Study protocol of the 'HEAL-HOA' dual randomized controlled trial: Testing the effects of volunteering on loneliness, social, and mental health in older adults.

Background: Interventions to reduce loneliness in older adults usually do not show sustained effects. One potential way to combat loneliness is to offer meaningful social activities. Volunteering has been suggested as one such activity - however, its effects on loneliness remain to be tested in randomized controlled trials (RCT). Methods: This planned Dual-RCT aims to recruit older adults experiencing loneliness, with subsequent randomization to either a volunteering condition (6 weeks of training before delivering one of three tele-based loneliness interventions to older intervention recipients twice a week for 6 months) or to an active control condition (psycho-education with social gatherings for six months). Power analyses require the recruitment of N = 256 older adults to detect differences between the volunteering and the active control condition (128 in each) on the primary outcome of loneliness (UCLA Loneliness Scale). Secondary outcomes comprise social network engagement, perceived social support, anxiety and depressive symptoms, self-rated health, cognitive health, perceived stress, sleep quality, and diurnal cortisol (1/3 of the sample). The main analyses will comprise condition (volunteering vs. no-volunteering) × time (baseline, 6-, 12-, 18-, 24-months follow-ups) interactions to test the effects of volunteering on loneliness and secondary outcomes. Effects are expected to be mediated via frequency, time and involvement in volunteering. Discussion: If our trial can show that volunteers delivering one of the three telephone-based interventions to lonely intervention recipients benefit from volunteer work themselves, this might encourage more older adults to volunteer, helping to solve some of the societal issues involved with rapid demographic changes.

Effects of volunteering over six months on loneliness, social and mental health outcomes among older adults: The HEAL-HOA Dual Randomized Controlled Trial.

OBJECTIVE: To determine the beneficial effects of volunteering as lay counselor via telephone on own loneliness, social network engagement, perceived social support, stress, anxiety, and depressive symptoms among Chinese older adults in Hong Kong during the COVID-19 pandemic. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: "Helping Alleviate Loneliness in Hong Kong Older Adults" (HEAL-HOA), a dual randomized controlled trial, was implemented to test effects of telephone-based psychosocial interventions delivered by older-adult volunteers for low-income lonely older adults. To evaluate the effects of volunteering on loneliness, we randomized 375 individuals ages 50-70 into a volunteering condition versus an active control (psychoeducation with social gatherings). Following a 6-week training, participants in the volunteering condition, delivered tele-interventions to older intervention recipients. MEASUREMENT: The primary outcome was loneliness measured with the UCLA Loneliness Scale. Secondary outcomes were loneliness measured with the De Jong Gierveld Scale (DJG), social network engagement, perceived social support, perceived stress, anxiety, and depressive symptoms. Assessments were completed before training (baseline) and immediately after the 6-month volunteering period. RESULTS: Results from linear mixed models show significant positive effects of volunteering (significant interactions of condition × time) on both measures of loneliness (dppc2 = -0.41 ULCA Loneliness score, dppc2 = -0.70 total DJG score), social network engagement, stress and depressive symptoms as compared to control participants. CONCLUSIONS: The HEAL-HOA trial demonstrates beneficial effects of volunteer-delivered tele-interventions on decreasing loneliness on the volunteer interventionists themselves. Communicating these benefits for volunteers may attract more older adults into volunteering. This effective tele-based volunteer program is scalable for wider implementation. SUMMARY: This RCT tested effects of volunteering on loneliness in Hong Kong during the COVID-19-pandemic. Three hundred seventy-five individuals ages 50-70 were randomized into volunteering (delivering tele-interventions against loneliness) versus an active control condition. After 6 months, volunteers compared to controls, showed benefits on loneliness, social network engagement, stress and depressive symptoms. A program engaging lonely older adults in loneliness intervention delivery has beneficial effects on volunteers themselves and could be a scalable solution for our loneliness epidemic.

Reducing older people's risk of fraud victimization through an anti-scam board game.

This study adopted an experimental design to evaluate the effectiveness of an anti-scam education program for older adults. Participants in the experimental group (n = 55) first participated in an anti-scam board game and then joined another board game featuring local tea restaurants two weeks later, whereas such order was reversed for the control group (n = 54). Compared with the control group, participants in the experimental group reported significant increases in their self-efficacy in fraud prevention and awareness of scam situations, and a significant decrease in perceived susceptibility to scams immediately and two weeks after the intervention, demonstrating the immediate and the short-term effects of the anti-scam education program in reducing fraud victimization risk of older adults.

Maintaining psychological well-being amidst the COVID-19 pandemic: The beneficial effects of health-promoting behaviors and sense of control.

The present research reports the findings of three studies, with objectives to demonstrate the impacts of health-promoting behaviors on psychological well-being as well as the mediating roles of sense of control (SOC) and perceived severity of COVID-19 in these relationships. Study 1 was a cross-sectional survey conducted in 473 middle-aged and older Chinese adults before the COVID-19 pandemic to assess their health-promoting behaviors, personal mastery and perceived constraints, life satisfaction, and depressive symptoms. Study 2 was conducted during the second wave of the COVID-19 outbreak in Hong Kong (between March to April 2020), in which 292 participants from Study 1 were successfully contacted to report their emotional responses to the pandemic. Using a different sample, Study 3 was a longitudinal study that measured 495 participants' health-promoting behaviors, personal mastery and perceived constraints at baseline, and their perceived severity and mental health outcomes during the outbreak of omicron cases in Hong Kong (i.e., the fifth wave of the COVID-19 outbreak) in March 2022. All three studies demonstrate that the beneficial effects of health behaviors can be extended to psychological well-being and reveal possible underlying mechanisms through enhancing one's SOC and lowering perceived severity of the COVID-19 outbreak. These results provide important insights to future health promotion programs for improving psychological resources and psychological well-being of middle-aged and older adults in face of disease-related threats.

Cultural specificity of socioemotional selectivity: age differences in social network composition among Germans and Hong Kong Chinese.

We examined age differences in social network composition among 330 Germans and 330 Hong Kong Chinese, aged 20 to 91 years. We measured social network composition with the Social Convoy Questionnaire. In both cultures, older age was associated with the same number of close social partners and fewer peripheral social partners than was younger age. However, the patterns of age differences in specific relationships differed across cultures: Age was negatively associated with the proportion of nuclear family members among Germans but the association was positive among Hong Kong Chinese. Age was positively associated with the proportion of acquaintances among Germans but the association was negative among Hong Kong Chinese. We discuss the findings in terms of whether the socioemotional selectivity theory holds in both cultures.

Age differences in coping and emotional responses toward SARS: a longitudinal study of Hong Kong Chinese.

This study examined age-related emotional responses and coping at the peak and the end of the SARS outbreak in Hong Kong. Three hundred and eighty-five Hong Kong Chinese, aged 18-86 years, rated the extent that they experienced 'shock', 'sadness', 'anger' and 'fear' in the face of SARS. They also completed selected items from Brief COPE (Carver, 1997). The results showed that older adults consistently experienced less anger than did their younger counterparts. Younger adults used more emotion-focused coping than did middle-aged and older adults at the peak of SARS; yet they exhibited the lowest increase in this form of coping throughout the outbreak, such that the age differences had reversed by the end of the outbreak. Findings of this study suggest that older adults may be better at emotional regulation than are their younger counterparts, they react to a crisis with less anger and are better able to adapt their coping strategies to the changing environment.

Psychosocial correlates of emotional responses to menarche among Chinese adolescent girls.

PURPOSE: To determine the psychosocial correlates of emotional responses to menarche among Chinese adolescent girls. METHODS: A large sample of 1573 post-menarcheal Chinese junior high school students in Hong Kong completed questionnaires on knowledge and preparation of menarche, attitudes toward menstruation, gender-role attitudes, body image, self-esteem, and emotional responses to the onset of the first menstruation. Pearson correlation and hierarchical regression analyses were conducted to determine associations among variables. RESULTS: Participants' mean age at menarche was 11.67 years. Their emotional reactions to menarche were largely negative, with almost 85% reporting feeling annoyed and embarrassed. In spite of these negative feelings, about two-thirds of the participants also reported feeling grown up and another 40% felt as if becoming more feminine. Results of the hierarchical regression analyses showed that negative emotional responses to menarche were correlated with perceptions of menstruation as a negative event, inadequate preparation for menarche, endorsement of indigenous negative menstrual attitudes, and poor self-esteem (24.5% variance explained). Positive emotional responses to menarche were correlated with perceptions of menstruation as a natural event, rejection of indigenous negative menstrual attitudes, positive body image, and adequate preparation for menarche (13.4% variance explained). CONCLUSIONS: This study illustrates the need to attend to various psychosocial and cultural factors in the understanding of Chinese adolescent girls' responses to their first menstruation. In particular, general and indigenous menstrual attitudes, which may have been internalized by Chinese adolescent girls at an early age, are found to be the most salient correlates of their emotional responses to menarche.