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Interventions to improve the health and wellbeing of older people living alone: a mixed-methods systematic review of effectiveness and accessibility

Published online by Cambridge University Press:  07 January 2020

Georgina Johnstone Open the ORCID record for Georgina Johnstone [Opens in a new window] ,
Marissa Dickins Open the ORCID record for Marissa Dickins [Opens in a new window] ,
Judy Lowthian ,
Emma Renehan ,
Joanne Enticott ,
Duncan Mortimer  and
Rajna Ogrin Open the ORCID record for Rajna Ogrin [Opens in a new window]
Georgina Johnstone*
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia
Marissa Dickins
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Melbourne, Australia
Judy Lowthian
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia Institute of Future Environments, Queensland University of Technology, Brisbane, Queensland, Australia
Emma Renehan
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Beyond Blue, Hawthorn, Victoria, Australia
Joanne Enticott
Affiliation:
Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Melbourne, Australia Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
Duncan Mortimer
Affiliation:
Centre for Health Economics, Monash Business School, Monash University, Clayton, Australia
Rajna Ogrin
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Department of International Business and Asian Studies, Griffith University, Brisbane, Australia Biosignals for Affordable Healthcare, Royal Melbourne Institute of Technology University, Melbourne, Australia Austin Health Department of Medicine, University of Melbourne, Melbourne, Australia
*
*Corresponding author. Email: gjohnstone@boltonclarke.com.au
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Abstract

The global population is ageing and the likelihood of living alone increases with age. Services are necessary to help older people living alone to optimise health and wellbeing. This systematic review aimed to summarise the effectiveness and accessibility of interventions to improve the health and wellbeing of older people living alone. Relevant electronic databases (CINAHL, MEDLINE, PsycINFO and Scopus) were searched for all years up to August 2018. Studies were included if they involved older people (aged ⩾55 years) living alone, and an intervention with measured health and wellbeing outcomes. All study types were included. The Theory of Access was used to assess interventions across dimensions of accessibility, availability, acceptability, affordability, adequacy and awareness. Twenty-eight studies met the eligibility criteria; 17 studies focused on ageing safely in place and 11 on psychological and social wellbeing. Studies comprised quantitative (N = 19), qualitative (N = 4) and mixed-methods (N = 5) approaches. Dimensions from the Theory of Access were poorly addressed in the studies, particularly those of higher-quality methodology. Studies were heterogeneous, preliminary in scope and lacked consistent study design, methodology or measurement. Services that do not address user accessibility in design or evaluation may be limited in their uptake and impact. It is recommended that dimensions of access and co-creation principles be integrated into service design processes and be evaluated alongside clinical effectiveness.

Keywords

older adultsliving aloneaccesshealthwellbeingageing in place
Type
Review Article
Information
Ageing & Society , Volume 41 , Issue 7 , July 2021 , pp. 1587 - 1636
Copyright
Copyright © The Authors, 2020. Published by Cambridge University Press.

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