Evaluating the Effectiveness of an Integral Neighbourhood-oriented Approach for Healthy Ageing: Findings from a Cluster-randomised Controlled Trial in Socioeconomically Diverse Communities

This article reports an effectiveness study of Neighbourhood Active & Connected, a novel neighbourhood-oriented approach to promote healthy ageing among older adults from lower socioeconomic positions (LSPs). This group faces significant health disparities and limited access to preventive care. The intervention aims to enhance physical activity, reduce loneliness, and improve social cohesion and health-related quality of life, while fostering digital engagement to support healthcare access and independence. To evaluate its impact, we conducted a parallel, superiority, 1:1 cluster-randomised controlled trial, randomly assigning LSP neighbourhoods and their inhabitants to either the intervention (N = 560) or a waitlist control group (N = 369), with 277 and 221 participants completing the baseline assessment, respectively. The intervention resulted in increases in physical activity after three months, with improvements in both moderate-to-vigorous (B = 346.618 min/week, SE = 141.185, p = 0.014) and light-intensity (B = 583.612 min/week, SE = 180.736, p = 0.001), although these effects diminished by six months. Loneliness, however, showed sustained reductions after three (B = -0.436, SE = 0.229, p = 0.058) and six months (B = -0.765, SE = 0.237, p < 0.001), highlighting the potential of a neighbourhood-oriented approach to reducing social isolation. No significant improvements were found in health-related quality of life, social cohesion, or digital engagement. These findings suggest that while neighbourhood-oriented interventions may effectively improve physical activity and reduce loneliness, further research and more targeted strategies are needed to enhance lasting improvements in physical activity and address broader health and well-being outcomes. This study emphasises the importance of considering the socio-environmental context in interventions and the need for ongoing support to maintain behavioural changes among older adults from lower socioeconomic backgrounds.