Contributions of Volunteer Networking To Isolated Seniors in Hong Kong

This article was downloaded by: [City University of Hong Kong Library]
On: 25 November 2012, At: 01:16

Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954
Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH,
UK
Journal of Gerontological
Social Work
Publication details, including instructions for
authors and subscription information:
http://www.tandfonline.com/loi/wger20
Contributions of Volunteer
Networking to Isolated Seniors
in Hong Kong
a a
Chau-Kiu Cheung PhD & Man-Hung Ngan PhD
a
The Department of Applied Social Studies, City
University of Hong Kong, Hong Kong, China
Version of record first published: 20 Oct 2008.
To cite this article: Chau-Kiu Cheung PhD & Man-Hung Ngan PhD (2000): Contributions
of Volunteer Networking to Isolated Seniors in Hong Kong, Journal of Gerontological
Social Work, 33:2, 79-100
To link to this article: http://dx.doi.org/10.1300/J083v33n02_06
PLEASE SCROLL DOWN FOR ARTICLE
Full terms and conditions of use: http://www.tandfonline.com/page/terms-

and-conditions
This article may be used for research, teaching, and private study purposes.
Any substantial or systematic reproduction, redistribution, reselling, loan,
sub-licensing, systematic supply, or distribution in any form to anyone is
expressly forbidden.
The publisher does not give any warranty express or implied or make any
representation that the contents will be complete or accurate or up to
date. The accuracy of any instructions, formulae, and drug doses should be
independently verified with primary sources. The publisher shall not be liable
for any loss, actions, claims, proceedings, demand, or costs or damages
whatsoever or howsoever caused arising directly or indirectly in connection
with or arising out of the use of this material.
Downloaded by [City University of Hong Kong Library] at 01:16 25 November 2012
Contributions of Volunteer Networking

to Isolated Seniors in Hong Kong
Chau-kiu Cheung, PhD
Man-hung Ngan, PhD
ABSTRACT. Although research and theory suggest that volunteers con-

tribute to the quality of life of senior people whom they serve, rigorous
empirical investigation is missing for senior Hong Kong Chinese. A
project that recruits, trains, and matches volunteers for isolated and frail
senior Hong Kong Chinese is good for the investigation because it repre-
sents a new approach. This study employed a two-wave panel design to
collect data from 125 users of the volunteer networking project. Its
results demonstrate that volunteer input, in terms of contact intensity and
helpfulness, significantly contributed to Wave 2 quality-of-life outcomes,
including reduction in worry, increase in community knowledge, and
social integration given the control of their prior scores. Nevertheless,
volunteer input had no significant effects on the senior visitees health.
[Article copies available for a fee from The Haworth Document Delivery Ser-
vice: 1-800-342-9678. E-mail address: <getinfo@haworthpressinc.com>
Website: <http://www.HaworthPress.com>]
KEYWORDS. Chinese elderly, volunteers impact on quality of life,

volunteers and social integration
Several studies have suggested that volunteer visitors can make

salutary contributions to senior people (Biegel, 1985; Korte & Gupta,
Chau-kiu Cheung and Man-hung Ngan are affiliated with the Department of
Applied Social Studies, City University of Hong Kong, Hong Kong, China.
Address correspondence to: Chau-kiu Cheung, Department of Applied Social
Studies, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong,
China (E-mail: ssjacky@cityu.edu.hk).
The study benefits very much from the support of Aberdeen Kai-Fong Welfare
Association Social Service Centre, Hong Kong, China.
Journal of Gerontological Social Work, Vol. 33(2) 2000
E 2000 by The Haworth Press, Inc. All rights reserved. 79
80 JOURNAL OF GERONTOLOGICAL SOCIAL WORK
1991; McNeil, 1995). In the visit, the volunteer can offer help, advice,
care, stimulation and companionship to the senior. Besides, mere con-

versation and listening to the senior can be good for the senior, in
addition to any practical help the volunteer might give. These findings,
however, primarily stemmed from case studies of senior people in
Western countries which have not examined the contribution of volun-
teer visits thoroughly and rigorously by controlling confounding vari-
ables. In the case of isolated and frail seniors, the findings cannot
generalize about the effectiveness of a volunteering networking pro-
gram for promoting the seniors sense of security, community knowl-
edge, social integration, and health. To ascertain such effectiveness, a
specially designed empirical study is therefore necessary.
A thorough examination of seniors quality of life should focus on
their biological, psychological, social, and material aspects (Seed &
Kayer, 1994). As such, seniors health, social integration, and commu-
nity knowledge have been outcome variables for research (Chappell &
Badger, 1989; Haley, Roth, Coleton, Ford, West, Collins, & Isobe,
1996; Kraus, Davis, Bazzini, Church, & Kirchman, 1993). Many se-
niors become socially isolated and physically frail (Chappell & Bad-
ger, 1989; Korte & Gupta, 1991; Mor-Barak & Miller, 1991). These
seniors are targets of a number of social services that attempt to im-
prove their quality of life. In Hong Kong, a social networking program
has recently been developed to recruit and train volunteers so that they
can visit and help frail seniors who are living alone. This program
aims at (re)-creating a social network for isolated seniors by strength-
ening their contact with volunteers, friends, relatives, neighbors, and
other people, and their knowledge and use of a variety of services
prepared for them. What is more important, the introduction of the
social networking program is a response to isolated and frail seniors
concern about dying precipitated by the cold weather in 1995. Hence,
reducing the seniors anxiety about social isolation and death is of
paramount concern. Examining the effectiveness of the social net-
working program in satisfying these goals is the objective of this
two-wave longitudinal study. To highlight the contribution of the pro-
gram, a rigorous study should unravel the mechanism of the contribu-
tion and distinguish it from other alternative influences. Therefore, the
present study examines effects of the volunteers contact and helpful-
ness perceived by the senior on quality-of-life outcomes, by control-
ling the prior quality of life and background characteristics.
Chau-kiu Cheung and Man-hung Ngan 81
LITERATURE REVIEW
The literature indicates the contribution of volunteer visits as a way

to strengthen the senior visitees quality of life. Recent research in
Western societies suggests that volunteer visits, which involve com-
panionship and conversation seem to effectively sustain the senior
visitees happiness and health (McNeil, 1995; Korte & Gupta, 1991;
Wheeler et al., 1998). It holds that the salutary effects are persistent
and lead to reduction in the senior visitees social isolation, to an
increase in morale, and to a delay in the onset of institutionalization.
However, researchers have noted that there was no prior research on
effects of volunteer visits (McNeil, 1995; Korte & Gupta, 1991). Fur-
thermore, these researchers only offer limited empirical evidence de-
rived from small samples and bivariate analytic techniques. McNeil
(1995) recruited 30 older adults who received volunteer visits over six
weeks. During this period, the volunteer either accompanied the senior
for a 20-minute walk or had a 20-minute conversation two or three
times a week. However, the studies fail to examine effects of volunteer
visits on a thorough set of quality-of-life outcomes. The volunteers
were undergraduate psychology students. McNeil (1995) found that
older adults benefited in terms of their raised happiness and subjective
health. Such advantages were clear in comparison with those who did
not receive the volunteer visit.
In another study, Korte and Gupta (1991) described the success of
the Sunshine Visitor Program. The program trained and randomly
assigned volunteers to function as network builders with their isolated
elderly visitees as a way to strengthen their social support networks.
Volunteers of the program tended to encourage network building rath-
er than getting directly involved with the clients social networks. The
usual aims of friendly visiting are to reduce social isolation, increase
morale and well-being, and delay the onset of institutionalization.
Each volunteer functions as a new, and usually temporary, social rela-
tionship for the elderly person, providing social stimulation, compan-
ionship, advice, and a listening ear. Korte and Gupta (1991) took the
prevalence and persistence of the program as an indication of effec-
tiveness. Moreover, seniors receiving friendly visiting showed higher
morale, better health, and better mental status, grooming, and apart-
ment upkeep. The overall evaluation of the Program was positive.
Wheeler et al. (1998) presented a meta-analysis of studies of older
volunteers. Some older volunteers helped other older people. The
mean effect on clients, in terms of such measures of life satisfaction,

was .458. Nevertheless, evidence for the effect of volunteer visits on

seniors was only indirect. This study and others did not offer over-
whelmingly convincing evidence to substantiate volunteers contribu-
tion to their elderly visitees. Some evidence stems only from impres-
sionistic and anecdotal evaluation (Biegel, 1985; Korte & Gupta,
1991). Other evidence was derived from small, specific samples of
volunteers and seniors (McNeil, 1995). There is a need for more
evidence in support of volunteers contribution to substantial areas of
seniors, especially in a non-Western social context.
Apart from research on volunteers contribution, reviews of infor-
mal and formal support lend credence to the claim about the effective-
ness of volunteer visits as instituted in the social networking program
in Hong Kong. They imply that volunteers, just like friends and rela-
tives, can become a source of informal support for seniors (Biegel,
1985). Like family members, friends, and other agents of informal
support, volunteers visit and provide help to senior clients of the social
network project at their own discretion or in response to the clients
request, without the need for arrangement by the social networking
agency. Furthermore, the visit and help involve no exchange of money
for service. After a visit, neither the volunteer nor client needs to
report to the networking agency. Development of friendship between
the volunteer and senior and the friendly manner of the volunteer
characterize the informal support of volunteers (Korte & Gupta,
1991).
In addition, volunteers acquire and mediate formal support pro-
vided by the social service agency which is responsible for recruiting
and training volunteers, matching them to isolated and frail seniors,
and reviewing the results. Hence, volunteer visitors may function both
as an informal source of support and a mediator for formal support.
Research and theory have indicated that various kinds of informal
support can safeguard seniors quality of life (Heinemann, 1985;
Wills, 1992). They explain the positive effect by such mechanisms as
social integration and social control (Shye, Mullooly, Freeborn, &
Pope, 1995; Wills, 1992). Accordingly, ones psychological, social,
and even biological well-being would increase because of other
peoples acceptance, support, and care. Besides, the socially integrated
person would adopt the healthy norm held by other people who serve
as models, teachers, and advisors for each other. The senior can bene-
fit from social integration when the volunteer visitor plays a role of
confidant and companion (Chappell & Badger, 1989). Moreover, vol-

unteers can provide more instrumental assistance to seniors because of
their training and support received from the social networking agency.
This form of support is especially important to seniors whose health is
poor (Krause, 1990). These are essential elements of social integration
theory, which emphasizes the normative role of social networks in
sustaining social order (Deimling & Harel, 1984; Steinkamp & Kelly,
1987). Accordingly, social integration provides guidance for activities
and living in old age. Moreover, when social support fits the support
recipients need, it is particularly beneficial (Kahn, 1994). However,
when social support is unnatural, such as that provided by experiment-
ers and volunteers, it may not be always helpful (Kahn, 1994). The
effectiveness of volunteer support is therefore an unsettled research
question.
The contribution of volunteer networking may depend on the quali-
ty and quantity of the volunteers input. The quality of input refers to
help and helpfulness perceived by the senior visitee and the quantity of
input refers to the amount of contact between the senior and the
volunteer. There is evidence that a seniors health improves as a result
of more contact with friends and kin (Krause, 1997; Mor-Barak &
Miller, 1991), and that good health is a result of the amount of help
received by the senior and the perceived adequacy of it (Davies, Beb-
bington, & Charnley, 1990).
Effects of volunteer networking may not be certain without the
elimination of alternative explanations. One prominent alternative ex-
planation pertains to the self-selection with which the seniors quality
of life influences the amount and adequacy of volunteer contact (Mar-
kides & Lee, 1991). Because prior dimensions of the quality of life
also determine subsequent quality-of-life outcomes (Harlow & Can-
tor, 1996; Holahan & Sears, 1995), they may be common factors that
explain away the influence of volunteer networking on the quality of
life. This alternative explanation would become unlikely with the
presence of prior scores of outcomes as control variables. In addition,
background characteristics can affect the seniors quality of life and
possibly also the volunteers input. A female senior also tends to
display poorer health, more anxiety, and better social integration than
a male (Davies et al., 1990; Houts & Kassals, 1997; Johnson & Wolin-
sky, 1993; Kraus, Goldwater, Liang, Jay, & Maeda, 1993; Mor-Barak &
Miller, 1991). Moreover, a seniors received social support, including
that provided by the volunteer, can be a function of the seniors sex,

age, and health (Kincade, Rabiner, Bernard, Wwoomert, Konrad, De-

Friese, & Ory, 1998; Krause et al., 1993; Lawton, 1983; Logan &
Spitze, 1994; Miner, 1995). Alternatively, younger age implies higher
physical, cognitive, and social competence which is conducive to the
seniors well-being (Hummert, 1993).
The seniors health and sickness are likely to influence anxiety
levels and social integration (Bazargan & Hamm-Baugh, 1995; Chap-
pell & Badger, 1989; Calasanti, 1996; Harlow & Cantor, 1996; Krause
et al., 1993; Lee & Ishii-Kuntz, 1987; Mullins, Smith, Colquitt, &
Mushel, 1996). Because health is a basic consideration that contributes
to senior peoples daily difficulties, it would be a source of concern
(Russell & Cutrona, 1991). Exchange theory may explain peoples
rejection of frail and poor seniors who may be less able to reciprocate
(Mullins et al., 1996). On the other hand, prior problems may increase
the seniors likelihood of sickness (Wolinsky & Johnson, 1991).
Therefore, dimensions of the quality of life have remarkable relation-
ships among themselves concurrently and over time. They are indis-
pensable predictors of each other.
HYPOTHESES
The preceding theory and research findings cannot be applied to

senior people in Hong Kong without an empirical examination. Such
an examination is essential because of the (1) paucity of explanatory
studies of senior peoples well-being, (2) the high biological, psycho-
logical, and social risk of isolated and frail seniors, (3) the important
policy and program of the new social networking program to tackle
the risk, and (4) cultural differences between the Hong Kong popula-
tion and those of the West. The bulk of explanatory studies of local
senior peoples well-being is cross-sectional, without controlling for
prior scores (Cheung et al., 1997; Chi & Lee, 1989; Liu, Lee, Yu, Lee,
& Sun, 1993; Ngan, Leung, Kwan, Yeung, & Chong, 1996). These
studies, nevertheless, indicated that senior people living alone are at
higher risk for social, psychological, and health problems. To tackle
the problem, the government launched the social networking program
as a means to mobilize volunteer action in a short time with a low cost
(Wheeler et al., 1998). The success of this program would rely on
affirmative responses to the following hypotheses:
Hypothesis 1: The more contact with and/or helpfulness of the

volunteer in the past two months, the less anxious the senior will be.

volunteer in the past two months, the higher the seniors knowl-
edge about senior services will be.

volunteer in the past two months, the better the seniors health
will be.

volunteer in the past two months, the better the seniors social
integration will be.
The test of these hypotheses would be crucial for ascertaining the

generality of the input elements, the contact intensity and helpfulness,
of volunteer networking for senior service recipients in Hong Kong,
whose culture is obviously different from Western culture (Triandis,
Chen, & Chan, 1998). Hong Kong seniors are likely to adhere to
traditional Chinese culture, characterized by collectivism (Chiu, 1990;
Ikels, 1990). The collectivist element of the cultural tradition of older
Hong Kong Chinese renders social integration a particularly essential
consideration for seniors well-being (Cheung, Lee, & Chan, 1997).
Conversely, lack of social integration would be a significant problem
to isolated senior Chinese. However, collectivist culture emphasizes
the social integration with ones family and ingroup whereas it implies
rejection of outgroups (Triandis, 1995). As a result, senior people will
enjoy social integration if they regard volunteers as members of their
ingroups. However, they will become uncomfortable and alienated if
they regard the volunteers as members of outgroups. Consequently,
while volunteers impact is likely to be important for senior Chinese,
the effects could be either, positive or negative. This was an issue for
our study to address.
METHODS
The study employed a longitudinal, panel design to collect data

from 139 isolated and frail senior participants of the social (volunteer)
networking project in one of the 18 districts in the territory of Hong

Kong. It involved two surveys, one in September and October 1997

and another in March and April 1998. Since February 1997, the social
networking project has recruited and trained volunteers, enlisted iso-
lated and frail seniors in the district, and matched the volunteers to the
seniors. The training focused on the following topics: (1) concepts of
volunteer service, (2) roles and responsibilities of volunteers, (3) safe-
ty of volunteers, (4) knowledge about the aging process, (5) commu-
nication skills, (6) skills of oral presentation and observation, (7) knowl-
edge of the volunteer networking project, and (8) knowledge of
services for senior people. Besides attending the training, volunteers
shared their experience in the networking service in regular sessions.
They visited isolated and frail seniors in pairs or in teams. The project
recruited volunteers of all walks of life.
The sample of isolated and frail senior persons consisted of those
public housing (i.e., low-income) residents enrolled in the project with
high priority but having fewer than four visits by volunteers of the
project. The government department was responsible for ascertaining
and using these persons social and health status as a basis for deriving
their priority for receiving the volunteer networking service. It as-
sessed each applicant for the networking project on his or her living
arrangement (living alone), lack of care, health (being bed ridden,
using a wheelchair, limitation in walking, having chronic illness, and/or
mental retardation), receiving no home help services, having few vis-
its from relatives and friends, and living in an unfavorable or hazard-
ous environment. Seniors with all these characteristics would have
first priority for joining the networking project.
The respondents had joined the project almost at the same time
during its beginning. They had regular contact with volunteers whose
majority ( > 80%) was homemakers aged 35 years or above. Both
surveys of the study required home visits by volunteer interviewers
specially recruited and trained for the present research. To eliminate
any bias possibly due to the self-fulfilling prophecy, the study re-
cruited interviewers who were not providing services to seniors in the
volunteer networking project. The interviewers tended to be younger
than the regular volunteers assigned to the seniors. They employed a
structured questionnaire to conduct the interview. The questionnaire
was a modified version of an early draft administered to a few senior
persons as a pretest.
The study achieved an impressive response rate of 98.6% in the first

survey. Only two hospitalized senior persons missed the study. The
survey, however, was unable to contact 13 target respondents because
they had left Hong Kong and one had left the social networking
project. None refused to participate in the study. In the second wave,
the study surveyed 125 of the original 139 elderly respondents again.
The rate of retention was 89.9%. Two senior respondents deceased
before the second survey. Another research participant went to the
mainland of China. Four others were out of contact after three visits by
interviewers.
Sample Description
Descriptive analysis of background characteristics of the 125 senior
people who participated in both surveys showed that their average age
was 76.9 years. Their ages ranged from 61 to 92 years. Most (64.8%)
of them had an age in the range between 70 and 79 whereas 30.4% had
an age of 80 or older. About two-thirds (65.5%) of them were female
(see also Table 1).
Measures
Measures of the perceived helpfulness of the volunteer of the social
networking project, contact with the volunteer, health, social integra-
TABLE 1. Means at Wave 1 and Wave 2
Variable Wave 1 Wave 2
Anxiety (0-100) 26.9 20.7*

Knowledge of services (0-100) 30.3 35.4*
Health (0-100) 46.2 43.4
Social integration (0-100) 31.0 31.1
Volunteer helpfulness (0-100) 58.6 55.9
Contact with the volunteer (0-100) 35.5 37.8
Number of visits in the past 6 months 1.8 (0-4) 3.2 (0-9)
Number of seniors who had no contact with volunteers 10 4
Sickness (times) 1.42 1.15
* p < .05 (difference in means according to the paired t-test)

tion, worry, and knowledge about the community involved multiple

items based on a five-point rating scale, labeled from very little to very
much. Responses on the scale generated scores according to the fol-
lowing rule: (1) none = 0, (2) little = 25, (3) average = 50, (4) much =
75, and (5) very much = 100.
Anxiety. The measure of anxiety was the average of scores for six
items: (1) fear of having a serious illness, (2) the unavailability of help
in case of accidents, (3) being lonely, (4) the unavailability of help in
general, (5) death of cold and nobody aware of it, and (6) being
robbed, in descending order of concern. The reliability alpha of the
composite score was .811.
Social integration. The measure of expected social integration was
an average of scores for six items: the likelihood of (1) people express-
ing care to you, (2) times needed help received, (3) times of someone
accompanying you to participate in activities, (4) times visiting
friends, (5) friends coming to visit you, and (6) visits by relatives, in
descending order of the degree of social integration expected. The
reliability alpha of the composite score was .690.
Knowledge about senior services. The measure of knowledge about
senior services was a composite of four self-reported knowledge
items: (1) government departments of social security, (2) home help
service, (3) services of senior centers, and (4) day care services. The
reliability alpha of the composite score was .759.
Health. The measure of health was a composite of self-reported
health regarding present health status from very poor to very good and
health compared with that in the previous year. The reliability alpha of
the two-item measure was .517. The self-report measure is a popular
and valid one as demonstrated by studies that showed its relationships
to other indicators of health, including the physicians assessment and
objective assessment of disability (Boyer, 1980; Johnson & Wolinsky,
1993). Furthermore, the self-report measure had the advantage of
identifying a global and overall view of health as directly experienced
by oneself whereas objective measures might yield reflect an indirect
and partial view. The questionnaire also included a question about the
number of times being sick in the two months preceding the survey.
This item indicated the experience of sickness.
Contact with the volunteer. The measure of contact with the volun-
teer in the previous two months involved seven items: (1) conversa-
tion, (2) introducing activities, (3) meeting, (4) visit, (5) phone calling,
(6) introducing senior services, and (7) times of visits. The reliability
alpha of the composite score was .840.

Volunteer helpfulness. The measure of the helpfulness of the volun-
teer included four items perceived by the senior respondent: (1) volun-
teer expression of care, (2) feeling happy when seeing the volunteer,
(3) seeking help from the volunteer if necessary, and (4) help from the
volunteer. The reliability alpha of the composite score was .736.
Analytic Strategy
To test the hypotheses, regression analysis used predictors measured

at Wave 1 and Wave 2 to predict outcomes measured in Wave 2. The
predictors included prior scores of the outcomes measured at Wave 1.
These prior scores were useful for control for the heterogeneity of
respondents, thus contributing to valid estimation and testing of effects
of other predictors in the analysis (Kessler & Greenberg, 1981).
RESULTS
Six months after the initial survey, the isolated and frail senior
person, on average, displayed a significant decrease in anxiety (from
26.9 down to 20.7, see Table 1), and a significant increase in knowl-
edge of services (from 30.3 to 35.4). These findings attested to the
effectiveness of the volunteer networking in matching its primary goal
of reducing isolated and frail seniors anxiety and increasing their
knowledge.
Regression analysis showed that contact with the volunteer at Wave
2 had a significantly negative effect on anxiety ( = .209, see Table
2), positive effects on social integration (.273), and knowledge about
community services (.186). Besides, the perceived helpfulness of the
volunteer at Wave 2 showed significantly positive effects on knowl-
edge about senior services (.250, see Table 2) and social integration
(.176). These effects were all net effects in the presence of alternative
and competing predictors, including prior scores of the outcome vari-
ables. Thus, the significant findings support all the hypotheses, except
Hypothesis 4, concerning the effectiveness of volunteer inputs for
promoting isolated and frail seniors health.
As regards Hypothesis 1, both volunteer contact prior to Wave 2
TABLE 2. Standardized Effects on Worry, Knowledge, Life Satisfaction at

Wave 2
Predictor Worry Knowledge Health Social

integration
Volunteer helpfulness 2 .111 .250* .118 .176*
Contact with the volunteer 2 .209* .186* .033 .273*
Sickness 2 .096 .114 .357* .112
Anxiety 1 .373* .058 .067 .111
Knowledge of services 1 .037 .396* .005 .003
Health 1 .154 .036 .280* .009
Social integration 1 .033 .191* .158 .408*
Volunteer helpfulness 1 .127 .019 .026 .040
Contact with the volunteer 1 .125 .197* .070 .070
Sickness 1 .015 .015 .068 .071
Age .073 .060 .069 .069
Female .052 .106 .157 .127
R2 .243 .373 .308 .389
* p < .05
and helpfulness experienced exerted negative effects ( .209 and

.111, see Table 2) on Wave 2 worry. Probably because of redundan-
cy, only the effect of contact was significant. Wave 1 anxiety showed a
carry over effect (.373) at only a moderate level. The significant effect
of volunteer contact was quite important as compared with that of the
prior score. The contact was particularly important because no other
predictor was significant.
As regarding prediction of Wave 2 knowledge about senior ser-
vices, both volunteer contact and helpfulness exerted positive effects
(.186 and .250). In addition, prior scores of knowledge and social
integration contributed significant effects (.396 and .191) to Wave 2
knowledge. Effects of volunteer contact and helpfulness appeared to
be important among the small set of significant predictors. Given the
contribution of contact with the volunteer in the two months preceding

the second wave of the survey, contact with the volunteer eight months
before showed a negative effect ( .197) on the seniors knowledge.
The finding suggests that a senior who contacted a volunteer eight
months ago but did not contact the volunteer within the last two
months would have lower knowledge about senior services than oth-
ers. Such a senior might fail to acquire up-to-date information from
the volunteer and thus appear to have lower knowledge.
Hypothesis 3 concerning impacts of volunteer inputs on health
receives no significant support. Health perceived at Wave 2 appeared
to be a significant function of sickness in the two months preceding
Wave 2 ( = .357) and of health experienced at Wave 1 (.280).
On social integration at Wave 2, both volunteer contact and helpful-
ness contributed significantly positive effects (.273 and .176). These
findings obviously support Hypothesis 5. Social integration antici-
pated at Wave 1 showed a significantly positive effect (.408) on social
integration anticipated at Wave 2. The contribution of volunteers to
seniors social integration appeared to be notably high.
Further regression analysis revealed that the volunteers helpfulness
perceived at Wave 2 was a significant function of the seniors prior
helpfulness (.262, see Table 3) and prior contact with volunteers
(.171). Apparently, more contact made seniors perceive higher levels
of volunteer helpfulness. Results also showed that volunteer contact
within the two months before Wave 2 was significantly predictable by
the seniors prior contact before Wave 1 (.323). These results turned
out in the control of the seniors health, social integration, age, and
other characteristics in the regression analysis. These other Wave 1
characteristics, however, did not significantly predict volunteer con-
tact and helpfulness experienced at Wave 2. Hence, prior outcomes did
not substantially affect volunteer input and confound its effects.
DISCUSSION
All hypotheses, except that concerning health, received support

from results that demonstrated salutary effects of volunteer contact
and/or helpfulness on the senior visitees anxiety, knowledge about
senior services, and social integration. The support illustrates that
volunteer input in the social networking project is a significant factor
TABLE 3. Standardized Effects on Helpfulness, Contact, Financial Adequacy,

and Sickness at Wave 2
Helpfulness Contact with the volunteer
Anxiety 1 .106 .080

Knowledge of services 1 .100 .101
Health 1 .165 .137
Social integration 1 .046 .122
Volunteer helpfulness 1 .262* .100
Contact with the volunteer 1 .171* .323*
Sickness 1 .083 .088
Age .147 .100
Female .152 .032
R2 .212 .198
* p < .05
for improving the isolated and frail seniors psychosocial quality of

life. Moreover, regardless of the variation of volunteer input, the social
network project evidenced a decrease in seniors anxiety, and an in-
crease in community knowledge after six months of its operation. The
favorable results also echo similar results reported in previous re-
search and review (McNeil, 1995; Korte & Gupta, 1991; Wheeler et
al., 1998). Furthermore, they are broadly consistent with theory and
research on social support, social integration, and social control
(Kahn, 1994; Shye et al., 1995; Wills, 1992). Hence, the salutary
effects of volunteer input in the context of the social networking
project are credible in view of the weight of empirical and theoretical
support. They are also practically important (e.g., > .15) to improve
isolated and frail seniors well-being.
The effectiveness of volunteer input and the project as a whole may
not be solely attributable to the volunteers contribution. In addition,
the formal support provided by the social work agency and personnel
for the volunteers was certainly conducive to the desired outcome.
This formal support included training, matching, administration, hold-
ing review sessions, and other activities facilitating volunteer input
and interaction with seniors. Consequently, the combination of social
work personnels formal support and volunteers informal support

appears to be effective. Disentangling the social work and volunteer

inputs would be difficult; it is a topic for further research in order to
clarify their unique contribution. At any rate, social work input does not
obscure volunteer input, because volunteers are the persons who con-
tact frail and isolated seniors and this contributes significant effects.
Volunteers seem to make their greatest impact on isolated and frail
seniors social integration. This finding would dispel the suspicion
that contact with volunteers undermines seniors networking with rel-
atives and friends. On the contrary, networking with volunteers em-
powers isolated seniors social networks. Socializing and integrative
functions of volunteer networking are most notable in light of the role
of volunteers as network builders. Besides, volunteers are efficient
informers, conveying information about senior services. The role of
volunteers as a source of informal support is also remarkable in view
of the contribution of contact intensity to reduce seniors worry about
life situations. Such contribution might stem from the training package
that strengthened volunteers social skills. The finding that contact
rather than perceived helpfulness contributed to seniors well-being
suggests that the contribution did not rely on volunteers instrumental
support for seniors subjective evaluation of volunteers performance.
Hence, contact with volunteers was helpful enough to cultivate social
integration that promoted seniors well-being. All these findings pur-
port to the importance of informal social support and social integration
to enrich seniors life experiences. This functioning of volunteers
social support tends to be generic and need not concentrate on instru-
mental assistance and require seniors favorable evaluation.
The contribution of volunteer input does not seem to be contingent
on seniors demand. Volunteers visits and help thus become available
regardless of the seniors health and psychosocial status. This argu-
ment derives from the finding that the seniors age, sex, health, anxi-
ety, life satisfaction, and community knowledge did not have signifi-
cant effects on the volunteers contact and helpfulness. Hence,
volunteers did not seem to avoid seniors who were particularly un-
healthy and discontented. They could perform their role properly, free
of the influence of seniors characteristics.
One shortcoming of the volunteer networking project and its input
is the volunteers inability to improve isolated and frail seniors
health. This finding, however, appears to be realistic because volun-
teers were neither competent nor responsible for improving seniors

health. Obviously, most volunteers were not medical professionals and

had received only minimal training on medical knowledge relevant to
improving seniors health. Therefore, volunteers were unlikely to of-
fer health-related input. A rigorous test of volunteers contribution to
seniors health would be reasonable when the volunteers have re-
ceived health-related training, provided health-related input, and had
the input explicitly measured in the study.
Limitations
Inevitably, the study has limitations in its sample size, measure-

ment, and design. It could analyze panel data only from 125 isolated
and frail seniors enrolled in the social networking project in a district
of Hong Kong. Such a small sample prohibited more elaborate analy-
sis and constrained the statistical power of the analysis. It therefore
raised the effect size needed for detection of significance. The sample
consisted of isolated and frail seniors having priority for the volunteer
networking service. Hence, results would be most pertinent to those
particularly at risk. On the other hand, the sample of isolated frail
seniors is substantially different from seniors who are healthy, do not
participate in the project, and are potential members of a control
group. Therefore, the demonstrated effectiveness of volunteer contact
and helpfulness is likely to apply to an at-risk group rather than a
control group. The social networking services specially prepared for
isolated, frail seniors simply may not work for other seniors whose
need for the services does not fulfill the priority criteria. Hence, the
findings may not be generalizable to the other senior people. Inclusion
of a control group would not help substantiate the present findings if
the group had a lower priority for the networking services, and thereby
was inherently different from clients of the projects.
The design of the study aims at investigating the impact of volun-
teer input on senior visitees outcomes. It therefore neglects seniors
who did not enroll in the service and receive any volunteer input.
Furthermore, the study is unable, because of practical and ethical
reasons, to randomly assign isolated and frail seniors into an experi-
mental group and control group. It was also not possible to include
seniors in the waiting list in the study because their personal informa-
tion is not accessible to the volunteer networking project, owing to the
Privacy Ordinance. Its limitation is in the inability to generalize results

to all senior people.

On the other hand, the study might have included a pseudo-control
group (10 at Wave 1, see Table 1), consisting of senior clients who
received no visit by volunteers in the past two months. Therefore, the
study essentially compared seniors with no contact and those with
different levels of contact with volunteers. Its finding showed that
those who had more contact fared more favorably in their levels of
anxiety, community knowledge, and social integration than did those
who had no or less contact. Nevertheless, those who had no contact
did not form a real control group in the sense of not being enrolled in
the project. They were also isolated, frail seniors with characteristics
substantially different from those of nonclients. Whether nonclients
benefit from volunteer networking is a research question for further
research. However, isolated, frail seniors need for social networking
can be essential for the benefit of social networking. According to the
theory of social support, social support is particularly effective when it
meets the support recipients need (Kahn, 1994). In case social net-
working is what isolated, frail seniors desire, its salutary effects are
conceivable.
Measurement exclusively relied on respondents self-report. Rela-
tionships of self-reported variables might be partially attributable to
the common method of measurement. Other means of measurement,
such as observation and ratings by other people are absolutely neces-
sary to avoid bias due to the common method of measurement. These
alternative means are not readily available because the social work
agency has no record of volunteer input and seniors status because of
the inadequate computerized information system. The inadequacy is
understandable because the social networking project is only at its
infancy stage.
Implications
Focusing on the impact of volunteer input, the favorable results on
senior visitees psychological and social quality of life are encourag-
ing for further development of the social networking project. From
analysis of clients of the project, it is possible to predict a lower level
of psychological and social well-being in the frail, isolated senior if he
or she has no contact with a volunteer. Because contact and helpful-
ness are continuous variables, their high and low levels can be predic-
tive of corresponding levels of well-being. Volunteer contact, which
involves introduction to activities and services for seniors, is effective

for reducing worry and sustaining social integration. Given this result,
it is likely that increased volunteer input can achieve better quality-of-
life outcomes in senior visitees. There is room for such an increase
because the input has not yet reached its maximum (see Table 1).
Whereas volunteer introduction to senior activities and services can
help the senior increase knowledge and social integration, volunteer
health-related services might be effective for uplifting the seniors
health. One possibility is to provide volunteers with basic medical and
health training to enable them to sustain senior visitees health. Past
research has proven the success, in terms of satisfaction and useful-
ness, of such training (Hale, Bennett, Oslos, Cochran, & Burton,
1997). Accordingly, a 16-hour program was successful in identifying,
recruiting, and training 25 volunteers from racially and religiously
diverse institutions. It yielded favorable outcomes, including partici-
pants satisfaction and success in organizing numerous educational
and screening activities in their communities. Its topics included heart
diseases and hypertension, cancer, depression, dementia, and medical
management. Despite the study of volunteers, the effectiveness of
health training given to volunteers for ameliorating seniors health
conditions remains to be a question for further research.
Essential to strengthening the volunteer networking project, the
organization requires an overhaul of its information system. The infor-
mation system should keep up-to-date information on volunteer ser-
vices, including visits, meetings, and other activities with seniors.
Most important, the system should allow for easy retrieval of and
access to the information. This requirement will provide for account-
ability of the service and the feasibility of further research.
Overall, the present study presents evidence for significant favor-
able effects of volunteer input associated with the social networking
project on isolated and frail seniors in Hong Kong. The evidence is
credible because the panel design allows for control of prior scores
and background characteristics. It clearly corroborates and extends
findings from case studies and simple design and analysis in the West.
On the other hand, the nonsignificant finding concerning the effect of
volunteer input on the seniors health does not square with that of
previous research (McNeil, 1995). The discrepancy may be attribut-
able to differences in volunteer networking projects and design and
analytic techniques. According to the present study, when volunteers
had received minimal health-related training and were not well-pre-

pared for improving senior peoples health, they were unlikely to raise
senior visitees health above its existing level. Nevertheless, other
research suggests that volunteers can maintain seniors health relative
to others who have not received volunteer services without comparing
with their prior health. Because of their difference in reference points,
these two arguments are not contradictory. Notwithstanding the effect
on health, the volunteer input appears to be important to senior Hong
Kong Chinese. Hence, volunteers can be a significant source of infor-
mal support which fits seniors conception of the ingroup. At any rate,
volunteer contribution to frail, isolated seniors psychosocial quality
of life appears to hold in both Chinese and Western contexts.
REFERENCES
Andrews, F.M., & Robinson, J.P. (1991). Measures of subjective well-being. In J.P.
Robinson, P.R. Shaver & L.S. Wrightsman (Eds.), Measures of personality and
social psychological attitudes, Vol.1: Measures of social psychological attitudes
(pp. 61-114). San Diego, CA: Academic Press.
Bazargan, M., & Hamm-Baugh, V.P. (1995). The relationship between chronic illness
and depression in a community of urban black elderly persons. Journal of Ger-
ontology, 50, S119-127.
Biegel, D.E. (1985). The application of network theory and research to the field of
aging. In William J. Sauer & Raymond T. Coward (Eds.), Social support networks
and the care of the elderly: Theory, research, and practice (pp. 251-273). New
York: Springer.
Blieszner, R. (1993). Resource exchange in the social networks of elderly women. In
U.G. Foa, J. Converse, Jr., K.Y. Tornblom & E.B. Foa (Eds.), Resource theory:
Explorations and applications (pp. 67-79). San Diego, CA: Academic Press.
Boyer, E. (1980). Health perception in the elderly: Its cultural and social aspects. In
C.L. Fry (Ed.), Aging in culture and society: Comparative viewpoints and strate-
gies (pp. 198-216). New York: Praeger.
Calasanti, T.M. (1996). Gender and life satisfaction in retirement: An assessment of
the male model. Journal of Gerontology: Social Sciences, 51B, S18-S29.
Chappell, N.L., & Badger, M. (1989). Social isolation and well-being. Journal of
Gerontology, 44, S169-S176.
Cheung, C.K., Lee, J.J., & Chan, C.M. (1997). Factors affecting the life satisfaction
of elderly family caregivers and noncaregivers: A study of elderly center goers in
Sha Tin District. In D.T.L. Shek, M.C. Lam & C.F. Au (Eds.), Social work in
Hong Kong: Reflection and challenges (pp. 41-69). Hong Kong: Department of
Social Work, Chinese University of Hong Kong.
Chi, I., & Lee, J.J. (1989). A health survey of the elderly in Hong Kong. Hong Kong:
Department of Social Work and Social Administration, University of Hong Kong.
Chiu, C.Y. (1990). Normative expectations of social behavior and concern for mem-
bers of the collective in chinese society. Journal of Psychology, 124, 103-111.

Davies, B., Bebbington, A., & Charnley, H. (1990). Resources, needs, and outcomes
in community-based care: A comparative study of the production of welfare for
elderly people in ten local authorities in England and Wales. Aldershot, UK:
Avebury.
Deimling, G.T., & Harel, Z. (1984). Social integration and mental health of the aged.
Research on Aging, 6, 515-527.
Hale, W.D., Bennett, R.G., Oslos, N.R., Cochran, C.D., & Burton, J.R. (1997).
Project REACH: A Program to train community-based lay health educators. Ger-
ontologist, 37, 683-687.
Haley, W.E., Roth, D.L., Coleton, M.I., Ford, G.R., West, C.A.C., Collins, R.P., &
Isobe, T.L. (1996). Appraisal, coping, and social support as mediators of well-be-
ing in black and white family caregivers of patients with alzheimers disease.
Journal of Consulting and Clinical Psychology, 64, 121-129.
Harlow, R.E., & Cantor, N. (1996). Still participating after all these years: A study of
life task participation in later life. Journal of Personality & Social Psychology, 71,
1235-1249.
Heinemann, G.D. (1985). Interdependence in informal support systems: The case of
elderly, urban widows. In W.A. Peterson & J. Quadagno (Eds.), Social bonds in
later life: Aging and independence (pp. 165-186). Beverly Hills, CA: Sage.
Holahan, C.K., & Sears, R.R. (1995). The gifted group in later maturity. Stanford,
CA: Stanford University Press.
Houts, S., & Kassals, C. (1997). Rotters social learning theory and fear of crime:
Differences by race and ethnicity. Social Science Quarterly, 78, 122-136.
Hummert, M.L. (1993). Age and typicality judgments of stereotypes of the elderly:
Perceptions of elderly vs. young adults. International Journal of Aging and Hu-
man Development, 37, 217-226.
Ikels, C. (1990). Family caregivers and the elderly in China. In D.E. Biegel & A.
Blum (Eds.), Aging and caregiving: Theory, research, and policy (pp. 270-284).
Newbury Park, CA: Sage.
Johnson, R.J., & Wolinsky, F.D. (1993). The structure of health status among older
adults: Disease, desirability, functional limitation, and perceived health. Journal
of Health and Social Behavior, 34, 105-121.
Kahn, R.L. (1994). Social support: Content, causes, and consequences. In R.P.
Abeles, H.C. Gift & M.G. Ory (Eds.), Aging and quality of life (pp. 163-184).
New York: Springer.
Kessler, R.C., & Greenberg, D.F. (1981). Linear panel analysis: Model of quantita-
tive change. New York: Academic Press.
Kincade, J., Rabiner, D.J., Bernard, S.L., Wwoomert, A., Konrad, T.R., DeFriese,
G.H., & Ory, M.G. (1998). Older adults as a community resource: Results from
the national survey of self-care and aging. Gerontologist, 36, 474-482.
Korte, C., & Gupta, V. (1991). A program of friendly visitors as network builders.
Gerontologist, 31, 404-407.
Krause, N. (1990). Perceived health problems, formal/informal support and life
satisfaction among older adults. Journal of Gerontology, 45, S193-S205.
Krause, N. (1997). Received support, anticipated support, social class, and mortality.
Research on Aging, 19, 387-422.

Krause, N., Goldwater, L., Liang, J., Jay, G., & Maeda, D. (1993). Stress and exercise
among the Japanese elderly. Social Science & Medicine, 36, 1429-1441.
Lawton, M.P. (1983). Environment and other determinants of well-being in older
people. Gerontologist, 23, 349-357.
Lee G.R., & Ishii-Kuntz, M. (1987). Social interaction, loneliness, and emotional
well-being among the elderly. Research on Aging, 9, 459-482.
Liu, W.T., Lee, R.P.L., Yu, E.S.H., Lee, J.J., & Sun, S.G. (1993). Health status,
cognitive functioning and dementia among elderly community population in Hong
Kong. Hong Kong: Faculty of Social Sciences, Hong Kong Baptist College.
Logan, J.R., & Spitze, G.D. (1994). Family neighbors. American Journal of Sociolo-
gy, 100, 453-476.
Markides, K.S., & Lee, D.J. (1991). Predictors of health status in a middle-aged and
older Mexican Americans. Journal of Gerontology, 46, S243-S249.
McCulloch, B.J. (1990). The relationship of intergenerational reciprocity of aid to the
morale of older parents: Equity and exchange theory comparisons. Journal of
Gerontology, 45, S150-S155.
McNeil, J.K. (1995). Effects of nonprofessional home visit programs for subclinical-
ly unhappy and unhealthy older adults. Journal of Applied Gerontology, 14,
333-342.
Miner, S. (1995). Racial differences in family support and formal service utilization
among older persons: A nonrecursive model. Journal of Gerontology, 50B,
S143-153.
Mor-Barak, M.E., & Miller, L.S. (1991). A longitudinal study of the causal relation-
ship between social networks and health of the poor frail elderly. Journal of
Applied Gerontology, 10, 293-310.
Mullins, L.C., Smith, R., Colquitt, R., & Mushel, M. (1996). An examination of the
effects of self-rated and objective indicators of health conditions and economic
condition on the loneliness of older persons. Journal of Applied Gerontology, 15,
23-37.
Ngan, R.M.H., Leung, E.M.F., Kwan, A.Y.H., Yeung, D.W.T., & Chong, A.M.L.
(1996). A Study of the Long Term Care Needs, Patterns, and Impact of the Elderly
in Hong Kong. Hong Kong: Department of Applied Social Studies, City Universi-
ty of Hong Kong.
Russell, D., & Cutrona, C.E. (1991). Social support, stress, and depressive symptoms
among the elderly: Test of a process model. Psychology and Aging, 6, 190-201.
Seed, P., & Kayer, G. (1994). Handbook for assessing and managing care in the
community. London: Jessica Kingsley.
Shye, D., Mullooly, J.P., Freeborn, D.K., & Pope, C.R. (1995). Gender differences in
the relationship between social network support and mortality: A longitudinal
study of an elderly cohort. Social Science & Medicine, 41, 935-947.
Steinkamp, M.W., & Kelly, J.R. (1987). Social integration, leisure activity, and life
satisfaction in older adults: Activity theory revisited. International Journal of
Aging and Human Development, 25, 293-307.
Triandis, H.C. (1995). Individualism and collectivism. Boulder, CO: Westview.
Triandis, H.C., Chen, X.P., & Chan, D.K.S. (1998). Scenarios for the measurement of
collectivism and individualism. Journal of Cross-Cultural Psychology, 29,

275-289.
Wheeler, J.A., Gorey, K.M., & Greenblatt, B. (1998). The beneficial effect of volun-
teering for older volunteers and the people they serve: A meta-analysis. Interna-
tional Journal of Aging and Human Development, 47, 69-79.
Wills, T.A. (1992). The helping process in the context of personal relationships. In S.
Spacapan & S. Oskamp (Eds.), Helping and being helped: Naturalistic studies
(pp. 17-48). Newbury Park, CA: Sage.
Wolinsky, F.D., & Johnson, R.J. (1991). The use of health services by older adults.
Journal of Gerontology, 46, S345-S357.
MANUSCRIPT RECEIVED: 05/24/99

MANUSCRIPT SUBMITTED FOR BLIND REVIEW: 06/02/99
MANUSCRIPT RE-RECEIVED
IN ACCEPTABLE FORM: 10/13/99

Contributions of Volunteer Networking To Isolated Seniors in Hong Kong

Încărcat de

Informații document

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Contributions of Volunteer Networking To Isolated Seniors in Hong Kong

Încărcat de

Drepturi de autor:

Formate disponibile

This article was downloaded by: [City University of Hong Kong Library]

On: 25 November 2012, At: 01:16

To link to this article: http://dx.doi.org/10.1300/J083v33n02_06

PLEASE SCROLL DOWN FOR ARTICLE

Full terms and conditions of use: http://www.tandfonline.com/page/terms-

Contributions of Volunteer Networking

ABSTRACT. Although research and theory suggest that volunteers con-

KEYWORDS. Chinese elderly, volunteers impact on quality of life,

Several studies have suggested that volunteer visitors can make

care, stimulation and companionship to the senior. Besides, mere con-

The literature indicates the contribution of volunteer visits as a way

mean effect on clients, in terms of such measures of life satisfaction,

was .458. Nevertheless, evidence for the effect of volunteer visits on

confidant and companion (Chappell & Badger, 1989). Moreover, vol-

that provided by the volunteer, can be a function of the seniors sex,

age, and health (Kincade, Rabiner, Bernard, Wwoomert, Konrad, De-

The preceding theory and research findings cannot be applied to

Hypothesis 1: The more contact with and/or helpfulness of the

Hypothesis 2: The more contact with and/or helpfulness of the

Hypothesis 3: The more contact with and/or helpfulness of the

Hypothesis 4: The more contact with and/or helpfulness of the

The test of these hypotheses would be crucial for ascertaining the

The study employed a longitudinal, panel design to collect data

networking project in one of the 18 districts in the territory of Hong

Kong. It involved two surveys, one in September and October 1997

The study achieved an impressive response rate of 98.6% in the first

TABLE 1. Means at Wave 1 and Wave 2

Variable Wave 1 Wave 2

Anxiety (0-100) 26.9 20.7*

* p < .05 (difference in means according to the paired t-test)

tion, worry, and knowledge about the community involved multiple

alpha of the composite score was .840.

To test the hypotheses, regression analysis used predictors measured

TABLE 2. Standardized Effects on Worry, Knowledge, Life Satisfaction at

Predictor Worry Knowledge Health Social

Volunteer helpfulness 2 .111 .250* .118 .176*

Contact with the volunteer 2 .209* .186* .033 .273*

Sickness 2 .096 .114 .357* .112

Anxiety 1 .373* .058 .067 .111

Knowledge of services 1 .037 .396* .005 .003

Health 1 .154 .036 .280* .009

Social integration 1 .033 .191* .158 .408*

Volunteer helpfulness 1 .127 .019 .026 .040

Contact with the volunteer 1 .125 .197* .070 .070

Sickness 1 .015 .015 .068 .071

Age .073 .060 .069 .069

Female .052 .106 .157 .127

R2 .243 .373 .308 .389

and helpfulness experienced exerted negative effects ( .209 and

contribution of contact with the volunteer in the two months preceding

All hypotheses, except that concerning health, received support

TABLE 3. Standardized Effects on Helpfulness, Contact, Financial Adequacy,

and Sickness at Wave 2

Helpfulness Contact with the volunteer

Anxiety 1 .106 .080

for improving the isolated and frail seniors psychosocial quality of

work personnels formal support and volunteers informal support

appears to be effective. Disentangling the social work and volunteer

teers were neither competent nor responsible for improving seniors

health. Obviously, most volunteers were not medical professionals and

Inevitably, the study has limitations in its sample size, measure-

Privacy Ordinance. Its limitation is in the inability to generalize results

to all senior people.