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Systematic review Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis
Inhye Kim2orcid , Hyunseo An4orcid , Sohyeon Yun3orcid , Hae Yean Park1orcid
Epidemiol Health 2024;e2024013
DOI: https://doi.org/10.4178/epih.e2024013 [Accepted]
Published online: January 3, 2024
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1College of Software and Digital Healthcare Convergence, Yonsi University, Wonju,Korea
2Graduate school, Yonsei University, Wonju, Korea
3Graduate school, Yonsei University, Wonju, Korea
4Graduate school, Yonsei University, Wonju, Korea
Corresponding author:  Hae Yean Park,
Email: haepark@yonsei.ac.kr
Received: 28 July 2023   • Revised: 6 December 2023   • Accepted: 11 December 2023

OBJECTIVES
This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis.
METHODS
The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions.
RESULTS
Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.958 (95% confidence interval [CI], 0.665 to 1.251) and 0.432 (95% CI, 0.263 to 0.601), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.977 (95% CI, 0.731 to 1.222) for health behavior and 0.675 (95% CI, 0.194 to 1.157) for mental health.
CONCLUSIONS
This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.


Epidemiol Health : Epidemiology and Health