Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis

Can 'What Is Known' about Social Isolation and Loneliness Interventions Sufficiently Inform the Clinical Practice of Health Care and Social Service Professionals Who Work with Older Adults? Exploring Knowledge-to-Practice Gaps

Establishing intervention effectiveness is an important component of a broader knowledge translation (KT) process. However, mobilizing the implementation of these interventions into practice is perhaps the most important aspect of the KT cycle. The purpose of the current study was to conduct an umbrella review to (a) identify promising interventions for SI&L in older adults, (b) interpret (translate) the findings to inform clinical knowledge and practice interventions in different settings and contexts, and (c) highlight research gaps that may hinder the uptake of these interventions in practice. The broader purpose of this study was to inform evidence-based clinical practice guidelines on SI&L for HCSSPs. In line with other reviews, our study noted variations in methods and intervention designs that prohibit definitive statements about intervention effectiveness. Perhaps, the most significant contribution of the current review was in identifying knowledge-to-practice gaps that inhibit the implementation of interventions into practice-based realities.

Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health

BACKGROUND

Despite that stakeholder participation in evidence synthesis could result in more useful outcomes, there are few examples of processes that actively involve them in synthesis work. Techniques are needed that engage diverse stakeholders as equal partners in knowledge co-production. The aims of this paper are to describe an innovative participatory process of synthesising a large body of academic research products and compare the findings of the participatory process against two traditional approaches to synthesis: a rapid review and a structured review.

METHODS

First, a rapid synthesis of all research outputs (n = 86) was conducted by researchers with in-depth knowledge of the collaboration's research. Second, a team of researchers and service providers conducted a structured synthesis of seventy-eight peer-reviewed articles and reports generated by the collaboration. Fifty-five publications were brought forward for further synthesis in part three, a facilitated participatory synthesis. Finally, we explored the value added by the participatory method by comparing findings generated across the three synthesis approaches.

RESULTS

Twelve researchers and 11 service providers/policy partners-8 self-identified as Aboriginal and/or Torres Strait Islander-participated in two facilitated workshops (totalling 4 h). Workshop activities engaged participants in reviewing publication summaries, identifying key findings, and evoked review, discussion and refinement. The process explicitly linked experiential knowledge to citations of academic research, clearly connecting the two knowledge types. In comparing the findings generated across all three methods we found mostly consistencies; the few discrepancies did not contradict but gave deeper insights into statements created by the other methods. The participatory synthesis generated the most, detailed, and unique findings, and contextual insights about the relevance of the key messages for practice.

CONCLUSION

The participatory synthesis engaged stakeholders with diverse backgrounds and skillsets in synthesising a large body of evidence in a relatively short time. The participatory approach produced findings comparable to traditional synthesis methods while extending knowledge and identifying lessons most relevant for the participants who, ultimately, are the end users of the research. This process will interest other large-scale research collaborations seeking to engage stakeholders in evidence synthesis.

What works in interventions targeting loneliness: a systematic review of intervention characteristics

BACKGROUND

Loneliness has been linked to negative health and economic outcomes across the life course. Health effects span both physical and mental health outcomes, including negative health behaviours, lower well-being, and increased mortality. Loneliness is however preventable with effective intervention. This systematic review aims to identify what has worked in interventions for loneliness to guide the development of future interventions.

METHODS

Eight electronic databases (Medline, Embase, PsycINFO, Social Policy and Practice, Social Sciences Citation Index, Epistemonikos, CINAHL, Cochrane Library) were systematically searched from inception to February 2022 using terms for intervention and loneliness to identify relevant interventions in the general population. No restrictions on age, socio-economic status, or geographic location were imposed. Studies were to measure loneliness as the primary outcome through a validated scale or single-item question. Case studies were excluded. Additional studies were identified through citation chasing. Extracted data included study and intervention characteristics, and intervention effectiveness for cross-study comparison. Critical appraisal was conducted using the Joanna Briggs Institute and Critical Appraisal Skills Programme tools before the studies were summarised in a narrative synthesis.

RESULTS

Searches identified 4,734 hits, from which 22 studies were included in this review. Of these studies, 14 were effective in reducing loneliness. Additionally, five studies presented unclear findings, and three concluded no decrease in loneliness. Interventions varied between group vs. individual format, online vs. in person delivery, and regarding both intervention duration and individual session length. Furthermore, this review highlighted five key areas when considering designing an intervention for loneliness: use of between session interaction, inclusion of clear learning mechanisms, role of active participation, number of opportunities for group or facilitator interaction, and variation in teaching and learning styles.

CONCLUSIONS

Group sessions seem preferred to individual formats, and interaction through active participation and group or facilitator contact appear beneficial, however studies also recognised the importance of a person-tailored approach to delivery. Studies suggest there is no 'quick fix' to loneliness, but that learnt practices, behaviours, and community connection should be built into one's lifestyle to achieve sustained intervention effectiveness. Future interventions should consider longer follow-up periods, male and populations with lower educational levels.

Understanding Social and Emotional Loneliness among Black Older Adults: A Scoping Review

Black older adults’ (BOAs) experience of loneliness differs from other ethnic groups because of the disproportionate disadvantages faced across their life course. This scoping review aimed to describe the range of research on loneliness or subjective social isolation among BOAs, identifying the contributing factors to loneliness in this population, based on Weiss’ Social provision Framework. Of the 15,345 initial retrieved citations from seven databases and corporate websites, we included 27 studies conducted in the USA, Nigeria, South Africa, Ghana, Canada, the United Kingdom, and Uganda. Studies reporting on BOAs’ experience of loneliness focused on the influence of attachment, social integration, opportunity for nurturance, reassurance of worth, guidance, socio-economic factors, health-related factors and behaviors, and technology, media device possession and usage. There is a need for future studies to identify which social provisions (when targeted) could reduce loneliness, allowing clinicians to develop relevant interventions.

Social Isolation, Loneliness and Health: A Descriptive Study of the Experiences of Migrant Mothers With Young Children (0–5 Years Old) at La Maison Bleue

Background

Migrant women with young children, including asylum seekers and refugees, have multiple vulnerability factors that put them at increased risk of social isolation and loneliness, which are associated with negative health outcomes. This study explored the experiences of social isolation and loneliness among migrant mothers with children aged 0–5 years as well as their perceptions on possible health impacts.

Methods

A qualitative descriptive study was conducted at La Maison Bleue, a non-profit organization providing perinatal health and social services to vulnerable women in Montreal, Canada. Recruitment and data collection occurred concurrently during the COVID-19 pandemic, between November and December 2020. Eleven women participated in individual semi-structured interviews and provided socio-demographic information. Interview data were thematically analyzed.

Results

Migrant women in this study described social isolation as the loss of family support and of their familiar social/cultural networks, and loneliness as the feelings of aloneness that stemmed from being a mother in a new country with limited support. Multiple factors contributed to women's and children's social isolation and loneliness, including migration status, socioeconomic circumstances, language barriers, and being a single mother. Women expressed that the COVID-19 pandemic exacerbated pre-existing experiences of social isolation and loneliness. Mothers' experiences affected their emotional and mental health, while for children, it reduced their social opportunities outside the home, especially if not attending childcare. However, the extent to which mothers' experiences of social isolation and loneliness influenced the health and development of their children, was less clear.

Conclusion

Migrant mothers' experiences of social isolation and loneliness are intricately linked to their status as migrants and mothers. Going forward, it is critical to better document pandemic and post-pandemic consequences of social isolation and loneliness on young children of migrant families. Supportive interventions for migrant mothers and their young children should not only target social isolation but should also consider mothers' feelings of loneliness and foster social connectedness and belongingness. To address social isolation and loneliness, interventions at the individual, community and policy levels are needed.

Older Chinese migrants in coronavirus pandemic: exploring risk and protective factors to increased loneliness

Older migrants may be one of the most vulnerable populations during the coronavirus pandemic, yet the degree of impact remains largely unknown. This study explores (1) the consequences of the coronavirus pandemic for older Chinese migrants in Belgium and the Netherlands in terms of increased loneliness and its risk factors (reduced in-person contact, decreased social participation, feelings of existential threat) and protective factors (increased non-in-person contact, more individual activities), and (2) which risk and protective factors have contributed to the incidence and prevention of higher loneliness levels. Using quantitative data of a survey among 98 Chinese migrants aged 50 years and older in Belgium (n = 84) and the Netherlands (n = 14), the findings first indicate that the coronavirus pandemic has a significant impact on older Chinese migrants' lives. One in five experienced more loneliness. Second, reduced social participation (measured as less frequent participation in outdoor group activities) and financial insecurity (measured as experiencing financial difficulties) lead to higher than pre-pandemic loneliness levels. Problem-focused coping strategies (measured as increased non-in-person contact, via telephone or social media) and emotion-focused coping (measured as finding distraction through increased participation in individual activities) were not found to protect against increased loneliness in the pandemic. Two practical implications for loneliness interventions for older Chinese migrants are put forward. Organizing COVID-19-safe social participation activities and paying more attention to older Chinese migrants' financial situation can be beneficial when addressing higher levels of loneliness due to the coronavirus pandemic.