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Background:
The proportion of elderly people has dramatically increased in recent decades. Moreover, social and demographic trends show a global increase of elderly people at risk of loneliness and lack of social relationships. The objective of this study was to evaluate the process, the effectiveness and the cost-effectiveness of an intervention to reduce social isolation and its negative effects on health in elderly persons.
Methods:
This is a mixed methods multi-approach evaluation that includes: 1) A qualitative evaluation among coordinators and participants taking part in the intervention, through in depth-interviews and focus groups, respectively. The main topics covered will be positive and negative aspects of the intervention, suggestions for its improvement, opinions on different aspects of the intervention, and perceived benefits. 2) A quantitative quasi-experimental design, comparing a group of individuals taking part in the intervention with another group with similar characteristics not receiving the intervention. Data will be collected at the beginning and at the end of the intervention. Social support will be measured through questions drawn from the Medical Outcomes Study and the National Social Life, Health, and Aging Project questionnaires. Psychological morbidity will be measured through Goldberg's General Health Questionnaire, and Health-related Quality of Life will be measured through the EuroQoL questionnaire. Information on visits to the primary care center in the years before and after the intervention will be obtained from the electronic records of the primary care centers. 3) A cost-utility analysis, conducted from a health system (primary care) perspective, including direct costs of the program and the primary care health services used. The effects of the intervention will be measured on quality-adjusted life years.
Discussion:
There is an urgent need for studies assessing the effectiveness and the efficiency of potential interventions to reduce social isolation among elderly persons. The results of this study will help to fill the knowledge gap in this area and might be especially useful for the development of social and public health policies and programs for older people in disadvantaged neighborhoods in urban areas.
Hypothesis:
The intervention evaluated in this protocol will significantly improve social support, mental health, general health status and distinct dimensions of quality of life in the intervention group (IG) compared with the comparison group (CG). Among participants in the IG, the intervention will also significantly reduce the number of visits to their primary care centers. Furthermore, this intervention will be cost effective.
Objectives:
General objective To evaluate the process, effectiveness and cost-effectiveness of an intervention to reduce social isolation and its consequent negative impact on health in the elderly.
Specific objectives
Methods:
Study design
This is a mixed methods multi-approach evaluation that includes:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Schools of Health for the Elderly | Experimental | Participants receiving the community intervention (explained in the section "Intervention") |
|
| Comparison Group | No Intervention | Participants in the study that do not receive the intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Schools of Health for the Elderly | Other | The intervention "School of Health for the Elderly " consists of 22 weekly group sessions of 1.5 hours each. In addition to helping participants learn about different health issues, the intervention encourages interaction among participants and works on personal skills. Furthermore, most sessions are led by professionals who are experts on the topic covered and work in the neighborhood (professionals from the health services, social services, markets or neighborhood associations), making it easier to inform participants of the neighborhood's available resources. The aim of the intervention is to decrease social isolation and loneliness and, therefore, to improve mental health, self-perceived health and wellbeing |
| Measure | Description | Time Frame |
|---|---|---|
| Psychological morbidity will be measured through Goldberg's General Health Questionnaire (GHQ | The General Health Questionnaire (GHQ) is a psychometric screening tool to identify common psychiatric conditions. | The outcome measure will be measured up to 12 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Visits to the primary care center will be measured through access to the electronic records of the primary care centers. | Primary care centers have records of all the patient visits. | The outcome measure will be measured up to 12 months. |
| Health-related quality of life will be measured through the EuroQoL (EQ-5D) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| MarÃa José López, PhD | Public Health Agency of Barcelona | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36074028 | Derived | Lapena C, Continente X, Sanchez Mascunano A, Mari dell'Olmo M, Lopez MJ. Effectiveness of a community intervention to reduce social isolation among older people in low-income neighbourhoods. Eur J Public Health. 2022 Oct 3;32(5):677-683. doi: 10.1093/eurpub/ckac100. | |
| 30777022 | Derived | Lopez MJ, Lapena C, Sanchez A, Continente X, Fernandez A; 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 Feb 18;19(1):44. doi: 10.1186/s12877-019-1055-9. |
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| ID | Term |
|---|---|
| D012934 | Social Isolation |
| ID | Term |
|---|---|
| D012919 | Social Behavior |
| D001519 | Behavior |
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|
The EQ-5D health questionnaire provides a simple descriptive profile and a single index value for health status. |
| The outcome measure will be measured up to 12 months. |
| Social support will be also measured based on the "National Social Life, Health, and Aging Project" questionnaire | The National Social Life, Health, and Aging project includes the measurement of social connectedness items | The outcome measure will be measured up to 12 months. |
| Social support based on Measures of Quality of Life Core Survey (MOS) | The Medical Outcomes Study Social Support Survey cover four domains (emotional/informational support, tangible [also called instrumental] support, positive social interaction, and affection) | The outcome measure will be measured up to 12 months. |