Contexts, mechanisms and outcomes of interventions to counter ageism toward older adults in undergraduate health and social services students: Results of a realist review

ABSTRACT

Ageism might reduce the effectiveness and quality of care in older adults essential with the aging population. Although interventions to counter ageism were carried out among students, no clear integration of their results described the mechanisms underlying their impact. This study aimed to provide a comprehensive understanding of which interventions amongst undergraduate health and social services students are effective, under which circumstances, how, and with what outcomes. A realist review was carried out using 44 keywords in 6 databases. The configurations for contexts, mechanisms, and outcomes were identified for three types of interventions, considering their impact on stereotypes, prejudices, and discrimination toward older adults. In the 63 studies selected, intergenerational contact interventions exhibited the greatest proportion (14/15; 93.3%) of evidence supporting improvement in outcomes of ageism, followed by combined (67/84; 79.8%) and educational (51/67; 76.1%) interventions. Stereotypes and prejudices were challenged by the transmission of realistic and balanced information, as well as through meaningful and high-quality intergenerational contact. Meeting or hearing about a broad variety of older adults in specific conditions also helped to decrease ageism. Results highlighted the importance of seeing diversity and uniqueness in older adults, and their competencies rather than their limitations. Mechanisms were occasionally hampered by obstacles, such as induced anxiety and confirmation of negative aspects of aging. Countering ageism in health and social services students is essential to ensuring high-quality care. In knowing that educators, professionals, and institutions have a direct influence on students, their awareness of ageism should be enhanced by interventions targeting them.

Acknowledgements

The authors would like to acknowledge Louise Tremblay and Jean-François Cardinal for helping in selecting the studies and for their assistance in extracting data. They also would like to thank Dany Baillargeon, Marie Beaulieu, Annie Carrier, Alan A. Cohen, Sylvain Giroux, Laurie Kirouac, Martine Lagacé, Sébastien Lord, Christine Morin, and André Tourigny, co-researchers in the project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by a Fonds de la recherche du Québec – Santé [AUDACE Program; #2020-VIAU-279578] and by the Luc Maurice Foundation. Carine Bétrisey received a postdoctoral scholarship from the Research Centre on Aging and a Mitacs Accelerate fellowship [#IT23325]. At the time of the study, Mélanie Levasseur was a Canadian Institutes of Health Research (CIHR) New Investigator [#360880] and a Fonds de la recherche du Québec – Santé Senior Researcher [#298996]. She now holds a Tier 1 Canadian Research Chair in Social Participation and Connection for Older Adults [CRC-2022-00331; 2023-2030].