Academic Research Centers, NORC at the University of Chicago, USA.
Research Department of Behavioural Science and Health, University College London, UK.
Soc Sci Med. 2020 Nov;265:113467. doi: 10.1016/j.socscimed.2020.113467. Epub 2020 Oct 21.
The purpose of this study is to compare mean levels of loneliness, and correlates of loneliness, among older adults in the U.S. and England. Comparisons are conducted after attending to comparability of the loneliness measure between countries based on tests for discriminatory capacity and differential item functioning of the 3-item UCLA Loneliness Scale. Cross-sectional data from the 2015-16 wave of the National Social Life, Health and Aging Project (NSHAP) and the 2014-2015 wave of the English Longitudinal Study on Ageing (ELSA) were analyzed using graded item response models and multiple indicators and multiple causes (MIMIC) models. Risk factors included demographic variables, health characteristics, and social characteristics that were harmonized across surveys. Because of differences in the racial-ethnic composition of the U.S. and England, analyses were limited to white respondents (N = 2624 in NSHAP; N = 6639 in ELSA). Only respondents born 1925-1965 were included in analyses. Discriminatory capacity was evident in each item being able to distinguish a lonely from a nonlonely individual. Differential item functioning (DIF) was evident in country differences in the likelihood of endorsing the "lack companionship" item at a given level of trait loneliness, and in DIF among marital status, education, and gender subgroups that were comparable across countries. Overall loneliness levels are equivalent in England and the U.S. Risk factor impact did not differ between countries, but differences in risk factor prevalence between countries combined to produce a net result of slightly lower mean levels of loneliness in older adults in England than in the U.S. after risk factor adjustment. The fact that the impact of risk factors were similar across countries suggests that evidence of successful interventions in one country could be leveraged to accelerate development of effective interventions in the other.
本研究旨在比较美国和英国老年人的孤独感平均水平及其相关因素。在关注两国孤独感测量的可比性之后，我们对这一比较进行了测试，具体做法是检验 3 项 UCLA 孤独量表的辨别能力和区别性项目功能。本研究分析了来自 2015-2016 年国家社会生活、健康和老龄化项目（NSHAP）以及 2014-2015 年英国老龄化纵向研究（ELSA）的横断面数据，采用分级项目反应模型和多指标多原因（MIMIC）模型进行分析。风险因素包括人口统计学变量、健康特征和社会特征，这些因素在不同调查中都进行了协调。由于美国和英国的种族-民族构成存在差异，因此分析仅限于白人受访者（NSHAP 中 N=2624；ELSA 中 N=6639）。仅包括 1925-1965 年出生的受访者。在每个项目中，辨别能力都能够区分孤独者和非孤独者。在特征孤独感的特定水平下，对“缺乏陪伴”项目的认同可能性存在国家差异，在婚姻状况、教育和性别亚组中也存在区别性项目功能（DIF），这些差异在国家之间是可比的。英国和美国的总体孤独感水平相当。风险因素的影响在两国之间没有差异，但两国之间风险因素的流行率差异结合起来，导致英国老年人的孤独感平均水平略低于美国老年人，这是在调整风险因素后得出的结果。风险因素的影响在两国之间相似的事实表明，一国成功干预措施的证据可以被利用，以加速另一国有效干预措施的发展。
