EVALUATION COMMITTEE

The Faculty Council has appointed the following adjudication committee to evaluate the thesis and the associated lecture: 

• Professor Vicki Goodwin, University of Exeter, United Kingdom
• Professor Lori Weeks, Dalhousie University, Canada
• Dr. Karin Bundgaard Mikkelsen,  Department of Clinical Medicine, Aalborg University, Denmark (Chairman)

Moderator: Associate Professor Kirsten Schultz Petersen, Health Science and Technology, Aalborg University, Denmark

ABSTRACT

Social isolation is a significant challenge for older people, negatively impacting their health and well-being, where factors such as frailty, mobility limitations, and the loss of close relations contribute to this isolation. At the same time, a sense of belonging is essential for maintaining well-being but often diminishes with aging and life transitions. Given the potential of municipal senior centres to support older peoples’ social engagement, this PhD project focused on developing and feasibility testing a new supportive intervention in Danish senior centres to promote belongingness and reduce social isolation among older people.

This PhD project consists of two phases with three embedded studies. The project followed the British Medical Research Council’s framework for complex interventions. For the development phase, the INDEX guidance was applied to ensure a structured approach based on stakeholder involvement, existing research, and social theory. The feasibility phase included two process evaluations: one assessing how the intervention was implemented in three senior centres and another examining staff and user acceptability of the intervention.

The first phase resulted in an intervention encompassing three key elements: (1) a start conversation for all new users, (2) an assigned “buddy” among existing users, and (3) monthly follow-up conversations with staff members. The feasibility test was initiated in April 2022, following two half-day workshops that trained staff in intervention delivery and data collection, and ended in April 2023.

Findings from the process evaluations highlighted challenges in implementing the intervention particularly in maintaining a systematic approach and navigating frailty among the users, resulting in a lack of integration of the intervention. While initial staff acceptance was high, it declined over time as they felt that it challenged their usual way of welcoming users and felt boundary-pushing to perform. In contrast, users generally maintained a positive perception of the intervention.

The findings underscore the need for structured yet flexible approaches in senior centres to enhance belongingness and reduce social isolation. Implications include positioning senior centres as vital for health promotion among older people, enhancing their role in municipalities and demonstrating measurable health benefits possibly securing more sustainable funding. This project underscores the need for future iterative testing and refinement, aligning with the MRC framework, to develop effective interventions to increase sense of belongingness and reduce social isolation among older people.