Leveraging Community Support Services to Support an Integrated Health and Social System Response to COVID-19: A Mixed Methods Study

The COVID-19 pandemic restricted access to health and social care for older adults. In response, a standardized, self-report instrument, the interRAI COVID-19 Vulnerability Screener (CVS), was developed. In collaboration with a community support service organization, this project aimed to evaluate a surveillance process to identify those at risk and triage them to health- or social-care services. A convergent, mixed methods design was used. Virtual focus groups were conducted with partner staff. The clinical, social, and functional characteristics of screened clients were analyzed descriptively. The mixed methods analysis generated implementation considerations. Participants successfully utilized the CVS to identify and support vulnerable clients who may have otherwise been overlooked. Most screened clients were not experiencing COVID-19 symptoms, yet had elevated mortality risk should they become infected, and were negatively impacted by social isolation. Findings support the use of the CVS by community support services during the pandemic or other disasters to identify those at risk due to frailty and social or economic vulnerability. Implementation requirements include a knowledgeable workforce, active facilitation, and incorporation of the CVS into existing workflows. Health- and social-care integration would be enhanced by the development of updated privacy policies and shared digital infrastructure.