Social isolation and loneliness in the elderly: Steps to an evidence-informed health-promoting and preventive practice

People affected by social isolation and loneliness are at a higher risk of mortality. They more frequently suffer from physical and mental illnesses, such as cardiovascular diseases (Leigh-Hunt et al., 2017). In 2018, 37% of the Austrian population lived alone and the trend is increasing (Statistics Austria, 2018). 51% of all people 65 or older live alone (Statistics Austria, 2018) and are especially affected by social isolation and loneliness. The aim of the research project is to provide the best available knowledge and to design an evidence-informed decision-making process for the selection, adaptation, and implementation of suitable measures to prevent and alleviate loneliness and social isolation among older people. The project is being implemented in a research practice cooperation with "Tut gut!" Gesundheitsvorsorge GmbH, the hub for health promotion and prevention in Lower Austria (https://www.noetutgut.at/tut-gut/leitbild/). The procedure corresponds to that of evidence-informed Public Health (Ciliska, Chociolko, & Shum, 2010), follows the transdisciplinary model of evidence-based practice (Satterfield et al., 2009), the recommendations of the UK Medical Research Council (UK MRC) on development and evaluation of complex interventions (Craig et al., 2008), and the evidence standards for effectiveness research in prevention sciences (Gottfredson et al., 2015). It is therefore necessary to implement the following eight steps: (1) Clarification of the question using an exploratory search (Döring, Bortz, & Pöschl, 2016) and formulation of the research question using the PICO format (Higgins et al., 2019). (2) Formation of a recommendation group to take into account the experience of practitioners, the needs and values of the target group, and the scientific evidence. (3) A focused systematic search for German and English-language evidence-based guidelines and evidence synthesis (Systematic Reviews, Overviews of Reviews, Scoping Reviews and Rapid Reviews) and a survey of German-speaking experts to identify effective measures. (4) The critical assessment of the methodological quality of the search results, using the AGREE II instrument (Brouwers et al., 2010) for Guidelines and AMSTAR (Shea et al., 2009) for evidence synthesis. (5) The summary of the best (highest methodological quality) and the latest evidence (date of search). (6) Adaptation of the selected measures to the local context in Lower Austria (Chambers & Norton, 2016). (7) Supporting "Tut gut!" in developing an implementation plan (Lavis, Robertson, Woodside, McLeod, & Abelson, 2003). (8) The systematic, collection of information about the activities, characteristics and outcomes about the selected measure(s) to make judgments about the program, improve program effectiveness, and/or inform decisions about future programming. The project is funded by the Lower Austrian Social and Health Fund. Literature: Brouwers, M., Kho, M., Browman, G., Burgers, J., Cluzeau, F., Feder, G., . . . Consortium, A. N. S. (2010). Development of the AGREE II, part 2: assessment of validity of items and tools to support application. CMAJ, 182, E472 - E478. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900368/pdf/182e472.pdf Chambers, D. A., & Norton, W. E. (2016). The Adaptome: Advancing the Science of Intervention Adaptation. Am J Prev Med, 51(4 Suppl 2), S124-131. doi:10.1016/j.amepre.2016.05.011 Ciliska, D., Chociolko, C., & Shum, M. (2010). National Collaborating Centre for Methods and Tools. Evidence-informed decision-making in environmental health. Retrieved from https://hslmcmaster.libguides.com/c.php?g=441702&p=3012120 Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., Petticrew, M., & Medical Research Council, G. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ, 337, a1655. doi:10.1136/bmj.a1655 Döring, N., Bortz, J., & Pöschl, S. (2016). Forschungsmethoden und Evaluation in den Sozial- un