Skip to main content
Top
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

An evaluation of the effectiveness of a community mentoring service for socially isolated older people: a controlled trial

Authors: Andy P Dickens, Suzanne H Richards, Annie Hawton, Rod S Taylor, Colin J Greaves, Colin Green, Rachel Edwards, John L Campbell

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Social isolation affects a significant proportion of older people and is associated with poor health outcomes. The current evidence base regarding the effectiveness of interventions targeting social isolation is poor, and the potential utility of mentoring for this purpose has not previously been rigorously evaluated. The purpose of this study was to examine the effectiveness of a community-based mentoring service for improving mental health, social engagement and physical health for socially isolated older people.

Methods

This prospective controlled trial compared a sample of mentoring service clients (intervention group) with a matched control group recruited through general practice. One hundred and ninety five participants from each group were matched on mental wellbeing and social activity scores. Assessments were conducted at baseline and at six month follow-up. The primary outcome was the Short Form Health Survey v2 (SF-12) mental health component score (MCS). Secondary outcomes included the SF-12 physical health component score (PCS), EuroQol EQ-5D, Geriatric Depression Score (GDS-10), social activity, social support and morbidities.

Results

We found no evidence that mentoring was beneficial across a wide range of participant outcomes measuring health status, social activity and depression. No statistically significant between-group differences were observed at follow-up in the primary outcome (p = 0.48) and in most secondary outcomes. Identifying suitable matched pairs of intervention and control group participants proved challenging.

Conclusions

The results of this trial provide no substantial evidence supporting the use of community mentoring as an effective means of alleviating social isolation in older people. Further evidence is needed on the effectiveness of community-based interventions targeting social isolation. When using non-randomised designs, there are considerable challenges in the recruitment of suitable matches from a community sample.

Trial registration

SCIE Research Register for Social Care 105923
Appendix
Available only for authorised users
Literature
1.
go back to reference United Nations: Profiles of ageing by country or area. World Population Ageing 2007. 2007, New York: United Nations, 133-517. United Nations: Profiles of ageing by country or area. World Population Ageing 2007. 2007, New York: United Nations, 133-517.
3.
go back to reference Department of Health: National service framework for older people. 2001, DoH, London Department of Health: National service framework for older people. 2001, DoH, London
4.
go back to reference Jacobzone S, Cambois E, Chaplain E, Robine JM: The health of older persons in OECD countries: is it improving fast enough to compensate for population ageing?. 1999, Paris, full_text.CrossRef Jacobzone S, Cambois E, Chaplain E, Robine JM: The health of older persons in OECD countries: is it improving fast enough to compensate for population ageing?. 1999, Paris, full_text.CrossRef
5.
go back to reference Daviglus ML, Liu K, Pirzada A, Yan LL, Garside DB, Feinglass J, Guralnik JM, Greenland P, Stamler J: Cardiovascular risk profile earlier in life and Medicare costs in the last year of life. Arch Intern Med. 2005, 165: 1028-1034. 10.1001/archinte.165.9.1028.CrossRefPubMed Daviglus ML, Liu K, Pirzada A, Yan LL, Garside DB, Feinglass J, Guralnik JM, Greenland P, Stamler J: Cardiovascular risk profile earlier in life and Medicare costs in the last year of life. Arch Intern Med. 2005, 165: 1028-1034. 10.1001/archinte.165.9.1028.CrossRefPubMed
6.
7.
go back to reference Department of Work and Pensions: Link-Age: developing networks of services for older people. 2004, London Department of Work and Pensions: Link-Age: developing networks of services for older people. 2004, London
8.
go back to reference Department of Health: The NHS Plan: a plan for investment, a plan for reform. 2000, DoH, London Department of Health: The NHS Plan: a plan for investment, a plan for reform. 2000, DoH, London
9.
go back to reference Department of Health: Modernising social services. 1998, DoH, London Department of Health: Modernising social services. 1998, DoH, London
10.
go back to reference World Health Organisation: Active ageing: a policy framework. 2002, WHO, Geneva World Health Organisation: Active ageing: a policy framework. 2002, WHO, Geneva
11.
go back to reference Department of Work and Pensions: Opportunity age: meeting the challenges of ageing in the 21st century. 2005, London Department of Work and Pensions: Opportunity age: meeting the challenges of ageing in the 21st century. 2005, London
12.
go back to reference HM Government: Building a society for all ages. 2009, London HM Government: Building a society for all ages. 2009, London
13.
go back to reference Tomaszewski W, Barnes M: Investigating the dynamics of social detachment in old age. Living in the 21st century: older people in England. The 2006 English Longitudinal Study of Ageing (wave 3). Edited by: Banks J, Breeze E, Lessof C, Nazroo J. 2008, London: Institute of Fiscal Studies, 150-185. Tomaszewski W, Barnes M: Investigating the dynamics of social detachment in old age. Living in the 21st century: older people in England. The 2006 English Longitudinal Study of Ageing (wave 3). Edited by: Banks J, Breeze E, Lessof C, Nazroo J. 2008, London: Institute of Fiscal Studies, 150-185.
15.
go back to reference Holt-Lunstad J, Smith TB, Layton JB: Social relationships and mortality risk: a meta-analytic review. Public Library of Science Medicine. 2010, 7: e1000316-PubMedPubMedCentral Holt-Lunstad J, Smith TB, Layton JB: Social relationships and mortality risk: a meta-analytic review. Public Library of Science Medicine. 2010, 7: e1000316-PubMedPubMedCentral
16.
go back to reference Cornwell EY, Waite LJ: Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior. 2009, 50: 31-48. 10.1177/002214650905000103.CrossRefPubMedPubMedCentral Cornwell EY, Waite LJ: Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior. 2009, 50: 31-48. 10.1177/002214650905000103.CrossRefPubMedPubMedCentral
17.
go back to reference Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B: Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000, 355: 1315-1319. 10.1016/S0140-6736(00)02113-9.CrossRefPubMed Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B: Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000, 355: 1315-1319. 10.1016/S0140-6736(00)02113-9.CrossRefPubMed
18.
go back to reference Lund R, Nilsson CJ, Avlund K: Can the higher risk of disability onset among older people who live alone be alleviated by strong social relations? A longitudinal study of non-disabled men and women. Age Ageing. 2010, 39: 319-326. 10.1093/ageing/afq020.CrossRefPubMed Lund R, Nilsson CJ, Avlund K: Can the higher risk of disability onset among older people who live alone be alleviated by strong social relations? A longitudinal study of non-disabled men and women. Age Ageing. 2010, 39: 319-326. 10.1093/ageing/afq020.CrossRefPubMed
19.
go back to reference Hawton A, Green C, Dickens AP, Richards SH, Taylor RS, Edwards R, Greaves CJ, Campbell JL: The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research. 2010, 1-11. Hawton A, Green C, Dickens AP, Richards SH, Taylor RS, Edwards R, Greaves CJ, Campbell JL: The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research. 2010, 1-11.
20.
go back to reference Department of Health: Confident communities, brighter future. A framework for developing well-being. 2010, DoH, London Department of Health: Confident communities, brighter future. A framework for developing well-being. 2010, DoH, London
21.
go back to reference Findlay R: Interventions to reduce social isolation amongst older people: where is the evidence?. Ageing Soc. 2003, 23: 647-658. 10.1017/S0144686X03001296.CrossRef Findlay R: Interventions to reduce social isolation amongst older people: where is the evidence?. Ageing Soc. 2003, 23: 647-658. 10.1017/S0144686X03001296.CrossRef
22.
go back to reference Cattan M, White M, Bond J, Learmouth A: Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing Soc. 2005, 25: 41-67. 10.1017/S0144686X04002594.CrossRef Cattan M, White M, Bond J, Learmouth A: Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing Soc. 2005, 25: 41-67. 10.1017/S0144686X04002594.CrossRef
23.
go back to reference Cattan M, White M: Developing evidence based health promotion for older people: a systematic review and survey of health promotion interventions targeting social isolation and loneliness among older people. Internet Journal of Health Promotion. 1998 Cattan M, White M: Developing evidence based health promotion for older people: a systematic review and survey of health promotion interventions targeting social isolation and loneliness among older people. Internet Journal of Health Promotion. 1998
24.
go back to reference Charlesworth G, Shepstone L, Wilson E, Thalanany M, Mugford M, Poland F: Does befriending by trained lay workers improve psychological well-being and quality of life for carers of people with dementia, and at what cost? A randomised controlled trial. Health Technology Assessment. 2008, 4: Charlesworth G, Shepstone L, Wilson E, Thalanany M, Mugford M, Poland F: Does befriending by trained lay workers improve psychological well-being and quality of life for carers of people with dementia, and at what cost? A randomised controlled trial. Health Technology Assessment. 2008, 4:
25.
go back to reference Bouman A, van Rossum E, Nelemans P, Kempen G, Knipschild P: Effects of intensive home visiting programs for older people with poor health status: a systematic review. BMC Health Services Research. 2008, 8: 74-10.1186/1472-6963-8-74.CrossRefPubMedPubMedCentral Bouman A, van Rossum E, Nelemans P, Kempen G, Knipschild P: Effects of intensive home visiting programs for older people with poor health status: a systematic review. BMC Health Services Research. 2008, 8: 74-10.1186/1472-6963-8-74.CrossRefPubMedPubMedCentral
26.
go back to reference Bearman S, Blake-Beard S, Hunt L, Crosby FJ: New directions in mentoring. The Blackwell Handbook of Mentoring: a multiple perspectives approach. Edited by: Allen TD, Eby LT. 2007, Oxford: Blackwell Publishing, 375-396. Bearman S, Blake-Beard S, Hunt L, Crosby FJ: New directions in mentoring. The Blackwell Handbook of Mentoring: a multiple perspectives approach. Edited by: Allen TD, Eby LT. 2007, Oxford: Blackwell Publishing, 375-396.
27.
go back to reference Eby LT, Rhodes JE, Allen TD: Definition and evolution of mentoring. The Blackwell Handbook of Mentoring: a multiple perspectives approach. Edited by: Allen TD, Eby LT. 2007, Oxford: Blackwell Publishing, 7-20. Eby LT, Rhodes JE, Allen TD: Definition and evolution of mentoring. The Blackwell Handbook of Mentoring: a multiple perspectives approach. Edited by: Allen TD, Eby LT. 2007, Oxford: Blackwell Publishing, 7-20.
28.
go back to reference Department of Health: Healthy living centres. 1999, DoH, London Department of Health: Healthy living centres. 1999, DoH, London
29.
go back to reference Greaves C, Farbus L: Effects of creative and social activity on the health and well-being of social isolated older people: outcomes from a multi-method observational study. Journal of the Royal Society for the Promotion of Health. 2006, 126: 134-142. 10.1177/1466424006064303.CrossRefPubMed Greaves C, Farbus L: Effects of creative and social activity on the health and well-being of social isolated older people: outcomes from a multi-method observational study. Journal of the Royal Society for the Promotion of Health. 2006, 126: 134-142. 10.1177/1466424006064303.CrossRefPubMed
30.
go back to reference Ware JE, Kosinski M, Turner-Bowker DM, Gandek B: How to score SF-12 items. SF-12 v2: how to score version 2 of the SF-12 Health Survey. 2002, Lincoln, RI: QualityMetric Incorporated, 29-38. Ware JE, Kosinski M, Turner-Bowker DM, Gandek B: How to score SF-12 items. SF-12 v2: how to score version 2 of the SF-12 Health Survey. 2002, Lincoln, RI: QualityMetric Incorporated, 29-38.
33.
go back to reference Devon County Council: Community mentoring manual. 2007, Exeter Devon County Council: Community mentoring manual. 2007, Exeter
34.
go back to reference Farbus L, Greaves CJ: The Upstream Healthy Living Centre: research on the processes and outcomes of an intervention to promote health and quality of life in a socially isolated elderly population. 2005, Exeter Farbus L, Greaves CJ: The Upstream Healthy Living Centre: research on the processes and outcomes of an intervention to promote health and quality of life in a socially isolated elderly population. 2005, Exeter
35.
go back to reference Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 health survey manual and interpretation guide. 1993, Boston Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 health survey manual and interpretation guide. 1993, Boston
36.
go back to reference Campbell JL, Winder R, Richards SH, Wyatt K, Hobart J: The FAB study: final report. 2004, Exeter Campbell JL, Winder R, Richards SH, Wyatt K, Hobart J: The FAB study: final report. 2004, Exeter
37.
go back to reference Richards S, Coast J, Gunnell D, Peters T, Pounsforth J, Darlow M: A randomised controlled trial comparing the effectiveness and acceptability of an early discharge hospital at home scheme with acute hospital care. BMJ. 1998, 316: 1796-1801.CrossRefPubMedPubMedCentral Richards S, Coast J, Gunnell D, Peters T, Pounsforth J, Darlow M: A randomised controlled trial comparing the effectiveness and acceptability of an early discharge hospital at home scheme with acute hospital care. BMJ. 1998, 316: 1796-1801.CrossRefPubMedPubMedCentral
38.
go back to reference Wang H, Boissel JP, Nony P: Revisiting the relationship between baseline risk and risk under treatment. Emerging Themes in Epidemiology. 2009, 6: 10.1186/1742-7622-6-1. Wang H, Boissel JP, Nony P: Revisiting the relationship between baseline risk and risk under treatment. Emerging Themes in Epidemiology. 2009, 6: 10.1186/1742-7622-6-1.
39.
go back to reference Oleckno WA: An overview of epidemiologic study designs. Epidemiology: concepts and methods. 2008, Illinois: Waveland Press, Inc, 55-84. Oleckno WA: An overview of epidemiologic study designs. Epidemiology: concepts and methods. 2008, Illinois: Waveland Press, Inc, 55-84.
40.
go back to reference Harmatz MG, Well AD, Overtree CE, Kawamura KY, Rosal M, Ockene IS: Seasonal variation of depression and other moods: a longitudinal approach. Journal of Biological Rhythms. 2000, 15: 344-350. 10.1177/074873000129001350.CrossRefPubMed Harmatz MG, Well AD, Overtree CE, Kawamura KY, Rosal M, Ockene IS: Seasonal variation of depression and other moods: a longitudinal approach. Journal of Biological Rhythms. 2000, 15: 344-350. 10.1177/074873000129001350.CrossRefPubMed
41.
go back to reference Ware J, Kosinski M, Turner-Bowker D, Gandek B: How to score version 2 of the SF-12 Health Survey (with a supplement documenting version 1). 2002, Lincoln, RI: QualityMetric Incorporated Ware J, Kosinski M, Turner-Bowker D, Gandek B: How to score version 2 of the SF-12 Health Survey (with a supplement documenting version 1). 2002, Lincoln, RI: QualityMetric Incorporated
42.
go back to reference Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A: Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Rheumatology. 1997, 36: 551-559. 10.1093/rheumatology/36.5.551.CrossRef Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A: Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Rheumatology. 1997, 36: 551-559. 10.1093/rheumatology/36.5.551.CrossRef
43.
go back to reference D'ath P, Katona P, Mullan E, Evans S, Katona C: Screening, detection and management of depression in elderly primary care attenders. I: the acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract. 1994, 11: 260-266.CrossRefPubMed D'ath P, Katona P, Mullan E, Evans S, Katona C: Screening, detection and management of depression in elderly primary care attenders. I: the acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract. 1994, 11: 260-266.CrossRefPubMed
44.
go back to reference Donald C, Ware J: The measurement of social support. Research in Community and Mental Health. 1984, 4: 325-370. Donald C, Ware J: The measurement of social support. Research in Community and Mental Health. 1984, 4: 325-370.
45.
go back to reference Sherbourne C, Stewart A: The MOS social support survey. Soc Sci Med. 1991, 32: 705-714. 10.1016/0277-9536(91)90150-B.CrossRefPubMed Sherbourne C, Stewart A: The MOS social support survey. Soc Sci Med. 1991, 32: 705-714. 10.1016/0277-9536(91)90150-B.CrossRefPubMed
46.
go back to reference von Elm E, Altman D, Pocock S, Gotzsche P, Vandenbroucke J: Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007, 335: 806-808. 10.1136/bmj.39335.541782.AD.CrossRefPubMedPubMedCentral von Elm E, Altman D, Pocock S, Gotzsche P, Vandenbroucke J: Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007, 335: 806-808. 10.1136/bmj.39335.541782.AD.CrossRefPubMedPubMedCentral
47.
go back to reference Rothman KJ: No adjustments are needed for multiple comparisons. Epidemiology. 1990, 1: 43-46. 10.1097/00001648-199001000-00010.CrossRefPubMed Rothman KJ: No adjustments are needed for multiple comparisons. Epidemiology. 1990, 1: 43-46. 10.1097/00001648-199001000-00010.CrossRefPubMed
48.
go back to reference Little RJA, Rubin DB: Introduction. Statistical Analysis with Missing Data. 2002, New Jersey: John Wiley & Sons, 3-23. 2 Little RJA, Rubin DB: Introduction. Statistical Analysis with Missing Data. 2002, New Jersey: John Wiley & Sons, 3-23. 2
49.
go back to reference Coull A, Taylor V, Elton R, Murdoch P, Hargreaves A: A randomised controlled trial of senior lay health mentoring in older people with ischaemic heart disease: the Braveheart project. Age Ageing. 2004, 33: 348-354. 10.1093/ageing/afh098.CrossRefPubMed Coull A, Taylor V, Elton R, Murdoch P, Hargreaves A: A randomised controlled trial of senior lay health mentoring in older people with ischaemic heart disease: the Braveheart project. Age Ageing. 2004, 33: 348-354. 10.1093/ageing/afh098.CrossRefPubMed
50.
go back to reference Bazzano AT, Zeldin AS, Diab IR, Garro NM, Allevato NA, Lehrer D: The Healthy Lifestyle Change Program: a pilot of a community-based health promotion intervention for adults with developmental disabilities. American Journal of Preventive Medicine. 2009, 37: S201-S208. 10.1016/j.amepre.2009.08.005.CrossRefPubMed Bazzano AT, Zeldin AS, Diab IR, Garro NM, Allevato NA, Lehrer D: The Healthy Lifestyle Change Program: a pilot of a community-based health promotion intervention for adults with developmental disabilities. American Journal of Preventive Medicine. 2009, 37: S201-S208. 10.1016/j.amepre.2009.08.005.CrossRefPubMed
51.
go back to reference Bennetts C: The traditional mentor relationship and the well-being of creative individuals in school and work. International Journal of Health Promotion and Education. 2000, 38: 22-27.CrossRef Bennetts C: The traditional mentor relationship and the well-being of creative individuals in school and work. International Journal of Health Promotion and Education. 2000, 38: 22-27.CrossRef
52.
go back to reference Juni P, Altman DG, Egger M: Systematic reviews in health care: assessing the quality of controlled clinical trials. BMJ. 2001, 323: 42-46. 10.1136/bmj.323.7303.42.CrossRefPubMedPubMedCentral Juni P, Altman DG, Egger M: Systematic reviews in health care: assessing the quality of controlled clinical trials. BMJ. 2001, 323: 42-46. 10.1136/bmj.323.7303.42.CrossRefPubMedPubMedCentral
53.
go back to reference Petticrew M, Roberts H: Evidence, hierarchies, and typologies: horses for courses. J Epidemiol Community Health. 2003, 57: 527-529. 10.1136/jech.57.7.527.CrossRefPubMedPubMedCentral Petticrew M, Roberts H: Evidence, hierarchies, and typologies: horses for courses. J Epidemiol Community Health. 2003, 57: 527-529. 10.1136/jech.57.7.527.CrossRefPubMedPubMedCentral
54.
go back to reference Hawe P, Shiell A, Riley T, Gold L: Methods for exploring implementation variation and local context within a cluster randomised community intervention trial. J Epidemiol Community Health. 2004, 58: 788-793. 10.1136/jech.2003.014415.CrossRefPubMedPubMedCentral Hawe P, Shiell A, Riley T, Gold L: Methods for exploring implementation variation and local context within a cluster randomised community intervention trial. J Epidemiol Community Health. 2004, 58: 788-793. 10.1136/jech.2003.014415.CrossRefPubMedPubMedCentral
55.
go back to reference Oakley A, Strange V, Bonell C, Allen E, Stephenson J, RIPPLE Study Team: Process evaluation in randomised controlled trials of complex interventions. BMJ. 2006, 332: 413-416. 10.1136/bmj.332.7538.413.CrossRefPubMedPubMedCentral Oakley A, Strange V, Bonell C, Allen E, Stephenson J, RIPPLE Study Team: Process evaluation in randomised controlled trials of complex interventions. BMJ. 2006, 332: 413-416. 10.1136/bmj.332.7538.413.CrossRefPubMedPubMedCentral
56.
go back to reference Gandek B, Ware J, Aaronson N, Apolone G, Bjorner J, Brazier J, Bullinger M, Kaasa S, Leplege A, Prieto L, et al: Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. Journal of Clinical Epidemiology. 1998, 51: 1171-1178. 10.1016/S0895-4356(98)00109-7.CrossRefPubMed Gandek B, Ware J, Aaronson N, Apolone G, Bjorner J, Brazier J, Bullinger M, Kaasa S, Leplege A, Prieto L, et al: Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. Journal of Clinical Epidemiology. 1998, 51: 1171-1178. 10.1016/S0895-4356(98)00109-7.CrossRefPubMed
57.
go back to reference Craig D, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: new guidance. 2008 Craig D, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: new guidance. 2008
Metadata
Title
An evaluation of the effectiveness of a community mentoring service for socially isolated older people: a controlled trial
Authors
Andy P Dickens
Suzanne H Richards
Annie Hawton
Rod S Taylor
Colin J Greaves
Colin Green
Rachel Edwards
John L Campbell
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-218

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue