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Systematic Review
1. “What is the effectiveness of interventions aimed at alleviating loneliness and/or social isolation in people of all ages across the life-course?”
2. “Is there an association between core intervention theme/setting/population and the direction and size of effect?
The most common core intervention theme was social support for approximately half of studies. This includes medium to longer-term and semi-structured to structured social support interventions, or projects that equip individuals with the necessary skills to facilitate social connection. Befriending/mentoring/peer-support programmes, followed by social and emotional skills development were the most common intervention types. Social interaction-themed interventions reduce loneliness by growing an individual’s social relationships or network, while psychological interventions provide targeted non-pharmacological therapeutic support/treatment, often based on a psychological theory. The review found the same proportion of studies for each of these themes. Arts/music/culture and social activities with multiple-themes were the most common social interaction-based programmes, while structured therapy-based approaches made up the vast majority of psychological interventions.
The more reliable evidence of effectiveness was from controlled studies and found medium to strong statistically significant effects for a range of intervention types spanning 24 three core themes. Overall, it suggests that there are multiple approaches to alleviating loneliness in the short-term, almost all of which target specific age groups or vulnerable populations. More specifically, these include:
• Structured therapeutic support and approaches that develop emotional and social skills. These include interventions targeting adolescents and young adults in education-based settings and Cognitive Behavioural Therapy delivered to individuals over 18 years of age.
• Social support interventions that develop social skills through targeted relationship-building skills and discussion-based activities.
• Interventions involving art and dance activities in community-based settings as a medium to facilitate social inclusion.
• Social interaction interventions involving facilitated animal/robot interactions, food delivery and social and health promotion activities within a single programme have moderate to strong effects on loneliness across different age groups.
In studies that did not use control groups, consistent evidence of loneliness improvements was found for a range of targeted approaches. This includes evidence for:
• Interventions that combine social and psychological support, 8-12 week social prescribing link worker schemes and government-funded programmes providing social activities and support through voluntary sector organisations.
• The UK Ageing Better programme (2017-2022) which consistently suggest that community-focused active participation in a wide range of group and one-to-one activities can generate loneliness improvements for over-50s.
Given the targeted nature of programmes included in the review, it is likely that context/s play an important role in shaping the success of loneliness interventions.
While qualitative data were not systematically searched for in this review, evidence from approximately one quarter of studies sheds light on potential enabling factors, key ingredients and causal pathways that may lead to improvements in loneliness.
• For social prescribing schemes, the lack of local infrastructure, health and mobility issues faced by participants, alongside other personal circumstances, can act as important barriers to face-to-face participation.
• The emotional bond and caring/trusting relationship built with mentors, befrienders, link workers and homesharers all act as connectors to the wider world, providing a first step towards increasing the confidence and social connectedness of participants.
• For group activities, specific factors that enable participation include: the opportunity to connect with ‘people like you’, a safe place to meet, ‘locally situated’ activities, as well as skilled facilitation.
• Community-focused connections and the experience of positive emotions/mood may be a precursor to reduced loneliness. Group settings also appear to offer a pretext for social contact and meaningful interaction, acting as catalysts for larger individual-level changes
This rapid systematic review found 95 individual studies, published between 2008 and 2023, which present evidence on the effectiveness of 101 loneliness interventions. Loneliness evaluation research has grown exponentially since 2020 and to date, the field is largely composed of peer-reviewed studies published in Europe and North America. For UK-based interventions, the majority of evidence is from grey literature reports. The UCLA loneliness scale – the UK’s national indicator of indirect loneliness – is by far the most commonly used measure in included studies, followed by the De Jong Gierveld scale. The vast majority of studies report effectiveness using results from statistical tests conducted on mean scores for participants pre- and post-intervention and nearly half of the studies identified use a control group. Overall, the quality of included studies is moderate to high, although the lack of a control group and potentially high attrition rates affect the reliability of findings. A more thorough risk of bias assessment as part of a full systematic review would likely generate lower overall quality scores across the included set of studies.