PROTOCOL: Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map.
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SUBMITTER: Welch V
PROVIDER: S-EPMC9233308 | biostudies-literature | 2022 Sep
REPOSITORIES: biostudies-literature
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PROTOCOL: Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map.
Welch Vivian V Ghogomu Elizabeth Tanjong ET Barbeau Victoria I VI Boulton Elisabeth E Boutin Sabrina S Haitas Niobe N Kneale Dylan D Salzwedel Douglas M DM Simard Roger R Herbert Paul P Mikton Christopher C
Campbell systematic reviews 20220625 3
This is the protocol for a Campbell systematic review. The objectives are as follows: the aim is to map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. ...[more]
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Project description:BackgroundSocial isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions.ObjectivesTo map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings.Search methodsWe searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos.Selection criteriaTitles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria.Data collection and analysisWe developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map.Main resultsWe included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories.Authors' conclusionsThe restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
| S-EPMC10681039 | biostudies-literature
Project description:This is the protocol for an evidence and gap map. The objectives are as follows: This EGM aims to map available evidence on the effects of in-person interventions to reduce social isolation and/or loneliness across all age groups in all settings.
| S-EPMC10286723 | biostudies-literature
Project description:BackgroundThere is a compelling need for an innovative and creative approach to promote social connectedness among older adults to optimize their well-being and quality of life. One possible solution may be through a digital intergenerational program.ObjectiveThis realist review aimed to identify existing digital intergenerational programs that were used to reduce loneliness or social isolation among older adults and analyze them in terms of strategy, context, mechanisms, and outcomes.MethodsWe performed a realist review with an extensive search of published and gray literature. For scholarly literature, we searched PubMed, Embase, CINAHL, PsycINFO (Ovid), and Social Sciences Citation Index databases for articles published between January 2000 to August 2020. A grey literature search was performed using the Google search engine, and the search was completed in May 2021. We included programs that evaluated digital intergenerational programs for older adults, which described outcomes of loneliness or social isolation. We included quantitative, mixed methods, and qualitative studies, as well as relevant theoretical papers, policy documents, and implementation documents. The studies were appraised based on their relevance and rigor. We synthesized the available evidence from the literature into Strategy-Context-Mechanism-Outcome (S-C-M-O) configurations to better understand what, when, and how programs work.ResultsA total of 31 documents reporting 27 digital intergenerational programs were reviewed. Our final results identified 4 S-C-M-O configurations. For S-C-M-O configuration 1, we found that for community-dwelling older adults, provision of access to and training in digital technology may increase older adults' self-efficacy in digital devices and therefore increase the use of digital communication with family. In S-C-M-O configuration 2, digital psychosocial support and educational interventions from nurses were found to be useful in reducing loneliness among community-dwelling older adults. In S-C-M-O configuration 3, a video call with a student or family was found to reduce loneliness among older adults residing in long-term residential care facilities. Finally, for S-C-M-O configuration 4, we found that behavioral activation provided through videoconferencing by a lay coach may be useful in reducing loneliness among older adults who are lonely. However, as almost half (11/27, 41%) of the included programs only reported quantitative results, this review focused on screening the discussion section of publications to identify author opinions or any qualitative information to elucidate the mechanisms of how programs work.ConclusionsThis review identified the key strategy, context, and mechanism influencing the success of programs that promote intergenerational interaction through digital means. This review revealed that different strategies should be adopted for different groups of older adults (eg, older adults who are lonely, older adults who reside in long-term residential care facilities, and community-dwelling older adults). The S-C-M-O configurations should be considered when designing and implementing digital intergenerational programs for older adults.
| S-EPMC9850285 | biostudies-literature
Project description:ObjectiveTo describe our modification of Behavioral Activation to address social isolation and loneliness: Brief Behavioral Activation for Improving Social Connectedness. Our recent randomized clinical trial demonstrated the effectiveness of the intervention, compared to friendly visit, in alleviating loneliness, reducing depressive symptoms, and increasing social connectedness with lonely homebound older adults receiving home-delivered meals.MethodsWe modified Brief Behavioral Activation Treatment for Depression to address social isolation and loneliness by addressing each of its key elements: Psychoeducation; intervention rationale; exploration of life areas, values and activities; and activity monitoring and planning. The intervention consisted of six weekly sessions, up to 1 hour each. Interventionists were bachelor's-level individuals without formal clinical training who participated in an initial 1-day training as well as ongoing supervision by psychologists and social workers trained in BA throughout the study delivery period.ResultsWe provide three case examples of participants enrolled in our study and describe how the intervention was applied to each of them.ConclusionsOur preliminary research suggests that Behavioral Activation modified to address social connectedness in homebound older adults improves both social isolation and loneliness. This intervention has potential for scalability in programs that already serve homebound older adults. Further research is needed to solidify the clinical evidence base, replicate training and supervision procedures, and demonstrate the sustainability of Brief Behavioral Activation for Improving Social Connectedness for homebound and other older adults.
| S-EPMC7933361 | biostudies-literature
Project description:BackgroundLoneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components.MethodsThree electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O'Malley and further developed by Levac, et al. was used to guide the scoping review process.ResultsA total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews.ConclusionMany interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how.
| S-EPMC7020371 | biostudies-literature
Project description:Objectives This is the protocol for an evidence and gap map. The objectives are as follows: The aim of this evidence and gap map is to map the available evidence on the effectiveness of social prescribing interventions addressing a non-medical, health-related social need for older adults in any setting. Specific objectives are as follows: 1.To identify existing evidence from primary studies and systematic reviews on the effects of community-based interventions that address non-medical, health-related social needs of older adults to improve their health and wellbeing.2.To identify research evidence gaps for new high-quality primary studies and systematic reviews.3.To highlight evidence of health equity considerations from included primary studies and systematic reviews.
| S-EPMC10903187 | biostudies-literature
Project description:BackgroundSocial prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.ObjectiveThis study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.MethodsA meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.ResultsThe meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.ConclusionsA range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
| S-EPMC10233446 | biostudies-literature
Project description:BackgroundA significant proportion of the worldwide population is at risk of social isolation and loneliness as a result of the COVID-19 pandemic. We aimed to identify effective interventions to reduce social isolation and loneliness that are compatible with COVID-19 shielding and social distancing measures.Methods and findingsIn this rapid systematic review, we searched six electronic databases (Medline, Embase, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews and SCOPUS) from inception to April 2020 for systematic reviews appraising interventions for loneliness and/or social isolation. Primary studies from those reviews were eligible if they included: 1) participants in a non-hospital setting; 2) interventions to reduce social isolation and/or loneliness that would be feasible during COVID-19 shielding measures; 3) a relevant control group; and 4) quantitative measures of social isolation, social support or loneliness. At least two authors independently screened studies, extracted data, and assessed risk of bias using the Downs and Black checklist. Study registration: PROSPERO CRD42020178654. We identified 45 RCTs and 13 non-randomised controlled trials; none were conducted during the COVID-19 pandemic. The nature, type, and potential effectiveness of interventions varied greatly. Effective interventions for loneliness include psychological therapies such as mindfulness, lessons on friendship, robotic pets, and social facilitation software. Few interventions improved social isolation. Overall, 37 of 58 studies were of "Fair" quality, as measured by the Downs & Black checklist. The main study limitations identified were the inclusion of studies of variable quality; the applicability of our findings to the entire population; and the current poor understanding of the types of loneliness and isolation experienced by different groups affected by the COVID-19 pandemic.ConclusionsMany effective interventions involved cognitive or educational components, or facilitated communication between peers. These interventions may require minor modifications to align with COVID-19 shielding/social distancing measures. Future high-quality randomised controlled trials conducted under shielding/social distancing constraints are urgently needed.
| S-EPMC7888614 | biostudies-literature
Project description:BackgroundSocial isolation and loneliness (SIL) are complex issues that impact mental and physical wellbeing and are significant public health concerns. People from minority ethnic backgrounds living in Organisation for Economic Cooperation and Development (OECD) member states may be particularly vulnerable to experiencing SIL. This is due to various challenges associated with life in foreign countries, including cultural differences, settlement issues, low incomes, and discrimination. While many interventions have been developed to address SIL in the general population, there is little information about interventions designed for minority ethnic populations in OECD countries. Our study aimed to 1) Investigate existing interventions for minority ethnic communities in OECD countries; 2) Assess how these interventions are conceptualised to increase awareness of SIL risks on health factors.3) Explore culturally sensitive approaches in these interventions, and 4) Identify the most effective interventions in reducing SIL in minority ethnic populations.Methods and findingsWe searched Medline, APA PsycINFO, Psychology and Behavioural Sciences Collection, CINAHL, Web of Science, and Scopus from their inception to September 19th, 2023, and registered the scoping review at https://osf.io/fnrvc. Our search yielded 10,479 results, of which 12 studies were included: five RCTs, six non-randomized quasi-experimental studies, and one qualitative study. Interventions were grouped into four main categories: social facilitation, befriending, leisure and skills development, and health education programmes. While only a few interventions targeted minority ethnic populations specifically, our findings highlight the potential of culturally sensitive interventions in reducing social isolation and loneliness among minority ethnic communities in OECD countries. However, given the type and extent of evidence, it is still unclear which interventions are superior in reducing SIL in minority ethnic populations in OECD countries. Further research is necessary to understand which activities may be most effective for which communities. Such interventions should be designed and tailored to account for the broader risk implications of SIL to raise awareness of the population's peculiar health risk profile.DiscussionInterventions designed to address SIL among minority ethnic groups in OECD member states are scarce and have not been designed to account for the health risks profile of the population. Integrated research designs involving groups linked with minority ethnic populations are needed to link individual, community, and societal factors alongside population risk profiles for increased recognition of SIL as an important health factor.
| S-EPMC11658517 | biostudies-literature
Project description: Not available
| S-EPMC8988637 | biostudies-literature