Physical activity interventions for loneliness in community-dwelling older adults

Shvedko, Anastasia ORCID: 0000-0002-0556-8901 (2020). Physical activity interventions for loneliness in community-dwelling older adults. University of Birmingham. Ph.D.

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This thesis addresses the important health concern of loneliness among community-dwelling older adults and attempted to contribute to the collective knowledge of interventions to reduce loneliness with a particular interest in PA interventions for loneliness, due to the current limited evidence. The first aim of this PhD was to systematically review the impact of physical activity interventions for loneliness among older adults, and conduct a meta-analysis of their effects. Developed from the findings of the systematic review of randomised controlled trials (RCTs), the next part of this PhD was to design a Physical Activity Intervention for Loneliness (PAIL) and protocol development. The next aim was to examine the acceptability and feasibility of the PAIL intervention in community-dwelling older adults at risk of loneliness. The PAIL intervention was a randomised controlled feasibility study and had a mixed-methods research design utilising quantitative and qualitative (i.e. focus groups) research methods. The systematic review found PA intervention effects on social functioning. The sensitivity analysis for social functioning obtained the strongest effects for solely PA interventions versus those with a social interaction component, (e.g. health education), among diseased versus healthy populations, in a group exercise setting versus individual, and delivered by a medical healthcare provider versus non-medical provider. However, coincident with the literature, no effect of PA was found for social support or social networks outcomes. Due to the lack of studies, it was not possible to review PA intervention effects for loneliness. From the intervention, based on responses of participants to interviews, the PAIL intervention was mostly accepted positively by participants who were seeking to increase their social networks and engage in PA. However, it was not feasible to recommend roll-out in a full-scale RCT in its present form. For example, the intervention design could be significantly improved by providing transport, classifying groups by a level of walking (e.g. beginners, improver, advanced), adding group leaders, and delivering the healthy workshops as an extracurricular activity separately from the intervention. Similarly, the failure of the recruitment criteria shows the need to be improved possibly by recruiting through GPs and contacting the activity leaders of community organisations. The a priori recruitment criteria for progression to a large-scale RCT was not met, but the retention criteria were met and no adverse events occurred. Therefore, this thesis also discusses changes needed to support adequate recruitment of community-dwelling older adults at risk for loneliness and adherence into a definitive RCT.

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
Licence: All rights reserved All rights reserved All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Life & Environmental Sciences
School or Department: School of Sport, Exercise and Rehabilitation Sciences
Funders: None/not applicable
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine


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