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

Shah, Syed Ghulam Sarwar; Nogueras, David; Woerden, H. van; Kiparoglou, Vasiliki

doi:10.1136/bmjopen-2019-032455

Cited by 34 publications

(33 citation statements)

References 55 publications

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“…Although a loneliness epidemic [ 9 ] was reported in many countries (including Australia, the United Kingdom, and the United States) prior to the COVID-19 pandemic [ 10 ], the burden of loneliness has increased during pandemic lockdowns [ 11 ]. An increase in lockdown loneliness during the COVID-19 pandemic is evident from the latest statistics on coronavirus and loneliness in Great Britain, released in June 2020, which show that lockdown loneliness affected about 7.4 million adults (equivalent to about 14% of residents) during the COVID-19 pandemic lockdowns, while chronic loneliness remained at similar levels compared to prelockdown (2.6 million adults, equivalent to 5% of adults).…”

Section: Burden Of Lockdown Loneliness During the Covid-19 Pandemicmentioning

confidence: 99%

The COVID-19 Pandemic: A Pandemic of Lockdown Loneliness and the Role of Digital Technology

Shah¹,

Nogueras²,

Woerden³

et al. 2020

J Med Internet Res

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220

172

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The focus of this perspective is on lockdown loneliness, which we define as loneliness resulting from social disconnection as a result of enforced social distancing and lockdowns during the COVID-19 pandemic. We also explore the role of digital technology in tackling lockdown loneliness amid the pandemic. In this regard, we highlight and discuss a number of the key relevant issues: a description of lockdown loneliness, the burden of lockdown loneliness during the COVID-19 pandemic, characteristics of people who are more likely to be affected by lockdown loneliness, factors that could increase the risk of loneliness, lockdown loneliness as an important public health issue, tackling loneliness during the pandemic, digital technology tools for social connection and networking during the pandemic, assessment of digital technology tools from the end users’ perspectives, and access to and use of digital technology for tackling lockdown loneliness during the COVID-19 pandemic. We suggest that the most disadvantaged and vulnerable people who are more prone to lockdown loneliness are provided with access to digital technology so that they can connect socially with their loved ones and others; this could reduce loneliness resulting from social distancing and lockdowns during the COVID-19 crisis. Nonetheless, some key issues such as access to and knowledge of digital technology tools must be considered. In addition, the involvement of all key stakeholders (family and friends, social care providers, and clinicians and health allied professionals) should be ensured.

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Section: Burden Of Lockdown Loneliness During the Covid-19 Pandemicmentioning

confidence: 99%

The COVID-19 Pandemic: A Pandemic of Lockdown Loneliness and the Role of Digital Technology

Shah¹,

Nogueras²,

Woerden³

et al. 2020

J Med Internet Res

Self Cite

220

172

View full text Add to dashboard Cite

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“…However, in older people, loneliness can create serious problems that could not be alleviated with the social support only (53). Therefore, particular in older age, other types of interventions are required such as technological interventions (i.e., digital applications, online social networks and social robots) to enhance emotional support and social interaction (54).…”

Section: Discussionmentioning

confidence: 99%

Social Frailty in the COVID-19 Pandemic Era

et al. 2020

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Special attention and efforts to protect from or reduce health-related outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus triggering coronavirus disease 2019 (COVID-19), should be applied in susceptible populations, including frail older people. In particular, the early death cases occurred primarily in older people with a frailty status, possibly due to a weaker immune system fostering faster progression of the viral infection. Frailty is an age-related multidimensional clinical condition defined as a non-specific state of vulnerability, identifying older people at increased risk of falls, institutionalization, hospitalization, disability, dementia, and death. Among frailty phenotypes, social frailty has been least studied. It considers the role of socioeconomic context as a vulnerability status later in life. COVID-19 does not affect all populations equally, and social inequalities contribute to drive the spread of infections. It was known that the perception of social isolation, e.g., loneliness, affects mental and physical health, but the implicated molecular mechanisms, also related to the immune system, and its associated cognitive and health-related sequelae, are poorly understood. The increasing psychological distress derived by prolonged exposure to stress due to the lockdown scenario, and the reduced sources of support, contributed to making heavy demands on personal resources, i.e., self-efficacy and interpersonal variables. So, perceived loneliness may be a factor associated with psychological distress and an outcome in itself. In the COVID-19 pandemic era, a correct assessment of social frailty may be essential in terms of the prevention of late-life neuropsychiatric disorders.

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“…We registered our systematic review and meta-analysis with the PROSPERO database on 10 th June 2019 (Registration ID CRD42019131524) (35) and we published our protocol (34).…”

Section: Methodsmentioning

confidence: 99%

“…We therefore appraise the latest evidence to assess the effectiveness of digital technology interventions to reduce loneliness, which is imperative not only from the perspectives of patients and their families but also from the perspectives of other stakeholders such as public health, health and social care providers, and health insurers (34).…”

Section: Introductionmentioning

confidence: 99%

Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

Shah

Nogueras²,

Woerden

et al. 2020

Preprint

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Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

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

Cited by 34 publications

References 55 publications

The COVID-19 Pandemic: A Pandemic of Lockdown Loneliness and the Role of Digital Technology

The COVID-19 Pandemic: A Pandemic of Lockdown Loneliness and the Role of Digital Technology

Social Frailty in the COVID-19 Pandemic Era

Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

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