Efficacy of the I-SOCIAL intervention for loneliness in old age: Lessons from a randomized controlled trial

Cohen‐Mansfield, Jiska; Hazan, Haim; Lerman, Yaffa; Shalom, Vera; Birkenfeld, Shlomo; Cohen, Rinat

doi:10.1016/j.jpsychires.2018.01.014

Cited by 40 publications

(38 citation statements)

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“…The extent to and the conditions under which web-based activities can prevent loneliness should be explored in future research. However, the lack of social interaction in web-based activities is not unlike that at senior centers, which provide live lectures, concerts, or exercise classes; many participants arrive to these activities alone and leave without having had significant social interaction [45]. Strategies to promote social interaction both on the web and in person should be examined in future research.…”

Section: Principal Findingsmentioning

confidence: 99%

Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study (Preprint)

Cohen‐Mansfield¹,

Muff²,

Meschiany³

et al. 2020

Preprint

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BACKGROUND Background: Group activities are a strategy to address social isolation and loneliness among older adults. Due to the Covid-19 pandemic most of these activities had to be cancelled and online activities have been offered as an alternative by some organizations. Yet, the effectiveness of online group activities for older adults has scarcely been researched. OBJECTIVE We aimed to understand the extent to which online activities for older adults provide an adequate substitute for in-person activities. METHODS In this telephone survey, we interviewed 105 older adults in Israel who were offered the opportunity to participate in online activities after routine activities closed due to Covid-19. We inquired about background characteristics, satisfaction with activities, and reasons for participation or nonparticipation in the activities. RESULTS Those who participated in the online activities tended to be highly satisfied with at least some of them. They rated enjoyment from the content of the activity as the most important motivator, followed by maintaining a routine, enjoying the activity, and the presence of others. Over 50% wished to continue with the exercise program after the end of the Covid-19 pandemic, and 40% with online lectures. The most common reasons cited by those who did not participate were not being aware of the online program (43%), lack of interest in the content (32%), and technical issues (23%), such as not owning or being able to fully utilize a computer. Both participants and nonparticipants were interested in a wide range of topics, with many being very particular about the topics they wished to access, and about half expressing willingness to pay for access. CONCLUSIONS Findings suggest a need for online activities for countering boredom and a sense of isolation. The main challenges in substituting in-person services are: promoting social relationships, which are currently not incorporated into most online programs, accommodating a wider range of topics, and making current programs accessible to the population who needs them. Such approaches are needed to help homebound older persons during and after the Covid-19 pandemic.

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Section: Principal Findingsmentioning

confidence: 99%

Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study (Preprint)

Cohen‐Mansfield¹,

Muff²,

Meschiany³

et al. 2020

Preprint

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“…This evaluation supports other studies that have utilized individualized interventions that are tailored to individual barriers and needs, working to identify goals, beginning on a one-to-one basis, with the aim of integrating into a wider social setting. [24][25][26] One of the key mechanisms of success in the Upstream intervention 25 was social re-integration of people via enjoyable and appropriate activities that maximized opportunities for social interaction. Another similar intervention, i-SOCiAL, had difficulty finding suitable groups within the local community, 24 which highlights the need for local resources that are available, suitable and accessible in maximizing lasting social opportunities for older people.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26] One of the key mechanisms of success in the Upstream intervention 25 was social re-integration of people via enjoyable and appropriate activities that maximized opportunities for social interaction. Another similar intervention, i-SOCiAL, had difficulty finding suitable groups within the local community, 24 which highlights the need for local resources that are available, suitable and accessible in maximizing lasting social opportunities for older people. The qualitative data from Cadwyn Môn indicates that the volunteers harnessed clients' confidence and opportunities to visit local clubs.…”

Section: Discussionmentioning

confidence: 99%

“…A clinical cut-off point of <12 is considered at risk of extreme social isolation. well-being was assessed with the Satisfaction with Life Scale (SwLS), 29 which asks five questions designed to measure global cognitive judgements of satisfaction with one's life, providing a maximum total score of 35 that falls into six categories of satisfaction (very high (30)(31)(32)(33)(34)(35), High (25)(26)(27)(28)(29), Average (20)(21)(22)(23)(24), Below average (15)(16)(17)(18)(19), Dissatisfied (10-14) and extremely dissatisfied (5)(6)(7)(8)(9)). The data were coded in accordance with the guidelines of the measures used.…”

Section: Methodsmentioning

confidence: 99%

“…For example, the i-SOCiAL intervention showed lasting reductions in loneliness in the intervention group in a randomized controlled trial. 24 The Upstream service for socially isolated older people elicited initial quantitative and qualitative improvements in mental well-being and depression, with improvements in perceived social support emerging at 12-month follow-up. 25 Following on from the Upstream study, the Community Mentoring randomized controlled trial explored the model further, yielding no significant effects on standardized measures, 26 highlighting the need for further research of this type of intervention.…”

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confidence: 99%

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Evaluation of an intervention targeting loneliness and isolation for older people in North Wales

Roberts

Windle

2019

Perspect Public Health

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Aims: Age Cymru Gwynedd and Môn provided a service, Cadwyn Môn, which aimed to reduce loneliness and isolation of older people living on Anglesey, North Wales. It involved working with individuals to identify goals, beginning on a one-to-one basis, with the aim of integrating into a wider social setting. The aim of this study was evaluate the impact of Cadwyn Môn on those who received the service. Methods: The evaluation adopted a mixed-methods design. Standardized measures of loneliness, social isolation and well-being were obtained at baseline and follow-up time points, and a qualitative element explored client experiences further. Results: Improvements were observed in all standardized measures. Qualitative interviews also revealed important psychological and lifestyle changes. Conclusions: Given the anticipated rise in loneliness and social isolation alongside an ageing population, this evaluation contributes to understanding the qualities required for interventions to be effective. The findings provide support for the importance of developing individualized interventions that aim to gradually re-integrate people into their communities.

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Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults

et al. 2022

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ImportanceLoneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality.ObjectiveTo evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation.Data SourcesOVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020.Study SelectionPeer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included.Data Extraction and SynthesisTwo independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022.Main Outcomes and MeasuresQuantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences.ResultsSeventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants’ ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (−1.86; 95% CI, −3.14 to −0.59; I2 = 86%) followed by technological interventions (videoconferencing) in long-term care (−1.40; 95% CI, −2.37 to −0.44; I2 = 70%).Conclusions and RelevanceIn this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size’s magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.

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Efficacy of the I-SOCIAL intervention for loneliness in old age: Lessons from a randomized controlled trial

Cited by 40 publications

References 30 publications

Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study (Preprint)

Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study (Preprint)

Evaluation of an intervention targeting loneliness and isolation for older people in North Wales

Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults

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