title: The effect of out-of-home activity intervention delivered by volunteers on depressive symptoms among older people with severe mobility limitations: a randomized controlled trial.
abstract: OBJECTIVE
  To examine the effects of an individualized outdoor activity intervention carried out by volunteers on depressive symptoms among community-living older people with severe mobility limitations who have difficulties accessing the outdoors independently.
  
  
  METHODS
  Secondary analyses of the 'Volunteering, Access to Outdoor Activities and Wellbeing in Older People' (VOW) data (ISRCTN56847832). VOW was a randomized single blinded two-arm controlled trial conducted in Jyväskylä, Finland, in 2009-2011. At baseline, 121 people aged 67-92 years with severe mobility limitations were interviewed at home and randomized into either an intervention or waiting list control group. Volunteers (n = 47) had retired from regular work and were trained for the study. A volunteer assisted the participant in attending recreational out-of-home activities once a week for three months. Depressive symptoms were assessed using the Center for the Epidemiological Studies Depression Scale (CES-D).
  
  
  RESULTS
  In the intervention group the CES-D score did not change during the intervention (from 15.1 ± standard error 0.9 to 15.1 ± 0.9), while in the control group it increased from 17.0 ± 1.3 to 19.1 ± 1.4 (intervention effect p = .096). Among the subgroups with minor depressive symptoms at baseline (CES-D score 16-20), the CES-D score decreased in the intervention group and increased in the control group (p = .025).
  
  
  CONCLUSIONS
  A three-month outdoor activity intervention may improve mood among older people with severe mobility limitations. More randomized controlled trials of the topic are needed.
authors.affiliation: a Gerontology Research Center and Department of Health Sciences , University of Jyväskylä , Jyväskylä, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Rantakokko
authors.forename: Inka
authors.initials: I
authors.lastname: Pakkala
authors.forename: Irma
authors.initials: I
authors.lastname: Äyräväinen
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity; D011998:Recreation / Q000523:psychology; D057173:Recreation Therapy / Q000379:methods*; D016896:Treatment Outcome; D014838:Volunteers
keywords: depression; older people; out-of-home activity; volunteering