scholarly journals Rapid systematic review of systematic reviews: what befriending, social support and low intensity psychosocial interventions, delivered remotely, are effective in reducing social isolation and loneliness among older adults? How do they work?

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1368
Author(s):  
Elisabeth Boulton ◽  
Dylan Kneale ◽  
Claire Stansfield ◽  
Paul Heron ◽  
Katy Sutcliffe ◽  
...  

Background: During the 2020 COVID-19 pandemic, millions of older adults are advised to avoid contact with those outside their household. ‘Social distancing’ has highlighted the need to minimise loneliness and isolation through the provision of remotely delivered befriending, social support and low intensity psychosocial interventions. We wanted to know what interventions are effective and how they work to help inform decisions about different approaches. Methods: We followed a systematic ‘review of reviews’ approach and included systematic reviews focussed on the effectiveness or implementation of remote interventions to reduce levels of social isolation or loneliness in adults aged 50+. Searches of 11 databases were undertaken during April 2020 and eligible reviews were critically appraised using AMSTAR2. Narrative synthesis was used at a review and study level to develop a typology of intervention types and their effectiveness. Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) were used at a study level to explore the characteristics of successful interventions. Results: We synthesised evidence from five systematic reviews and 18 primary studies. Remote befriending, social support and low intensity psychosocial interventions took the form of: (i) supported video-communication; (ii) online discussion groups and forums; (iii) telephone befriending; (iv) social networking sites; and (v) multi-tool interventions. The majority of studies utilised the first two approaches, and were generally regarded positively by older adults, although with mixed quantitative evidence around effectiveness. Focussing on processes and mechanisms, using ICA and QCA, we found that the interventions that were most effective in improving social support: (i) enabled participants to speak freely and to form close relationships; (ii) ensured participants have shared experiences/characteristics; (iii) included some form of pastoral guidance. Conclusions: The findings highlight a set of intervention processes that should be incorporated into interventions, although they do not lead us to recommend particular modes of remote support.

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1368
Author(s):  
Elisabeth Boulton ◽  
Dylan Kneale ◽  
Claire Stansfield ◽  
Paul Heron ◽  
Katy Sutcliffe ◽  
...  

Background: During the COVID-19 pandemic ‘social distancing’ has highlighted the need to minimise loneliness and isolation among older adults (aged 50+). We wanted to know what remotely delivered befriending, social support and low intensity psychosocial interventions may help to alleviate social isolation and loneliness and how they work. Methods: We followed a systematic ‘review of reviews’ approach. Searches of 11 databases from the fields of health, social care, psychology and social science were undertaken during April 2020. Reviews meeting our PICOS criteria were included if they focussed on the evaluation of remote interventions to reduce levels of social isolation or loneliness in adults aged 50+ and were critically appraised using AMSTAR2. Narrative synthesis was used at a review and study level to develop a typology of intervention types and their effectiveness. Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) were used at a study level to explore the characteristics of successful interventions. Results: We synthesised evidence from five systematic reviews and 18 primary studies. Remote befriending, social support and low intensity psychosocial interventions took the form of: (i) supported video-communication; (ii) online discussion groups and forums; (iii) telephone befriending; (iv) social networking sites; and (v) multi-tool interventions. The majority of studies utilised the first two approaches, and were generally regarded positively by older adults, although with mixed evidence around effectiveness. Focussing on processes and mechanisms, using ICA and QCA, we found that the interventions that were most successful in improving social support: (i) enabled participants to speak freely and to form close relationships; (ii) ensured participants have shared experiences/characteristics; (iii) included some form of pastoral guidance. Conclusions: The findings highlight a set of intervention processes that should be incorporated into interventions, although they do not lead us to recommend specific modes of support, due to the heterogeneity of interventions.


2021 ◽  
Vol 12 ◽  
Author(s):  
Feng Tong ◽  
ChengLin Yu ◽  
LinSen Wang ◽  
Iris Chi ◽  
Fang Fu

Background: The social isolation of older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that ~40% of the population will be aged 50 or above within the next few decades. This systematic review aims to summarize and renew knowledge of the effectiveness of existing interventions for alleviating social isolation of older adults.Methods: Relevant electronic databases, including Cochrane Library, CINAHL, SCOPUS, and Web of Science, were searched by a systematic evaluation method. Eligible randomized controlled trial (RCT) studies were published between 1978 and 2021 in English or Chinese. The primary and secondary outcomes were social isolation and loneliness. The quality of the included RCTs was scored by the Cochrane risk-of-bias tool to assess their quality. Two independent reviewers extracted data, using a standardized form. Narrative synthesis and vote-counting methods were used to summarize and interpret study data.Results: Twenty-four RCTs were finally included in this review. There was evidence of substantial heterogeneity in the interventions delivered. The overall quality of included studies indicated a low-to-medium risk of bias. Eighteen of 24 RCTs showed at least one dimension effect on reducing social isolation. The interventions with accurate targeting of clients in social and public places had more obvious effect. The interventions in which older people are active participants also appeared more likely to be effective. In addition, group intervention activities and individual intervention interviews were effective in improving structural social support; mixed intervention, and group intervention on training support significantly improved functional social support.Conclusions: This study suggests that group and mixed intervention targeting of older adults could be helpful for alleviating social isolation problems. The use of modern technology for remote services could also present good results. More well-conducted RCTs of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. Especially as the debating results of remote interventions, further research in this field should be conducted.


2021 ◽  
Vol 10 (11) ◽  
pp. 2308
Author(s):  
Pascale Heins ◽  
Lizzy M. M. Boots ◽  
Wei Qi Koh ◽  
An Neven ◽  
Frans R. J. Verhey ◽  
...  

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation.


2018 ◽  
Vol 53 (16) ◽  
pp. 996-1002 ◽  
Author(s):  
Melanie K Farlie ◽  
Lauren Robins ◽  
Romi Haas ◽  
Jennifer L Keating ◽  
Elizabeth Molloy ◽  
...  

ObjectiveThe objective of this systematic review was to examine the effects of different balance exercise interventions compared with non-balance exercise controls on balance task performance in older adults.DesignSystematic review.Data sourcesMedline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus and Cochrane Database of Systematic Reviews were searched until July 2017.Eligibility criteria for selecting studiesSystematic reviews and meta-analyses of randomised trials of balance exercise interventions for older adults were identified for extraction of eligible randomised trials. Eligibility criteria for inclusion of randomised trials in meta-analyses were comparison of a balance exercise intervention with a control group that did not perform balance exercises, report of at least one end-intervention balance outcome measurement that was consistent with the five subgroups of balance exercise identified, and full-text article available in English.ResultsNinety-five trials were included in meta-analyses and 80 in meta-regressions. For four balance exercise types (control centre of mass, multidimensional, mobility and reaching), significant effects for balance exercise interventions were found in meta-analyses (standardised mean difference (SMD) 0.31–0.50), however with considerable heterogeneity in observed effects (I2: 50.4%–80.6%). Risk of bias assessments (Physiotherapy Evidence Database score and funnel plots) did not explain heterogeneity. One significant relationship identified in the meta-regressions of SMD and balance exercise frequency, time and duration explained 2.1% of variance for the control centre of mass subgroup.ConclusionLimitations to this study included the variability in design of balance interventions, incomplete reporting of data and statistical heterogeneity. The design of balance exercise programmes provides inadequate explanation of the observed benefits of these interventions.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026667 ◽  
Author(s):  
Tengku Amatullah Madeehah Tengku Mohd ◽  
Raudah Mohd Yunus ◽  
Farizah Hairi ◽  
Noran N Hairi ◽  
Wan Yuen Choo

ObjectivesThis review aims to: (1) explore the social support measures in studies examining the association between social support and depression among community-dwelling older adults in Asia and (2) the evidence of association.DesignA systematic review was conducted using electronic databases of CINAHL, PubMed, PsychINFO, Psychology and Behavioural Sciences Collection, SocINDEX and Web of Science for articles published until the 11th of January 2018.Eligibility criteriaAll observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included.ParticipantsOlder adults aged 60 years and more who are living in the community.Exposure measuresSocial support.Outcome measuresDepression.ResultsWe retrieved16 356 records and screened 66 full-text articles. Twenty-four observational studies were included in the review. They consisted of five cohort studies and 19 cross-sectional studies. Social support was found to be measured by multiple components, most commonly through a combination of structural and functional constructs. Perceived social support is more commonly measured compared with received social support. Good overall social support, having a spouse or partner, living with family, having a large social network, having more contact with family and friends, having emotional and instrumental support, good support from family and satisfaction with social support are associated with less depressive symptoms among community-dwelling older adults in Asia.ConclusionsThere were 20 different social support measures and we applied a framework to allow for better comparability. Our findings emphasised the association between good social support and decrease depression among older adults. Compared with western populations, family support has a greater influence on depression among community-dwelling older adults in Asia. This indicates that the family institution needs to be incorporated into designed programmes and interventions when addressing depression in the Asian context.Trialregistration numberCRD42017074897.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Jeffrey Burr ◽  
Lien Quach

Abstract Relatively little is known about the relationship between social isolation and the risk of falls among older adults. Yet, a considerable amount of research demonstrates that lack of sufficient social relationships, broadly defined, represents a modifiable risk factor for many indicators of well-being in later life. This study examines the association between two types of social isolation and the risk of falls. The study also examines whether depression mediates the association between social isolation and risk of falls. Longitudinal data from the Health and Retirement Study (2006-2012) were collected from community-dwelling participants aged 65 and older (N=8,464). The outcome variable was number of falls self-reported over the observation period. Independent variables included perceived isolation (feeling lonely, perceptions of social support), social disconnectedness (e.g., having no friends or relatives living nearby, living alone), and number of depressive symptoms. Results from regression models indicated that social disconnectedness was associated with a 5% increase in the risk of falls (IRR=1.05, 95% CI=1.01-1.09). Perceived social support was associated with a 21% increase in the risk of falls; when examined together, perceived social support and loneliness were associated with a combined 37% increase in falls risk. Depression was associated with a 47% increase in falls. Depression mediated the association between perceived isolation and falls. Further, perceived isolation mediated the association between social disconnectedness and falls. Reducing perceived social isolation and social disconnectedness may be an avenue for designing interventions to reduce the risk of falls, especially for older adults with depression.


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