Dataset Information

Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis.

ABSTRACT:

Introduction

Loneliness is an emerging public health problem that is associated with social, emotional, mental and physical health issues. The application of digital technology (DT) interventions to reduce loneliness has significantly increased in the recent years. The effectiveness of DT interventions needs to be assessed systematically.

Methods and analysis

Aim: To undertake a systematic review and meta-analysis on the effectiveness of DT interventions to reduce loneliness among adults.

Design

Systematic review and meta-analysis.

Data sources

PubMed, Medline, CINAHL, EMBASE and Web of Science.Publication period: 1 January 2010 to 31 July 2019.

Inclusion criteria

Primary studies involving the application of DT interventions to reduce loneliness, involving adult participants (aged ?18 years), follow-up period ?3 months and published in the English language.Synthesis and meta-analysis: A narrative summary of the characteristics of included studies, findings by the type of DT intervention, and the age, gender and ethnicity of participants. A meta-analysis by the study design and duration of follow-up and determination of random effects size using the RevMan V.5 software.Quality of evidence and bias: Quality of evidence assessed the RoB V.2.0 (revised tool for Risk of Bias in randomized trials) and ROBINS-I (Risk Of Bias in Non-randomized Studies-of Interventions) tools for randomised control trials and non-randomised studies, respectively. Heterogeneity between studies will be determined by the I² and Cochran's Q statistics and publication bias checked with funnel plots and the Egger's test.

Ethics and dissemination

Ethics approval was not required for this protocol. The findings will be disseminated through journal articles and conference presentations.

Prospero registration number

CRD42019131524.

SUBMITTER: Shah SGS

PROVIDER: S-EPMC6773278 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis.

Shah Syed Ghulam Sarwar SGS Nogueras David D van Woerden Hugo H Kiparoglou Vasiliki V

BMJ open 20190927 9

<h4>Introduction</h4>Loneliness is an emerging public health problem that is associated with social, emotional, mental and physical health issues. The application of digital technology (DT) interventions to reduce loneliness has significantly increased in the recent years. The effectiveness of DT interventions needs to be assessed systematically.<h4>Methods and analysis</h4>Aim: To undertake a systematic review and meta-analysis on the effectiveness of DT interventions to reduce loneliness among ...[more]

PMID: 31562164

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Project description:BackgroundLoneliness is a serious public health issue, and its burden is increasing in many countries. Loneliness affects social, physical, and mental health, and it is associated with multimorbidity and premature mortality. In addition to social interventions, a range of digital technology interventions (DTIs) are being used to tackle loneliness. However, there is limited evidence on the effectiveness of DTIs in reducing loneliness, especially in adults. The effectiveness of DTIs in reducing loneliness needs to be systematically assessed.ObjectiveThe objective of this study is to assess the effectiveness of DTIs in reducing loneliness in older adults.MethodsWe conducted electronic searches in PubMed, MEDLINE, CINAHL, Embase, and Web of Science for empirical studies published in English from January 1, 2010, to July 31, 2019. The study selection criteria included interventional studies that used any type of DTIs to reduce loneliness in adults (aged ≥18 years) with a minimum intervention duration of 3 months and follow-up measurements at least 3 months after the intervention. Two researchers independently screened articles and extracted data using the PICO (participant, intervention, comparator, and outcome) framework. The primary outcome measure was loneliness. Loneliness scores in both the intervention and control groups at baseline and at follow-up at 3, 4, 6, and 12 months after the intervention were extracted. Data were analyzed via narrative synthesis and meta-analysis using RevMan (The Cochrane Collaboration) software.ResultsA total of 6 studies were selected from 4939 screened articles. These studies included 1 before and after study and 5 clinical trials (4 randomized clinical trials and 1 quasi-experimental study). All of these studies enrolled a total of 646 participants (men: n=154, 23.8%; women: n=427, 66.1%; no gender information: n=65, 10.1%) with an average age of 73-78 years (SD 6-11). Five clinical trials were included in the meta-analysis, and by using the random effects model, standardized mean differences (SMDs) were calculated for each trial and pooled across studies at the 3-, 4-, and 6-month follow-ups. The overall effect estimates showed no statistically significant difference in the effectiveness of DTIs compared with that of usual care or non-DTIs at follow-up at 3 months (SMD 0.02; 95% CI -0.36 to 0.40; P=.92), 4 months (SMD -1.11; 95% CI -2.60 to 0.38; P=.14), and 6 months (SMD -0.11; 95% CI -0.54 to 0.32; P=.61). The quality of evidence was very low to moderate in these trials.ConclusionsOur meta-analysis shows no evidence supporting the effectiveness of DTIs in reducing loneliness in older adults. Future research may consider randomized controlled trials with larger sample sizes and longer durations for both the interventions and follow-ups.International registered report identifier (irrid)RR2-10.1136/bmjopen-2019-032455.

Project description:BackgroundThe global population of older adults (aged >60 years) is expected to triple to 2 billion by 2050. Proportionate rises in older adults affected by loneliness and social isolation (or social connectedness) are expected. Rapid deployability and social changes have increased the availability of technological devices, creating new opportunities for older adults.ObjectiveThis study aimed to identify, synthesize, and critically appraise the effectiveness of technology interventions improving social connectedness in older adults by assessing the quality of reviews, common observations, and derivable themes.MethodsFollowing the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), 4 databases (PsycINFO, PubMed, Embase, and MEDLINE) were searched between February 2020 and March 2022. We identified reviews with adults aged ≥50 years in community and residential settings, reporting outcomes related to the impact of technologies on social disconnectedness with inclusion criteria based on the population, intervention, context, outcomes, and study schema-review-type articles (systematic, meta-analyses, integrative, and scoping)-and with digital interventions included. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to measure the strength of outcome recommendations including the risk of bias. The reviews covered 326 primary studies with 79,538 participants. Findings were extracted, synthesized, and organized according to emerging themes.ResultsOverall, 972 publications met the initial search criteria, and 24 met our inclusion criteria. Revised Assessment of Multiple Systematic Reviews was used to assess the quality of the analysis. Eligible reviews (3/24, 12%) were excluded because of their low Revised Assessment of Multiple Systematic Reviews scores (<22). The included reviews were dedicated to information and communications technology (ICT; 11/24, 46%), videoconferencing (4/24, 17%), computer or internet training (3/24, 12%), telecare (2/24, 8%), social networking sites (2/24, 8%), and robotics (2/27, 8%). Although technology was found to improve social connectedness, its effectiveness depended on study design and is improved by shorter durations, longer training times, and the facilitation of existing relationships. ICT and videoconferencing showed the best results, followed by computer training. Social networking sites achieved mixed results. Robotics and augmented reality showed promising results but lacked sufficient data for informed conclusions. The overall quality of the studies based on GRADE was medium low to very low.ConclusionsTechnology interventions can improve social connectedness in older adults. The specific effectiveness rates favor ICT and videoconferencing, but with limited evidence, as indicated by low GRADE ratings. Future intervention and study design guidelines should carefully assess the methodological quality of studies and the overall certainty of specific outcome measures. The lack of randomized controlled trials in underlying primary studies (<28%) and suboptimal methodologies limited our findings. Robotics and augmented or virtual reality warrant further research. Low GRADE scores highlight the need for high-quality research in these areas.Trial registrationPROSPERO CRD42022363475; https://tinyurl.com/mdd6zds.

Project description:BackgroundDigital interventions, defined as any intervention accessed and taking input from patients in the form of a computer/Web-based program or mobile phoned-based app, can potentially help empower patients to self-manage long-term conditions such as hypertension. Importantly, digital interventions have the potential to provide patients with personalized information and support for active involvement in treatment as well as cost saving.ObjectiveThe purpose of this systematic review is to synthesize the evidence for using digital interventions to support patient self-management of hypertension, and determine their impact on control and reduction of blood pressure, other clinical outcomes, quality of life, medication adherence, health service utilization, and economic benefits.MethodsA systematic search of bibliographic databases including Medline, Embase, CINAHL, and PsycINFO will be undertaken. Abstracts and citations will be independently screened by 2 researchers against predetermined inclusion criteria. Any disagreements will be resolved by discussion and further consideration of the inclusion criteria. Only randomized controlled trials which have been published in peer peer-reviewed journals with a diagnosis of hypertension will be considered. Inclusion criteria will be (1) adults (age ≥ 18 years) with hypertension (as defined by the primary authors); (2) an interactive digital intervention compared with usual care; and (3) outcomes of objectively measured change in blood pressure. Data extraction from identified articles will be undertaken by 2 independent reviewers using a uniform template. The main outcomes are systolic blood pressure (SBP) and diastolic blood pressure (DBP), and quality of life indicators. Secondary outcomes include cost- effectiveness, medication adherence, emotional well-being, and physical activity. Risk of bias of included studies will be assessed using the Cochrane tool.ResultsOur research is currently ongoing. Data will be summarized narratively, and if possible, meta-analyses will be performed to assess the impact of the interventions on outcomes.ConclusionsBy summarizing and synthesizing available data, this review will help inform policy on the use of digital interventions for self-management of hypertension and will clarify areas for further research.Trial registrationProspero 2014: CRD42014010268; http://www.crd.york.ac.uk/PROSPERO/display_record.asp? ID=CRD42014010268 (Archived by WebCite at http://www.webcitation.org/6c5alQQJL).

Project description:BackgroundSedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults.MethodsFour electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age???18?years, were eligible for inclusion. Relevant data were extracted, and Hedge's g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis.ResultsNineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g?=?0,32; 95% CI?=?0,14 -?0,50; p?=?0,001) and occupational sedentary time (Hedge's g?=?0,56; 95% CI?=?0,07 -?0,90; p?=?0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g?=?0,40; 95% CI?=?0,19 -?0,60; p?<?0,001), and if the intervention only targeted sedentary behavior (g?=?0,45; 95% CI?=?0,15-0,75; p?=?0,004). No significant intervention effects were found on the number of breaks in sedentary behavior.ConclusionsDespite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future - preferably large-scale studies - can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior.

Project description:BackgroundSuicidal ideation is a highly prevalent condition. There are several barriers for individuals to seek treatment that may be addressed by providing internet-based self-help interventions (ISIs). Current evidence suggests that ISIs for mental disorders may only be effective in reducing suicidal ideation if they specifically target suicidal thoughts or behaviors.ObjectiveThe aim of this systematic review and meta-analysis is to investigate the effectiveness of ISIs that directly target suicidal thoughts or behaviors.MethodsWe will conduct a sensitive systematic literature search in PsycINFO, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Centre for Research Excellence of Suicide Prevention databases. Only randomized controlled trials evaluating the effectiveness of ISIs for suicide prevention will be included. Interventions must be delivered primarily in a Web-based setting; mobile-based interventions and interventions targeting gatekeepers will be excluded. Suicide ideation will be the primary outcome; secondary outcomes will be completed suicides, suicide attempts, depressiveness, anxiety, and hopelessness. Study quality will be assessed using the Cochrane Risk of Bias tool. We will provide a narrative synthesis of included studies. If studies are sufficiently homogenous, we will conduct a meta-analysis of the effectiveness on suicide ideation and, if possible, we will evaluate publication bias using funnel plots. We will evaluate the cumulative evidence in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework.ResultsThis review is in progress, with findings expected by August 2019.ConclusionsThis systematic review and meta-analysis focuses on the effectiveness of ISIs for suicidal thoughts and behaviors. It will provide guidance to clinical practice and encourage further research by synthesizing the best available evidence.Trial registrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42019130253; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130253.International registered report identifier (irrid)PRR1-10.2196/14174.

Project description:BackgroundThere is a compelling need for an innovative and creative approach to promote social connectedness among older adults to optimize their well-being and quality of life. One possible solution may be through a digital intergenerational program.ObjectiveThis realist review aimed to identify existing digital intergenerational programs that were used to reduce loneliness or social isolation among older adults and analyze them in terms of strategy, context, mechanisms, and outcomes.MethodsWe performed a realist review with an extensive search of published and gray literature. For scholarly literature, we searched PubMed, Embase, CINAHL, PsycINFO (Ovid), and Social Sciences Citation Index databases for articles published between January 2000 to August 2020. A grey literature search was performed using the Google search engine, and the search was completed in May 2021. We included programs that evaluated digital intergenerational programs for older adults, which described outcomes of loneliness or social isolation. We included quantitative, mixed methods, and qualitative studies, as well as relevant theoretical papers, policy documents, and implementation documents. The studies were appraised based on their relevance and rigor. We synthesized the available evidence from the literature into Strategy-Context-Mechanism-Outcome (S-C-M-O) configurations to better understand what, when, and how programs work.ResultsA total of 31 documents reporting 27 digital intergenerational programs were reviewed. Our final results identified 4 S-C-M-O configurations. For S-C-M-O configuration 1, we found that for community-dwelling older adults, provision of access to and training in digital technology may increase older adults' self-efficacy in digital devices and therefore increase the use of digital communication with family. In S-C-M-O configuration 2, digital psychosocial support and educational interventions from nurses were found to be useful in reducing loneliness among community-dwelling older adults. In S-C-M-O configuration 3, a video call with a student or family was found to reduce loneliness among older adults residing in long-term residential care facilities. Finally, for S-C-M-O configuration 4, we found that behavioral activation provided through videoconferencing by a lay coach may be useful in reducing loneliness among older adults who are lonely. However, as almost half (11/27, 41%) of the included programs only reported quantitative results, this review focused on screening the discussion section of publications to identify author opinions or any qualitative information to elucidate the mechanisms of how programs work.ConclusionsThis review identified the key strategy, context, and mechanism influencing the success of programs that promote intergenerational interaction through digital means. This review revealed that different strategies should be adopted for different groups of older adults (eg, older adults who are lonely, older adults who reside in long-term residential care facilities, and community-dwelling older adults). The S-C-M-O configurations should be considered when designing and implementing digital intergenerational programs for older adults.

Project description:BackgroundThere is a high prevalence of older adults experiencing depression and anxiety. In response to heightened demands for mental health interventions that are accessible and affordable, there has been a recent rise in the number of digital mental health interventions (DMHIs) that have been developed and incorporated into mental health treatments. Digital interventions are promising in their ability to provide researchers, medical practitioners, and patients with personalized tools for assessing behavior, consultation, treatment, and care that can be used remotely. Reviews and meta-analyses have shown the benefits of DMHIs for the treatment and prevention of depression, anxiety, and other mental illnesses, but there is still a lack of studies that focus on the benefits and use of DMHIs in the older population.ObjectiveThe aim of this systematic review is to investigate the current evidence for the effect of technology-delivered interventions, such as smartphone/tablet applications, remote monitoring and tracking devices, and wearable technology, for the treatment and prevention of depression and anxiety in adults older than 50 years.MethodsThe academic databases SCOPUS, PsycINFO, AgeLine (EBSCO), and Medline (PubMed) will be searched from January 1, 2010, to the date of search commencement to provide a review of existing randomized controlled trial studies. The search will include 3 key concepts: "older adults," "digital intervention," and "depression/anxiety." A set of inclusion criteria will be followed during screening by two reviewers. Data will be extracted to address aims and objectives of the review. The risk of bias for each study will be determined using appropriate tools. If possible, a random-effects meta-analysis will be performed, and the heterogeneity of effect sizes will be calculated.ResultsPreliminary searches were conducted in September 2020. The review is anticipated to be completed by April 2021.ConclusionsThe data accumulated in this systematic review will demonstrate the potential benefits of technology-delivered interventions for the treatment of depression and anxiety disorders in older adults. This review will also identify any gaps in current studies of aging and mental health interventions, thereby navigating a way to move forward and paving the path to more accessible and user-friendly digital health interventions for the diverse population of older adults.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42020192532; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192532.International registered report identifier (irrid)PRR1-10.2196/22738.

Dataset Information

Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis.

Introduction

Methods and analysis

Design

Data sources

Inclusion criteria

Ethics and dissemination

Prospero registration number

Publications

Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis.

Similar Datasets

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