Abstract
As a global public health concern, elder abuse negatively affects health, psychosocial wellbeing, and mortality among elders. Research and practice efforts made to explore effective prevention and intervention strategies are growing. Despite the growing number of intervention studies on elder abuse, research synthesis on the empirical literature seems lacking. This study aims to identify the pooled effect size of prevention and interventions targeted ultimate and intermediate outcomes for elder abuse that occurred in community settings. Following the Cochrane guideline, our team searched across eight electronic databases and manually searched reference lists of eligible studies and existing systematic reviews for all potentially eligible studies. A random-effects model of 51 effect size estimates reported an overall positive and statistically significant treatment effect of psychosocial interventions for elder abuse, d = 0.63, p < 0.05. The overall treatment effect was approaching statistical significance at 0.1 level for ultimate outcomes, d = 0.32, p = 0.09, and intermediate outcomes, d = 0.75, p = 0.1. An overall significant effect size was found among family-based interventions, d = 0.59, p < 0.05, and interventions targeting older adults and their caregivers, d = 0.45, p < 0.05. Existing evidence supports an overall significant effect for psychosocial interventions for elder abuse. Interventions that used a family-based model, combined education and supportive services, and targeted both caregivers and elders, showed significant effect size, suggesting such features being considered in elder abuse intervention design. Future intervention research is needed to shed light on the link between intervention activities and ultimate change in elder abuse behaviors.
Highlights
Elder abuse refers to intentional or unintentional harmful acts toward an older person where trust is expected
The inclusion criteria for studies published in English are those that (1) assessed the effectiveness of a prevention or intervention program designed to address abuse or neglect of elders aged 65 or older living the community settings, (2) targeted at elders or family members, (3) used randomized controlled trials (RCTs) or controlled trials, (4) reported at least one elder abuse intervention outcome, and (5) reported statistical information sufficient to calculate effect size required for meta-analysis
This study represents an initial effort to examine the pooled effect of elder abuse preventions and interventions via metaanalyses
Summary
Elder abuse refers to intentional or unintentional harmful acts toward an older person where trust is expected. Current elder abuse interventions include public education and advocacy, caregiver support, psychological support for victims, care coordination, and multidisciplinary case management to name a few (Acierno et al, 2010). Programs that suggest the effectiveness of elder abuse are through providing (1) caregiver supportive services (Livingston et al, 2013), (2) money management coaching (Sacks et al, 2012), (3) telephone helplines (van Bavel et al, 2010), (4) emergency shelters for older victims (Heck and Gillespie, 2013), and (5) access to a multidisciplinary team (Teaster et al, 2003). Elder abuse preventions and interventions tend to achieve two types of outcomes: reducing the occurrence of abusive behaviors (Hsieh et al, 2009; Khanlary et al, 2016), and mitigating elder abuse risk factors, such as psychosocial stress and lack of awareness or competency among nursing staff, family caregivers, and older adults themselves (Pellfolk et al, 2010; Baker et al, 2016; Estebsari et al, 2018)
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