Digital Intergenerational Program to Reduce Loneliness and Social Isolation Among Older Adults: Realist Review

Abstract

Background There 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. Objective This 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. Methods We 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. Results A 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. Conclusions This 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.

Barriers and facilitators to older adult participation in intergenerational physical activity program: a systematic review

“…According to Anderson’s [ 80 ] research, older adults appreciated the challenge of playing against virtual trainers as well as the visual stimulus offered by games. This not only helps to focus attention on the enjoyment of electronic games but also gains the health benefits of PA. Phang's [ 81 ] study supports this finding by demonstrating that digital intergenerational programs can increase older adults' engagement and reduce loneliness.…”

Examining the Effect of Contactless Intergenerational Befriending Intervention on Social Isolation Among Older Adults and Students’ Attitude Toward Companionship: Content Analysis

“…Although SI is a global epidemic implying the absence of meaningful human relations and social connectedness, befriending is a psychosocial tonic to building social relationships and intergenerational friendships [ 7 ] that might reduce boredom and depression and significantly enhance the quality of life among older adults [ 8 ] and youth. The feeling of companionship is augmented when an intergenerational conversation is conducted purposefully, thereby negating the exacerbating consequences of SI such as boredom or even the feeling of loneliness.…”

“…SI is one of the most disruptive transformations that exacerbate the quality of life, affecting human behavior, perceptions, and experiences [ 10 , 15 ]. It is a condition that leaves one with feelings of boredom and loneliness that are detrimental to physical and mental health [ 7 ]. Loneliness among older adults is the subjective, distressed feeling of being alone or separated, whereas SI is the objective physical separation from the community [ 14 , 16 ].…”

“…In this population, >7 million (13%) are socially isolated. Of those 7 million individuals, 1.3 million are severely socially isolated [ 5 , 7 ]. The crucial drivers of boredom [ 18 , 20 ], namely, lack of recreational opportunities; limited personal contacts; immobility; prescribed home office; and, especially, COVID-19 quarantine and isolation have dissuaded the everyday lives of older adults, triggering anxiety and monotony [ 4 , 16 , 21 ].…”

Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review

“…This highlights the need for developing social, physical, and technological/digital intergenerational services, spaces, and places that not only accommodate older adults but that welcome them as an integral part of everyday community life. Moreover, research has shown that intergenerational interventions can improve cognitive, emotional, and physical outcomes for both older and younger participants, as well as promote positive attitudes towards aging and reduce ageism and stereotypes [ 17 , 18 , 19 , 20 , 21 , 22 ].…”