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      Technology-Mediated Communication in Familial Relationships: Moderated-Mediation Models of Isolation and Loneliness

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          Abstract

          Background and Objectives

          We examined whether technology-mediated communication has functional or emotional equivalence to face-to-face (FtF) contact in familial relationships, by scrutinizing the effects of phone, text/e-mail, and video contact on isolation and loneliness.

          Research Design and Methods

          We tested whether FtF contact with a relative would mediate the pathway between proximity to family and (i) isolation and (ii) loneliness. We then tested hypotheses that telephone, text/e-mails, and video contact would moderate this mediated pathway. We compared models for younger (<75) and older (≥75) cohorts, expecting to observe moderation effects for text/e-mail and video contact in the younger cohort only. Data were drawn from Wave 2 of CFAS Wales (United Kingdom) study ( N = 2,099).

          Results

          Proximity to a relative had a significant indirect effect on isolation and loneliness through the mediating variable FtF contact. Phone and text/e-mail contact moderated the effect of FtF contact on isolation for all samples. None of the technologies moderated the impact of FtF contact on loneliness for the full sample. Telephone contact had a moderating influence on loneliness for the younger cohort only. Video calls had no significant moderation effect.

          Discussion and Implications

          Telephone and text/e-mail contact have functional equivalence to FtF contact in familial relationships. None of the forms of technological communication have emotional equivalence to the “gold standard” of embodied presence. The study demonstrates the importance of theorizing about the pathways to isolation and loneliness to better understand the likelihood of implementing successful interventions using technology-mediated communication within families.

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          Most cited references50

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          Loneliness and social isolation as risk factors for mortality: a meta-analytic review.

          Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
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            A meta-analysis of interventions to reduce loneliness.

            Social and demographic trends are placing an increasing number of adults at risk for loneliness, an established risk factor for physical and mental illness. The growing costs of loneliness have led to a number of loneliness reduction interventions. Qualitative reviews have identified four primary intervention strategies: (a) improving social skills, (b) enhancing social support, (c) increasing opportunities for social contact, and (d) addressing maladaptive social cognition. An integrative meta-analysis of loneliness reduction interventions was conducted to quantify the effects of each strategy and to examine the potential role of moderator variables. Results revealed that single-group pre-post and nonrandomized comparison studies yielded larger mean effect sizes relative to randomized comparison studies. Among studies that used the latter design, the most successful interventions addressed maladaptive social cognition. This is consistent with current theories regarding loneliness and its etiology. Theoretical and methodological issues associated with designing new loneliness reduction interventions are discussed.
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              Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations.

              There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale (LSNS-6), which was used to screen for social isolation among community-dwelling older adult populations in three European countries. Based on the concept of lack of redundancy of social ties we defined clinical cut-points of the LSNS-6 for identifying persons deemed at risk for social isolation. Among all three samples, the LSNS-6 and two subscales (Family and Friends) demonstrated high levels of internal consistency, stable factor structures, and high correlations with criterion variables. The proposed clinical cut-points showed good convergent validity, and classified 20% of the respondents in Hamburg, 11% of those in Solothurn (Switzerland), and 15% of those in London as at risk for social isolation. We conclude that abbreviated scales such as the LSNS-6 should be considered for inclusion in practice protocols of gerontological practitioners. Screening older persons based on the LSNS-6 provides quantitative information on their family and friendship ties, and identifies persons at increased risk for social isolation who might benefit from in-depth assessment and targeted interventions.
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                Author and article information

                Contributors
                Role: Decision Editor
                Journal
                Gerontologist
                Gerontologist
                geront
                The Gerontologist
                Oxford University Press (US )
                0016-9013
                1758-5341
                October 2020
                05 May 2020
                05 May 2020
                : 60
                : 7
                : 1202-1212
                Affiliations
                [1 ] School of Nursing, Faculty of Medical and Health Sciences, University of Auckland , New Zealand
                [2 ] School of Population Health, Faculty of Medical and Health Sciences, University of Auckland , New Zealand
                [3 ] Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University , Wales, UK
                [4 ] School of Health Sciences, Bangor University , Wales, UK
                Author notes
                Address correspondence to: Vanessa Burholt, PhD, School of Nursing, Faculty of Health and Medical Sciences, University of Auckland, Room 235B, Level 2, Building 505, 85 Park Road, Grafton, Auckland 1010, New Zealand. E-mail: vanessa.burholt@ 123456auckland.ac.nz
                Author information
                http://orcid.org/0000-0002-6789-127X
                Article
                gnaa040
                10.1093/geront/gnaa040
                8059137
                32369112
                7bf58cc8-cbd7-41eb-bdbc-5f49235b48fe
                © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 December 2019
                : 13 March 2020
                : 05 May 2020
                Page count
                Pages: 11
                Funding
                Funded by: Economic and Social Research Council, DOI 10.13039/501100000269;
                Award ID: RES-060-25-0060
                Categories
                Technology and Aging
                AcademicSubjects/SOC02600

                Geriatric medicine
                telephone,computer-mediated communication,social relationships,families,cfas wales study

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