Implementation of Evidence-Based Practices in Intergenerational Programming: A Scoping Review

Abstract Intergenerational programs facilitate mutually beneficial interactions between youth and older adults, achieving an array of outcomes. With few exceptions, implementation factors rarely figure into outcome analyses, though researchers frequently gather data on factors influencing outcomes. The resulting practice-evidence gap may deter wide-spread adoption of intergenerational programming. We conducted a scoping review of 35 peer-reviewed articles (2000-2019) to map key concepts and evidence sources of empirically-supported practices impacting intergenerational program outcomes. A scoping review is appropriate when an area is complex, like intergenerational programs that incorporate diverse participants, content, and goals. Primarily qualitative studies involved programs equally likely to involve young, school-age, or post-secondary age youth and independent or frail older adults. Half had sample sizes under 50, frequently measuring both age groups. Implementation practices included co-learning and sharing personal stories. Program content (e.g., technology) and greater exposure amplified outcomes. Rigorous implementation research is needed to advance evidence-based intergenerational practice.


THE IMPACT OF PUBLIC BENEFITS ON LOW-INCOME OLDER ADULTS' FINANCIAL WELL-BEING Lauren Popham, National Council on Aging, Arlington, Virginia, United States
Nineteen percent (13 million) older adults have incomes below 150% of the Federal Poverty Level, leaving them with limited means to afford basic living expenses. Public benefits can help bridge the gap allowing older adults to afford food, home energy, and health expenses. There are studies demonstrating the positive health outcomes associated with public benefits in older adults. It remains unclear how benefits may also improve subjective measures of well-being in older adults. To examine this question, baseline measures of well-being including the CFPB Financial Well-Being Scale were administered to older adults before they enrolled in benefits and again six months after receiving benefits to examine changes in well-being as a result of accessing benefits to help ease some of their financial burdens. Results revealed that older adults experience subjective, psychological improvements from benefits. These findings have implications for the social and behavioral determinants of health in older adults.

USING IMPLEMENTATION RESEARCH TO PROMOTE THE EXPANSION AND SUSTAINABILITY OF INTERGENERATIONAL PROGRAMS Chair: Leslie Hasche
Implementation studies provide guidance on how to reduce the gap between empirically-supported interventions and routine care. For intergenerational programs that bring older adults and other generations together to promote social connection, improve health and well being, and to reduce ageism, the role of implementation science is rarely studied. Intergenerational programs have a long-standing role in social service and housing contexts, yet the quality of the evidence and sustainability of these programs is often in question. This symposium aims to demonstrate how implementation studies can identify available evidence and influential contextual factors to examine issues of adoption, fidelity, and sustainability of intergenerational programs. First, a scoping review of the available evidence on best practices of intergenerational programs will help highlight fidelity issues. Second, an environmental scan for intergenerational housing will highlight how contextual factors may impact the adoption and spread of intergenerational programs. Third, a pre-implementation study delivering multi-modal best practices training to local community sites will share indicators of the feasibility of training staff to implement evidencebased intergenerational practices. Finally, an evaluation of a community collaborative of organizations implementing intergenerational programs will highlight the process by which organizations develop and sustain partnerships. The chair will summarize how the studies' methodological approaches incorporate implementation science and outcomes. Implications for both future research on organizational context, funding, and implementation strategies, as well as for practice settings will be named. The discussion will identify implementation gaps that will need to be overcome to expand and sustain intergenerational programs.

IMPLEMENTATION OF EVIDENCE-BASED PRACTICES IN INTERGENERATIONAL PROGRAMMING:
A SCOPING REVIEW Shannon Jarrott, Rachel Scrivano, Nancy Mendoza, and Cherrie Park, The Ohio State University, Columbus, Ohio, United States Intergenerational programs facilitate mutually beneficial interactions between youth and older adults, achieving an array of outcomes. With few exceptions, implementation factors rarely figure into outcome analyses, though researchers frequently gather data on factors influencing outcomes. The resulting practice-evidence gap may deter wide-spread adoption of intergenerational programming. We conducted a scoping review of 35 peer-reviewed articles (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019) to map key concepts and evidence sources of empiricallysupported practices impacting intergenerational program outcomes. A scoping review is appropriate when an area is complex, like intergenerational programs that incorporate diverse participants, content, and goals. Primarily qualitative studies involved programs equally likely to involve young, school-age, or post-secondary age youth and independent or frail older adults. Half had sample sizes under 50, frequently measuring both age groups. Implementation practices included co-learning and sharing personal stories. Program content (e.g., technology) and greater exposure amplified outcomes. Rigorous implementation research is needed to advance evidence-based intergenerational practice.

CONNECTING GENERATIONS IN SENIOR HOUSING: PROMISING PRACTICES AND CHALLENGES Nancy Henkin, Generations United, Merion, Pennsylvania, United States
Senior housing can be an ideal platform for high quality intergenerational programming. Often older adults who move to congregate housing settings experience feelings of loneliness and a loss of purpose. Creating long term partnerships with educational and youth-serving organizations can help senior housing providers expand residents' social networks and create meaningful civic engagement opportunities. A 3-year national initiative involving an environmental scan of intergenerational practice in senior housing communities, the development of a toolkit for senior housing providers, and the piloting of intergenerational partnerships and programs in six national housing communities was conducted by Generations United and Leading Age and supported by the Retirement Research Foundation. Promising practices, challenges, and lessons learned from this initiative will be shared and strategies for "scaling" this work will be discussed.

IMPLEMENTING IG BEST PRACTICES IN COMMUNITY-BASED SETTINGS: A PRE-IMPLEMENTATION STUDY
Lisa Juckett, 1 Shannon Jarrott, 1 Jill Naar, 2 Rachel Scivano, 1 and Alicia Bunger, 3 1. The Ohio State University, Columbus, Ohio, United States, 2. Appalachian State University, Boone,North Carolina,United States,3. Ohio State University,Columbus,Ohio,United States Programs that intentionally engage unrelated young and old persons often lead to mutual benefits; however, specific implementation strategies that support the use of evidence-based intergenerational programming in community settings are understudied. With strong demand for training resources among intergenerational program providers, this pilot study examined how a multifaceted training strategy facilitated the implementation of 14 distinct evidence-based intergenerational best practices. Intergenerational programming was implemented with nine staff from two small community sites using three implementation strategies including educational meetings, ongoing consultation, and routine practice reminders. Observational analysis of video recorded intergenerational program sessions indicated that staff adopted an average of 81.7% of intergenerational best practices suggesting the feasibility of implementing IG in community settings. Findings yield valuable insight that can inform training refinements, and selection of strategies for improving implementation. Next steps include aligning specific practices with participant outcomes.

A PROCESS EVALUATION ON THE IMPLEMENTATION OF CROSS-ORGANIZATIONAL INTERGENERATIONAL PARTNERSHIPS
Carson De Fries, 1 Andrew Steward, 1 Rachel Fix, 2 and Leslie Hasche, 1 1. University of Denver,Denver,Colorado,United States,2

. University of Denver -Graduate School of Social Work, Denver, Colorado, United States
A collaborative group of organizations in the rocky mountain region of the U.S. implemented sixteen intergenerational programs with varying themes (i.e. mentorship, music and art therapy, baking, life stories, etc.). This two-year study used survey data and a focus group to understand successful approaches and challenges to implementing cross-organizational partnerships between adult-serving and youth-serving organizations. We utilized qualitative data through open-ended comments on program evaluations and a focus group discussion with leaders of seven community organizations. Questions in the focus group prompted participants to describe the process of initiating, developing, and sustaining partnerships. The three main themes were: the benefits of shared organizational values, outlining programmatic roles and expectations, and an ability to cope with negative partnership experiences. Insights about successful approaches to implementing cross-organizational partnerships, as well as the challenges of developing and sustaining such partnerships may be beneficial in similar settings.

VULNERABLE OLDER ADULTS IN DISASTERS: EFFECTS OF HURRICANE IRMA ON NURSING HOMES AND ASSISTED LIVING
Chair: Lindsay Peterson Co-Chair: David Dosa Discussant: Patricia D'Antonio Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/ short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders