compares The CONNECT Program, delivered via
telephone or virtually, to routine community programming (i.e., community participation
as usual), which may occur in telephone, virtual, or in-person formats. The primary
outcome is psychological flexibility; secondary outcomes include loneliness, social
isolation, anxiety, depression, emotional support, mental health literacy. Implementation
outcomes will be evaluated following the Proctor et al. framework.
This trial will contribute evidence on the mental health needs of adults 55+ and the
value of low-barrier, community-based programs delivered remotely. Findings will guide
further national and international implementation of The CONNECT Program and similar
initiatives aimed at addressing the challenges of loneliness, social isolation, and
mental health problems in late life.
