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Results for 'intervention'

Results 21 - 30 of 106

Interventions to reduce social isolation and loneliness among older people: an integrative review

GARDINER Clare, GELDENHUYS Gideon, GOTT Merryn
2018

Loneliness and social isolation are major problems for older adults. Interventions and activities aimed at reducing social isolation and loneliness are widely advocated as a solution to this growing problem. The aim of this study was to conduct an integrative review to identify the range and scope of interventions that target social isolation and loneliness among older people, to gain insight into why interventions are successful and to determine the effectiveness of those interventions. Six electronic databases were searched from 2003 until January 2016 for literature relating to interventions with a primary or secondary outcome of reducing or preventing social isolation and/or loneliness among older people. Data evaluation followed Evidence for Policy and Practice Information and Co‐ordinating Centre guidelines and data analysis was conducted using a descriptive thematic method for synthesising data. The review identified 38 studies. A range of interventions were described which relied on differing mechanisms for reducing social isolation and loneliness. The majority of interventions reported some success in reducing social isolation and loneliness, but the quality of evidence was generally weak. Factors which were associated with the most effective interventions included adaptability, a community development approach, and productive engagement. A wide range of interventions have been developed to tackle social isolation and loneliness among older people. However, the quality of the evidence base is weak and further research is required to provide more robust data on the effectiveness of interventions. Furthermore, there is an urgent need to further develop theoretical understandings of how successful interventions mediate social isolation and loneliness.

Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial

COULTON Simon, et al
2015

Aims: This study aimed to evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method: A pilot pragmatic individual randomised controlled trial comparing group singing with usual activities in those aged 60 years or more. Results: A total of 258 participants were recruited across five centres in East Kent. At 6 months post-randomisation, significant differences were observed in terms of mental health-related quality of life measured using the SF12 in favour of group singing. In addition, the intervention was found to be marginally more cost-effective than usual activities. At 3 months, significant differences were observed for the mental health components of quality of life, anxiety and depression. Conclusions: Community group singing appears to have a significant effect on mental health-related quality of life, anxiety and depression, and it may be a useful intervention to maintain and enhance the mental health of older people.

A review of the basic principles of sustainable community-based volunteering approaches to tackling loneliness and social isolation among older people

PARKINSON Andy, GRIFFITHS Endaf, TRIER Eva
2018

This study examines the social, economic and environmental conditions that enable community-based volunteering projects to reduce loneliness and isolation in older people to become successful. It also identifies barriers to volunteering approaches, and how they can be tackled. The study involved a literature review, consultation with stakeholders, and an analysis of eight case studies in Wales. Drawing on the findings, it also sets out a Theory of Change to show how programmes have the potential to reduce loneliness and social isolation and provides a framework for the future self-evaluation of programmes. The study found that schemes employ a range of approaches in order to engage and support their clients, including in-home visits, telephone befriending, and group activities. This can be influenced by funding or its ability to support the project’s aims and outcomes. Other key findings highlight the need for schemes to be able to accurately assess the social and emotional status of older people so as to deliver appropriate interventions; for schemes to target effectively to reach those most at risk. It also found that schemes adopting a participatory approach which places local people at the heart and schemes which focused on smaller geographical areas tended to be more effective. The report makes eight recommendations, which include the development of a standard method or tools for monitoring and evaluating volunteer-led schemes.

Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review

FRANCIS-COAD Jacqueline, et al
2018

Objective: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Introduction: Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. Inclusion criteria: The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). Methods: A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Results: Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29; 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76; 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26; 95% CI [−3.72, −0.80]). Conclusions: Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.

Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis

KELLY Sarah, et al
2018

Background: harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified. Methods: two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA. Results: thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) −0.18 (95% CI −0.28, −0.07) and 12 months (6 studies; 2,788 participants SMD −0.16 (95% CI −0.32, −0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect. Conclusions: alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes.

The association between physical activity and social isolation in community-dwelling older adults

ROBINS Lauren M., et al
2018

Objectives: Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Methods: Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Results: Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01–1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R2 = 0.104). Discussion: Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Preventative support for adult carers in Wales: rapid review

SOCIAL CARE INSTITUTE FOR EXCELLENCE
2018

This rapid review, commissioned by Social Care Wales, draws on research published since 2012 to identify emerging and promising practice in adult carers support. It focuses on support that takes a preventative approach by providing information and support to reduce or prevent the likelihood of carer crisis and breakdown, and improve the overall quality of carers’ lives. The review identifies key characteristics of effective preventative support services. It presents the review findings across the following key themes: identification and recognition of carers; the provision of information, advice and assistance; and supporting carers for a life outside of their caring role, through services such as respite and short breaks, emotional and employment support. Examples of services and interventions from Wales and England are included throughout. The final section looks at the available evidence on evaluating what works for carers.

What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England

KHARICHA Kalpa, et al
2017

Twenty-eight community dwelling people, aged 65 and over who reported being ‘lonely much of the time’ or identified as lonely from the de Jong Gierveld six-item loneliness scale in a larger study, participated in in-depth interviews, between June 2013 and May 2014. Views and experiences on seeking support from primary care and community based one-to-one and group based activities, including social and shared interest groups, were explored. Interviews were recorded and transcribed. Thematic analysis was conducted by a multidisciplinary team, including older people. Using two different measures of loneliness enabled a spectrum of loneliness experience to be explored. Two-thirds of the participants were the ‘younger old’ and all were able to leave their homes independently. Older people with characteristics of loneliness were generally knowledgeable about local social and community resources but, for the majority, community and primary care based services for their loneliness were not considered desirable or helpful at this point in their lives. However, group based activities with a shared interest were thought preferable to one-to-one support (befriending) or groups with a social focus. Descriptions of support as being for loneliness and specific to older people discouraged engagement. Older people experiencing or at risk of loneliness did not consider that primary care has a role in alleviating loneliness because it is not an illness. They thought primary care practitioners lack understanding of non-physical problems and that a good relationship was necessary to discuss sensitive issues like loneliness. For many, loneliness was a complex and private matter that they wished to manage without external support.

Gig buddies: project report: January 2013 - December 2014

STAY UP LATE
2015

This evaluation report looks at how the Gig Buddies scheme has developed, the lessons learned, and the way support is offered to people to be less socially isolated while new types of volunteers are created in the process. Gig Buddies is a project that pairs up people with and without learning disabilities in Sussex to be friends and to go to events together. This report also looks at the plans to replicate Gig Buddies as a social franchise (‘Gig Buddies in a box’) by sharing experience and creating a model that enables replication, whilst also protecting the integrity of the project. The report argues that the pilot project demonstrates that Gig Buddies has the potential to transform communities, enabling many more people with learning disabilities and autism to be less socially isolated and unleashing the capacity of communities to become more involved in voluntary work.

Evaluation of a web-based app to assist home-hazard modification in falls prevention

WARD Gillian, WALKER-CLARKE Aimee, HOLLIDAY Nikki
2017

Introduction: Given the impact falls can have on older people and their families, many health and social care services are focused on preventing falls and implementing interventions to reduce future falls. FallCheck is a web app that supports identification of home-hazards and directs users towards self-management strategies to reduce risk of falling. Method: A survey by clinical experts of a beta version of FallCheck was conducted, producing quantitative and qualitative data including issues and attributes identified by respondents. Thirty-six individuals signed up to take part in the study, and 27 respondents took part in the final evaluation survey. Findings: Testing by health and social care professionals found there is scope for using the app as a digital self-assessment tool by people at risk of falls. It has further potential as an effective tool to support environmental/behavioural change to reduce risk of falls. Conclusion: FallCheck was developed from a sound evidence-base to support home-hazard modification as an effective intervention component within a multifactorial intervention to prevent falls. Health and social care professionals found it had good acceptability for use in practice, justifying further testing of the usability and effectiveness of the app in supporting behavioural changes and environmental modifications with people at risk of falling and carers.

Results 21 - 30 of 106

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