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Results 11 - 20 of 752

Intergroup ‘Skype’ quiz sessions in care homes to reduce loneliness and social isolation in older people

ZAMIR Sonam, et al

Video calls using software such as Skype, Zoom and FaceTime can improve socialisation among older people and family, however it is unknown if video calls are able to improve socialisation among older people and their peers. Twenty-two residents across three British care homes engaged with each other using ‘Skype quiz’ sessions with the support of staff once a month over an eight-month trial. Video calls were accessed via a ‘Skype on Wheels’ intervention that comprised a wheeled device that could hold an iPad, or through Skype TV. Residents met other residents from the three care homes to build new friendships and participate in a thirty-minute quiz session facilitated by eight staff. Staff were collaborators who recruited older people, implemented the intervention and provided feedback that was analysed using thematic analysis. Residents enjoyed being able to see other residents’ faces and surroundings. Analysis of the field notes revealed five themes of: residents with dementia remember faces not technology, inter and intra connectedness, re-gaining sense of self and purpose, situational loneliness overcome and organisational issues create barriers to long-term implementation. Inter-care home connection through video calls to reduce feelings of loneliness in residents seems acceptable and a feasible, low cost model, especially during times of public crisis such as COVID-19

Video-calls to reduce loneliness and social isolation within care environments for older people: an implementation study using collaborative action research

ZAMIR Sonam, et al

Background: Older people in care may be lonely with insufficient contact if families are unable to visit. Face-to-face contact through video-calls may help reduce loneliness, but little is known about the processes of engaging people in care environments in using video-calls. This study aimed to identify the barriers to and facilitators of implementing video-calls for older people in care environments. Methods: A collaborative action research (CAR) approach was taken to implement a video-call intervention in care environments. The researchers undertook five steps of recruitment, planning, implementation, reflection and re-evaluation, in seven care homes and one hospital in the UK. The video-call intervention ‘Skype on Wheels’ (SoW) comprised a wheeled device that could hold an iPad and handset, and used Skype to provide a free video-call service. Care staff were collaborators who implemented the intervention within the care-setting by agreeing the intervention, recruiting older people and their family, and setting up video-calls. Field notes and reflective diaries on observations and conversations with staff, older people and family were maintained over 15 months, and analysed using thematic analysis. Results: Four care homes implemented the intervention. Eight older people with their respective social contacts made use of video-calls. Older people were able to use SoW with assistance from staff, and enjoyed the use of video-calls to stay better connected with family. However five barriers towards implementation included staff turnover, risk averseness, the SoW design, lack of family commitment and staff attitudes regarding technology. Conclusions: The SoW intervention, or something similar, could aid older people to stay better connected with their families in care environments, but if implemented as part of a rigorous evaluation, then co-production of the intervention at each recruitment site may be needed to overcome barriers and maximise engagement.

Effect of layperson-delivered, empathy-focused program of telephone calls on loneliness, depression, and anxiety among adults during the COVID-19 Pandemic: a randomized clinical trial

KAHLON Maninder K., et al

Importance Loneliness is a risk factor for many clinical conditions, but there are few effective interventions deployable at scale. Objective To determine whether a layperson-delivered, empathy-focused program of telephone calls could rapidly improve loneliness, depression, and anxiety in at-risk adults. Design, Setting, and Participants From July 6 to September 24, 2020, were recruited and followed up 240 adults who were assigned to receive calls (intervention group) or no calls (control group) via block randomization. Loneliness, depression, and anxiety were measured using validated scales at enrollment and after 4 weeks. Intention-to-treat analyses were conducted. Meals on Wheels Central Texas (MOWCTX) clients received calls in their homes or wherever they might have been when the call was received. The study included MOWCTX clients who fit their service criteria, including being homebound and expressing a need for food. A total of 296 participants were screened, of whom 240 were randomized to intervention or control. Interventions Sixteen callers, aged 17 to 23 years, were briefly trained in empathetic conversational techniques. Each called 6 to 9 participants over 4 weeks daily for the first 5 days, after which clients could choose to drop down to fewer calls but no less than 2 calls a week. Main Outcomes and Measures Primary outcome was loneliness (3-item UCLA Loneliness Scale, range 3-9; and 6-item De Jong Giervald Loneliness [De Jong] Scale, range 0-6). Secondary outcomes were depression (Personal Health Questionnaire for Depression), anxiety (Generalized Anxiety Disorder scale), and self-rated health (Short Form Health Survey Questionnaire). Results The 240 participants were aged 27 to 101 years, with 63% aged at least 65 years (n = 149 of 232), 56% living alone (n = 135 of 240), 79% women (n = 190 of 240), 39% Black or African American (n = 94 of 240), and 22% Hispanic or Latino (n = 52 of 240), and all reported at least 1 chronic condition. Of 240 participants enrolled, 13 were lost to follow-up in the intervention arm and 1 in the control arm. Postassessment differences between intervention and control after 4 weeks showed an improvement of 1.1 on the UCLA Loneliness Scale (95% CI, 0.5-1.7; P < .001; Cohen d of 0.48), and improvement of 0.32 on De Jong (95% CI, −0.20 to 0.81; P = .06; Cohen d, 0.17) for loneliness; an improvement of 1.5 on the Personal Health Questionnaire for Depression (95% CI, 0.22-2.7; P < .001; Cohen d, 0.31) for depression; and an improvement of 1.8 on the Generalized Anxiety Disorder scale (95% CI, 0.44 to 3.2; P < .001; Cohen d, 0.35) for anxiety. General physical health on the Short Form Health Questionnaire Survey showed no change, but mental health improved by 2.6 (95% CI, 0.81 to 4.4; P = .003; Cohen d of 0.46). Conclusions and Relevance A layperson-delivered, empathy-oriented telephone call program reduced loneliness, depression, and anxiety compared with the control group and improved the general mental health of participants within 4 weeks. Future research can determine whether effects on depression and anxiety can be extended to maximize clinical relevance.

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?

BOULTON Elisabeth, et al

[version 1; peer review: 2 approved with reservations] 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: This study 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: This study 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, this study 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.

Delivering prevention in an ageing world: inspiring and engaging people with prevention: consultation paper


As part of the ‘Delivering prevention in an ageing world’ programme, this consultation paper collates insights on what works in inspiring and engaging policy makers with the prevention agenda; healthcare professionals with promoting preventative services and activities; and individuals with uptake of preventative services and activities. The paper argues that to inspire and engage with policymakers we must: make prevention visible by celebrating our collective achievements and demonstrating the very real impact of prevention; build a coalition of the willing – a group of stakeholders who are strong advocates for investing in prevention and who can help to create clear, consistent messaging to influence governments, including health and finance ministers; use quick wins and engage local policymakers to encourage reluctant governments to invest, to help create space for, and greater acceptance of, longer-term preventative healthcare investments. To inspire and engage with healthcare professionals we must: close the gap between public health and primary healthcare to tackle some of the biggest health concerns countries face; support and maximise the role of allied healthcare professions by demonstrating to policymakers the vital role they play, and can play, in delivering prevention; share patient data to facilitate better coordinated care so that healthcare professionals can provide the best preventative healthcare to their patients. To inspire and engage with individuals we need to: change the messenger for preventative healthcare messages, using trusted sources that won’t discourage marginalised groups from seeking preventative treatment; ensure that all healthcare professionals promote prevention, from first point of contact to last, to help instil a culture of prevention throughout people’s lives; use behavioural economics to improve uptake of preventative healthcare and help individuals overcome their cognitive bias.

Occupational therapy interventions to support aging in place: a rapid systematic review

BROWN Tori, et al

(Occupational Therapy Doctoral Student Rapid Systematic Review) This rapid systematic review discusses the evidence of 30 studies for the effectiveness of occupational therapy (OT) in supporting aging in place, or safely living in one’s home independently. Many older adults suffer from at least one disability, which can be a threat to both independence and safety. Further, falls and injuries raise healthcare costs, which can include nursing facility housing. The transition from living in one’s home to living in a long-term care facility dramatically impacts occupational participation and performance. Supporting aging in place increases safety, quality of life, and independence in one’s home environment. In order to support aging in place, this study looked at the effectiveness of multiple occupational therapy interventions that targeted occupational performance and participation, quality of life, falls and hospital readmissions, and community mobility. Overall, this study found strong evidence to support the effectiveness of these client centred occupational therapy interventions for improving aging in place in community dwelling older adults and preventing negative health outcomes.

The effectiveness of e-interventions in preventing falls in community-dwelling older adults: a systematic review and meta-analysis

YEUNG Janice Chan Kuang

This is a Doctoral dissertation. Background: Falls in older adults can have serious, life-limiting consequences. An increasing number of fall prevention interventions are making use of technology to reduce the number of falls in community-dwelling adults. Various types of e-interventions are being tested in clinical trials and in the community. These include telehealth, exergames, cognitive games, socialized training, smart home systems and non-conventional balance training. Currently, no systematic review and meta-analysis has assessed the overall effectiveness of e-interventions and compared the effectiveness of the different types. Objectives: The aim of this review was to evaluate the effectiveness of e-interventions on prevention of falls for community-dwelling older adults. Methods: A rigorous three-step search was conducted in nine online databases for published and unpublished randomized controlled trials studying e-interventions. Studies were screened and assessed for individual and overall risk of bias by two independent reviewers. Six fall-related outcomes were evaluated in the meta-analysis: fall risk, balance, lower extremity strength, fall efficacy, cognitive function and health-related quality of life. Subgroup and sensitivity analysis were conducted during meta-analysis. Results: Thirty-one studies fit the eligibility criteria and had an overall 74.7% low risk of bias. A total of 4877 older adults from 17 countries were included in narrative synthesis and meta-analysis. Telehealth combined with exercise programmes and smart home systems were able to reduce fall risk significantly (risk ratio=0.79, 95% CI [0.72, 0.86]) . E-interventions also significantly improved balance and fall efficacy (standardized mean difference=0.28, 95% CI [0.04, 0.53]). Lower extremity strength, cognitive function and health-related quality of life did not show significant improvements. Conclusion: Telehealth combined with exercise and smart home systems demonstrated the best evidence of effectiveness in reduction of falls in community-dwelling older adults. However, limited studies and small sample sizes affected power analysis. Future research should focus on testing promising e-interventions on larger samples to improve the strength of evidence of fall prevention by e-interventions.

Timebanking and the co‐production of preventive social care with adults; what can we learn from the challenges of implementing person‐to‐person timebanks in England?

NAUGHTON‐DOE Ruth, et al

This paper explores the potential contribution of timebanking, an innovative volunteering scheme, to the co‐production of preventive social care with adults in England. Interest in volunteering in social care has increased as one proposed solution to the international crisis of a rising demand for services in juxtaposition with decreased resources. Volunteering has been particularly promoted in preventive services that prevent or delay care needs arising. Despite sustained interest in volunteering and co‐production in social care, little is known about how theory translates into practice. Reporting implementation data from a Realistic Evaluation of six case studies in England, this paper explores one volunteering scheme, timebanking. The research explores how timebanks were working, what contribution they can make to adult social care, and whether they are an example of co‐production. Data collected included interviews, focus groups or open question responses on surveys from 84 timebank members, and semi‐structured interviews with 13 timebank staff. Each timebank was visited at least twice, and all timebank activity was analysed for a period of 12 months. Data were triangulated to improve reliability. The research found that in practice, timebanks were not working as described in theory, there were small numbers of person‐to‐person exchanges and some timebanks had abandoned this exchange model. Timebanks faced significant implementation challenges including managing risk and safeguarding and the associated bureaucracy, a paternalistic professional culture and the complexity of the timebank mechanism which required adequate resources. Lessons for timebanks are identified, as well as transferable lessons about co‐production and volunteering in social care if such schemes are to be successful in the future.

Interventions to reduce social isolation and loneliness during COVID-19 physical distancing measures: a rapid systematic review


Background: A significant proportion of the worldwide population is at risk of social isolation and loneliness as a result of the COVID-19 pandemic. This study aimed to identify effective interventions to reduce social isolation and loneliness that are compatible with COVID-19 shielding and social distancing measures. Methods and findings: this rapid systematic review, 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. This review 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 the 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. Conclusions: Many 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.

Intergenerational programmes bringing together community dwelling non-familial older adults and children: a systematic review

PETERS Ruth, et al

Background: Social isolation is associated with an increased risk of adverse health outcomes, including functional decline, cognitive decline, and dementia. Intergenerational engagement, i.e. structured or semi structured interactions between non-familial older adults and younger generations is emerging as tool to reduce social isolation in older adults and to benefit children and adults alike. This has great potential for our communities, however, the strength and breadth of the evidence for this is unclear. The researchers undertook a systematic review to summarise the existing evidence for intergenerational interventions with community dwelling non-familial older adults and children, to identify the gaps and to make recommendations for the next steps. Methods: Medline, Embase and PsychInfo were searched from inception to the 28th Sept 2020. Articles were included if they reported research studies evaluating the use of non-familial intergenerational interaction in community dwelling older adults. PROSPERO registration number CRD42020175927 Results: Twenty articles reporting on 16 studies were included. Although all studies reported positive effects in general, numerical outcomes were not recorded in some cases, and outcomes and assessment tools varied and were administered un-blinded. Caution is needed when making interpretations about the efficacy of intergenerational programmes for improving social, health and cognitive outcomes. Discussion: Overall, there is neither strong evidence for nor against community based intergenerational interventions. The increase in popularity of intergenerational programmes alongside the strong perception of potential benefit underscores the urgent need for evidence-based research.

Results 11 - 20 of 752


Prevention in social care

Prevention in social care What it means, the policy context, role for commissioners and practitioners and the evidence base.

H4All wellbeing service

H4All wellbeing service Practice example about how H4All Wellbeing Service is using the Patient Activation Measure (PAM) tool

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia


KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families
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