Table 2.
Characteristics of studies stratified by i) study design and ii) delivery mode
| Study, year (country) | Participants | Explicit targeting | Activity | Groups | Outcomes considered in the review | |
|---|---|---|---|---|---|---|
| Intervention | Control | |||||
| RANDOMISED CONTROLLED TRIALS (n = 16): | ||||||
| Group | ||||||
| Constantino, 1988 (USA) [66] | Community-dwelling, widows | No | Support group | (1) Bereavement crisis intervention (BCI). Set in University. Weekly 1.5 hr planned group discussions on set themes. Six weeks. (2) Social adjustment intervention (SAI). Set in venue of selected activities. Weekly activities for 6 weeks. |
Not described | Revised Social Adjustment Scale (RSAS), Beck Depression Inventory (BDI), Depression Adjective Check List (DACL) Form E |
| Fukui et al, 2003 (Japan) [55] | Women with primary breast cancer | No | Education/support group | Psychosocial group inc. health education, coping skills, stress management, set in hospital. Three groups of 6-10 patients, weekly 1.5 hrs meeting for 6 weeks. | Waiting list control | Revised UCLA Loneliness Scale, Utilisation of confidants questionnaire, Satisfaction with mutual aid with other cancer survivors |
| Harris & Bodden, 1978 (USA) [67] | Community-dwelling, Meals on wheels recipients | Yes | Social activity | Activity group, setting not stated. 1 × weekly 2 hrs session, for 6 weeks. | Usual care | Shortened 35-item version of Chicago Activity Inventory |
| Kremers et al, 2006 (Netherlands) [68] | Community-dwelling, single women | No | Self-management group | Self-management group intervention, setting not reported. 6 × 2.5 hr weekly meetings. | No intervention | de Jong Gierveld Loneliness Scale, Social Production Function Index Level Scale |
| Lokk, 1990 (Sweden) [69] | Community-dwelling, people with handicaps | No | Discussion group | Group discussion re: goals plus standard reactivation programme, set in day care centre. Sessions twice a week (?12 weeks) inc. discussion, feedback and decision making. | Usual care - standard reactivation programme, set in day care centre | Activities outside institution, social network index, contact desire index, Hopelessness Index, Depression Index, loneliness, perceived health |
| Ollonqvist et al, 2008 (Finland) [70] | Community-dwelling, at risk of institutionalisation within 2 yrs due to decreasing functional capacity | No | Physical activity | Inpatient geriatric rehabilitation, including group physical activities, group discussions and lectures. Based at rehab centre. Eight months duration. | No intervention | Loneliness, Loneliness causing insecurity, Being left alone causing insecurity, Satisfaction with engagement with their children, Number of friends and relatives, Geriatric Depression Scale (GDS-15) |
| Routasalo et al, 2009 (Finland) [13] | Community-dwelling, reported feelings of loneliness | Yes | Social activity | Psychosocial group nursing, inc art & inspiring activities, exercise & discussions, therapeutic writing & group therapy. Based in community centres. Weekly sessions over 3 month period. | No intervention | UCLA Loneliness Scale (version 3), Lubben's Social Network Scale, Social activity, psychological wellbeing |
| Savelkoul & de Witte (2004) (Netherlands) [56] | Chronic rheumatic disorder patients | Yes | Coping education group | Coping group, unsure of setting. Groups of 10-12 pts, 10 × 2 hr sessions over 13 weeks. Awareness raising of social support sources. | (1) Mutual support group, unsure of setting. 5 × groups of 10-12 patients, 10 × 2 hr sessions over 13 weeks. (2) Waiting list control |
Social Support List-Interactions, de Jong Gierveld Loneliness Scale, Sickness Impact Profile 68 |
| White et al, 2002 (USA) [64] | Nursing home and congregate housing residents | No | Internet training | Internet training, set in nursing homes/congregate housing. 9 hrs group training over 2 weeks. 24 hr access to computers, for 5 months. | Usual care, nursing homes/congregate housing. | Modified form of revised UCLA Loneliness scale for use with older adults, Number of confidants in their life, CES-Depression scale |
| One-to-one | ||||||
| Brennan et al, 1995 (USA) [51] | Community-dwelling, Caregivers of Alzheimer's Disease (AD) sufferers | No | Computer support network | Provision of & training for, a computer network for AD caregivers. Set in ppts' homes. 90 mins training session. 24 hr access to software for 12 months. Monthly phone calls on service use. | 90 mins training session, identifying local services & resources. Monthly phone calls on service use, for 12 months | Instrumental and Expressive Social Support Scale, Centre for Epidemiological Studies Depression scale, Contact with community and medical services |
| Heller et al, 1991 (USA) [58] | Low-income housing residents | Yes | Telephone support | (1) Staff telephone contact & peer telephone dyads (as initiator), ppts' home. Frequency not reported. 30 week duration. (2) As above, but was recipient in peer telephone dyad. (3) Staff telephone contact only, ppts' home. Frequency not reported. 20 week duration. (4) Staff telephone contact. 10 week duration. |
No intervention | Paloutzian & Ellison Loneliness Scale, Perceived Social Support Scale, Network embeddedness, Philadelphia Geriatric Center Morale Scale, Center for Epidemiological Studies Depression Scale |
| MacIntyre et al, 1999 (Canada) [71] | Recipients of home nursing & homemaking services | Yes | Home visiting | Volunteer visitor programme, clients' home. Weekly 3 hr visits, for 6 weeks. Activities were mutually agreed. | Usual care control group | Personal Resource Questionnaire |
| O'Loughlin et al, 1989 (Canada) [57] | Chronic mental health problems, socially isolated | Yes | Home visiting | Volunteer visiting, in clients' home. Weekly visits, duration not reported. Provision of info re: medical/community resources. | Waiting list control | Recent social and leisure activities |
| Schulz, 1976 (USA) [59] | Private, church-affiliated retirement home residents | No | Home visiting | (1) Friendly visiting, set in retirement home. Ppts controlled duration and frequency of visits. Two-month visiting period. (2) Friendly visiting, predicted but not controlled by ppt, set in retirement home. Two-months visiting period. |
(1) Random friendly visits, set in retirement home. No notification given of visits. Two-month visiting period. (2) No visit comparison group |
Activity index, % of time per day spent in active pursuits, % of next 7 days devoted to special commitments, Tri scale activity composite, Wohlford hope scale, happiness, medication taken/day |
| Slegers et al, 2008 (Netherlands) [72] | Community-dwelling, no prior computer experience | No | Computer/internet training | Computer & internet training, provision of PC. 3 × 4 hr training sessions over 2-week period. PC use for 12 months. | (1) Not interested. No PC use for 12 months (2) Interested, but no training. No PC use for 12 months (3) Interested, received training. No PC use for 12 months |
de Jong Gierveld Loneliness Scale, social networks, SF-36 Mental Component Summary, depression subscale of Symptoms Check List, anxiety subscale of Symptoms Check List |
| Mixed mode | ||||||
| Drentea et al, 2006 (USA) [52] | Caregivers to Alzheimer's disease (AD) sufferers | No | Counselling/support group | Individual & family counselling, support group and ad hoc counselling. Setting unclear. Four months duration. Subsequent attendance at support groups and contact with counsellors for up to five years. | Usual care. Received resources information pack and referrals on request | Items from the Stokes Social Network List, Satisfaction with social support |
| QUASI-EXPERIMENTAL STUDIES (n = 16): | ||||||
| Group | ||||||
| Arnetz & Theorell, 1983 (Sweden) [60] | Senior citizen apartment residents | No | Social activity | Activity programme, set in apartment. Assistance to organise social activity groups & outings. 4-8 ppts per group, met once or twice a week for 6 months. | No intervention | Participation in bureau/church/occupational therapy activities, depression, suicidal thoughts. |
| Baumgarten et al, 1988 (Canada) [61] | Residents of two govt subsidised apartment buildings | Yes | Social activity | Activity group including a mutual help network and leisure/cultural group activities. Set in apartment building. 11 month duration. | No intervention | Number of social ties, Index of support satisfaction, Center for Epidemiologic Studies Depression |
| Evans & Jaureguy, 1982 (USA) [73] | Blind, community-dwelling | No | Group therapy | Phone group therapy. Set at home. 8 × 1 hr weekly phone conference calls. Eight week duration. | No intervention | UCLA Loneliness Scale, Wakefield self-rating depression scale, Outside social activities, Household chores |
| Fujiwara et al, 2009 (Japan) [74] | Community-dwelling | No | Social activity | Picture book reading to children, set in schools. Weekly or bi-weekly school visits for 18 months. Mutual learning monthly meetings. | Conventional social activities, setting not specified | Social activity checklist, Social networks, Social support scale |
| Martina & Stevens, 2006 (Netherlands) [75] | Participants of a Friendship Programme for older women (int) & community-dwelling (control) | Yes | Educational programme | Educational friendship programme, setting not reported. 12 lessons (duration of lessons & programme not reported). | No intervention | de Jong Gierveld Loneliness Scale, items from the Assertiveness scale, Personal Convoy Model of relationships, Positive and Negative Affect Scale |
| Rosen & Rosen, 1982 (USA) [76] | Community-dwelling, member of senior citizen centre | No | Group counselling | Mental health counselling group, set in local senior centres. Group meetings (?2 hrs, ?weekly), met for 40-49 sessions over 12-15 months. | (1) Comparison group, not needing MH services (2) Control group, in need of MH services |
Social isolation, activity and morale measures from OARS |
| Stevens & van Tilburg, 2000 (Netherlands) [77] | Participants of a Friendship Programme for older women (int), community-dwelling (control) | Yes | Educational programme | Educational friendship programme, setting not reported. 12 lessons (duration of lessons & programme not reported). | No intervention | de Jong Gierveld Loneliness Scale |
| Toseland et al, 1990 (USA) [53] | Caregivers, community-dwelling | No | Support group | (1) Group support. Setting not stated. 8 × weekly 2 hr sessions. (2) Individual counselling. Setting not stated. 8 × weekly 1 hr sessions. |
Control group. Given funding for respite, community resources information & a referral to a community agency if requested | Change in support network size, Extent of support, Satisfaction with support network, Bradburn Affect Balance Scale, Brief Symptom Inventory |
| White et al, 1999 (USA) [62] | Retirement community residents | No | Internet training | Internet training set in retirement community. Nine hrs training. 24 hr access to PCs. Five month duration. | Comparison group. No PC use during the study. Offered computer training after study | UCLA Loneliness Scale, Duke Social Support Index, Bradburn Affect Balance Scale, CES-Depression scale |
| Winningham & Pike, 2007 (USA) [63] | Assisted Living Facility (ALF) residents | No | Cognitive behavioural therapy | Cognitive Enhancement Programme, in ppts' ALF. 3 × sessions per week. Three month duration. | Usual care control group | Self-appraisal re: their social support, beliefs re: family/friends support behaviour, UCLA Loneliness Scale v3 |
| One-to-one | ||||||
| Bogat & Jason, 1983 (USA) [78] | Community-dwelling, on waiting list for a Friendly Visitor Programme | Yes | Home visiting | (1) Network-building visiting programme, set in clients' home. Weekly, 1 hr visits for 3 months. (2) Relationship-oriented visiting programme, set in clients' home. Weekly, 1 hr visits for 3 months |
No intervention | Current networks, desired networks, N phone calls/week, N visitors/visits made per week |
| Fokkema & Knipscheer, 2007 (Netherlands) [79] | Community-dwelling, living alone, lonely | Yes | Internet training | Internet training, set in clients' home. Internet access for three years. 5 × 2 hr lessons & home visits every two or three weeks. | No intervention | de Jong Gierveld Loneliness Scale inc. social & emotional loneliness subscales |
| Mulligan & Bennett, 1977 (USA) [80] | Community-dwelling, very isolated | Yes | Home visiting | Friendly visiting programme, ppts' homes. 1 × 1 hr structured home visit every two weeks, for six months. | No intervention | Past Month Isolation Index, Mental Status Questionnaire, Mental Status Schedule |
| Rook & Sorkin, 2003 (USA) [81] | Community-dwelling attenders of regional centres for lower-income older adults | No | Social activity | Foster Grandparent Programme for developmentally-disabled child, set at hospital. Contact with child 4 hrs/day, five mornings a week. Duration not reported. | (1) non-volunteer programme with access to age peers. Content not reported. (2) not reported - assuming no intervention |
Abbreviated UCLA Loneliness Scale, number of new relationships formed in past year, number of people who depended on the participant, Center for Epidemiological Studies-Depression Scale, Rosenberg Self-Esteem Scale |
| Toseland & Smith, 1990 (USA)[54] | Caregivers, community-dwelling | No | Counselling | (1) Individual professional counselling. Setting not stated. 8 × weekly 1 hr sessions. (2) Individual peer counselling. Setting not stated. 8 × weekly 1 hr sessions. |
No intervention | Number of people in network, Change in support network, Bradburn Affect Balance Scale, Brief Symptom Inventory, |
| Service provision | ||||||
| Bergman-Evans, 2004 (USA) [65] | Residents from two types of nursing home | No | Service provision | Human Habitat model of care, set in nursing home. Daily contact with pets, plants and children. One year duration. | Standard nursing home model (non-profit). Usual care | UCLA Loneliness Scale (version 3), helplessness item of GDS-30, boredom item of GDS-30 |