Service-Learning Intervention on Loneliness and Ageism: Comparison
Please note this is a comparison between versions V1 by Randall Osborne and V2 by Jason Zhu.

Service-learning is an effective intervention to solve social issues. Given that the COVID-19 pandemic exacerbated the loneliness level of everyone and especially senior individuals, this kind of pandemic should not deter peopleus from capitalizing on technology and engaging senior individuals in virtual interactions to alleviate loneliness burden. While the cost of such interaction is minimal, the gain can be substantial given the negative effects of loneliness on health outcomes. Service-learning is a two edged-sword that can both solve a social issue and train students in social engagement [36]. Therefore, college programs with a special focus on social issues could incorporate service-learning in their curriculum as it has proven to be an effective and efficient means to both educate students and solve social issues, such as hunger, racism and discrimination, ageism, poverty, homelessness, physical disability, education, and legislative advocacy.

  • service-learning
  • loneliness
  • ageism

1. Introduction

For at least a generation, advocates for the improved quality of life in older adults have identified social well-being as a crucial aspect of an individual’s overall health. Calling for a culture change in societal attitudes about the elderly and their care, these transition figures have focused on the plagues of the elderly—helplessness, boredom, and loneliness. Helplessness is felt when one always receives care but can never give care. Boredom results when one’s life has no variety or spontaneity. Loneliness is the pain of wanting but not having companionship [1]. The researcheuthors consider the potential of a program of intergenerational service-learning to lessen the impact of the plagues on the elderly, concentrating specifically on the plague of loneliness, while reducing ageism by college students.
Service-learning is an experiential learning. Bringle and Hatcher [2] define service-learning as a “course-based, credit-bearing educational experience in which students (a) participate in an organized service activity that meets identified community needs and (b) reflect on the service activity in such a way as to gain further understanding of a course content, a broader appreciation of the discipline, and an enhanced sense of civic responsibility” [2]. As such, service-learning is a means to educate students about social/community problems by involving students in community-based services/activities. Another learning component of service-learning consists of students writing a diary of their daily activity and a reflection on what they have learned from the activities [2]. While educating students about these social/community issues, they are also part of the solutions to these issues. Intergenerational service-learning is an extension of service-learning where college students are engaged in activities that involve individuals of older generation.
Humans are social beings who thrive from having relationships with others. Loneliness, described as “the subjective perception of lack of meaningful relationship” and “social isolation” portrayed as an objective evaluation of scarce social engagements and social contacts have been concerning social issues declared as a “global epidemic” [3], page 456, among the world’s elderly population by the US Surgeon General Vivek Murthy in 2017 [4]. In fact, about 24% of non-institutionalized older adults have experienced social isolation and 35% of adults ≥45 years old have felt lonely [5]. Many older adults without a strong network of friends or family are at a disadvantage with shrunken social network with very limited scope of interaction [6].
Both loneliness and social isolation may be associated with negative health outcomes. For instance, the most recent report from the National Academies showed that individuals who are socially isolated are more likely to die younger and develop dementia compared with those who are not socially isolated. Individuals who experience poor social relationships, described as social isolation or loneliness, have 29% higher risk of coronary heart disease and 39% higher risk of stroke compared with those who have rich social relationships [5].
In addition, the risk of death among lonely individuals who have heart failure is four times higher than those with heart failure but are not lonely. Moreover, lonely individuals have 68% higher risk of hospitalization and 57 % higher risk of emergency department visits compared with those who are not lonely [5], as well as increased risk of depression, alcoholism, sleep problems, change in immunological system, Alzheimer’s disease, poor general health status, decreased wisdom, anxiety, suicide, accelerated cognitive decline, hypertension, diabetes, and death [7][8][9][10][11][12][13][7,8,9,10,11,12,13].
Older individuals tend to experience loneliness or social isolations more than younger individuals because they tend to live alone and their poorer health and weaker physical conditions may limit their ability to have some meaningful social interactions [3]. In fact, many older adults without a strong network of friends or family are at a disadvantage with shrunken social network with very limited scope of interaction [6]. In addition, the older generation might not be as comfortable speaking to someone 50 years younger in comparison to someone of the same age; however, this does not mean that the older adults do not crave that interpersonal connection.
Social interaction through a service-learning program has been found to enhance connectivity, and reduce the risk of losing the motivation to maintain an active and healthy lifestyle [8]. Moreover, intergenerational service-learning conversations foster the comfort level of the youth and that of seniors with time and often make the senior feel that he/she is cared for while in conversation [14]. Additionally, such programs are found to improve 54% of the youth social skills [15].
The majority of service-learning projects have been conducted face-to-face where college students have direct/physical interactions with their assigned community partners. However, due to COVID-19 pandemic that mandated total home confinement for several months, face-to-face service-learning was not an option. Fortunately, advances in communication technologies provide opportunities to conduct service-learning activities virtually, if feasible and appropriate. Regardless, little is known about the effectiveness of virtual service-learning in solving social issues and educating students about these issues.

2. Interventions to Reduce Loneliness and Social Isolation

A body of interventions has been undertaken to alleviate the burden of loneliness and social isolation among elder adults both at the national and the organizational/community levels. For instance, at the national level, the National Academies created the Committee on the Health and Medical Dimensions of Social Isolation and Loneliness in Older Adults in 2018. That Committee is responsible for collecting evidence regarding the negative impacts of social isolation and loneliness on quality of life of adults ≥50 years old, as well as recommending strategies, to be implemented by healthcare providers, to reduce the negative health outcomes of social isolation and loneliness [5]. In another instance, the British and Japanese governments appointed a Ministry of Loneliness in 2018 and 2021, respectively, to create nationwide programs to reduce loneliness and its side effects, such as suicide, which has increased during COVID19 pandemic [9][16][17][9,17,18].
In addition, several interventions to tackle loneliness and/or social isolation have been implemented at the community or local level. The scoping researchview and meta-analysis of Masi et al., (2011) suggests that the aims of such interventions may fall into four major categories: to improve social skills, to grow social support, to offer more opportunities for social interaction, and to deal with maladaptive social cognition [18][19]. Direct interventions that specifically address social isolation and loneliness, such as a one-on-one interaction between individuals who experience loneliness and social isolations and volunteers who have accepted to interact with the affected individuals has been deemed more effective than interventions that target a group of lonely individuals [5]. An example of one-on one interaction is the Intergenerational Social Support through service-learning that provides individuals a heightened chance of connection with the society [19][20]. Community driven opportunities for seniors to be socially integrated, can enhance the quality of life [20][21]. Furthermore, targeted measures through service-learning program interventions such as 30-min storytelling or sharing of daily life experiences in weekly conversations develop understanding of the complex relationships between the aged and the student that might enhance positive emotions [21][22]. Seniors do not feel that students condescend to them, and this often helps to elevate positive experiences. With time, this increases the feeling in older adults that they are being listened to and not invisible [14].
Since the aging population and loneliness are global issues, intergenerational service-learning has become a globally accepted pedagogy to address both issues [22][23][24][23,24,25]. Intergenerational service-learning is especially advantageous because both the older and younger generations can benefit from it. First, among the older generation, social interaction through service-learning programs enhances connectivity, reduces the risk of losing the motivation to maintain an active and healthy lifestyle [8][24][8,25], and improves quality of life [25][26]. It also gives the older adults the opportunity to challenge stereotypes and experience a feeling of successful aging [24][25]. Second, among college students, (younger generation), intergenerational service-learning improves their academic and professional learning skills, as well as increase their social awareness with respect to the struggles faced by disadvantaged communities, such as ageism [24][26][25,27].