Provision of community facilities
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Levinger et al., 2020 [52] |
Australia; Elderly participants recruited from the general community in the suburbs close to the Seniors Exercise Parks in Melbourne, between October 2018 to November 2019 |
Seniors Exercise Park program: a 12-week structured supervised physical activity program using an outdoor exercise park, followed by a 6-month unstructured physical activity program (ongoing unsupervised access to the exercise park/twice a week exercise session with no formal structured group activity) Each structured exercise session was followed by morning/afternoon tea |
Actively promote community wellbeing through the provision of a unique exercise and social support program in elderly people as well as the effects of sustained engagement in physical activity on physical, mental, social and health outcomes |
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95 elderly people (≥60 years) at baseline (mean age 73.0 ± 7.4; 82.1 % female)
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follow-up data for 80 people to compare pre-post intervention scores (mean age 72.8 ± 7.5; 81.3 %)
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58 people took part in 9-month follow up
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Health-related quality of life using EQ-5D-5L/visual analogue scale (VAS); Mental wellbeing using WHO-5 Wellbeing questionnaire; Loneliness using 3-item UCLA Loneliness Scale; Depression using Geriatric Depression Scale (GDS-15); fear of falls using The Short Falls-Physical activity level using Community Healthy Activities Model Program for Seniors (CHAMPS)
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Physical function using 2-minute walk test; step test; 4 m walk test
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Falls Efficacy Scale International (Short FES-I) questionnaire; self-efficacy using The Self-Efficacy for Exercise (SEE); enjoyment using Physical Activity Enjoyment Scale (PACES); Social isolation and social support using Lubben Social Network Scale (LSNS6)
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Fall risk assessment using The Fall Risk for Older People in the Community (FROP-Com)
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Pre-post study design
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Analysis of variance (ANOVA) repeated measures to compare scores on all measures at baseline and at 9-month follow-up
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A separate ANOVA repeated measures examine the effect of the exercise program on all outcomes between baseline and 3 months/3 months and 9 months
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Significant increase in physical activity level after the intervention (p < 0.01, moderate to large effect sizes)
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Significant improvements in all physical function measures (p < 0.01, small to large effect sizes), self-rated quality of life (p = 0.04, small effect size), wellbeing (p < 0.01, small effect size), fear of falls (p < 0.01, medium effect size), falls risk (p < 0.01, medium effect size), depressive symptoms (p = 0.01, small effect size), loneliness (p = 0.03, small effect size)
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No significant changes in socialisation and self-efficacy for exercise outcomes (p > 0.05)
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EQ-5D-5L: improvements in self-care (p < 0.01) and depression domains (p = 0.02)
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9 month follow up versus baseline: significant improvements in physical function (p < 0.05, moderate to large size effect); significant changes only in the health related quality of life mobility and self-care domains (p < 0.05, EQ-5D-5L), no changes in other domains; significant reductions in both fear of falls and falls risk (p < 0.01)
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very few changes were observed between 3 and 9 months follow up
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Improvement in depressive symptoms (Depression domain in Quality of Life Scale and GDS-15)
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Slight improvement in loneliness but with no changes in social isolation/support (UCLA3/LSNS6 did not suggest experienced severe loneliness or lack of social engagement at baseline)
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None |
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COVID-19, associated restrictions and lockdown causing smaller sample in 9 months follow up (underestimation)
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Level of physical activity was measured using self-reported questionnaire (CHAMPS), but has been widely used in research and suited for older Australian
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Relatively high proportion of females, whereas males have been reported to have specific preferences and characteristic of exercise interventions
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Wang et al., 2020 [58] |
China; Elderly participants recruited from villages of Jinhua in Zhejiang, between July and October 2017 |
Community canteen services offered to older adults in 7 villages, compared with older adults from 7 closest villages without canteen services. |
Recipients of the canteen service (canteen group; CG) would show significantly better health than the non-recipients (NCG) |
Final sample size of 284 elderly people responded to the survey comprehensively
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140 participants with canteen services, 144 without
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148 females (52.1%)
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Average age 83.07 ± 4.19, with a range of 75 to 98 years
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General mental health using Chinese version of General Health Questionnaire(GHQ-12)
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Satisfaction with life using Chinese version of Satisfaction with Life Scale (SWLS)
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Social capital using Social Capital Questionnaire (SCQ) developed by Yang with acceptable reliability and validity
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Nutritional status using Chinese version of Revised Mini Nutritional Assessment Short-Form (MNA-SF)
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Cross-sectional design
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Independent t-test to compare continuous variables
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Chi-square test and Mann–Whitney test to compare categorical data
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ANOVA and Fisher’s Least Significant Difference (LSD) test to compare nutritional differences among three groups (CG with government support and enterprise donation; CG with government support only; NCG)
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Adults in the CG had better mental health (mean = 1.39, SD = 1.95) and richer social capital (mean = 17.89, SD = 1.38) than NCG (GHQ: mean = 1.93/SD = 2.36; SCQ: mean = 17.48/SD = 1.64)
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Nutritional status was not significantly different between CG and NCG, but was significantly different when considering funding sources and daily meal costs: ie those in the CG group with government support and enterprise donation (n = 40) had better nutritional status (mean = 13.28, SD = 1.32)
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Those in the CG group had higher satisfaction with meals, self-evaluation of the meal nutrition, and regularity of meals compared to NCG
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No significant differences in age, gender, marital status, educational level, or income between the CG and the NCG.
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Not measured |
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Cross-sectional study and only evaluated relationships at specific time points
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Canteen service policies may be different for different provinces and result may not be applicable to poorer regions
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Not measured confounding factors but only measured the benefits, not what people did not like
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Self-report bias
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Housing regeneration
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Jalaludin et al., 2012 [53] |
Australia; Participants recruited from all 57 households in a suburb 45 km to the southwest of the Sydney central business district from December 2008 to April 2009 |
Urban renewal program conducted between April 2009 and August 2010, and in the two streets of established social housing
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Internal upgrades: internal painting, replacement of kitchens, bathrooms and carpets where required, and general maintenance such as repairing water leakages, faulty windows and doors
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External upgrades: property painting, new front and back fencing, new carports, letterboxes, concrete driveways, drainage, landscaping and general external maintenance
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Social interventions: community engagement activities, learning and employment initiatives, and provision of a community meeting place.
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The renewal program and its social components were intended to bring about improvement in social capital, social connectedness, a sense of community and in the economic conditions of residents. |
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Psychological distress using Kessler Psychological Distress Scale (K10)
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Questions about social connectedness, social capital, self-rated health, psychological distress and health risk factors as taken from the New South Wales Population Health Survey
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Perceptions of neighbourhood safety, aesthetics and access to services within walking distance using the Neighbourhood Environment Walkability Scale (NEWS)
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Adequate physical activity defined as a total of 150 min per week
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Hazardous alcohol drinking defined as consumption of more than 2 standard drinks on any one day
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Pre-post study design
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Only included individuals who completed both surveys
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Fisher-Freeman-Halton exact test to compare independent proportions
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Paired chi-square tests (McNemar’s test) to compare paired proportions.
Note that due to multiple testing, a p value threshold of 0.0013 was used, after applying the Bonferroni Correction but uncorrected exact p-values were presented throughout the manuscript.
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Uncorrected p values presented suggested that there were no significant differences on any measures. The authors reported: no significant change in perceptions of neighbourhood aesthetics, safety or walkability, or in psychological distress and self-rated health. They reported a significant increase in the proportion of people reporting that there were attractive buildings and homes in the neighbourhood (18% versus 64%), and of feeling that they belonged to the neighbourhood (48% versus 70%), that their area had a reputation for being a safe place (8% versus 27%), they felt safe walking down their street after dark (52% versus 85%), and that people who came to live in the neighbourhood would be more likely to stay rather than move elsewhere (13% versus 54%). As the lowest uncorrected p-value presented was 0.0072, we infer that all corrected p-values showed no statistically significant findings. |
None |
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Small sample size
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No comparison group (to take into account the influence of any changes occurring over that period due to factors other than the program)
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Short follow-up
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Results in the specific setting of this social housing neighbourhood may not be generalisable to other settings
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Not possible to identify the active ingredients of the intervention, i.e., the urban renewal component versus the community engagement initiatives
Use of uncorrected p-values throughout made it hard to interpret the findings, suggesting that no differences were significant |