title: Effect of physical activity, social support, and skills training on late-life emotional health: a systematic literature review and implications for public health research.
abstract: OBJECTIVE
  Given that emotional health is a critical component of healthy aging, we undertook a systematic literature review to assess whether current interventions can positively affect older adults' emotional health.
  
  
  METHODS
  A national panel of health services and mental health researchers guided the review. Eligibility criteria included community-dwelling older adult (aged ≥ 50 years) samples, reproducible interventions, and emotional health outcomes, which included multiple domains and both positive (well-being) and illness-related (anxiety) dimensions. This review focused on three types of interventions - physical activity, social support, and skills training - given their public health significance and large number of studies identified. Panel members evaluated the strength of evidence (quality and effectiveness).
  
  
  RESULTS
  In all, 292 articles met inclusion criteria. These included 83 exercise/physical activity, 25 social support, and 40 skills training interventions. For evidence rating, these 148 interventions were categorized into 64 pairings by intervention type and emotional health outcome, e.g., strength training targeting loneliness or social support to address mood. 83% of these pairings were rated at least fair quality. Expert panelists found sufficient evidence of effectiveness only for skills training interventions with health outcomes of decreasing anxiety and improving quality of life and self-efficacy. Due to limitations in reviewed studies, many intervention-outcome pairings yielded insufficient evidence.
  
  
  CONCLUSIONS
  Skills training interventions improved several aspects of emotional health in community-dwelling older adults, while the effects for other outcomes and interventions lacked clear evidence. We discuss the implications and challenges in moving forward in this important area.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine , Seattle, WA , USA.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Snowden
authors.affiliation: Health Promotion Research Center, University of Washington , Seattle, WA , USA.
authors.forename: Lesley E
authors.initials: LE
authors.lastname: Steinman
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine , Seattle, WA , USA.
authors.forename: Whitney L
authors.initials: WL
authors.lastname: Carlson
authors.affiliation: University of Washington School of Nursing with Environmental Health Focus , Seattle, WA , USA ; Adolescent Medicine, Seattle Children's , Seattle, WA , USA.
authors.forename: Kara N
authors.initials: KN
authors.lastname: Mochan
authors.affiliation: Department of Sociomedical Sciences, Columbia University Mailman School of Public Health , New York, NY , USA.
authors.forename: Ana F
authors.initials: AF
authors.lastname: Abraido-Lanza
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver , Aurora, CO , USA.
authors.forename: Lucinda L
authors.initials: LL
authors.lastname: Bryant
authors.affiliation: Department of Educational Psychology, Counseling Psychology Program, Texas A&M University , College Station, TX , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Duffy
authors.affiliation: Davis School of Gerontology and Department of Psychology, University of Southern California , Los Angeles, CA , USA.
authors.forename: Bob G
authors.initials: BG
authors.lastname: Knight
authors.affiliation: Sam and Rose Stein Institute for Research on Aging and Department of Psychiatry, University of California San Diego , San Diego, CA , USA.
authors.forename: Dilip V
authors.initials: DV
authors.lastname: Jeste
authors.affiliation: College of Social Work, University of South Carolina , Columbia, SC , USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Leith
authors.affiliation: Department of Psychiatry, Washington University School of Medicine , St Louis, MO , USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.affiliation: Department of Psychosocial and Community Health, University of Washington School of Nursing , Seattle, WA , USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Logsdon
authors.affiliation: School of Public Health, University of California Berkeley , Berkeley, CA , USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Satariano
authors.affiliation: Division of Chronic Disease and Injury Prevention, Michigan Department of Community Health , Lansing, MI , USA ; Healthy Aging Council and Health Equity Council, National Association of Chronic Disease Directors , Atlanta, GA , USA.
authors.forename: Damita J
authors.initials: DJ
authors.lastname: Zweiback
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA , USA ; Rollins School of Public Health, Emory University , Atlanta, GA , USA.
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Anderson
keywords: aged; health promotion; mental health; review