3.1 Blue Zones Project®

Fort Worth, Texas

Beach Cities, California

Southwest Florida

Other Blue Zones Project Community Work

3.3 The Power 9® Principles in the Community

Obstacles to Move Naturally in the Community

  • Ferreira Silva RM, Mendonça CR, Azevedo VD, Raoof Memon A, Noll PRES, Noll M. Barriers to high school and university students' physical activity: A systematic review. PLoS One. 2022;17(4):e0265913. Published 2022 Apr 4. https://doi.org/10.1371/journal.pone.0265913
  • Silva R, Mendonça C, Noll M. Barriers to high school and university students’ physical activity: a systematic review protocol. Int J Educ Res. 2021;106:101743. https://doi.org/10.1016/j.ijer.2021.101743
  • Domosławska-Żylińska K, Łopatek M, Krysińska-Pisarek M, Sugay L. Barriers to adherence to healthy diet and recommended physical activity perceived by the Polish population. J Clin Med. 2023;13:22. https://doi.org/10.3390/jcm13010022
  • Melo E, Ferreira L, Cavalcanti R, et al. Nuances between sedentary behavior and physical inactivity: cardiometabolic effects and cardiovascular risk. Rev Assoc Med Bras. 2021;67(2):335-343. https://doi.org/10.1590/1806-9282.67.02.20200746
  • Kumareswaran S. Detrimental impact of sedentary behaviour on health. Eur J Med Health Sci. 2023;5(1):1630. https://doi.org/10.24018/ejmed.2023.5.1.1630
  • Portela-Pino I, Alvariñas-Villaverde M, Pino-Juste M. Environmental barriers as a determining factor of physical activity. Sustainability. 2021;13:3019. https://doi.org/10.3390/su13063019
  • Hamer O, Larkin D, Relph N, Dey P. Fear‐related barriers to physical activity among adults with overweight and obesity: a narrative synthesis scoping review. Obes Rev. 2021;22:e13307. https://doi.org/10.1111/obr.13307
  • Healy S, Brewer B, Laxton P, et al. Brief report: perceived barriers to physical activity among a national sample of autistic adults. J Autism Dev Disord. 2021;52:4583-4591. https://doi.org/10.1007/s10803-021-05319-8
  • Wongsila S, Chernbumroong S, Sureephong P. Systematic reviews of elderly exercise barriers. 2022 Joint Int Conf Digital Arts Media Technol; 460-462. https://doi.org/10.1109/ECTIDAMTNCON53731.2022.9720400
  • Rainham D, Bennett M, Blanchard C, et al. Parents and children should be more active together to address physical inactivity and sedentary behaviours. Front Public Health. 2022;10:633111. https://doi.org/10.3389/fpubh.2022.633111
  • Woessner M, Tacey A, Levinger-Limor A, et al. The evolution of technology and physical inactivity: the good, the bad, and the way forward. Front Public Health. 2021;9:655491. https://doi.org/10.3389/fpubh.2021.655491
  • Petersen R, Pedroso M. Economic benefits of promoting safe walking and biking to school: creating momentum for community improvements. Am J Prev Med. 2021;60(1):e41-e43. https://doi.org/10.1016/j.amepre.2020.08.004
  • Zhong J, Liu W, Niu B, Lin X, Deng Y. Role of built environments on physical activity and health promotion: a review and policy insights. Front Public Health. 2022;10:950348. https://doi.org/10.3389/fpubh.2022.950348

Move Naturally Strategies in the Community

  • Petersen R, Pedroso M. Economic benefits of promoting safe walking and biking to school: creating momentum for community improvements. Am J Prev Med. 2021;60(1):e41-e43. https://doi.org/10.1016/j.amepre.2020.08.004
  • Zhong J, Liu W, Niu B, Lin X, Deng Y. Role of built environments on physical activity and health promotion: a review and policy insights. Front Public Health. 2022;10:950348. https://doi.org/10.3389/fpubh.2022.950348
  • Zhang X, Warner M. Linking urban planning, community environment, and physical activity: a socio-ecological approach. Int J Environ Res Public Health. 2023;20:42944. https://doi.org/10.3390/ijerph20042944
  • You Y, Chen Y, Zhang Q, et al. Systematic and meta-based evaluation of the relationship between the built environment and physical activity behaviors among older adults. PeerJ. 2023;11:e16173. https://doi.org/10.7717/peerj.16173
  • Lee C, Xu M, Zhu X, et al. Moving to an activity-friendly community can increase physical activity. J Phys Activ Health. 2023:1-9. https://doi.org/10.1123/jpah.2023-0045
  • Zhu X, Ory M, Xu M, et al. Physical activity impacts of an activity-friendly community: a natural experiment study protocol. Front Public Health. 2022;10:929331. https://doi.org/10.3389/fpubh.2022.929331
  • Wang Y, Steenbergen B, Krabben E, et al. The impact of the built environment and social environment on physical activity: a scoping review. Int J Environ Res Public Health. 2023;20:126189. https://doi.org/10.3390/ijerph20126189
  • Prochnow T, Curran L, Amo C, Patterson M. Bridging the built and social environments: a systematic review of studies investigating influences on physical activity. J Phys Activ Health. 2023;1-22. https://doi.org/10.1123/jpah.2022-0403
  • Saito Y, Tanaka A, Tajima T, et al. A community-wide intervention to promote physical activity: a five-year quasi-experimental study. Prev Med. 2021;106708. https://doi.org/10.1016/j.ypmed.2021.106708
  • Chew L, Tavitian-Exley I, Lim N, Ong A. Can a multi-level intervention approach, combining behavioural disciplines, novel technology and incentives increase physical activity at population-level? BMC Public Health. 2021;21:10092. https://doi.org/10.1186/s12889-020-10092-x
  • Lightner J, Ziegler N, Gardiner K, Collie-Akers V. Community health improvement plans and physical activity implementation strategies: findings from a cross-sectional survey of US local health departments. J Public Health Manag Pract. 2023;29:120-127. https://doi.org/10.1097/PHH.0000000000001696
  • Michalchuk V, Lee S, Waters C, Hong O, Fukuoka Y. Systematic review of the influence of physical work environment on office workers' physical activity behavior. Workplace Health Saf. 2022;70:97-119. https://doi.org/10.1177/21650799211039439
  • Kim J, Mizushima R, Nishida K, Morimoto M, Nakata Y. Proposal of a comprehensive and multi-component approach to promote physical activity among Japanese office workers: a wualitative focus group interview study. Int J Environ Res Public Health. 2022;19:42172. https://doi.org/10.3390/ijerph19042172
  • Taylor W, Williams J, Harris L, Shegog R. Computer prompt software to reduce sedentary behavior and promote physical activity among desk-based workers: w systematic review. Hum Factors. 2021;65:891-908. https://doi.org/10.1177/00187208211034271
  • Petrigna L, Thomas E, Brusa J, et al. Does learning through movement improve academic performance in primary schoolchildren? a systematic review. Front Pediatr. 2022;10:841582. https://doi.org/10.3389/fped.2022.841582
  • Li MH, Sum RKW, Sit CHP, Wong SHS, Wing YK. Promoting physical literacy and 24-hour movement in Hong Kong primary school children through a blended classroom-based intervention: protocol and baseline characteristics of the “Stand+Move” cluster-randomized controlled trial. Published online April 14, 2021.  https://doi.org/10.21203/RS.3.RS-414376/V1
  • Murphy M, Carlin A. S12-1 school-based interventions to promote physical activity amongst children and adolescents. Eur J Public Health. 2023;33:ckad133.058. https://doi.org/10.1093/eurpub/ckad133.058

Obstacles to Right Outlook in the Community

Right Outlook Strategies in the Community

  • Bagnall A, South J, Southby K, et al. Community infrastructure to boost social relations: a systematic review. Euro J Public Health. 2019;29(Supplement_4):ckz185.318.  https://doi.org/10.1093/eurpub/ckz185.318
  • Tesfaye Y, Agenagnew L, Terefe Tucho G, et al. Attitude and help-seeking behavior of the community towards mental health problems. PLoS One. 2020;15(11):e0242160. https://doi.org/10.1371/journal.pone.0242160
  • Galla BM, O'Reilly GA, Kitil MJ, Smalley SL, Black DS. Community-based mindfulness program for disease prevention and health promotion: targeting stress reduction. Am J Health Promot. 2015;30(1):36-41. https://doi.org/10.4278/ajhp.131107-QUAN-567
  • Evans S, Ferrando S, Carr C, Haglin D. Mindfulness-based stress reduction (MBSR) and distress in a community-based sample. Clin Psychol Psychother. 2011;18(6):553-558. https://doi.org/10.1002/cpp.727
  • Lee SM, Jang HJ, Yun HK, Jung YB, Hong IK. Effect of apartment community garden program on sense of community and stress. Int J Environ Res Public Health. 2022;19(2):708. https://doi.org/10.3390/ijerph19020708
  • Maton KI. Community settings as buffers of life stress? Highly supportive churches, mutual help groups, and senior centers. Am J Comm Psychol. 1989;17(2):203-232.   https://doi.org/10.1007/BF00931008
  • Nápoles AM, Ortíz C, Santoyo-Olsson J, et al. Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer. Am J Public Health. 2015;105 Suppl 3(Suppl 3):e55-e63. https://doi.org/10.2105/AJPH.2015.302598
  • Ruotsalainen J, Serra C, Marine A, Verbeek J. Systematic review of interventions for reducing occupational stress in health care workers. Scand J Work Environ Health. 2008;34(3):169-178. https://doi.org/10.5271/SJWEH.1240
  • Derringer JC, Biddle MJ. Potential directions for farm stress research: a systematic review of educational interventions to reduce psychosocial stress among farm and rural populations. J Rural Health. 2022;38(3):554-573. https://doi.org/10.1111/jrh.12633
  • Shamah D. Supporting a strong sense of purpose: lessons from a rural community. New Dir Youth Dev. 2011;2011(132):45-9. https://doi.org/10.1002/yd.427
  • Bains KK, Turnbull T. Improving Health Outcomes and Serving Wider Society: The potential role of understanding and cultivating prosocial purpose within health psychology research and practice to address climate change and social isolation and loneliness. Front Psychol. 2019;10:1787. https://doi.org/10.3389/fpsyg.2019.01787
  • Jenkinson CE, Dickens AP, Jones K, et al. Is volunteering a public health intervention? a systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health. 2013;13:773. https://doi.org/10.1186/1471-2458-13-773
  • Benenson J, Stagg A. An asset-based approach to volunteering: exploring benefits for low-income volunteers. NVSQ. 2016;45(1_suppl):131S-149S. https://doi.org/10.1177/0899764015604739
  • Merriam SB, Kee Y. Promoting community wellbeing: the case for lifelong learning for older adults. Adult Ed Q. 2014;64(2):128-144.  https://doi.org/10.1177/0741713613513633
  • Ware VA. Supporting healthy communities through arts programs. Australian Institute of Health and Welfare; 2014. https://www.aihw.gov.au/reports/indigenous-australians/supporting-healthy-communities-through-arts-progra/contents/table-of-contents. Published February 7, 2014. Accessed October 16, 2025.
  • Kraag G, Zeegers MP, Kok G, Hosman C, Abu-Saad HH. School programs targeting stress management in children and adolescents: A meta-analysis. J School Psych. 2006;44(6):449-472. https://doi.org/10.1016/J.JSP.2006.07.001
  • Rugel EJ, Carpiano RM, Henderson SB, Brauer M. Exposure to natural space, sense of community belonging, and adverse mental health outcomes across an urban region. Environ Res. 2019;171:365-377. https://doi.org/10.1016/j.envres.2019.01.034

Obstacles to Eat Wisely in the Community

  • Lopez NV, Sirvinskas E, Sutliffe JT. Facilitators and barriers for adopting a plant-based diet: results from a pilot study among vegans in the united states. Am J Lifestyle Med. 0(0):15598276231198486. http://doi.org/10.1177/15598276231198486 
  • Volpp KG, Berkowitz SA, Sharma SV, et al. Food is medicine: a presidential advisory from the American Heart Association. Circulation. 2023;148(18):1417-1439. https://doi.org/10.1161/CIR.0000000000001182
  • Kegler MC, Raskind IG, Bundy ŁT, et al. Barriers to creating healthier home food environments: process evaluation results from 2 home food environment intervention studies. Fam Community Health. 2022;45(4):247-256. https://doi.org/10.1097/FCH.0000000000000335
  • Hammons A, Olvera N, Teran-Garcia M, Villegas E, Fiese B. Mealtime resistance: Hispanic mothers' perspectives on making healthy eating changes within the family. Appetite. 2021;159:105046. https://doi.org/10.1016/j.appet.2020.105046
  • Viroli G, Kalmpourtzidou A, Cena H. Exploring benefits and barriers of plant-based diets: health, environmental impact, food accessibility and acceptability. Nutrients. 2023;15(22):4723. Published 2023 Nov 8. https://doi.org/10.3390/nu15224723
  • Rosin M, Mackay S, Gerritsen S, Te Morenga L, Terry G, Ni Mhurchu C. Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review. Nutr Rev. 2024;82(4):503-535. https://doi.org/10.1093/nutrit/nuad062
  • Stotz SA, Brega AG, Gonzales K, Hebert LE, Moore KR; AI/AN WCIE study group . facilitators and barriers to healthy eating among American Indian and Alaska Native adults with type 2 diabetes: stakeholder perspectives. Curr Dev Nutr. 2021;5(15):22-31. https://doi.org/10.1093/cdn/nzaa114
  • Magalhães P, Vilas C, Pereira B, et al. Children's perceived barriers to a healthy diet: the influence of child and community-related factors. Int J Environ Res Public Health. 2022;19(4):2069. https://doi.org/10.3390/ijerph19042069
  • Macdiarmid JI. The food system and climate change: are plant-based diets becoming unhealthy and less environmentally sustainable?. Proc Nutr Soc. 2022;81(2):162-167. https://doi.org/10.1017/s0029665121003712
  • McInnes C, Carstairs SA, Cecil JE. A qualitative study of young peoples' thoughts and attitudes to follow a more plant-based diet. Front Psychol. 2023;14:1196142. https://doi.org/10.3389/fpsyg.2023.1196142
  • Matos MS, Suzuki S, White N. Addressing barriers to healthy eating through food as medicine initiatives. Am J Lifestyle Med. 2023;17(6):750-753. https://doi.org/10.1177/15598276231188645
  • Betz MV, Nemec KB, Zisman AL. Patient perception of plant based diets for kidney disease. J Ren Nutr. 2023;33(2):243-248. https://doi.org/10.1053/j.jrn.2022.09.006
  • Wetherill MS, Duncan AR, Bowman H, et al. Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating. Prev Med. 2021;153:106723.. https://doi.org/10.1016/j.ypmed.2021.106723
  • Langlet B, Nyberg M, Wendin K, Zandian M. The clinicians' view of food-related obstacles for treating eating disorders: A qualitative study. Food Nutr Res. 2023;67:10.29219/fnr.v67.8771. https://doi.org/10.29219/fnr.v67.8771

Eat Wisely Strategies  in the Community

  • Espinosa-Marrón A, Adams K, Sinno L, et al. Environmental impact of animal-based food production and the feasibility of a shift toward sustainable plant-based diets in the United States. Front Sustain. 2022;3:841106. https://doi.org/10.3389/frsus.2022.841106
  • Fergus L, Seals K, Holston D. Nutrition interventions in low-income rural and urban retail environments: a systematic review. J Acad Nutr Diet. 2021;121(6):1087-1114. https://doi.org/10.1016/j.jand.2020.12.018
  • Doustmohammadian A, Bazhan M. Social marketing-based interventions to promote healthy nutrition behaviors: a systematic review protocol. Syst Rev. 2021;10(1):75. https://doi.org/10.1186/s13643-021-01625-5
  • Shavit Y, Roth Y, Teodorescu K. Promoting healthy eating behaviors by incentivizing exploration of healthy alternatives. Front Nutr. 2021;8:658793. https://doi.org/10.3389/fnut.2021.658793
  • Chew HSJ, Rajasegaran NN, Chng S. Effectiveness of interactive technology-assisted interventions on promoting healthy food choices: a scoping review and meta-analysis. Br J Nutr. 2023;130(7):1250-1259. https://doi.org/10.1017/S0007114523000193
  • Lim TJ, Okine RN, Kershaw JC. Health- or environment-focused text messages as a potential strategy to increase plant-based eating among young adults: an exploratory study. Foods. 2021;10(12):3147. https://doi.org/10.3390/foods10123147
  • Babbott KM, Cavadino A, Brenton-Peters J, Consedine NS, Roberts M. Outcomes of intuitive eating interventions: a systematic review and meta-analysis. Eat Disord. 2023;31(1):33-63. https://doi.org/10.1080/10640266.2022.2030124
  • Teggart K, Phillips S, Ganann R, et al. Group-based nutrition interventions for community-dwelling older adults: a systematic review to inform community co-design. Ann Fam Med. 2022;20(20 Suppl 1):2875. https://doi.org/10.1370/afm.20.s1.2875
  • Yoong SL, Lum M, Wolfenden L, et al. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev. 2023;6(6):CD013862. https://doi.org/10.1002/14651858.CD013862.pub2
  • Gayoso L, De Tomas I, Téllez R, Maiz E, Etxeberria U. Mindfulness-Based Eating Intervention in Children: Effects on Food Intake and Food-Related Behaviour During a Mid-morning Snack. Mindfulness. 2021;12(5):1185-1194. https://doi.org/10.1007/s12671-020-01587-0
  • Landry MJ, van den Berg AE, Hoelscher DM, et al. Impact of a school-based gardening, cooking, nutrition intervention on diet intake and quality: The TX Sprouts randomized controlled trial. Nutrients. 2021;13(9):3081. https://doi.org/10.3390/nu13093081
  • Tapper K. Mindful eating: what we know so far. Nutr Bull. 2022;47(2):168-185. https://doi.org/10.1111/nbu.12559
  • Sterling S, Bowen SA. Abstract P054: Plant-based nutrition and lifestyle intervention to improve dietary behaviors among Black Adults in the South. Circulation. 2022;145(Suppl_1). https://doi.org/10.1161/circ.145.suppl_1.p054
  • Jia SS, Liu Q, Allman-Farinelli M, et al. The use of portion control plates to promote healthy eating and diet-related outcomes: a scoping review. Nutrients. 2022;14(4):892. https://doi.org/10.3390/nu14040892
  • Wolgast H, Halverson MM, Kennedy N, Gallard I, Karpyn A. Encouraging healthier food and beverage purchasing and consumption: a review of interventions within grocery retail settings. Int J Environ Res Public Health. 2022;19(23):16107. https://doi.org/10.3390/ijerph192316107
  • Dunn CG, Wilcox S, Saunders RP, Kaczynski AT, Blake CE, Turner-McGrievy GM. Healthy eating and physical activity interventions in faith-based settings: a systematic review using the reach, effectiveness/efficacy, adoption, implementation, maintenance framework. Am J Prev Med. 2021;60(1):127-135. https://doi.org/10.1016/j.amepre.2020.05.014
  • Harrison ME, Norris ML, Obeid N, Fu M, Weinstangel H, Sampson M. Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Can Fam Physician. 2015;61(2):e96-e106. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325878/

Obstacles to Connect in the Community

  • Perez SG, Nuccio AG, Stripling AM. A rapid review of the detrimental impact of loneliness and social isolation in caregivers of older adults. Am J Geriat Psych. 2021;29(4):S122-S123. https://doi.org/10.1016/J.JAGP.2021.01.117
  • Park J, Jang Y, Oh H, Chi I. Loneliness as a mediator in the association between social isolation and psychological distress: a cross-sectional study with older Korean immigrants in the United States. Res Aging. 2023;45(5-6):438-447. https://doi.org/10.1177/01640275221098180
  • Röhr S, Wittmann F, Engel C, et al. Social factors and the prevalence of social isolation in a population-based adult cohort. Soc Psychiatry Psychiatr Epidemiol. 2022;57(10):1959-1968. https://doi.org/10.1007/s00127-021-02174-x
  • Kanbay M, Tanriover C, Copur S, et al. Social isolation and loneliness: Undervalued risk factors for disease states and mortality. Eur J Clin Invest. 2023;53(10):e14032. https://doi.org/10.1111/eci.14032
  • Ahmed M, Cerda I, Maloof M. Breaking the vicious cycle: The interplay between loneliness, metabolic illness, and mental health. Front Psychiatry. 2023;14:1134865. https://doi.org/10.3389/fpsyt.2023.1134865
  • Giacco D. Loneliness and mood disorders: consequence, cause and/or unholy alliance?. Curr Opin Psychiatry. 2023;36(1):47-53. https://doi.org/10.1097/YCO.0000000000000832
  • Lay-Yee R, Matthews T, Moffitt T, Poulton R, Caspi A, Milne B. Do socially isolated children become socially isolated adults?. Adv Life Course Res. 2021;50:100419. https://doi.org/10.1016/J.ALCR.2021.100419
  • Constanta Maritime University, Bărhalescu ML, Costescu E, “Apollonia” University of Iasi,  Faculty of Dental Medicine,  Romania /, Bărhalescu ML, Constanta Maritime University, Romania. The role of social media in user health. JMTE. 2023;2(2):7-11.  https://doi.org/10.53464/jmte.02.2023.01
  • Winstone L, Mars B, Haworth CMA, Kidger J. Social media use and social connectedness among adolescents in the United Kingdom: a qualitative exploration of displacement and stimulation. BMC Public Health. 2021;21(1):1736. https://doi.org/10.1186/s12889-021-11802-9
  • Seki T and Kurnaz M. Examining the relationship between individuals’ digital addictions and loneliness levels: a meta-analysis study. Ed Acad Res. 2022. https://doi.org/10.54614/aujkkef.2022.991723
  • Moens E, Baert S, Verhofstadt E, Van Ootegem L. Does loneliness lurk in temp work? Exploring the associations between temporary employment, loneliness at work and job satisfaction. PLoS One. 2021;16(5):e0250664. https://doi.org/10.1371/journal.pone.0250664
  • Becker WJ, Belkin LY, Tuskey SE, Conroy SA. Surviving remotely: How job control and loneliness during a forced shift to remote work impacted employee work behaviors and well‐being. Hum Res Man. 2022;61(4):449-464. https://doi.org/10.1002/hrm.22102
  • Chiao C, Lin WH, Chen YH, Yi CC. Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep. BMC Geriatr. 2021;21(1):590. https://doi.org/10.1186/s12877-021-02550-x
  • Schafer M, Sun H, Lee J. Do social connections buffer loneliness associated with living alone? Innov Aging. 2021;5(Supplement_1):459-459.   https://doi.org/10.1093/geroni/igab046.1777
  • Schafer MH, Sun H, Lee JA. Compensatory connections? Living alone, loneliness, and the buffering role of social connection among older American and European adults. J Gerontol B Psychol Sci Soc Sci. 2022;77(8):1550-1560. https://doi.org/10.1093/geronb/gbab217
  • Barreto M, Victor C, Hammond C, Eccles A, Richins MT, Qualter P. Loneliness around the world: Age, gender, and cultural differences in loneliness. Pers Individ Dif. 2021;169:110066. https://doi.org/10.1016/j.paid.2020.110066

Connect Strategies in the Community

  • Ellard OB, Dennison C, Tuomainen H. Interventions addressing loneliness among university students: a systematic review. Published online February 16, 2021.  https://doi.org/10.21203/RS.3.RS-234688/V1
  • Franke T, Sims-Gould J, Nettlefold L, Ottoni C, McKay HA. "It makes me feel not so alone": features of the Choose to Move physical activity intervention that reduce loneliness in older adults. BMC Public Health. 2021;21(1):312. https://doi.org/10.1186/s12889-021-10363-1
  • Noone C, Yang K. Community-based responses to loneliness in older people: A systematic review of qualitative studies. Health Soc Care Community. 2022;30(4):e859-e873. https://doi.org/10.1111/hsc.13682
  • McDaid D, Park AL. Addressing loneliness in older people through a personalized support and community response program. J Aging Soc Policy. 2024;36(5):1062-1078. https://doi.org/10.1080/08959420.2023.2228161
  • Lasgaard M, Løvschall C, Qualter P, et al. Are loneliness interventions effective in reducing loneliness? A meta-analytic review of 128 studies. Euro J Pub Health. 2022;32(Supplement_3):ckac129.266. https://doi.org/10.1093/eurpub/ckac129.266
  • Phang JK, Kwan YH, Yoon S, et al. Digital intergenerational program to reduce loneliness and social isolation among older adults: realist review. JMIR Aging. 2023;6:e39848. https://doi.org/10.2196/39848
  • Van Bogart K, Johnson JA, Nayman S, Nobel J, Smyth JM. Iterative design, feasibility, and preliminary efficacy testing for the development of a cooperative card game intervention to reduce loneliness and foster social connection. Games Health J. 2023;12(5):377-384. https://doi.org/10.1089/g4h.2022.0245
  • Cao K. The loneliness of low-income older adults in a federal volunteering program: a mixed-method network perspective. Innov Aging. 2023;7:21-22. https://doi.org/10.1093/geroni/igad104.0072
  • Lee S. Volunteering and loneliness in older adults: a parallel mediation model. Aging Ment Health. 2022;26(6):1234-1241. https://doi.org/10.1080/13607863.2021.1913477
  • Jiménez FN, Brazier JF, Davoodi NM, Florence LC, Thomas KS, Gadbois EA. A technology training program to alleviate social isolation and loneliness among homebound older adults: a community case study. Front Public Health. 2021;9:750609. https://doi.org/10.3389/fpubh.2021.750609

3.4 Health Equity