Interventions As the literature on loneliness and isolation has Characteristics of effective and grown, researchers have been able to identify ineffective interventions. characteristics of effective (as well as ineffective) interventions. However, these characteristics Despite the limited evaluation evidence available, have been drawn from a finite pool of academic it has been suggested that the most effective evaluations of interventions. Most interventions interventions share a number of common have never been held up to scrutiny, perhaps characteristics. These include: involving a due to a lack of resources or capacity, a lack combination of strategies; involving [older] people of understanding about the benefits of rigorous and/or their representative groups in intervention evaluations, or even reluctance to undertake planning and implementation; having well trained, research that could be critical of the intervention appropriately supported and resourced facilitators in question. Whatever the reasons, it remains the and coordinators; utilising existing community case that there are many effective and ineffective resources; and targeting specific groups interventions currently underway about which we (Grenade and Boldy 2008). know very little. In their review of the literature, Cattan and others This section makes a clear distinction between (2005: 57) found that effective interventions approaches and methods, which is often unclear shared several characteristics. In general, ones in much of the literature. Four primary strategies for which were effective: reducing loneliness or isolation are presented here: Included group-based interventions with > improving social skills, enhancing social support, a focused educational input, or ones that increasing opportunities for social interaction, and provided targeted support activities addressing negative thoughts about self-worth. Targeted specific groups, such as women, > Common types of intervention include self- care-givers, the widowed, the physically management, peer support, community-based inactive, or people with serious mental interventions, technology-based interventions and health conditions animal-assisted interventions, and so on. There is Enabled some level of participant and/ no “right” approach or intervention, but the literature > stresses the importance of matching individuals or facilitator control or consulted with the with appropriate approaches and interventions. This intended target group before the intervention Evaluated an existing service or activity often boils down to asking people about their needs > and involving them in choosing an appropriate (demonstration study) or were developed and intervention, which seems to be more effective than conducted within an existing service one-sided approaches such as self-selection. Identified participants from agency lists > Framework for loneliness (GPs, social services, service waiting lists), interventions obituaries, or through mass-media solicitation (while self-selection was a problem noted in The Campaign to End Loneliness has produced many studies) a comprehensive framework to tackle loneliness Included some form of process evaluation > (http://campaigntoendloneliness.org/guidance/ and their quality was judged to be high. theoretical-framework/. Their framework The same authors found that the only distinguishes between direct interventions or major characteristic among the “ineffective” “foundation services” (such as lunch clubs or book interventions was that they were one-to-one groups) and “structural enablers” – the mechanisms interventions conducted in people’s own homes. by which these groups come into being (including Four evaluated home-visiting schemes, while the neighbourhood approaches, asset-based fifth considered the effectiveness of social support community development and volunteering). using the telephone. Inconclusive studies covered diverse interventions and were characterised by Isolation and loneliness 23