Exploring Program to Encourage Active and Rewarding Lives for Seniors (PEARLS) with hard-to-reach populations

Background: PEARLS is a home-based evidence-based depression intervention for older adults. While the program was designed to reach elders outside of traditional mental health settings, implementation has been challenging in some communities. Aims: We partnered with several local community-based organizations to identify hard-to-reach populations and strategies for improving program reach and implementation with these communities. Methods: Interviews and focus groups were conducted using semi-structured guides with staff and former clients from three social service agencies. Transcripts were analyzed using thematic content analysis to identify hard-to-reach populations and approaches for improving recruitment, enrollment, and retention. Member checking was used with participating agencies to refine our interpretation. Results: Veterans, African-American men and women, Filipino men, older adults (75+), rural communities, and people with limited education were identified as hard-to-reach populations. Strategies for improving recruitment and enrollment include sharing materials at local trusted organizations, introducing the program in private settings, and framing the program as life-skills and problem-solving. Training members of these communities as counselors and being flexible with the timing of sessions are important for facilitating client retention. Implications: Research findings will be used to inform technical assistance activities with PEARLS providers, changes to PEARLS program and training materials, and future PEARLS research activities.