Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial. A social model for health promotion for an aging population: Initial evidence on the experience corps model An evaluation of the effectiveness of a community mentoring service for socially isolated older people: a controlled trial To RCT or not to RCT: deciding when ‘more evidence is needed’ for public health policy and practice How do systematic reviews incorporate risk of bias assessments into the synthesis of evidence? A methodological study Effects of a peer-led senior health education program. Intergenerational interaction, social capital and health: results from a randomised controlled trial in Brazil. Evaluating the potential of group singing to enhance the well‐being of older people Effects of computer training and Internet usage on the well-being and quality of life of older adults: a randomized, controlled study. Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: a randomized trial among older migrants in Japan. Language bias in randomised controlled trials published in English and German Does a ‘Singing Together Group’ improve the quality of life of people with a dementia and their carers? A pilot evaluation study
BACKGROUND As the population ages , older people account for a greater proportion of the health and social care budget . Whereas some research has been conducted on the use of music therapy for specific clinical population s , little rigorous research has been conducted looking at the value of community singing on the mental health-related quality of life  of older people . AIMS To evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in Engl and . METHOD A pilot pragmatic individual r and omised controlled trial comparing group singing with usual activities in those aged 60 years or more . RESULTS A total of 258 participants were recruited across five centres in East Kent . At 6 months post-r and omisation , significant differences were observed in terms of mental health-related quality of life measured using the SF12 ( mean difference = 2.35 ; 95 % CI = 0.06 - 4.76 ) in favour of group singing . In addition , the intervention was found to be marginally more cost-effective than usual activities . At 3 months , significant differences were observed for the mental health components of quality of life ( mean difference = 4.77 ; 2.53 - 7.01 ) , anxiety ( mean difference = -1.78 ; -2.5 to -1.06 ) and depression ( mean difference = -1.52 ; -2.13 to -0.92 ) . CONCLUSIONS Community group singing appears to have a significant effect on mental health-related quality of life , anxiety and depression , and it may be a useful intervention to maintain and enhance the mental health of older people This report evaluates whether a program for older volunteers  , design ed for both benerativity and health promotion , leads to short-term improvements inmultiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities . The Experience Corps ® places  older volunteers  in public elementary schools in roles design ed to meet schools ’ needs and increase the social , physical , and cognitive activity of the volunteers . This article reports on a pilot r and omized trial in Baltimore , Maryl and . The 128 volunteers were 60–86 years old ; 95 % were African American . At follow-up of 4–8 months , physical activity , strength , people one could turn to for help , and cognitive activity increased significantly , and walking speed decreased significantly less , in participants compared to controls . In this pilot trial , physical , cognitive , and social activity increased , suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children 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 prospect i ve 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 . Assessment s 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-r and omised design s , there are considerable challenges in the recruitment of suitable matches from a community sample .Trial registration SCIE Research Register for Social Care Background Amid the calls for ‘ more public health evidence ’ , we also need simple underst and able methods of determining when more research really is needed . This paper describes a simple decision aid to help policymakers , research ers and other decision makers assess the potential ‘ information value ’ of a new public health r and omised controlled trial . Methods The authors developed a flow chart to help make explicit ( 1 ) the user 's information needs , ( 2 ) the intended use of the new information that the study will produce , ( 3 ) the added value of the evidence to be derived from the new study and ( 4 ) the levels of precision , bias and generalisability required by the user . Results The flow chart is briefly illustrated , first in generic form and then in a worked example , showing how it may be used in deciding whether a new study should be commissioned to evaluate the health impact of allowing motorcycles to use bus lanes in London . Conclusions In this paper , the authors have presented a flow chart for enacting an informal ‘ Value-of-Information’-like approach to deciding when a new public health evaluation is needed . The authors do not suggest that the flow chart approach is technically the equivalent of Value-of-Information methods . Nonetheless , it represents a valuable perspective and process to adopt , and this structured approach will be more revealing than an unstructured thought experiment as the basis for decisions about a new study . To aid in its development as an effective tool , we invite users from a variety of perspectives and context s to review it , to use it in practice and to send us their comments Background Systematic review s ( SRs ) are expected to critically appraise included studies and privilege those at lowest risk of bias ( RoB ) in the synthesis . This study examines if and how critical appraisal s inform the synthesis and interpretation of evidence in SRs . Methods All SRs published in March – May 2012 in 14 high-ranked medical journals and a sample from the Cochrane library were systematic ally assessed by two review ers to determine if and how : critical appraisal was conducted ; RoB was summarised at study , domain and review levels ; and RoB appraisal s informed the synthesis process . Results Of the 59 SRs studied , all except six ( 90 % ) conducted a critical appraisal of the included studies , with most using or adapting existing tools . Almost half of the SRs reported critical appraisal in a manner that did not allow readers to determine which studies included in a review were most robust . RoB assessment s were not incorporated into synthesis in one-third ( 20 ) of the SRs , with their consideration more likely when review s focused on r and omised controlled trials . Common methods for incorporating critical appraisal s into the synthesis process were sensitivity analysis , narrative discussion and exclusion of studies at high RoB. Nearly half of the review s which investigated multiple outcomes and carried out study -level RoB summaries did not consider the potential for RoB to vary across outcomes . Conclusions The conclusions of the SRs , published in major journals , are frequently uninformed by the critical appraisal process , even when conducted . This may be particularly problematic for SRs of public health topics that often draw on diverse study design The effect of a health education course guided by peers aged 55 and over was evaluated . The aim of the course was to empower older adults to participate in society and to promote their wellbeing . Evaluation included determining the effect on attitude toward aging , self-efficacy , perception of the societal opinion regarding the place of the elderly in society ( social influence ) , social participation , perceived social support , and wellbeing of the participants aged 55 to 79 years . A quasi-experimental approach was used . The effect on the experimental group of course participants was studied compared to a  control group of older adults on the waiting list .  The respondents filled out postal question naires at three time points ( before starting the course ( t0 ) , immediately after termination ( t1 ) and three months later ( t2 ) ) . Using a multivariate analysis procedure , a significant interaction effect between time of measurement and group membership was found with respect to the outcome of social influence . At t1 an effect was absent , but at t2 , the current idea that elderly occupy a marginal position in society , found less favour with the experimental group than the control group . Moreover perceived social support and subjective health improved significantly at t1 and t2 among the course members , when compared to the control group . No effect was found on attitude , self-efficacy , social participation and wellbeing in the short time span of a three months follow-up Recent years have seen a burgeoning of intergenerational programmes aim ing to improve the well being of participants . However , very few programmes have been formally evaluated . In this paper we report results from a r and omised controlled trial of a school-based intergenerational intervention undertaken in Brazil . R and omly selected sample s of 253 adolescents and 266 elders aged 60 and over resident in the school 's catchment area were administered a question naire including questions on cognitive components of social capital , family relationships , and self-rated health . Participants were then r and omly allocated to control and intervention groups . The intervention comprised participation in a 4 month programme of intergenerational activities in which the elders shared their memories with the students . At the end of the intervention the question naire was re-administered to the sample s. High proportions ( 85 - 95 % ) of both sample s completed the question naires but compliance with the intervention was low in the elderly group . In the analysis of results from the elderly sample , we therefore compared the control group with the group assigned to the intervention ( intention to treat analysis ) . Results showed that adolescents in the intervention group were nearly three times more likely to rate their health as good than those in the control group , but also more likely to judge that most people were selfish . In the elderly sample , those from the intervention group were over twice as likely as those from the control group to report positively on the helpfulness of neighbours ; judge most people to be honest or consider their family relationships as good . There were no significant differences between groups on other outcome measures . These results suggest that structured intergenerational activities may have positive effects on some aspects of social capital for both adolescents and elderly people , although further research is needed to eluci date the processes involved and the extent to which the findings are context specific . This study is the first to use a controlled trial design to evaluate this type of intervention and is valuable in showing that this design can be used in interventions of this kind , and also the difficulties involved To evaluate the effect of a singing program developed specifically for older community‐dwelling people on measures of health and well‐being The quality of life of older adults may be improved by the use of computer or Web-based services . A limited number of experimental studies on this topic have shown mixed results . We carried out a r and omized , controlled intervention study that aim ed to examine the causal relationship between computer use and measures of physical well-being , social well-being , emotional well-being , development and activity , and autonomy . We r and omly assigned a group of 191 participants to an intervention group , a training-no intervention group , or a no training-no intervention group .  A fourth group consisted of 45 participants with no interest in computer use . We collected data at baseline , after 4 months , and after 12 months . The results showed that using computers and the Internet neither positively nor negatively influenced everyday functioning , well-being and mood , and the social network of healthy older individuals . We discuss possibilities for future studies Social isolation among the elderly is a concern in developed countries . Using a r and omized trial , this study examined the effect of a social isolation prevention program on loneliness , depression , and subjective well-being of the elderly in Japan . Among the elderly people who relocated to suburban Tokyo , 63 who responded to a pre-test were r and omized and assessed 1 and 6 months after the program . Four sessions of a group-based program were design ed to prevent social isolation by improving community knowledge and networking with other participants and community " gatekeepers . " The Life Satisfaction Index A ( LSI-A ) , Geriatric Depression Scale ( GDS ) , And o-Osada-Kodama ( AOK ) loneliness scale , social support , and other variables were used as outcomes of this study . A linear mixed model was used to compare 20 of the 21 people in the intervention group to 40 of the 42 in the control group , and showed that the intervention program had a significant positive effect on LSI-A , social support , and familiarity with services scores and a significant negative effect on AOK over the study period . The program had no significant effect on depression . The findings of this study suggest that programs aim ed at preventing social isolation are effective when they utilize existing community re sources , are tailor-made based on the specific needs of the individual , and target people who can share similar experiences BACKGROUND Some r and omised controlled trials ( RCTs ) done in German-speaking Europe are published in international English- language journals and others in national German- language journals . We assessed whether authors are more likely to report trials with statistically significant results in English than in German . METHODS We studied pairs of RCT reports , matched for first author and time of publication , with one report published in German and the other in English . Pairs were identified from reports round in a manual search of five leading German- language journals and from reports published by the same authors in English found on Medline .  Quality of methods and reporting were assessed with two different scales by two investigators who were unaware of authors ' identities , affiliations , and other characteristics of trial reports . Main study endpoints were selected by two investigators who were unaware of trial results . Our main outcome was the number of pairs of studies in which the levels of significance ( shown by p values ) were discordant . FINDINGS 62 eligible pairs of reports were identified but 19 ( 31 % ) were excluded because they were duplicate publications . A further three pairs ( 5 % ) were excluded because no p values were given . The remaining 40 pairs were analysed . Design characteristics and quality features were similar for reports in both language s. Only 35 % of German- language articles , compared with 62 % of English- language articles , reported significant ( p < 0.05 ) differences in the main endpoint between study and control groups ( p = 0.002 by McNemar 's test ) . Logistic regression showed that the only characteristic that predicted publication in an English- language journal was a significant result . The odds ratio for publication of trials with significant results in English was 3.75 ( 95 % CI 1.25 - 11.3 ) . INTERPRETATION Authors were more likely to publish RCTs in an English- language journal if the results were statistically significant . English language bias may , therefore , be introduced in review s and meta-analyses if they include only trials reported in English . The effort of the Cochrane Collaboration to identify as many controlled trials as possible , through the manual search of many medical journals published in different language s will help to reduce such bias Ten people with dementia ( PWD ) and their family carers participated in a Singing Together Group for 10 weeks and measures of mood , quality of life , PWD 's behavioural and psychological problems , activities of daily living and cognitive status were measured at pre , post and 10-week follow-up . Engagement levels were monitored during the sessions and care partners asked to rate each session . Additional qualitative information was obtained through interview pre-post and at follow-up and subjected to thematic analysis . The results showed that PWD were deteriorating slowly over the course of the study on all measures but that they and their carers ’ quality of life remained relatively stable . Engagement levels during the group were very high and attendance excellent . Qualitative data gave strong support to the group having promoted wellbeing of all participants and Nolan 's ‘ Senses Framework ’ was used to explore this further . Future research directions are suggested
Background Many interventions have been developed to promote respect and social inclusion among older people , but the evidence on their impacts on health has not been synthesis ed .
This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature .