The helping older people engage (HOPE) study: Protocol & COVID modifications for a randomized trial

Kimberly A Van Orden, Yeates Conwell, Benjamin P Chapman, April Buttaccio, Alexandra VanBergen, Ellen Beckwith, Angela Santee, Jody Rowe, Deborah Palumbos, Geoffrey Williams, Susan Messing, Silvia Sörensen, Xin Tu, Kimberly A Van Orden, Yeates Conwell, Benjamin P Chapman, April Buttaccio, Alexandra VanBergen, Ellen Beckwith, Angela Santee, Jody Rowe, Deborah Palumbos, Geoffrey Williams, Susan Messing, Silvia Sörensen, Xin Tu

Abstract

Objectives: Evidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively few studies have used randomized controlled trials (RCTs) to examine benefits of volunteering, and none have examined loneliness. The primary objective of the Helping Older People Engage (HOPE) study is to examine the social-emotional benefits of a social volunteering program for lonely older adults. This manuscript describes the rationale and design of the trial.

Methods: We are randomly assigning adults aged 60 or older (up to 300) who report loneliness to 12 months of either AmeriCorps Seniors volunteering program or an active control (self-guided life review). Co-primary outcomes are assessed via self-report-loneliness (UCLA Loneliness Scale) and quality of life (WHOQOL-Bref). Enrollment was completed in May 2022 and follow-up assessments will continue through May 2023, with completion of primary outcomes soon thereafter.

Conclusions: Since older adults who report loneliness are less likely to actively seek out volunteering opportunities, if results support efficacy of volunteering for reducing loneliness, dissemination and scaling up efforts may involve connecting primary care patients who are lonely with AmeriCorps Seniors through aging services agencies.This RCT is registered at clinicaltrials.gov (NCT03343483).

Keywords: Aging; Loneliness; Older adult; Quality of life; Social connection; Volunteerism.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

© 2022 The Authors.

Figures

Fig. 1
Fig. 1
CONSORT diagram.

References

    1. Golden J., Conroy R.M., Bruce I., et al. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int. J. Geriatr. Psychiatr. 2009;24(7):694–700. doi: 10.1002/gps.2181.
    1. Luo Y., Hawkley L.C., Waite L.J., Cacioppo J.T. Loneliness, health, and mortality in old age: a national longitudinal study. Soc. Sci. Med. 2012;74(6):907–914. doi: 10.1016/j.socscimed.2011.11.0283303190.
    1. Hawkley L.C., Thisted R.A., Masi C.M., Cacioppo J.T. Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychol. Aging. 2010;25(1):132–141. doi: 10.1037/a0017805.2841310.
    1. Tomaka J., Thompson S., Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J. Aging Health. 2006;18(3):359–384. doi: 10.1177/0898264305280993. 18/3/359 [pii]
    1. Holt-Lunstad J., Smith T.B., Baker M., Harris T., Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect. Psychol. Sci. 2015;10(2):227–237. doi: 10.1177/1745691614568352.
    1. Steptoe A., Shankar A., Demakakos P., Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc. Natl. Acad. Sci. U. S. A. 2013;110(15):5797–5801. doi: 10.1073/pnas.12196861103625264.
    1. Perissinotto C.M., Stijacic Cenzer I., Covinsky K.E. Loneliness in older persons: a predictor of functional decline and death. Arch. Intern. Med. 2012:1–7. doi: 10.1001/archinternmed.2012.1993.
    1. Wenger G.C., Burholt V. Changes in levels of social isolation and loneliness among older people in a rural area: a twenty-year longitudinal study. Can. J. Aging. 2004;23(2):115–127.
    1. AARP . 2010. Loneliness Among Older Adults: A National Survey of Adults 45+
    1. Charles S.T. Strength and vulnerability integration: a model of emotional well-being across adulthood. Psychol. Bull. 2010;136(6):1068–1091. doi: 10.1037/a0021232.
    1. Baumeister R.F., Leary M.R. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol. Bull. 1995;117(3):497–529. doi: 10.1037/0033-2909.117.3.497.
    1. Cacioppo J.T., Cacioppo S., Boomsma D.I. Evolutionary mechanisms for loneliness. Cognit. Emot. 2014;28(1):3–21. doi: 10.1080/02699931.2013.837379PMC3855545.
    1. Cacioppo S., Grippo A.J., London S., Goossens L., Cacioppo J.T. Loneliness: clinical import and interventions. Perspect. Psychol. Sci. 2015;10(2):238–249. doi: 10.1177/1745691615570616PMC4391342.
    1. Cohen-Mansfield J., Hazan H., Lerman Y., Shalom V. Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights. Int. Psychogeriatr. 2015:1–20. doi: 10.1017/S1041610215001532.
    1. Hoogendijk E.O., Suanet B., Dent E., Deeg D.J., Aartsen M.J. Adverse effects of frailty on social functioning in older adults: results from the Longitudinal Aging Study Amsterdam. Maturitas. 2016;83:45–50. doi: 10.1016/j.maturitas.2015.09.002.
    1. Theeke L.A. Sociodemographic and health-related risks for loneliness and outcome differences by loneliness status in a sample of U.S. older adults. Res. Gerontol. Nurs. 2010;3(2):113–125. doi: 10.3928/19404921-20091103-99.
    1. Qualter P., Vanhalst J., Harris R., et al. Loneliness across the life span. Perspect. Psychol. Sci. 2015;10(2):250–264. doi: 10.1177/1745691615568999.
    1. Aartsen M., Jylha M. Onset of loneliness in older adults: results of a 28 year prospective study. Eur. J. Ageing. 2011;8(1):31–38. doi: 10.1007/s10433-011-0175-7PMC3047676.
    1. Masi C.M., Chen H.Y., Hawkley L.C., Cacioppo J.T. A meta-analysis of interventions to reduce loneliness. Pers. Soc. Psychol. Rev. 2011;15(3):219–266. doi: 10.1177/1088868310377394.
    1. Hickin N., Kall A., Shafran R., Sutcliffe S., Manzotti G., Langan D. The effectiveness of psychological interventions for loneliness: a systematic review and meta-analysis. Clin. Psychol. Rev. 2021;88 doi: 10.1016/j.cpr.2021.102066.
    1. Sabir M., Wethington E., Breckman R., Meador R., Reid M.C., Pillemer K. A community-based participatory critique of social isolation intervention research for community-dwelling older adults. J. Appl. Gerontol. 2009;28(2):218–234. doi: 10.1177/0733464808326004PMC4142440.
    1. Thomas P.A. Is it better to give or to receive? Social support and the well-being of older adults. J. Gerontol. B Psychol. Sci. Soc. Sci. 2010;65B(3):351–357. doi: 10.1093/geronb/gbp113.
    1. Hooyman N.R., Kawamoto K.Y., Kiyak H.A. Pearson; New York: 2015. Aging Matters: an Introduction to Social Gerontology.
    1. Klein Ikkink K., Tilburg Tv. Broken ties: reciprocity and other factors affecting the termination of older adults' relationships. Soc. Network. 1999;21(2):131–146. doi: 10.1016/S0378-8733(99)00005-2.
    1. Okun M.A., Yeung E.W., Brown S. Volunteering by older adults and risk of mortality: a meta-analysis. Psychol. Aging. 2013;28(2):564–577. doi: 10.1037/a0031519.
    1. Jenkinson C.E., Dickens A.P., Jones K., et al. Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Publ. Health. 2013;13:773. doi: 10.1186/1471-2458-13-7733766013.
    1. Anderson N.D., Damianakis T., Kroger E., et al. The benefits associated with volunteering among seniors: a critical review and recommendations for future research. Psychol. Bull. 2014 doi: 10.1037/a0037610.
    1. Fried L.P., Carlson M.C., Freedman M., et al. A social model for health promotion for an aging population: initial evidence on the Experience Corps model. J. Urban Health. 2004;81(1):64–78. doi: 10.1093/jurban/jth0943456134.
    1. Pilkington P.D., Windsor T.D., Crisp D.A. Volunteering and subjective well-being in midlife and older adults: the role of supportive social networks. J. Gerontol. B Psychol. Sci. Soc. Sci. 2012;67(2):249–260. doi: 10.1093/Geronb/Gbr154.
    1. Harris A.H., Thoresen C.E. Volunteering is associated with delayed mortality in older people: analysis of the longitudinal study of aging. J. Health Psychol. 2005;10(6):739–752. Published 2005/09/24.
    1. Morrow-Howell N., Hong S.-I., McCrary S., Blinne W. Changes in activity among older volunteers. Res. Aging. 2012;34(2) doi: 10.1177/0164027511419371.
    1. Morrow-Howell N., Kinnevy S., Mann M. The perceived benefits of participating in volunteer and educational activities. J. Gerontol. Soc. Work. 1999;32(2):65–80. doi: 10.1300/J083v32n02_06.
    1. Rook K.S., Sorkin D.H. Fostering social ties through a volunteer role: implications for older-adults' psychological health. Int. J. Aging Hum. Dev. 2003;57(4):313–337.
    1. Shmotkin D., Blumstein T., Modan B. Beyond keeping active: concomitants of being a volunteer in old-old age. Psychol. Aging. 2003;18(3):602–607. doi: 10.1037/0882-7974.18.3.602.
    1. Fried L.P., Carlson M.C., McGill S., et al. Experience Corps: a dual trial to promote the health of older adults and children's academic success. Contemp. Clin. Trials. 2013;36(1):1–13. doi: 10.1016/j.cct.2013.05.0034112377.
    1. Varma V.R., Tan E.J., Gross A.L., et al. Effect of community volunteering on physical activity: a randomized controlled trial. Am. J. Prev. Med. 2015 doi: 10.1016/j.amepre.2015.06.015.
    1. Carlson M.C., Kuo J.H., Chuang Y.F., et al. Impact of the baltimore experience corps trial on cortical and hippocampal volumes. Alzheimer's Dementia : the journal of the Alzheimer's Association. 2015 doi: 10.1016/j.jalz.2014.12.005.
    1. Morrow-Howell N., Hong S.I., McCrary S., Blinne W. Changes in activity among older volunteers. Res. Aging. 2012;34(2):174–196. doi: 10.1177/0164027511419371.
    1. Parisi J.M., Kuo J., Rebok G.W., et al. Increases in lifestyle activities as a result of experience Corps(R) participation. J. Urban Health : Bull. N. Y. Acad. Med. 2015;92(1):55–66. doi: 10.1007/s11524-014-9918-zPMC4338117.
    1. Jiang D., Warner L.M., Chong A.M., Li T., Wolff J.K., Chou K.L. Benefits of volunteering on psychological well-being in older adulthood: evidence from a randomized controlled trial. Aging Ment. Health. 2021;25(4):641–649. doi: 10.1080/13607863.2020.1711862.
    1. Onken L.S., Carroll K.M., Shoham V., Cuthbert B.N., Riddle M. Reenvisioning clinical science: unifying the discipline to improve the public health. Clin. Psychol. Sci. 2014;2(1):22–34. doi: 10.1177/2167702613497932PMC4374633.
    1. Institute of Medicine . National Academies Press; Washington, D.C.: 2011. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.
    1. Lyons A., Alba B., Waling A., et al. Volunteering among older lesbian and gay adults: associations with mental, physical and social well-being. J. Aging Health. 2021;33(1–2):3–13. doi: 10.1177/0898264320952910.
    1. Lamers S.M., Bohlmeijer E.T., Korte J., Westerhof G.J. The efficacy of life-review as online-guided self-help for adults: a randomized trial. J. Gerontol. B Psychol. Sci. Soc. Sci. 2015;70(1):24–34. doi: 10.1093/geronb/gbu030.
    1. Tang W., He H., Tu X.M. Chapman & Hall/CRC; New York: 2012. Applied Categorical and Count Data Analysis.
    1. Bollen K.A. John Wiley & Sons; Oxford, England: 1989. Structural Equations with Latent Variables. Wiley Series in Probability and Mathematical Statistics. Applied Probability and Statistics Section. Structural Equations with Latent Variables. Xiv; p. 514. England.
    1. Gunzler D., Tang W., Lu N., Wu P., Tu X.M. A class of distribution-free models for longitudinal mediation analysis. Psychometrika. 2014;79(4):543–568. doi: 10.1007/S11336-013-9355-Z.
    1. Olsson U.H., Foss T., Troye S.V., Howell R.D. The performance of ML, GLS, and WLS estimation in structural equation modeling under conditions of misspecification and nonnormality. Struct. Equ. Model. 2000;7(4):557–595. doi: 10.1207/S15328007sem0704_3.
    1. Jaccard J., Wan C.K. No. vols. 07–114. Sage Publications, Inc; US; Thousand Oaks, CA: 1996. LISREL Approaches to Interaction Effects in Multiple Regression. (Quantitative Applications in the Social Sciences).
    1. Kline R.B. Guilford; NY: 2004. Principles and Practice of Structural Equation Modeling.
    1. Shrier I., Steele R.J., Verhagen E., Herbert R., Riddell C.A., Kaufman J.S. Beyond intention to treat: what is the right question? Clin. Trials. 2014;11(1):28–37. doi: 10.1177/1740774513504151.
    1. Robins J.M. Correcting for noncompliance in randomized trials using structural nested mean models. Commun. Stat. 1994;23:2379–2412.
    1. Wu P., Gunzler D., Lu N., Chen T., Wymen P., Tu X.M. Causal inference for community-based multi-layered intervention study. Stat. Med. 2014;33(22):3905–3918. doi: 10.1002/sim.6199PMC4156555.
    1. Frangakis C.E., Rubin D.B. Principal stratification in causal inference. Biometrics. 2002;58(1):21–29. doi: 10.1111/j.0006-341X.2002.00021.x.
    1. Hm Government . 2019. A Connected Society: A Strategy for Tackling Loneliness. London, UK.
    1. Conwell Y. Suicide later in life: challenges and priorities for prevention. Am. J. Prev. Med. 2014;47(3S2):S244–S250. doi: 10.1016/j.amepre.2014.05.040.
    1. Hughes M.E., Waite L.J., Hawkley L.C., Cacioppo J.T. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res. Aging. 2004;26(6):655–672. doi: 10.1177/01640275042685742394670.
    1. Callahan C.M., Unverzagt F.W., Hui S.L., Perkins A.J., Hendrie H.C. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med. Care. 2002;40(9):771–781. doi: 10.1097/01.MLR.0000024610.33213.C8.
    1. Nasreddine Z.S., Phillips N.A., Bedirian V., et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J. Am. Geriatr. Soc. 2005;53(4):695–699. doi: 10.1111/j.1532-5415.2005.53221.x.
    1. Wittich W., Phillips N., Nasreddine Z.S., Chertkow H. Sensitivity and specificity of the montreal cognitive assessment modified for individuals who are visually impaired. J. Vis. Impair. Blind. (JVIB) 2010;104(6):360–368. doi: 10.1177/0145482X1010400606.
    1. Olson K., Smyth J.D., Wang Y., Pearson J.E. The self-assessed literacy index: reliability and validity. Soc. Sci. Res. 2011;40(5):1465–1476. doi: 10.1016/j.ssresearch.2011.05.002.
    1. Lubben J., Blozik E., Gillmann G., et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontol. 2006;46(4):503–513.
    1. Jackson S.D., Mohr J.J. Educational Publishing Foundation; 2016. Conceptualizing the Closet: Differentiating Stigma Concealment and Nondisclosure Processes; pp. 80–92.
    1. Russell D.W. UCLA loneliness scale (version 3): reliability, validity, and factor structure. J. Pers. Assess. 1996;66(1):20–40.
    1. Cacioppo J.T., Hawkley L.C., Thisted R.A. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychol. Aging. 2010;25(2):453–463. doi: 10.1037/a0017216.
    1. Skevington S.M., Lotfy M., O'Connell K.A., Group W. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual. Life Res. 2004;13(2):299–310. doi: 10.1023/B:QURE.0000018486.91360.00.
    1. World Health Organization Development of the world health organization WHOQOL-BREF quality of life assessment. The WHOQOL group. Psychol. Med. 1998;28(3):551–558.
    1. Hahn E.A., Devellis R.F., Bode R.K., et al. Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing. Qual. Life Res. 2010;19(7):1035–1044. doi: 10.1007/s11136-010-9654-0PMC3138729.
    1. Karayannis N.V., Baumann I., Sturgeon J.A., Melloh M., Mackey S.C. The impact of social isolation on pain interference: a longitudinal study. Ann. Behav. Med. 2019;53(1):65–74. doi: 10.1093/abm/kay017PMC6301311.
    1. Parkhurst K.A., Conwell Y., Van Orden K.A. The interpersonal needs questionnaire with a shortened response scale for oral administration with older adults. Aging Ment. Health. 2016;20(3):277–283. doi: 10.1080/13607863.2014.1003288PMC4520787.
    1. Ustun T.B., Chatterji S., Kostanjsek N., et al. Developing the world health organization disability assessment schedule 2.0. Bull. World Health Organ. 2010;88(11):815–823. doi: 10.2471/BLT.09.0672312971503.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren