Importance: Rural homebound older adults are a vulnerable population at risk for depression, loneliness, and limited participation, but studies that examine these factors in this population are scarce. Objective: To describe the degree of depression, loneliness, and activity engagement among rural homebound older adults and determine differences in loneliness and activity engagement between those with and those without self-reported depression. Design: Cross-sectional survey. Setting: Two rural counties in south central Indiana. Participants: Homebound adults ages 60 yr and older who received nutritional or companionship services from a local Area Agency on Aging. Outcomes and Measures: Depression was measured with an item on the self-report questionnaire and the Geriatric Depression Scale–15. Loneliness was measured with an item on the self-report questionnaire and the UCLA Loneliness Scale. Activity engagement was measured with the Engagement in Meaningful Activities Survey and the Meaningful Activity Participation Assessment. Results: Ninety-one participants returned surveys, of which 78 were analyzed. Regarding depression, 40% of participants reported having it, but results for the Geriatric Depression Scale–15 showed that 63% were in the indicative or suggestive range for depression. Participants in general reported moderate loneliness and low to moderate engagement in meaningful activities. Those with self-reported depression had significantly higher loneliness and lower activity engagement, particularly in self-care, leisure, and socializing activities. Conclusions and Relevance: A high proportion of this sample of rural homebound older adults had depression. Those who did tended to have a higher degree of loneliness and lower engagement in meaningful activities. What This Article Adds: Depression was associated with greater loneliness and lower activity engagement in rural homebound older adults. Occupational therapy practitioners serving rural homebound older adults with depression should consider providing interventions to address loneliness and facilitate activity engagement.

OBJECTIVE. We examined the efficacy of a 12-wk educational socialization program, Community Reintegration for Socially Isolated Patients (CRISP), in improving self-efficacy for people with multiple sclerosis (MS). We also examined whether participants in the experimental group with increased self-efficacy experienced reduced loneliness and depression. METHOD. This randomized controlled group design included 91 participants with MS (experimental group, n = 51; control group, n = 40). Participants were between ages 20 and 68 yr, and the majority experienced a relapsing–remitting MS course (86%) and mild to moderate disability. Participants completed baseline and posttreatment assessments, including questionnaires assessing self-efficacy, loneliness, and depression. RESULTS. Experimental group participants significantly improved in self-efficacy compared with control group participants. Experimental group participants who demonstrated improved self-efficacy reported reduced perceptions of loneliness but not depressive symptoms. CONCLUSION. CRISP is a promising intervention to improve self-efficacy for people with MS. However, results need to be treated with caution given the study’s limitations.

OBJECTIVE. This study investigated the mediational role of team sports and other leisure occupations for boys ages 10 to 13 years in the relationship between physical coordination ability and perceptions of loneliness. METHOD. Sixty boys with developmental coordination disorder (DCD) and 113 comparison boys without DCD completed a self-report measure of loneliness. Parents recorded information on leisure involvement over 7 days. RESULTS. Boys with DCD recorded significantly higher loneliness and lower participation rates in all group physical activities, whether structured (e.g., team sports) or unstructured (e.g., informal outdoor play) than boys without DCD. An inverse relationship between physical coordination ability and loneliness was mediated by participation in team sports. No other leisure pursuits were found to be significant mediators. Childhood physical coordination difficulties were significantly associated with loneliness. CONCLUSION. Participation in team sports acted as one potential mechanism mediating the inverse relationship between physical coordination ability and loneliness in boys. Occupational therapists can act as advocates to support boys with DCD who choose to participate in team sports. Further investigations are recommended to determine aspects of team sports environments that promote an optimal fit among child, activity, and environment.