Invited discussant comments during the UCL-Penn Global COVID Study webinar ‘Alone Together: Loneliness Research and Social Health Innovation in Lockdown and Beyond’
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Abstract
The coronavirus (Covid-19) pandemic has influenced people’s social relationships around
the world in surprising ways. It has also underscored the importance of and accelerated
innovation in solutions for social isolation and loneliness. This commentary offers
takeaways from emerging research findings and a wide lens on the societal movement
underway to create more socially connected communities.
Social distancing and ‘stay-at-home’ orders are essential to contain the coronavirus outbreak (COVID-19), but there is concern that these measures will increase feelings of loneliness, particularly in vulnerable groups. The present study examined change in loneliness in response to the social restriction measures taken to control the coronavirus spread. A nation-wide sample of American adults ( N = 1,545; 45% women; age 18 to 98, M = 53.68, SD = 15.63) was assessed on three occasions: in late-January/early-February 2020 (before the outbreak), in late-March (during the President’s initial ‘15 Days to Slow the Spread’ campaign), and in late-April (during the ‘stay-at-home’ policies of most states). Contrary to expectations, there were no significant mean-level changes in loneliness across the three assessments ( d = .04, p > .05). In fact, respondents perceived increased support from others over the follow-up period ( d = .19, p < .01). Older adults reported less loneliness overall compared to younger age groups but had an increase in loneliness during the acute phase of the outbreak ( d = .14, p <.05). Their loneliness, however, leveled off after the issuance of stay-at-home orders. Individuals living alone and those with at least one chronic condition reported feeling lonelier at baseline but did not increase in loneliness during the implementation of social distancing measures. Despite some detrimental impact on vulnerable individuals, in the present sample, there was no large increase in loneliness but remarkable resilience in response to COVID-19.
Objectives This study aimed to assess the degree to which the ‘social cure’ model of psychosocial health captures the understandings and experiences of healthcare staff and patients in a social prescribing (SP) pathway and the degree to which these psychosocial processes predict the effect of the pathway on healthcare usage. Design Mixed-methods: Study 1: semistructured interviews; study 2: longitudinal survey. Setting An English SP pathway delivered between 2017 and 2019. Participants Study 1: general practitioners (GPs) (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a 4-month follow-up after initial referral assessment. Intervention Chronically ill patients experiencing loneliness referred onto SP pathway and meeting with a health coach and/or link worker, with possible further referral to existing or newly created relevant third-sector groups. Main outcome measure Study 1: health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: patients’ primary care usage. Results Healthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging and reduced loneliness. Conclusions Methodological triangulation offers robust conclusions that ‘social cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating social cure processes into SP initiatives are discussed.
In two pre-registered studies, we tracked changes in individuals’ feelings of social connection during the COVID-19 pandemic. Both studies capitalized on measures of social connection and well-being obtained prior to the COVID-19 pandemic by recruiting the same participants again in the midst of the pandemic’s upending effects. Study 1 included a sample of undergraduates from a Canadian university (N = 467), and Study 2 included community adults primarily from the United States and the United Kingdom (N = 336). Our results suggest that people experienced relatively little change in feelings of social connection in the face of the initial reshaping of their social lives caused by the COVID-19 pandemic. Exploratory analyses suggested that relatively extraverted individuals exhibited larger declines in social connection. However, after controlling for levels of social connection prior to the pandemic (as pre-registered), the negative effect of extraversion reversed (Study 1) or disappeared (Study 2).
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