Analysis of factors associated with group Behavioral Health Education (BHE) usage in older adults: Focusing on BHE utilization level and pandemic-related timeframes

Background Current literature describes complexities in addressing older adult mental health and benefits of psychotherapeutic interventions, but limited knowledge exists regarding factors surrounding older adult group psychoeducation program usage. Objective This study analyzed associations of demographic and clinical characteristics with Behavioral Health Education (BHE) class usage patterns, focusing on BHE utilization level and COVID-19 pandemic-related timeframes of class initiation. Methods This retrospective cohort study examined adults ≥65 years old taking BHE classes from January 2019 to August 2022 in a Northern California healthcare system. Statistical analyses evaluated associations of demographic features, Charlson Comorbidity Index (CCI), and psychiatric diagnoses with class utilization (1, 2-4, or ≥5 classes). Analysis was also performed regarding these variables and pre-pandemic versus peri-pandemic class initiation. Results Among 1152 patients, higher CCI was associated with decreased likelihood of peri-pandemic class initiation (P=0.02). A greater percentage of patients had anxiety and fear-related disorders in the patient group utilizing ≥5 classes, versus 2-4 classes, versus 1 class (P=0.003). A greater likelihood of peri-pandemic class initiation was observed for patients with any psychiatric diagnosis (P=0.02), particularly those with a trauma and stressor-related disorder (P<0.001). Conclusions Medical comorbidity and trauma and stressor-related disorder diagnosis presence may be associated with pandemic-related timeframe of BHE class initiation. Anxiety and fear-related disorder diagnosis presence may be associated with BHE utilization. Accordingly, BHE class design should continue being inclusive and accessible to older adults from diverse backgrounds, while also recognizing how pandemic-associated factors, like increased isolation and medical risk, may be associated with BHE usage.