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

Abstract

Background To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people. Objectives The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives. Data sources Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants. Review methods Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness. Results The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness. Limitations There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked. Conclusions Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited. Future work UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities. Study registration This study is registered as PROSPERO CRD42017077378. Funding This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.

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

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“…Community and religious organizations were also identified as helpful. Research has shown previously that these organizations can help reduce loneliness by connecting migrants to resources or by directly offering assistance and by creating a sense of belonging (42). In Quebec, community organizations are integrated into the provincial healthcare network to facilitate referrals and optimize continuity of care (63) and in Montreal there are many that specifically aim to support newcomers and young families living in poverty (64).…”

“…Language barriers, and having a precarious immigration status, further intensify the situation by reducing access to support (8,10,41). Moreover, when migrant mothers are alone to care for their children, this limits time for selfdevelopment (e.g., language classes) and employment, which would help them overcome some of the barriers contributing to their isolation and loneliness (37,42).…”

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

“…The review study of O’Rourke et al ( 2018 ) presented group activities as one of the most-used intervention strategies to address social connectedness and loneliness. Moreover, a recent report by Salway et al ( 2020 ) points out that shared-identity social support groups (similar people coming together to support each other and engage in meaningful activities) exhibit the strongest beneficial effects for migrants. We can therefore recommend looking for ways to continue organizing these outdoor group activities in a COVID-19-friendly way so that people feel safe and are able to participate.…”

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“…At the same time, it would be important to set up practice-oriented research. Although a wide range of interventions have been developed to prevent or reduce loneliness among older persons (De Jong Gierveld and Fokkema 2015 ; Fakoya et al 2020 ), only a few are designed specifically for older migrants (Salway et al 2020 ). Academic interest and understanding on the effectiveness of loneliness interventions for older people—or the lack thereof—is developing (Cattan et al 2005 ; Dickens et al 2011 ; Gardiner et al 2018 ), whereas this is almost entirely absent for older migrants.…”