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Loneliness is considered to be a global public health challenge, impacting a range of physical and mental health conditions. Social prescribing, whereby service users are signposted into community-based activities and social groups by a community link worker, has been suggested as one mechanism to reduce service users' loneliness and social isolation. This paper reflects on service users' experiences of accessing a national social prescribing scheme. Drawing on qualitative findings from interviews with service users who were receiving support through a social prescribing programme between October 2017 and December 2018 (n = 26, with n = 12 interviewed a second time), we reflect on their experiences of the programme. We consider some of the complexities of providing short-term support with a focus on signposting people into local activities, when many service users prefer the companionship of their link worker. Furthermore, we highlight some of the difficulties in ending short-term support. Crucially, we highlight the importance of considering the intersection of the social determinants of health. We suggest that social prescribing schemes may exacerbate inequalities if consideration is not given to the ways in which people are (dis)advantaged in accessing the social capital necessary for their initial and continued involvement. [ABSTRACT FROM AUTHOR]

Loneliness is a global public health concern linked to a range of negative health outcomes (Cacioppo & Cacioppo, 2018. The Lancet. 391(10119), 426). Internationally, this has led to the development of a number of interventions, but these are rarely implemented or evaluated on a large scale. This paper is one of the first of its kind to describe elements of an evaluation of a large‐scale national social prescribing scheme to reduce loneliness, deploying individual link workers to signpost people to community activities. Reporting on findings from interviews with staff (n = 25 of which 6 were repeat interviews) and volunteers (n = 9) between October 2017 and December 2018 in localities across the United Kingdom. We reflect on the complexities of the link worker role, the challenges of service delivery and the importance of community infrastructure. There was evidence that highly skilled link workers who had developed positive relationships with providers and service‐users were key to the success of the intervention. As well as providing an effective liaison and signposting function, successful link workers tailored the national programme to local need to proactively address specific gaps in existing service provision. For social prescribing services to be successful and sustainable, commissioners must consider additional funding of community infrastructure. [ABSTRACT FROM AUTHOR]

Community environments have the potential to alleviate loneliness and social isolation as they offer opportunity for sociality and to expand personal social network connections. Implementing a social network intervention in community environments to connect people to who are at risk of loneliness or social isolation could help alleviate these concerns. However, implementing interventions in community environments is made difficult by the interplay between the community context and intervention. Thus, to support implementation a detailed understanding of the types of community contexts is required. To examine the optimal factors that promote the implementation of a social network designed to alleviate loneliness and social isolation intervention in the community observations, interviews and documentary analysis were conducted. The Consolidated Framework for Implementation Research and a typology of community contexts were used to inform the data analysis and interpret the findings. Key factors were found to affect the implementation of the intervention in the different community contexts. These inter‐related factors operated across three domains. Service User Needs affected intervention take up as its suitability varied. The stability of the workforce and nature of everyday work also impacted on implementation. Finally, the fluctuating capacity of organisations and the organisational culture were also influential. No single community environment was found to have all of the optimal factors required for implementation and sustainably. The UK policy agenda of austerity had negatively affected community environments' capacity to deliver such intervention through increasing service user needs and reducing available resources. Trial registration: ISRCTN19193075. [ABSTRACT FROM AUTHOR]

Ageing does not reduce people's need to connect with family members, friends, and acquaintances, and neither does migration. For those older migrants living in a foreign land, connectedness with others plays a particularly important role in achieving a sense of belonging and sustaining their health and well‐being. This paper explores the issues of social isolation and loneliness among older Asian migrants in New Zealand. Data were collected from in‐depth semi‐structured interviews with Chinese‐ or Korean‐speaking migrants aged between 75 and 84 years (n = 10: all females), and from three focus groups consisting of Chinese‐ and Korean‐speaking migrants (n = 10: 7 females, 3 males) and Chinese professionals (n = 5: 3 females, 2 males) between June 2016 and December 2016. The qualitative data obtained were analysed applying a thematic analysis approach using NVivo software for group analysis by a multidisciplinary research team. The findings from the study show that older Asian migrants experienced high levels of isolation and loneliness at least at some points in their migrant lives. Most participants in this study were living alone or with only their spouse, and this living arrangement was likely to provide fertile ground for isolation and loneliness to grow in the context of later‐life migration. It was also observed that their lonely ageing ironically resulted from their efforts to preserve family relationships through avoiding being a burden, while allowing them a sort of space to maintain now barely connected lives. The participants revealed multiple ways of coping with lonely and isolated experiences in their limited social network, and these individual strategies allow us to make suggestions about how best to reduce older migrants' social isolation and loneliness in the New Zealand context and beyond. [ABSTRACT FROM AUTHOR]

Many older people in Britain spend Christmas day alone. The Christmas period may be especially difficult for older people who are socially isolated, living with dementia or who have physical impairments, and may feel particularly marginalised at this time of year. This paper draws on evaluative research findings from a community Christmas event held in December 2014 at the University of Salford for older people and their carers who would be on their own on Christmas day. A multi-method approach was employed, seven guests took part in semi-structured interviews to explore their experiences and perceptions of the event, seven staff and student volunteers participated in a group interview to explore and discuss their participation in the event. Data collection took place during April and May 2015. Interview transcripts were subjected to thematic analysis. Three overarching themes were identified from the interviews: 'reasons for participants attending the event', 'a different Christmas day: the impact on guests and volunteers', and 'learning, planning and moving forwards'. The findings illustrate that a range of people participated in the Christmas day event for a variety of reasons. The event itself had a positive impact, including the shared experience of social belonging, for all involved. There are tangible longer term benefits as a result of the event, such as ongoing contact between participants and the development of supportive networks in the local community. [ABSTRACT FROM AUTHOR]

Social isolation is a well‐established determinant of late‐life well‐being, and it may be particularly relevant for older adults in Puerto Rico following Hurricane María. The abbreviated Lubben Social Network Scale (LSNS‐6) is a widely used measure of social isolation, but it has not been validated with Spanish‐speaking older adults. The objectives of this study were to (1) assess the psychometric properties of a Spanish‐language LSNS‐6 and (2) examine its association with self‐rated health (SRH) and psychological sense of community (PSOC). Data came from face‐to‐face survey interviews with a nonprobability sample of 154 community‐dwelling older adults in Puerto Rico 2 years after Hurricane María. We assessed the LSNS‐6's internal consistency reliability and convergent validity. We then conducted structural equational modelling consisting of (1) a measurement model using confirmatory factor analysis to test the factor structure of the LSNS‐6 and (2) a structural model using path analysis to examine the direct effect of social isolation on SRH and to test the role of PSOC as a mediator in this relationship. The LSNS‐6 demonstrated acceptable internal consistency reliability (α = 0.74) and convergent validity, r(151) = −0.33, p < 0.001. A correlated two‐factor model (Family and Friends) provided the best fit (comparative fit index = 0.986, Tucker–Lewis index = 0.975, root mean square error of approximation = 0.082, standardised root mean squared residual = 0.033). Path model results show the Friends factor was negatively associated with SRH (β = −0.31, p = 0.045), whilst the Family factor was nonsignificant. The Friends factor had a statistically significant indirect effect on SRH through PSOC (β = 0.08, 95% CI [0.01, 0.29]). Our findings provide insight into the effect of social isolation on health amongst older adults in Puerto Rico and highlight the potential role of PSOC for assessment and intervention with older adults in post‐disaster settings. [ABSTRACT FROM AUTHOR]

The effects of the coronavirus disease‐2019 (COVID‐19) pandemic on the lives of underserved populations are underexplored. This study aimed to identify the impacts of the COVID‐19 pandemic and associated public health responses on the health and social well‐being, and food security of users of Housing First (HF) services in Toronto (Canada) during the first wave of the COVID‐19 pandemic. This qualitative descriptive study was conducted from July to October 2020 in a subsample of 20 adults with a history of homelessness and serious mental disorders who were receiving HF services in Toronto. A semi‐structured interview guide was used to collect narrative data regarding health and social well‐being, food security and access to health, social and preventive services. A thematic analysis framework guided analyses and interpretation of the data. The COVID‐19 pandemic and response measures had a variable impact on the health, social well‐being and food security of participants. Around 40% of participants were minimally impacted by the COVID‐19 pandemic. Conversely, among the remaining participants (impacted group), some experienced onset of new mental health problems (anxiety, stress, paranoia) or exacerbation of pre‐existing mental disorders (depression, post‐traumatic stress disorder and obsessive‐compulsive disorder). They also struggled with isolation and loneliness and had limited leisure activities and access to food goods. The pandemic also contributed to disparities in accessing and receiving healthcare services and treatment continuity for non‐COVID‐19 health issues for the negatively impacted participants. Overall, most participants were able to adhere to COVID‐19 public health measures and get reliable information on COVID‐19 preventive measures facilitated by having access to the phone, internet and media devices and services. In conclusion, the COVID‐19 pandemic and associated response measures impacted the health, social well‐being, leisure and food security of people with experiences of homelessness and mental disorders who use supportive social and housing services in diverse ways. [ABSTRACT FROM AUTHOR]

Since the onset of the Covid‐19 pandemic, the UK, like many countries, has had restrictions on social contact, and injunctions of 'social distancing'. This study aimed to generate new insights into men's experiences of loneliness during the pandemic, and consider the ramifications of these for continued/future restrictions, the easing of restrictions, and the future beyond the pandemic. Twenty qualitative interviews were conducted with men between January and March 2021. A maximum variation purpose sample frame required at least three non‐white men, three LGBTQ+men, three men with a university education, three without a university education, three 18–30 years old, and three aged 60+. Thematic analysis, focused on semantic themes, was employed as part of a 'grounded' epistemology whereby the stated perspectives of the interviewees drove the content of the study. Seven themes were constructed: (i) lost and new activities and routines; (ii) remote social interaction; (iii) narrowed social spheres; (iv) rethought and renewed recognition of what is important; (v) loneliness with a purpose; (vi) anxiety of social contact; and (vii) easier for themselves than others. Lost routines, fewer meaningful activities, and a reduction in face‐to‐face interaction, were framed as challenges to preventing loneliness. Solo‐living gay men seemed particularly negatively affected. However, many men displayed new, more covid‐safe routines and activities. Remote forms of interaction were often utilised, and though they were imperfect, were constructed as worth engaging with, and held capacity for improvement. A moral need to reduce transmission of SARS‐COV‐2, and a fear of catching it, became important features of participants lives that also affected loneliness. Men at higher risk of health complications from Covid‐19 were particularly likely to highlight anxiety of social contact. Reducing restrictions alone may not return everyone to pre‐pandemic levels of loneliness, particularly if the pandemic remains a significant public health issue. [ABSTRACT FROM AUTHOR]

A large number of older adults (65+ years) live on their own, and can experience high levels of loneliness. However, accessing activities to engage with their community can be difficult either due to their age and associated comorbidities, such as frailty, or due to financial reasons, for lacking the funds to access transport to activities. The aim of this study was to evaluate an existing service in the North West of England, Community Connectors, which enables people aged 18 and above to access social activities within their community in order to reduce loneliness and social isolation. This study only included middle‐aged and older adults. A total of 13 semi‐structured interviews were performed after people had taken part in the 14‐week Community Connectors programme. Data were coded by two research team members by using thematic analysis. Members of the public were involved in the design of this study, and in the dissemination. Between June 2017 to September 2018, 234 older adults and 53 middle‐aged adults were referred to Community Connectors. Four themes emerged from the interviews: falling out of society; easy self‐referral; structured supportive services; and reconnecting with community. Services often depend on individuals making the first step to access, however, without easy or facilitated access people can becoming isolated. Participants reported on how Community Connectors provided easy and open access that enabled better response to individual needs. The structured support provided individuals with confidence in engaging with community activities and enhanced individuals' social networks. Community Connectors enables middle‐aged and older adults to engage with social activities in their community, and thus helps participants to feel less lonely and more socially connected. Future work needs to quantitatively measure the impacts of the service on loneliness, depression, and social connectedness in order to fully understand their impact. [ABSTRACT FROM AUTHOR]

Since coronavirus disease 2019 (COVID‐19) entered the Netherlands, the older adults (aged 70 or above) were recommended to isolate themselves, resulting in less social contact and possibly increased loneliness. The aim of this qualitative study was to explore independently living older adults' perceptions of social and emotional well‐being during the COVID‐19‐related self‐isolation, and their motivation to expand their social network in the future. Semi‐structured phone interviews were held with 20 community‐dwelling adults (age range 56–87; 55% female) between April and June 2020 in the Netherlands. The interviews were audio recorded and transcribed verbatim. Open coding process was applied to identify categories and themes. Participants said to use more digital technologies to maintain contacts and adapt to the government measurements. Most participants missed the lack of social contacts, while some participants had no problems with the reduced social contacts. The emotional well‐being of most participants did not change. Some participants felt unpleasant or mentioned that the mood of other people had changed. Participants were not motivated to expand their social network because of existing strong networks. The relatively vital community‐dwelling older adults in this study were able to adapt to the government recommendations for self‐isolation with limited negative impact on their socio‐emotional well‐being. [ABSTRACT FROM AUTHOR]

There is a sustained increase in demand for emergency and urgent care services in England. The NHS Long Term Plan aims to reduce the burden on emergency hospital services through changing how pre‐hospital care operates, including increased delivery of urgent care. Given the recognised potential of social prescribing to address wider determinants of health and reduce costs in other settings, this study aimed to understand the role that social prescribing can play in pre‐hospital emergency and urgent care from the perspectives of staff. Semi‐structured interviews (n = 15) and a focus group (n = 3) were conducted with clinical staff (n = 14) and non‐clinical health advisors (n = 4) from an English Ambulance Service covering emergency (999) and non‐emergency (111) calls. Data were analysed using a pre‐defined framework: awareness of social prescribing; potential cohorts suitable for social prescribing; and determinants of social prescribing. Awareness and knowledge of social prescribing was limited, though when social prescribing was explained to participants they almost universally recognised its benefits for their role. Social prescribing was considered to be most beneficial to those calling for reasons relating to mental health, loneliness or social isolation, in particular older people and frequent users of 999 and 111 services. Determinants of social prescribing were identified across the micro (patient and staff acceptability of social prescribing), meso (triage and referral pathways) and macro (commissioning and funding) levels of analysis. This is the first empirical study to explore social prescribing in pre‐hospital emergency and urgent care services, which suggests that it has potential to improve quality of care at the point of people accessing these services. There is a pressing need to address the micro, macro and meso level determinants identified within this study, in order to support staff within pre‐hospital emergency and urgent care services to socially prescribe. [ABSTRACT FROM AUTHOR]

Many interventions to combat the social isolation of older adults are hardly effective because they ignore both the heterogeneity of the target group and the uniqueness of the individual experiences of social isolation. In order to be effective, interventions must meet the individual needs of specific clients. In this study, we aim to gain insight into the process in which professionals seek to understand how clients assess their situation, and what this means for the help they provide. We investigated how social workers in one‐to‐one guidance trajectories try to attune to the needs of the clients they accompany and what considerations they make in doing so. The study was conducted between 2014 and 2017 in the city of Rotterdam in the Netherlands. Participants were 20 social workers of 8 social work agencies who provided guidance to community‐dwelling older adults who have been isolated for a long time and have problems in multiple life domains. We analysed 36 research‐driven logbooks, written by the social workers, which contain case study descriptions with information about specific clients who belong to the target group of this study. We also interviewed the individual social workers and organised six focus groups with 8–12 of the participating social workers. Our findings make clear how social workers try to identify the needs of their clients and provide help that is tailored to their possibilities and ambitions. By giving recognition to the emotions and situations of their clients, and by practical problem‐solving, they build a relationship with the older adults in which adequate help is accepted. The professionals set modest goals; their guidance helps stabilise the existing situation and may also contribute to the self‐reliance of their clients. This knowledge will be highly valuable in the developing and implementation of programmes and interventions for this less‐researched group. [ABSTRACT FROM AUTHOR]

This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community‐based intervention to reduce social isolation among older adults. The 'School of Health for Older People' is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi‐structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community‐dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in‐depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community. [ABSTRACT FROM AUTHOR]