This scoping review explores the existing literature pertaining to intergenerational interventions with university students in healthcare related fields for mitigating social isolation and loneliness among older adults in the United States. Our research question is: “What is the current state of research on intergenerational interventions involving college or university students in healthcare-related fields, aimed at reducing social isolation and loneliness among older adults in the United States, with a focus on studies conducted from the year 2010–2022?”

Our search strategy was implemented across multiple databases, including PubMed, PsychInfo, Embase, Academic Search Premier, and CINHAL Complete. The searches were carried out in June 2022, supplemented by a gray literature search in July 2022, with no date restrictions.

The main keywords/subjects were adjusted for each database for optimal searching. The core search string: “intergenerational relations” AND (elders OR elderly OR “older adults” OR seniors OR aged”) AND (loneliness OR “social participation” OR companionship OR connection OR “Social isolation” OR inclusion OR belonging OR engagement) AND (students AND (nursing OR medicine OR pharmacy OR “health occupations” OR “public health” OR college OR University OR “post secondary”)) All citations were uploaded into Covidence™ for de-duplication and screening.

The screening process comprised two stages: initial evaluation based on title and abstract, followed by a comprehensive assessment of full-text articles (see Figure 1 for details).

The information regarding characteristics on each of the studies, outlined in section 2.4.1, was extracted, and listed in Table 1. Demographic information varied, as did scales of measurement of the outcomes, which were primary areas of interest.

An area of interest for the researchers were the demographics. Out of the 13 articles included in the scoping review, approximately 5 of them did not provide any demographic information about the participants, making it challenging to ascertain the characteristics of the participants. Among the studies that did specify gender demographics, it was observed that female participants constituted a cumulative percentage of approximately 63.4%, while male participants accounted for approximately 36.6% across these studies.

Interestingly, none except 1 of the reviewed articles provided data on the sexual orientation of the participants, indicating a gap in this aspect of demographic information. One of the articles reported 7% of older adult participants identified as members of the LGBTQ+ community.

In terms of racial demographics, the cumulative summary of races involved across all the studies encompassed a range of non-Hispanic White participants making up around 48.5% of the total, non-Hispanic Black participants representing approximately 31.5%, Hispanic participants comprising about 4.7%, Asian-American participants constituting around 0.6%, and a category labeled as “Other” or “unclassified” including approximately 14.7% of the participants. These findings collectively underscore the need for future research to provide more comprehensive demographic data, particularly related to sexual orientation, to enhance the understanding of the diverse populations engaged in intergenerational interventions for reducing loneliness among older adults. Apart from Adepoju et al. (10), none related to the combination of social isolation and loneliness.

All but 1 article reported the number of student participants. The studies involved 15 graduate clinician participants from Speech-Language Pathology, focusing on social media training for cognitive and language interventions. Medicine students were notably included, with 74.4% of participants in one study coming from this discipline. Nursing students also participated, often alongside medical students and other healthcare fields.

Pharmacy students were part of intergenerational learning projects, contributing to the educational experience. Social Work was represented, with one program including 46 students, emphasizing the social aspects of healthcare. Students from Physician Assistant programs participated in discussions on interprofessional education. Audiology students took part in studies focused on virtual interprofessional learning. Gerontology students, particularly undergraduates, were involved in research aimed at reducing loneliness, highlighting the importance of age-related studies in healthcare education. Additionally, 35 students from Occupational Therapy were noted in various projects, and a student from Osteopathic Medicine also participated, showcasing the range of disciplines engaged in addressing the needs of older adults. From the available demographic data, all university participants were reported as enrolled in undergraduate, graduate, or professional programs related to caring professions (e.g., nursing, gerontology, social workers), with two articles that did not provide this information.

Four articles used a pre/posttest design, three mixed methods, one quasi-experimental, one qualitative, one narrative study, and two did not indicate a clear design. Across all articles, 12 different kinds of outcomes were measured (e.g., loneliness scores, isolation in older adults, student interest in working with older adults). Table 1 summarizes these outcomes.

Regarding older adult specific outcomes, only six articles specifically reported outcomes related to loneliness among older adults, but each study with this information reported significant reductions in older adult loneliness after participation in the intergenerational intervention. Specifically, after the older adults participated in a 6-week intervention that included committee meetings, mealtimes, 1:1 leisure, and transportation, Adepoju et al. (10) reported a decrease from 84.2 to 40% in UCLA Loneliness Scale scores.

Furthermore, Juris and colleagues (2022) found a 40.91% decrease in loneliness as measured by the Lubben Social Network Scale-6 and UCLA 3-item loneliness scale (38). This was supported by their qualitative findings that the program increased connectivity and prevented loneliness. Lastly, Adepoju et al. (10) found similar results utilizing a 3-item Loneliness Scale within a perceived social isolation measure. To strengthen these types of results, utilization of a randomized control group to compare results are plausible (10).

Interestingly, out of the 13 articles, 4 studies found that, within intergenerational activities, students and older adults predominantly found the conversation aspect to be the most enjoyable component, surpassing other activities. For example, one of the articles Zhang et al. (33) explains that while the programs involved various activities like committees, mealtime, one-on-one leisure, and transportation, the students consistently valued and relished engaging in meaningful dialogs with the older adults. This preference for conversations was evident across different activities, emphasizing the significance of the quality of interaction over specific tasks. For instance, committees allowed both generations to collaborate on shared goals, emphasizing the role of conversation in their engagement. Mealtime provided a conducive environment for comfortable social exchanges, leading to personal bonds. Even in one-on-one leisure activities, where the quantitative ratings suggested moderate enjoyment, qualitative data revealed that students highly valued the opportunities for connections and conversation. Thus, the students’ preference for conversations emerged as a notable and integral aspect of their participation in intergenerational programs, showcasing the significance of meaningful dialogs in fostering connections and mutual benefit between young and older adults.

Regarding the detailed exploration of older adult perspectives, among the 13 reviewed articles, only a few provided in-depth insights into the experiences and perspectives of older adults regarding social isolation, loneliness, and the effectiveness of interventions. While some studies shared valuable qualitative data on older adults’ experiences, many others primarily focused on outcomes and student perspectives. To better understand the nuances of social isolation and loneliness among older adults and to refine interventions, future research should prioritize conducting comprehensive qualitative inquiries, allowing older adults to express their thoughts, feelings, and preferences regarding these issues and the interventions designed to address them. Such an approach can provide a more holistic understanding and potentially lead to more tailored and effective interventions that resonate with the older adult population.

In this scoping review focusing on the needs surrounding social isolation, loneliness, and intergenerational interventions in the United States, the studies included demonstrative engagements from a variety of healthcare professions. Notably, fields such as speech-language pathology, medicine, nursing, pharmacy, and social work were represented, indicating a broad interprofessional involvement. This diversity is crucial, as it reflects the complex and multifaceted approach required to tackle issues of social isolation and loneliness among older adults effectively.

However, the variability in professional representation and the depth of engagement across these studies also highlight a significant limitation: the potential inconsistency in training and outcomes. This scoping review underscores the necessity for future research to establish more standardized, interprofessional educational frameworks that can be uniformly implemented. Such frameworks would ensure that healthcare students across various disciplines receive consistent training on addressing social isolation and loneliness effectively.

Future studies should also aim to evaluate the long-term impacts of these intergenerational interventions on the quality of life for older adults and the professional development of healthcare students. This would help in understanding how effectively these educational interventions prepare students for future careers in geriatrics and contribute to sustained improvements in the lives of older adults.

The articles largely focus on the outcomes and benefits of intergenerational programs in alleviating loneliness among older adults and fostering connections with university students. While these studies have yielded promising results, a critical gap emerges in their limited descriptions of the curriculum and training methodologies employed within these interventions. This absence of detailed curriculum outlines and training protocols is of paramount concern for the academic and practical development of intergenerational programs. Shenoi and colleagues showed that, while this study is promising, the authors note that there is no set curriculum that would allow other researchers to reproduce these results (16). This absence of specific curriculum outlines and training protocols limits the ability to replicate and adapt these programs effectively in other settings, emphasizing the need for more comprehensive documentation of such crucial aspects in future research and development of intergenerational programs. A well-structured curriculum ensures consistency in program implementation, and aids in the systematic evaluation of its impact on both older adults and students (42). Moreover, explicit training guidelines are essential for program scalability and dissemination.

Apart from the adoption of general concepts of pen pals, letter writing, and phone calls, there appeared to be no intentional building upon previous interventions done in the United States, nor regard to intergenerational programs that may be occurring in the commercial industry for collaboration or desired insight. The lack of such connections among intergenerational programs, social isolation, and loneliness, reveal a gap in literature. Additionally, this supports the need for research to focus more on the experiences of the older adult and describe what the intervention’s methods and strategies used to decrease social isolation and/or loneliness for the older adult. Research should investigate and include post-intervention follow-up information that show long-term effects of participation. For example, the Intergenerational Getting AHeAD program shared that older adult residents participated in year-to-year as a way of interacting with younger adults (19). Having data to draw from across the years from participating in the program, would be useful with understanding how these issues can be addressed and if at all the program is effective. It is worth noting that this diversity in interaction methods can be partially attributed to the unique circumstances of studies conducted during the COVID-19 pandemic. Articles did not embellish on a previously established intervention, which may also explain the variety of the multiple mediums across articles.

A limitation to this scope review could be the key terms that were not used for the inclusion criteria. For example, one article aimed to evaluate social connectedness among older adults by assessing their experiences while participating in an intergenerational program (8). The term “social connectedness” is what one might aim for when addressing social isolation and loneliness among older adults. This limitation could have potentially excluded relative literature available on the topic.

Future research should also explore the efficacy of intergenerational programs in older adults living with HIV (categorized as 50 and above), a group for which social isolation and loneliness is elevated and often coupled with stigma. In the pursuit of evidence-based practice and replicability, it is imperative to provide a comprehensive understanding of the educational components and training strategies employed in these interventions.