Effectiveness of a community intervention to reduce social isolation among older people in low-income neighbourhoods

C Lapena, X Continente, A Sánchez Mascuñano, M Mari dell'Olmo, M J López, C Lapena, X Continente, A Sánchez Mascuñano, M Mari dell'Olmo, M J López

Abstract

Background: Social and demographic trends show a global increase of proportion of older people at risk of social isolation. This study aimed to evaluate the effectiveness of an intervention conducted in low-income neighbourhoods to reduce social isolation and its negative effects on health in older persons.

Methods: A quasi-experimental study with a comparison group was performed. The 'School of Health for Older People' is a weekly community intervention that promotes resources among individuals and communities to enhance their ability to identify problems and activate solutions, encouraging community participation. Data were collected at the beginning and at the end of the intervention. Social support, psychological morbidity and health-related quality of life were measured through questionnaires information on visits to the primary care centre was obtained from the electronic medical records of primary care centres. Multivariate regression models were conducted to assess changes after the intervention.

Results: A total of 135 participants were included in the study. The intervention helped to improve participants' mental health (aPR = 0.46; 95% CI: 0.23-0.90) comparing with the comparison group. Also, the intervention helped to maintain quality of life and social support, which were worsened or maintained respectively in the case of comparison group.

Conclusions: Our results provide evidence on how a community intervention can improve quality of life, mental health and social support in older people. The evidence can help to fill the knowledge gap in this area and might be especially useful for the design of social and public health policies and programmes for older people in disadvantaged neighbourhoods in urban areas.

Trial registration: NCT03142048.

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.

References

    1. Luo Y, Hawkley LC, Waite LJ, et al. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med 2012;74:907–14.
    1. Enquesta de salut de Barcelona. Agència de Salut Pública de Barcelona. Available at: (July 2020, date last accessed).
    1. Idescat. Projeccions de poblacions. 2014. Available at: (July 2020, date last accessed).
    1. Goll JC, Charlesworth G, Scior K, et al. Barriers to social participation among lonely older adults: the influence of social fears and identity. PLoS One 2015;10:e0116664. Available at: .
    1. Weiss RS. Loneliness: The Experience of Emotional and Social Isolation, Vol. XXII. Cambridge, MA, USA: The MIT Press, 1973: 236.
    1. Gardiner C, Geldenhuys G, Gott M. Interventions to reduce social isolation and loneliness among older people: an integrative review. Health Soc Care Community 2018;26:147–57.
    1. Cacioppo JT, Cacioppo S. Social relationships and health: the toxic effects of perceived social isolation. Soc Personal Psychol Compass 2014;8:58–72.
    1. Steptoe A, Shankar A, Demakakos P, et al. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci USA 2013;110:5797–801.
    1. Gierveld J, Tilburg T, Dykstra P. New ways of theorizing and conducting research in the field of loneliness and social isolation. In: Vangelisti A, Perlman D, editors. The Cambridge Handbook of Personal Relationships (Cambridge Handbooks in Psychology). Cambridge: Cambridge University Press, 2018: 391–404. doi:10.1017/9781316417867.031, , , Oxford University Press
    1. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med 2010;7:e1000316.
    1. Cohen-Mansfield J, Hazan H, Lerman Y, et al. Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights. Int Psychogeriatr 2016;28:557–76.
    1. Hawton A, Green C, Dickens AP, et al. The impact of social isolation on the health status and health-related quality of life of older people. Qual Life Res 2011;20:57–67.
    1. Rico-Uribe LA, Caballero FF, Olaya B, et al. Loneliness, social networks, and health: a cross-sectional study in three countries. PLoS One 2016;11:e0145264.
    1. Dickens AP, Richards SH, Greaves CJ, et al. Interventions targeting social isolation in older people: a systematic review. BMC Public Health 2011;11:647.
    1. Windle. SCIE Research Briefing 39: Preventing Loneliness and Social Isolation: Interventions and Outcomes. 2011. Available at: (July 2020, date last accessed).
    1. Cattan M, White M, Bond J, et al. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing Soc 2005;25:41–67.
    1. Findlay. Interventions to Reduce Social Isolation Amongst Older People: Where Is The Evidence? 2003. Available at: (May 2016, date last accessed).
    1. Gandy R, Bell A, McClelland B, Roe B. Evaluating the delivery, impact, costs and benefits of an active lives programme for older people living in the community. Prim Health Care Res Dev 2017;18:122–34.
    1. Coll-Planas L, Nyqvist F, Puig T, et al. Social capital interventions targeting older people and their impact on health: a systematic review. J Epidemiol Community Health 2017;71:663–72.
    1. Chatterjee HJ, Camic PM, Lockyer B, Thomson LJM. Non-clinical community interventions: a systematised review of social prescribing schemes. Arts Health 2018;10:97–123.
    1. Masi CM, Chen H-Y, Hawkley LC, Cacioppo JT. A meta-analysis of interventions to reduce loneliness. Pers Soc Psychol Rev 2011;15:219–66.
    1. Valtorta N, Hanratty B. Loneliness, isolation and the health of older adults: do we need a new research agenda? J R Soc Med 2012;105:518–22.
    1. Landeiro F, Barrows P, Nuttall Musson E, et al. Reducing social isolation and loneliness in older people: a systematic review protocol. BMJ Open 2017;7:e013778.
    1. OHTAC Public Engagement Subcommittee. Public Engagement for Health Technology Assessment at Health Quality Ontario—Final Report from the Ontario Health Technology Advisory Committee Public Engagement Subcommittee. Toronto: Queen’s Printer for Ontario, 2015: 57. Available at: .
    1. Colell E, Sánchez-Ledesma E, Novoa AM, et al. Community health assessment of the programme "Barcelona Health in the Neighbourhoods". Methodology for a participatory process. Gac Sanit 2018;32:396–9.
    1. López MJ, Lapena C, Sánchez A, et al.; Evaluation Group of the “Schools of Health for older people”. Community intervention to reduce social isolation in older adults in disadvantaged urban areas: study protocol for a mixed methods multi-approach evaluation. BMC Geriatr 2019;19:44.
    1. Herdman M, Badia X, Berra S. El EuroQol-5D: una alternativa sencilla para la medición de la calidad de vida relacionada con la salud en atención primaria. Aten Primaria 2001;28:425–30.
    1. Goldberg DP, Oldehinkel T, Ormel J. Why GHQ threshold varies from one place to another. Psychol Med 1998;28:915–21.
    1. Rocha KB, Pérez K, Rodríguez-Sanz M, et al. Propiedades psicométricas y valores normativos del General Health Questionnaire (GHQ-12) en población general española. Int J Clin Health Psychol 2011;11:125–39.
    1. Revilla Ahumada L, Luna del Castillo J, Bailón Muñoz E, et al. Validación del cuestionario MOS de apoyo social en Atención Primaria. Medicina de Familia (And) 2005;1:10–8.
    1. Cornwell EY, Waite LJ. Measuring social isolation among older adults using multiple indicators from the NSHAP study. J Gerontol B Psychol Sci Soc Sci 2009;64B:i38–46.
    1. Liu N, Zeng L, Li Z, et al. Health-related quality of life and long-term care needs among elderly individuals living alone: a cross-sectional study in rural areas of Shaanxi Province, China. BMC Public Health 2013;13:313.
    1. Coll-Planas L, Del Valle Gómez G, Bonilla P, et al. Promoting social capital to alleviate loneliness and improve health among older people in Spain. Health Soc Care Community 2017;25:145–57.
    1. De Smedt D, Clays E, Annemans L, De Bacquer D. EQ-5D versus SF-12 in coronary patients: are they interchangeable? Value Health 2014;17:84–9.
    1. Ye Z, Sun L, Wang Q. A head-to-head comparison of EQ-5D-5 L and SF-6D in Chinese patients with low back pain. Health Qual Life Outcomes 2019;17:57.
    1. Ige J, Gibbons L, Bray I, Gray S. Methods of identifying and recruiting older people at risk of social isolation and loneliness: a mixed methods review. BMC Med Res Methodol 2019;19:181.
    1. Lapena C, Continente X, Sánchez Mascuñano A, et al. Qualitative evaluation of a community-based intervention to reduce social isolation among older people in disadvantaged urban areas of Barcelona. Health Soc Care Community 2020;28:1488–503.

Source: PubMed

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