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Cederroth CR, Earp BD, Gómez Prada HC, Jarach CM, Lir SA, Norris CM, Pilote L, Raparelli V, Rochon P, Sahraoui N, Simmon C, Vissandjee B, Mour C, Arbogast M, Armengol JM, Mason R. Integrating gender analysis into research: reflections from the Gender-Net Plus workshop. EClinicalMedicine 2024; 74:102728. [PMID: 39105192 PMCID: PMC11299571 DOI: 10.1016/j.eclinm.2024.102728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 08/07/2024] Open
Abstract
Gender equality has been a crosscutting issue in Horizon 2020 with three objectives: gender balance in decision-making, gender balance and equal opportunities in project teams at all levels, and inclusion of the gender dimension in research and innovation content. Between 2017 and 2022, the EU funded, in collaboration with national agencies, 13 transnational projects under "GENDER-NET Plus" that explored how to best integrate both sex and gender into studies ranging from social sciences, humanities, and health research. As the projects neared completion, forty researchers from these interdisciplinary teams met in November 2022 to share experiences, discuss challenges, and consider the best ways forward to incorporate sex and gender in research. Here, we summarize the reflections from this workshop and provide some recommendations for i) how to plan the studies (e.g., how to define sex and/or gender and their dimensions, rationale for the hypotheses, identification of data that can best answer the research question), ii) how to conduct them (e.g., adjust definitions and dimensions, perform pilot studies to ensure proper use of terminology and revise until consensus is achieved), and iii) how to analyze and report the findings being mindful of any real-world impact.
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Affiliation(s)
- Christopher R. Cederroth
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Translational Hearing Research, Tübingen Hearing Research Center, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Brian D. Earp
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, England
- Yale-Hastings Program in Ethics and Health Policy, Yale University, New Haven, CT, USA
| | | | - Carlotta M. Jarach
- Laboratory of Lifestyle Research, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Shlomit A. Lir
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Israel
| | - Colleen M. Norris
- Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Louise Pilote
- McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Paula Rochon
- Women's Age Lab, Women's College Hospital, Department of Medicine and RTO/ERO Chair in Geriatric Medicine, University of Toronto, Canada
| | - Nina Sahraoui
- Centre for Sociological and Political Research in Paris, CRESPPA, CNRS, Paris, France
| | - Cassandra Simmon
- European Centre for Social Welfare Policy and Research, Vienna, Austria
| | - Bilkis Vissandjee
- Faculté des Sciences Infirmières, Centre de Recherche en Santé Publique, Université de Montréal, Centre de Recherche SHERPA, Montréal, Québec, Canada
| | - Chloé Mour
- Mission pour la Place des femmes au CNRS, France
| | - Mathieu Arbogast
- Mission pour la Place des femmes au CNRS, CEMS, Cresppa-GTM, France
| | | | - Robin Mason
- Women's College Research Institute, Women's College Hospital and Dalla Lana School of Public Health, University of Toronto, Canada
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Hansen T, Nes RB, Hynek K, Nilsen TS, Reneflot A, Stene-Larsen K, Tornes RA, Bidonde J. Tackling social disconnection: an umbrella review of RCT-based interventions targeting social isolation and loneliness. BMC Public Health 2024; 24:1917. [PMID: 39020331 PMCID: PMC11256365 DOI: 10.1186/s12889-024-19396-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 07/08/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Social isolation and loneliness are urgent public health concerns associated with negative physical and mental health outcomes. Understanding effective remedies is crucial in addressing these problems. This umbrella review aimed to synthesize and critically appraise scientific evidence on the effectiveness of social isolation and loneliness interventions overall and across subgroups. We focused on systematic reviews (SRs) of randomized controlled trials (RCTs). METHODS We searched seven databases (June 2022 and updated June 2023) and supplemented the search with grey literature and reference screening to identify SRs published since 2017. Screening, data extraction, and quality assessment using the AMSTAR2 tool were conducted independently by author pairs, with disagreements resolved through discussion. RESULTS We included 29 SRs, 16 with meta-analysis and 13 with narrative synthesis. All SRs focused on loneliness, with 12 additionally examining social isolation. Four SRs focused on young people, 11 on all ages, and 14 on older adults. The most frequently examined intervention types were social (social contact, social support), psychological (therapy, psychoeducation, social skills training), and digital (e.g., computer use and online support). Meta-analyses indicated small-to-moderate beneficial effects, while narrative synthesis demonstrated mixed or no effect. Social interventions for social isolation and psychological interventions for loneliness were the most promising. However, caution is warranted due to the effects' small magnitude, significant heterogeneity, and the variable quality of SRs. Digital and other interventions showed mixed or no effect; however, caution is advised in interpreting these results due to the highly diverse nature of the interventions studied. CONCLUSIONS This overview of SRs shows small to moderate effectiveness of social interventions in reducing social isolation and psychological ones in tackling loneliness. Further rigorously conducted RCTs and SRs are needed to guide policy decisions regarding the implementation of efficacious and scalable interventions. Evaluation should focus on both preventive structural interventions and tailored mitigating strategies that address specific types and causes of loneliness.
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Affiliation(s)
- Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Kamila Hynek
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas Sevenius Nilsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild Agathe Tornes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Julia Bidonde
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
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Gustafsson PE, Fonseca-Rodríguez O, Nilsson I, San Sebastián M. Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting. Soc Sci Med 2022; 314:115447. [PMID: 36288648 PMCID: PMC9556960 DOI: 10.1016/j.socscimed.2022.115447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 01/26/2023]
Abstract
Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.
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Affiliation(s)
- Per E. Gustafsson
- Department of Epidemiology and Global Health, Umeå University, 901 87, Sweden,Corresponding author
| | | | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Unit of Occupational Therapy, Umeå University, 901 87, Sweden
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Guthmuller S. Loneliness among older adults in Europe: The relative importance of early and later life conditions. PLoS One 2022; 17:e0267562. [PMID: 35584108 PMCID: PMC9116676 DOI: 10.1371/journal.pone.0267562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/12/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of this paper is to study the association between childhood circumstances and loneliness in older adults in Europe. Based on rich information collected by the Survey on Health, Ageing, and Retirement in Europe (SHARE) on childhood characteristics and individual characteristics at age 50+, the study is able to control for personality traits, socioeconomic and demographic factors, social support and health in later life, and country-specific characteristics. The analyses show strong correlations between life circumstances in childhood and feeling lonely in older age; these correlations remain significant after adjusting for covariates. While ill health is the main factor correlated with loneliness at 50+, as expected, the analysis of the relative importance of the determinants reveals that personality traits account for more than 10% of the explained variance and that life circumstances during childhood account for 7%. Social support at older ages is the second highest category of factors, accounting for 27%-with, interestingly, support at home and social network characteristics contributing about 10% each, engaging in activities and computer skills accounting for 7% of the explained variance. Demographic and socioeconomic factors account for 6% and country-level characteristics contribute 5%. This paper points out the relevance of early life interventions to tackling loneliness in older age, and it shows that early interventions and interventions aiming at increasing social support in later life need to be adapted to all personality types. Thus, the role of childhood circumstances and the mechanisms explaining the association between loneliness in childhood and loneliness in later life deserve more attention in future research.
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Affiliation(s)
- Sophie Guthmuller
- Department of Socioeconomics, Health Economics and Policy group, Vienna University of Economics and Business, Vienna, Austria
- RWI Essen, Leibniz Science Campus Ruhr, Essen, Germany
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