An evaluation of the Standing Together project
There is evidence to suggest that peer-support groups can help to increase social connectedness among older people, thus improving their quality of life.
Given that 3.6 million older people live alone in the UK (Age UK. 2018), and the associated health risks of these conditions, such as increased mortality and declining cognitive function, there is a need to further investigate the impact of peer-support groups on the health and wellbeing of older people. The Mental Health Foundation's Standing Together project was set up tp address this through facilitated peer support and activity-based groups.
This evaluation sought to understand whether the Standing Together (ST) peer-support groups, which took place between 2015 and 2017, impacted on outcomes related to: lonlieness and social isolation; emotional wellbeing; and meaningful activity. It initially aimed to do this by comparing participants' scores on these outcome areas at baseline and follow-up.
A methodological shift during 2016, however, led to a greater focus on qualitative analsis. Focus groups with participants resulted in a richer, more nuanced understanding of the impact of the groups, which both complemented and enhanced the quantitative findings. The study also included a process evaluation to explore factors relating to the implementation of the groups, with a specific focus on assessing sustainability.
The qualitative analysis from the focus groups provided a broader, positive insight into the impact of the ST groups on participants. Findings from the focus groups, which consisted of 45 residents at baseline and 57 at follow-up, demonstrated that most residents felt that participating in the groups led to positive impacts in all the outcom areas identified.
That is, participants felt that the groups helped to: combat loneliness by strengthening a feeling of social connectedness and belonging; improve wellbeing through discussion among peers and the presence of a kind, caring facilitator; and provide meaningful, stimulating activities around people with whome they felt comfortable. Residents also expressed desire for the groups to continue.
The quantitative analysis found non-significant difference for 13 participants across outcomes, indicating that the groups had no impact on the outcomes, indicating that the groups had no impact on the outcome areas relating to life satisfaction, loneliness, wellbeing and social connectedness. However, there are a number of reasons why these results might have occurred, which came to light in the qualitative analysis.
Most notably, the time at which follow-up outcome data were collected could have negatively impacted participant scores; outcome scores may have reflected the participants' disappointment that the groups were coming to an end.
Standing Together groups ran in 19 schemes - of these, more than half (10) were able to sustain themselves following the completion of the initial programme. There are great challenges to sustainability, however, as this requires funding and volunteers, both of which are limited resources. The importance of strong facilitators and having designated court staff members to facilitate the group on the court's behalf were emphasised as key to promoting group sustatinability.
The process evaluation confirmed the positive findings of the focus groups. Staff members from all levels of the involvement in the programme also felt that the groups led to reduced feelings of isolation and loneliness, increased companionship, mental stimulation and social inclusion.
The process evaluation also emphasised the value in having two skilled tactful facilitators in each group who are able to effectively manage a group of residents, some of whome may have dementia or cognitive impairments.
A full set of evaluation recommendations will be published academically and shared on the Foundation's website separately to this report. However, three key recommendations for conducting future evaluations of group work in later life are summarised below:
- Interviews or smaller focus groups are preferable to larger focus groups to facilitate more effective data collection;
- A greater focus on the needs of the population to inform all aspects of the evaluation (including measurements used and data collection) is needed; and
- Further thought should be given to the appropriate time at which follow-up date should be collected to ensure the data are not impacted by emotions induced by the programme ending.