The Getting Active Project (GAP): A Randomized Trial of Volunteering to Reduce Loneliness in Later Life

项目摘要/摘要 启动项目(GAP)。与老年人孤独相关的许多负面后果 使孤独本身成为新的公共卫生目标。感到孤独的老年人患糖尿病的风险增加 降低生活质量、发病率和死亡率。与孤独相关的过早死亡风险至少是 与肥胖、缺乏运动、酗酒和吸烟等因素引起的风险一样大。 志愿服务是一种很有前途的干预措施，可以减少晚年的孤独感。这样做的主要目标是 一项提议是检验这样一种假设，即为孤独的老年人提供社会志愿服务计划将导致 孤独感和生活质量的提高。国家志愿服务基础设施(高级服务团)确保 志愿服务是一种高度可扩展的干预措施。 我们建议比较高级兵团志愿服务干预和自我指导的生活回顾的效果 老年人孤独感的主动控制状况。我们的初步数据，以及公布的 对晚年志愿服务的研究强烈表明，志愿服务(但不是生活回顾)应该减少 寂寞。然而，需要严格的实验研究来检验男性和女性的志愿者行为。 他们是孤独的，要确定使利益最大化的条件，并要了解机制。我们 根据自我决定理论的原则，假设增加了社会参与度和双方的感受 有用性和社会支持是志愿服务减少孤独的心理机制。 了解这些机制将促进有效实施，使社区能够适应 志愿者计划，同时保留有效成分。 我们会随机将报告孤独的老年人(150名女性，150名男性)分配给12个月以下的人：1) 有组织的社会志愿服务计划，为年老体弱、呆在家里的老年人提供同伴陪伴 每周至少4小时，或2)自我指导的生活回顾的积极对照干预。 我们的目标如下：1)考察志愿服务对孤独感和生活质量的影响；2) 考察社会参与度、感知的有用性和社会支持作为减少孤独的机制； 3)考察志愿服务在哪些条件下能最有效地减少孤独感。 我们的干预已经在全国范围内实施，表明规模化的可行性很高 (http://www.nationalservice.gov/programs/senior-corps).如果有效，志愿服务应该由 医生，并由政策推动。传播和扩大努力将涉及将初级保健联系起来 病人和老年服务客户在高级兵团感到孤独，我们已经证明这是可行的 在我们的同伴研究中，高级连接。现有的基础设施将使其有可能达到大型 孤独的老年人所占比例。减少孤独感有可能提高幸福感，拯救生命。 范奥登

Project Summary/Abstract The Getting Active Project (GAP). The many negative outcomes associated with loneliness in older people have rendered loneliness itself a new public health target. Older adults who feel lonely carry increased risk for reduced quality of life, morbidity, and mortality. The risk of premature mortality related to loneliness is at least as large as the risks arising from such factors as obesity, physical inactivity, alcohol misuse, and smoking. Volunteering is a promising intervention for reducing loneliness in later life. The primary objective of this proposal is to test the hypothesis that a social volunteering program for lonely older adults will lead to reduced loneliness and improved quality of life. National infrastructure for volunteering (The Senior Corps) ensures that volunteering is a highly scalable intervention. We propose to compare the effect of a Senior Corps volunteering intervention versus a self-guided life review active control condition on feelings of loneliness in older adults. Our preliminary data, as well as published studies of volunteering in later life, strongly suggest that volunteering (but not life review) should reduce loneliness. Rigorous experimental study is needed, however, to examine volunteering in both men and women who are lonely, to determine conditions that maximize benefit, and to understand mechanisms. We hypothesize, per tenets of Self-Determination Theory, that increased social engagement and feelings of both usefulness and social support function as psychological mechanisms whereby volunteering reduces loneliness. Understanding these mechanisms will promote effective implementation, allowing communities to adapt volunteering programs while retaining the active ingredients. We will randomly assign older adults (150 women, 150 men) who report loneliness to 12 months of either: 1) a structured social volunteering program providing peer companionship to frail, homebound older adults for at least 4 hours per week, or 2) an active control intervention with self-guided life review. Our aims are as follows: 1) To examine the effect of volunteering on loneliness and quality of life; 2) To examine social engagement, perceived usefulness, and social support as mechanisms for reducing loneliness; 3) To examine conditions under which volunteering is most effective at reducing loneliness. Our intervention is already implemented nation-wide, indicating high feasibility of going to scale (http://www.nationalservice.gov/programs/senior-corps). If effective, volunteering should be “prescribed” by physicians and promoted by policy. Dissemination and scaling up efforts will involve connecting primary care patients and aging services clients who are lonely with The Senior Corps, which we have shown to be feasible in our companion study, The Senior Connection. Existing infrastructure will make it possible to reach a large proportion of lonely older adults. Reducing loneliness has the potential to improve well-being and save lives. Van Orden