Development of the Making the Connection Intervention to Address Loneliness and Isolation in Older Adults

Abstract

Fifty percent of individuals aged over 60 are reported at risk of social isolation and one-third will experience some degree of loneliness later in life. Isolation and loneliness have been reported as having negative consequences for mental and physical health and mortality. Existing supportive interventions, even when successful are not widely adopted or utilized. A developmental, mixed methods approach was taken to building and testing the components and delivery of an intervention, Making the Connection (MTC) in preparation for mounting a larger, systematic test. Method : The approach relied upon the six steps of 6sQuID for the development of public health interventions: 1) Define and understand the problem and its causes. 2) Clarify which causal or contextual factors are malleable. 3) Identify how to bring about change. 4) Identify how to deliver the change mechanism. 5) Test and refine on small scale. 6) Collect sufficient evidence of effectiveness to justify rigorous evaluation/implementation. Depressive symptoms, how often people felt lonely, and size of social networks were quantitatively measured and analyzed. Qualitative measures were also used. Findings : All six steps in the 6sQuiD model were followed in building the intervention for potential testing. In an initial test within CCRC facilities, five loneliness-related areas were examined qualitatively and identified as potentially modifiable. Testing of a subsequent 10-session gamified intervention established trends for reduced reports of symptoms of depression, and increases in social connections. Pre and post-test found there was a statistically significant reduction in reports of loneliness in the past week. Discussion : Making the Connection manualized intervention appears both feasible and viable, a necessary first step to prepare for more systematic evaluation in a randomized control trial.