Process evaluation of a complex group-based intervention for older adults living alone

A complex intervention called ‘participatory group-based care management’ was developed and carried out in Central and Eastern Finland to promote older adults’ wellbeing and quality of life. This study analyses the process of the intervention using two types of qualitative data. Firstly, during the six-month intervention, 120 reflection diaries in total were written by researchers and care managers, based on their observations of the group meetings. Secondly, 24 focus group discussions were carried out with the intervention participants. Both data were analyzed jointly by using the grounded theory method to evaluate the intervention process. Based on the data, three important elements of the intervention were social support exchange, needs-based counseling, and scheduled group meetings. These elements support older people in terms of social wellbeing, resources and capacity, experiences of meaningfulness, participation and routines, and empowerment. Contextual and intervening factors related to the intervention, group tutors, and participants, are essential for achieving outcomes. The three important elements of the intervention (social support exchange, needs-based counseling, and scheduled group meetings) appear to empower some older adults and engage some of them in activities. According to the results, the effectiveness of the intervention is based on socially and individually constructed causal pathways, but the intervention should be refined before its further implementation.