Centre for Public Health and Wellbeing, University of the West of England, Bristol, Frenchay Campus, Bristol, BS16 1QY, UK.
South Gloucestershire Council, Yate, UK.
BMC Med Res Methodol. 2019 Aug 29;19(1):181. doi: 10.1186/s12874-019-0825-6.
Loneliness and social isolation are major determinants of mental wellbeing, especially among older adults. The effectiveness of interventions to address loneliness and social isolation among older adults has been questioned due to the lack of transparency in identifying and recruiting populations at risk. This paper aims to systematically review methods used to identify and recruit older people at risk of loneliness and social isolation into research studies that seek to address loneliness and social isolation.
In total, 751 studies were identified from a structured search of eleven electronic databases combined with hand searching of reference bibliography from identified studies for grey literature. Studies conducted between January 1995 and December 2017 were eligible provided they recruited community living individuals aged 50 and above at risk of social isolation or loneliness into an intervention study.
A total of 22 studies were deemed eligible for inclusion. Findings from these studies showed that the most common strategy for inviting people to participate in intervention studies were public-facing methods including mass media and local newspaper advertisements. The majority of participants identified this way were self-referred, and in many cases self-identified as lonely. In most cases, there was no standardised tool for defining loneliness or social isolation. However, studies that recruited via referral by recognised agencies reported higher rates of eligibility and enrolment. Referrals from primary care were only used in a few studies. Studies that included agency referral either alone or in combination with multiple forms of recruitment showed more promising recruitment rates than those that relied on only public facing methods. Further research is needed to establish the cost-effectiveness of multiple forms of referral.
Findings from this study demonstrate the need for transparency in writing up the methods used to approach, assess and enrol older adults at risk of becoming socially isolated. None of the intervention studies included in this review justified their recruitment strategies. The ability of researchers to share best practice relies greatly on the transparency of research.
孤独和社会隔离是心理健康的主要决定因素，尤其是在老年人中。由于缺乏确定和招募处于风险中的人群的透明度，干预措施在解决老年人孤独和社会隔离方面的有效性受到了质疑。本文旨在系统地回顾用于确定和招募有孤独和社会隔离风险的老年人参与旨在解决孤独和社会隔离问题的研究的方法。
总共从 11 个电子数据库进行了结构搜索，结合从已确定的研究中对手册的参考书目进行了手工搜索，共确定了 751 项研究。如果研究招募了社区居住的 50 岁及以上、有社会隔离或孤独风险的个体参与干预研究，则符合纳入标准。
共有 22 项研究被认为符合纳入标准。这些研究的结果表明，邀请人们参与干预研究最常见的策略是面向公众的方法，包括大众媒体和当地报纸广告。大多数以这种方式识别的参与者是自我推荐的，在许多情况下，他们自我认定为孤独。在大多数情况下，没有用于定义孤独或社会隔离的标准化工具。但是，通过公认机构转介招募的研究报告的合格和入组率更高。很少有研究通过初级保健转介。那些仅通过转介或与多种招募形式相结合的研究报告显示出比仅依赖于面向公众的方法更高的招募率。需要进一步研究以确定多种转介形式的成本效益。
这项研究的结果表明，在撰写接近、评估和招募有社交隔离风险的老年人的方法时需要透明度。本综述中包含的干预研究都没有证明其招募策略的合理性。研究人员分享最佳实践的能力在很大程度上依赖于研究的透明度。
