Qualitative evaluation of a community-based intervention to reduce social isolation among older people in disadvantaged urban areas of Barcelona.

Publisher: Hindawi in collaboration with John Wiley & Sons, Inc Country of Publication: England NLM ID: 9306359 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2524 (Electronic) Linking ISSN: 09660410 NLM ISO Abbreviation: Health Soc Care Community Subsets: MEDLINE

Publication: [London] : Hindawi in collaboration with John Wiley & Sons, Inc.
Original Publication: Oxford : Blackwell Scientific Publications, c1993-

Social Support*; Community Participation/*methods ; Social Isolation/*psychology ; Social Participation/*psychology ; Vulnerable Populations/*psychology; Aged ; Aged, 80 and over ; Female ; Focus Groups ; Humans ; Independent Living ; Interpersonal Relations ; Male ; Spain

This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community-based intervention to reduce social isolation among older adults. The 'School of Health for Older People' is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi-structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community-dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in-depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community.
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Agdal, R., Midtgård, I. H., & Meidell, V. (2019). Can asset-based community development with children and youth enhance the level of participation in health promotion projects? A qualitative meta-synthesis. International Journal of Environmental Research and Public Health., 16(19), 3778. https://doi.org/10.3390/ijerph16193778.
Ayala, G. X., & Elder, J. P. (2011). Qualitative methods to ensure acceptability of behavioral and social interventions to the target population. Journal of Public Health Dentistry, 71, S69-S79. https://doi.org/10.1111/j.1752-7325.2011.00241.x.
Bartoll, X., Baranda, L., González, J. M., Perez, K., Pasarın, M., Rodríguez-Sanz, M., & Borrell, C. (2018). Manual metodològic de l'Enquesta de Salut de Barcelona 2016/17. Barcelona, Spain: Agència de Salut Pública de Barcelona. Available from https://www.aspb.cat/wp-content/uploads/2018/07/Enquesta-salut-Barcelona-2016-17.pdf. Accessed 13 May 2019.
Bates, J., & Machin, A. (2016). Locality, loneliness and lifestyle: A qualitative study of factors influencing women's health perceptions. Health & Social Care in the Community, 24, 639-648. https://doi.org/10.1111/hsc.12242.
Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and Personality Psychology Compass, 8, 58-72. https://doi.org/10.1111/spc3.12087.
Carrascosa, L. L. (2015). Ageing population and family support in Spain. Journal of Comparative Family Studies, 46, 499-516. https://doi.org/10.3138/jcfs.46.4.499.
Cattan, M., White, M., Bond, J., & Learmouth, A. (2005). Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions. Ageing and Society, 25, 41-67. https://doi.org/10.1017/S0144686X04002594.
Cohen-Mansfield, J., Hazan, H., Lerman, Y., & Shalom, V. (2016). Correlates and predictors of loneliness in older-adults: A review of quantitative results informed by qualitative insights. International Psychogeriatrics, 28, 557-576. https://doi.org/10.1017/S1041610215001532.
Coll-Planas, L., Del Valle Gómez, G., Bonilla, P., Masat, T., Puig, T., & Monteserin, R. (2017). Promoting social capital to alleviate loneliness and improve health among older people in Spain. Health & Social Care in the Community, 25, 145-157. https://doi.org/10.1111/hsc.12284.
Coll-Planas, L., Nyqvist, F., Puig, T., Urrútia, G., Solà, I., & Monteserín, R. (2016). Social capital interventions targeting older people and their impact on health: A systematic review. Journal of Epidemiology and Community Health, 71, 663-672. https://doi.org/10.1136/jech-2016-208131.
Cooper, C., O'Cathain, A., Hind, D., Adamson, J., Lawton, J., & Baird, W. (2014). Conducting qualitative research within clinical trials units: Avoiding potential pitfalls. Contemporary Clinical Trials, 38(2), 338-343. https://doi.org/10.1016/j.cct.2014.06.002.
Cornwell, E. Y., & Waite, L. J. (2009). Measuring social isolation among older adults using multiple indicators from the NSHAP study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64B(Suppl 1), i38-i46. https://doi.org/10.1093/geronb/gbp037.
Cotterell, N., Buffel, T., & Phillipson, C. (2018). Preventing social isolation in older people. Maturitas, https://doi.org/10.1016/j.maturitas.2018.04.014.
Creswell, J. W. (2014). A concise introduction to mixed methods research (1st ed.). Los Angeles, CA: SAGE Publications Inc.
Creswell, J. D., Irwin, M. R., Burklund, L. J., Lieberman, M. D., Arevalo, J. M. G., Ma, J., … Cole, S. W. (2012). Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain, Behavior, and Immunity, 26, 1095-1101. https://doi.org/10.1016/j.bbi.2012.07.006.
Dickens, A. P., Richards, S. H., Hawton, A., Taylor, R. S., Greaves, C. J., Green, C., … Campbell, J. L. (2011). An evaluation of the effectiveness of a community mentoring service for socially isolated older people: A controlled trial. BMC Public Health, 11, 218. https://doi.org/10.1186/1471-2458-11-218.
Diez, E., Pasarin, M., Daban, F., Calzada, N., Fuentes, C., Artazcoz, L., & Borrell, C. (2012). Barcelona health in the neigbourhoods ["Salut als barris" en Barcelona, una intervención comunitaria para reducir las desigualdades sociales en salud]. Comunidad, 14, 121-126.
Dykstra, P. A. (2009). Older adult loneliness: Myths and realities. European Journal of Ageing, 6, 91-100. https://doi.org/10.1007/s10433-009-0110-3.
Eurostat. (2016). Population structure and ageing. Available from http://ec.europa.eu/eurostat/statistics-explained/index.php/Population_structure_and_ageing. Accessed 7 July 2017.
Findlay, R. A. (2003). Interventions to reduce social isolation amongst older people: Where is the evidence?. Available from http://www.iscet.pt/sites/default/files/obsolidao/interventions_reduce_social_isolation_among_older_people_evidence.pdf. Accessed 5 April 2016.
Friedler, B., Crapser, J., & McCullough, L. (2015). One is the deadliest number: The detrimental effects of social isolation on cerebrovascular diseases and cognition. Acta Neuropathologica, 129, 493-509. https://doi.org/10.1007/s00401-014-1377-9.
Gandy, R., Bell, A., McClelland, B., & Roe, B. (2017). Evaluating the delivery, impact, costs and benefits of an active lives programme for older people living in the community. Primary Health Care Research & Development, 18(02), 122-134. https://doi.org/10.1017/S146342361600027X.
Gardiner, C., Geldenhuys, G., & Gott, M. (2018). Interventions to reduce social isolation and loneliness among older people: An integrative review. Health & Social Care in the Community, 26(2), 147-157. https://doi.org/10.1111/hsc.12367.
Goll, J. C., Charlesworth, G., Scior, K., & Stott, J. (2015). Barriers to social participation among lonely older adults: The influence of social fears and identity. PLoS ONE, 10, e0116664. https://doi.org/10.1371/journal.pone.0116664.
Goodman, C., Davies, S. L., Dinan, S., See Tai, S., & Iliffe, S. (2011). Activity promotion for community-dwelling older people: A survey of the contribution of primary care nurses. British Journal of Psychiatry, 16, 12-17. https://doi.org/10.12968/bjcn.2011.16.1.12.
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7, e1000316. https://doi.org/10.1371/journal.pmed.1000316.
Hood, S., Lu, Y. Y. F., Jenkins, K., Brown, E., Beaven, J., Brown, S., … Austrom, M. G. (2018). Exploration of perceived psychosocial benefits of senior companion program participation among urban-dwelling, low-income older adult women volunteers. Innovation in Aging, 2(2), igy018. https://doi.org/10.1093/geroni/igy018.
Hwang, J., Wang, L., Siever, J., Medico, T. D., & Jones, C. A. (2019). Loneliness and social isolation among older adults in a community exercise program: A qualitative study. Aging & Mental Health, 23(6), 736-742. https://doi.org/10.1080/13607863.2018.1450835.
Kharicha, K., Iliffe, S., Manthorpe, J., Chew-Graham, C. A., Cattan, M., Goodman, C., … Walters, K. (2017). What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England. Health & Social Care in the Community, 25(6), 1733-1742. https://doi.org/10.1111/hsc.12438.
Lopez, M. J.; Group of Evaluation of the Schools of Health for the Elderly. (2019). Community intervention to reduce social isolation in elderly people in disadvantaged urban areas: Study protocol for a mixed methods multi-approach evaluation. BMC Geriatrics, 19(1), 44. https://doi.org/10.1186/s12877-019-1055-9.
Luo, Y., Hawkley, L. C., Waite, L. J., & Cacioppo, J. T. (2012). Loneliness, health, and mortality in old age: A national longitudinal study. Social Science & Medicine, 1982(74), 907-914. https://doi.org/10.1016/j.socscimed.2011.11.028.
Malterud, K., Siersma, V. D., & Guassora, A. D. (2015). Sample size in qualitative interview studies. Qualitative Health Research. https://doi.org/10.1177/1049732315617444.
Masi, C. M., Chen, H.-Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15(3), 219-266. https://doi.org/10.1177/1088868310377394.
Massimi, A., De Vito, C., Brufola, I., Corsaro, A., Marzuillo, C., Migliara, G., … Damiani, G. (2017). Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis. PLoS ONE, 12(3), e0173617. https://doi.org/10.1371/journal.pone.0173617.
McInnes, E., Seers, K., & Tutton, L. (2011). Older people's views in relation to risk of falling and need for intervention: A meta-ethnography. Journal of Advanced Nursing, 67(12), 2525-2536. https://doi.org/10.1111/j.1365-2648.2011.05707.x.
Menec, V. H., Newall, N. E., Mackenzie, C. S., Shooshtari, S., & Nowicki, S. (2019). Examining individual and geographic factors associated with social isolation and loneliness using Canadian Longitudinal Study on Aging (CLSA) data. PLoS ONE, 14(2), e0211143. https://doi.org/10.1371/journal.pone.0211143.
Miranda, D. E., Garcia-Ramirez, M., Balcazar, F. E., & Suarez-Balcazar, Y. (2019). A community-based participatory action research for Roma health justice in a deprived district in Spain. International Journal of Environmental Research and Public Health, 16(19), 3722. https://doi.org/10.3390/ijerph16193722.
Morgan, A., & Ziglio, E. (2007). Revitalising the evidence base for public health: An assets model. Promotion & Education, 14(2_suppl), 17-22. https://doi.org/10.1177/10253823070140020701x.
O'Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine, 89, 1245-1251. https://doi.org/10.1097/ACM.0000000000000388.
Perissinotto, C., Holt-Lunstad, J., Periyakoil, V. S., & Covinsky, K. (2019). A practical approach to assessing and mitigating loneliness and isolation in older adults. Journal of the American Geriatrics Society, 67(4), 657-662. https://doi.org/10.1111/jgs.15746.
Prieto-Flores, M. E., Fernandez-Mayoralas, G., Forjaz, M. J., Rojo-Perez, F., & Martinez-Martin, P. (2011). Residential satisfaction, sense of belonging and loneliness among older adults living in the community and in care facilities. Health Place., 17, 1183-1190. https://doi.org/10.1016/j.healthplace.2011.08.012.
Rahimi Foroushani, A., Estebsari, F., Mostafaei, D., Eftekhar Ardebili, H., Shojaeizadeh, D., Dastoorpour, M., … Taghdisi, M. H. (2014). The effect of health promoting intervention on healthy lifestyle and social support in elders: A clinical trial study. Iranian Red Crescent Medical Journal, 16, e18399. https://doi.org/10.5812/ircmj.18399.
Ramos, P., Pasarín, M. I., Artazcoz, L., Díez, E., Juárez, O., & González, I. (2013). Escuelas saludables y participativas: Evaluación de una estrategia de salud pública. Gaceta Sanitaria, 27(2), 104-110. https://doi.org/10.1016/j.gaceta.2012.04.002.
Relinque, C. S., Arroyo, M., Del, G., Fernández, G., & Tomás, M. (2013). Consejos prácticos para escribir un artículo cualitativo publicable en Psicología. Psychosocial Intervention, 22, 71-79. https://doi.org/10.5093/in2013a9.
Rico-Uribe, L. A., Caballero, F. F., Olaya, B., Tobiasz-Adamczyk, B., Koskinen, S., Leonardi, M., … Miret, M. (2016). Loneliness, social networks, and health: A cross-sectional study in three countries. PLoS ONE, 11(1), e0145264. https://doi.org/10.1371/journal.pone.0145264.
Taube, E., Jakobsson, U., Midlöv, P., & Kristensson, J. (2016). Being in a bubble: The experience of loneliness among frail older people. Journal of Advanced Nursing, 72, 631-640. https://doi.org/10.1111/jan.12853.
Tayabas, L. M. T., León, T. C., & Espino, J. M. (2014). Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services. International Journal of Qualitative Studies on Health and Well-being, 9, 24417. https://doi.org/10.3402/qhw.v9.24417.
Todd, C., Camic, P. M., Lockyer, B., Thomson, L. J. M., & Chatterjee, H. J. (2017). Museum-based programs for socially isolated older adults: Understanding what works. Health Place, 48, 47-55. https://doi.org/10.1016/j.healthplace.2017.08.005.
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349-357. https://doi.org/10.1093/intqhc/mzm042.
Valtorta, N., & Hanratty, B. (2012). Loneliness, isolation and the health of older adults: Do we need a new research agenda? Journal of the Royal Society of Medicine, 105, 518-522. https://doi.org/10.1258/jrsm.2012.120128.
van Beljouw, I. M. J., Heerings, M., Abma, T. A., Laurant, M. G. H., Veer-Tazelaar, P. J. V., Baur, V. E., … Van Exel, E. (2015). Pulling out all the stops: What motivates 65+ year olds with depressive symptoms to participate in an outreaching preference-led intervention programme? Aging & Mental Health, 19, 453-463. https://doi.org/10.1080/13607863.2014.944090.
VanderWeele, T. J., Hawkley, L. C., & Cacioppo, J. T. (2012). On the reciprocal association between loneliness and subjective well-being. American Journal of Epidemiology, 176, 777-784. https://doi.org/10.1093/aje/kws173.
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge, MA: The MIT Press.
Woith, W. M., Volchenkov, G., & Larson, J. L. (2012). Barriers and facilitators affecting tuberculosis infection control practices of Russian health care workers. The International Journal of Tuberculosis and Lung Disease, 16(8), 1092-1096. https://doi.org/10.5588/ijtld.10.0779.
Yang, K., & Victor, C. (2011). Age and loneliness in 25 European nations. Ageing and Society, 31, 1368-1388. https://doi.org/10.1017/S0144686X1000139X.

Keywords: community action; community nursing; loneliness; primary healthcare; programme evaluation; qualitative research; social isolation

Date Created: 20200319 Date Completed: 20210607 Latest Revision: 20210607

20240628

10.1111/hsc.12971

32185842