None listed
Conditions
Brief summary
Loneliness affects about 10% of older New Zealanders. It is associated with higher death rates and poorer health outcomes. There has been no previous NZ clinical trial on reducing loneliness among older adults. Overseas experiences suggest psychosocial group treatment can be effective for improving loneliness and health outcomes, and it is cost-effective. We therefore propose a NZ multi-centre study to investigate the benefits of a community based psychosocial group treatment for older adults with loneliness. However, a feasibility study will be required to inform many aspects of the full study. This feasibility study involves two Age Concern branches. Its principle methodology is to find out the feasibility of recruiting older adults through Age Concern and the district health boards' interRAI assessment process; training and supervision of group facilitators to deliver the group treatment; participants’ adherence and drop-out rates; and costs.
Interventions
Psychosocial group intervention
Two trained facilitators (an Age Concern staff and a volunteer) facilitate each group which has 6-8 participants. The group meets for 3 hours once a week for 12 weeks (a total of 12 group meetings).
The participants are transported to group meetings and back by van or other transport options. The group meetings included coffee, breaks and lunches; meetings are free of charge.
The psychosocial group intervention has three components:
a. Mindfulness and relaxa
Psychosocial group intervention Two trained facilitators (an Age Concern staff and a volunteer) facilitate each group which has 6-8 participants. The group meets for 3 hours once a week for 12 weeks (a total of 12 group meetings). The participants are transported to group meetings and back by van or other transport options. The group meetings included coffee, breaks and lunches; meetings are free of charge. The psychosocial group intervention has three components: a. Mindfulness and relaxation practice (20 minutes) a. In the art/inspiring activities (60 minutes), various artists (musicians, actors, artists) attend the meetings, participants visit cultural events and sights, and participants actively produce their own art. We will introduce a bicultural approach by including Maori art (e.g. bone carvings, weaving) to both Maori and non-Maori group participants. c. Group interpersonal psychotherapy (IPT) (60 minutes). IPT was developed for the treatment of adult depression in the 1970s and has been modified for numerous mental health conditions including older adult depression. It is a manual based, time-limited (12-16 sessions) and evidence based talking therapy. It is designed to improve communication skills and to modify expectations in relationships. IPT identifies and works on problem areas in a person’s relationship with others. The problem area of interpersonal sensitivity relates to people with loneliness/social isolation. Our treatment protocol will follow the group IPT guide published by the WHO. (REF) The aim is to help people to be less lonely and take steps to form ties with members of their community. Strategies used to help with loneliness include finding out if the participant wants to have more people around them; assisting the participant in finding opportunities to change their habits and end their social isolation by increasing activities with other people and joining in the community, workplace or places of religious worship; guiding the group to support each other and using extensive role-play and feedback in preparing and reviewing their interactions and activities with others. The remaining 40 minutes is allowed for coffee/tea at arrival and lunch at the end. Attendance list will be used to monitor adherence to the intervention. REF: World Health Organization and Columbia University. Group Interpersonal Therapy (IPT) for Depression (WHO generic field-trial version 1.0). World Health Organisation. 2016. Available from: http://apps.who.int/iris/bitstream/handle/10665/250219/WHO-MSD-MER-16.4-eng.pdf;jsessionid=AA494AA829B02735BEECAC06326EE85E?sequence=1
Sponsors
The University of Auckland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The study will recruit participants from Age Concern in Auckland and Dunedin, New Zealand. Potential participants are people with subjective loneliness who are referred to their AVS. Staff at Age Concern will approach potential participants about this study, and the research team will provide further information and obtain informed consent. Inclusion criteria: (i) Age 65+ (ii) living in the community, including retirement village (iii) adequate hearing and vision to allow participation in group work (iv) ability to move independently without another person’s aid (v) a score of 3 or above on the de Jong Gierveld Loneliness Scale
Exclusion criteria
Exclusion criteria: (i) significant cognitive impairment (Montreal Cognitive Assessment score <25/30) (ii) participants are required to be intervention naïve, e.g. they have not received AVS or any other loneliness service before (iii) significant medical co-morbidities likely to impact on survival over 2-year period (e.g. terminal cancer).
Outcome results
None listed