Table 3.
Older Adults: Summary of Included Studies
| Intervention | Description | Study design and study N | Mental health and mental health-related outcomes |
|---|---|---|---|
| 1. Green and blue spaces | Expansions of green (e.g., parks, fields, gardens) and blue (e.g., oceans, lakes) spaces in neighborhoods. Exposure to green and blue natural environments also promotes increased social interactions and exercise. | Cluster randomized trial of greening vacant urban land (74); 442 community-dwelling adults living within 110 vacant lot clusters assigned to 3 study groups: greening, trash cleanup, or no intervention | Decrease in self-reported depression symptoms in the intervention versus control condition |
| Systematic review of 35 quantitative studies, most conducted between 2012–2017 (77); The authors identified 22 studies as being of “good quality” | The 35 studies included had a range of exposures and outcomes, but overall, the evidence suggests a positive association between exposure to outdoor green space and mental health and wellbeing | ||
| Cross-sectional study of 249,405 Medicare Beneficiaries living in Miami-Dade County, Florida (72); analyzed the association of changes in block-level greenness (vegetative presence) with individuals’ mental health outcomes | An increase in the block-level of greenness from 1 standard deviation below the mean to 1 above the mean was associated with lowering the odds of depression by 37% in low-income neighborhoods, 27% in medium-income neighborhoods, and 21% in high-income neighborhoods | ||
| 2. Senior centers offering health promotion activities | Also referred to as “adult day service centers” in the scientific literature, these centers are community organizations for older adults and their caregivers that provide a range of resources such as adult education, health promotion activities, and opportunities for socializing. | Systematic review of 61 studies (83) evaluating the effectiveness of adult day service centers at improving caregiver outcomes (19 studies), participant health outcomes (39 studies), and adult day services and healthcare utilization (10 studies); 8 studies were randomized controlled trials, and the rest were longitudinal, quasi-experimental, or cross-sectional | The majority of quasi-experimental studies assessing participant depression and quality of life found greater improvements for intervention participants compared to controls; Most quasi-experimental studies assessing caregiver burden and stress found greater improvements for intervention caregivers compared to their controls |
| 3. Community-based disability prevention programs | A dual exercise and psychosocial program for older adults. Delivered by para-professionals either virtually, in-person, or hybrid. Available in English, Spanish, Mandarin, and Cantonese | Randomized controlled trial (84) involving 307 participants (intervention = 153; control = 154) in Massachusetts, New York, Florida, and Puerto Rico; most participants were Asian or Latinx | Compared to people receiving enhanced usual care, people in the intervention group experienced reductions in mood symptoms at 6 and 12 months |
| “EnhanceFitness” A low-cost group exercise program implemented across a range of community settings (e.g., religious institutions, recreational and senior centers) | Randomized controlled trial (89) involving 100 older adults (intervention = 53; control = 47) | After 6 months people in the intervention group had fewer depressive symptoms compared people in the control group | |
| Pre and post study (90) inclusive of older adults (n = 382) | Decreased social isolation and loneliness | ||
| “EnhanceWellness” pairs older adults with health and wellness coaches trained in motivational interviewing. | Five-state dissemination of community-based program. Within-group pre and post study (85) of older adults with chronic illness (n = 224) | Among the participants completing the one-year follow-up, there was a significant decrease in their depression symptom severity from enrollment to one-year follow-up | |
| 4. Chronic Disease Self-Management Program (CDSMP) | 6-week peer-led education program designed to help older adults gain skills and improve confidence to better manage chronic conditions | Meta-analysis of 18 studies on CDSMP outcomes among small English-speaking groups (93) | Small to moderate improvements in all measures of psychological health at 4 to 6 months and 9 to 12 months; Significant improvements in energy, fatigue, and selfrated health (4 to 6 months only), cognitive symptom management (4 to 6 months and 9 to 12 months) |
| Randomized community-based outcome trial (94) of the Spanish-language version of the CDSMP, with Spanish speakers (mean age 57) with heart disease, lung disease, or type 2 diabetes; Participants were randomized to the treatment group (n = 327) or the waitlist usual-care control group (n = 224) | At 4 months, intervention participants showed improved health status, health behavior, and self-efficacy and fewer emergency room visits, compared with people in usual care; At 1 year, intervention participants (n = 271 maintained these improvements and were significantly different from their baseline scores |