Interventions to reduce social isolation and loneliness during COVID-19 physical distancing measures: A rapid systematic review

Abstract

Background A significant proportion of the worldwide population is at risk of social isolation and loneliness as a result of the COVID-19 pandemic. We aimed to identify effective interventions to reduce social isolation and loneliness that are compatible with COVID-19 shielding and social distancing measures. Methods and findings In this rapid systematic review, we searched six electronic databases (Medline, Embase, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews and SCOPUS) from inception to April 2020 for systematic reviews appraising interventions for loneliness and/or social isolation. Primary studies from those reviews were eligible if they included: 1) participants in a non-hospital setting; 2) interventions to reduce social isolation and/or loneliness that would be feasible during COVID-19 shielding measures; 3) a relevant control group; and 4) quantitative measures of social isolation, social support or loneliness. At least two authors independently screened studies, extracted data, and assessed risk of bias using the Downs and Black checklist. Study registration: PROSPERO CRD42020178654. We identified 45 RCTs and 13 non-randomised controlled trials; none were conducted during the COVID-19 pandemic. The nature, type, and potential effectiveness of interventions varied greatly. Effective interventions for loneliness include psychological therapies such as mindfulness, lessons on friendship, robotic pets, and social facilitation software. Few interventions improved social isolation. Overall, 37 of 58 studies were of “Fair” quality, as measured by the Downs & Black checklist. The main study limitations identified were the inclusion of studies of variable quality; the applicability of our findings to the entire population; and the current poor understanding of the types of loneliness and isolation experienced by different groups affected by the COVID-19 pandemic. Conclusions Many effective interventions involved cognitive or educational components, or facilitated communication between peers. These interventions may require minor modifications to align with COVID-19 shielding/social distancing measures. Future high-quality randomised controlled trials conducted under shielding/social distancing constraints are urgently needed.

Prevalence and risk factors of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: findings from the ELSA-Brasil COVID-19 mental health cohort

“…using social apps) were associated with decreased risk. In fact, feelings of loneliness might have been attenuated via social media and electronic apps of mental health support; also, activities that could be done at home were not stopped (Williams et al, 2021 ).…”

Perceived Stress in Dentists and Dental Students of Latin America and the Caribbean during the Mandatory Social Isolation Measures for the COVID-19 Pandemic: A Cross-Sectional Study

“…In addition, we identify the sociodemographic, COVID-19-related, and health variables associated with this perceived stress. The extreme risk of SARS-CoV-2 infection in the general population has required the adoption, on a global scale, of measures commissioned by the health authorities of different countries to minimize the rate of infection [ 3 , 33 , 34 ]. This situation has had a significant impact on the social, working, and everyday life of the general populace—especially health workers, of which dentists and dental students are no exception.…”

“…Specifically, in Latin America, mathematical and statistical investigations involving the effective reproductive number (a parameter used to follow up on an epidemic) reveal a value >2 for 2019, indicating exponential growth [ 2 ]. Since the WHO declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic, governments have established escalating containment measures (such as border closures, lockdowns, and other isolation measures) to reduce viral transmission [ 3 ].…”

Psychological resilience during COVID-19: a meta-review protocol

“…[1][2][3][4] Most nations have strongly recommended or enforced social distancing, self-quarantine and physical isolation, all interventions that have known or predicted impacts on psychological well-being. 5 This has subsequently raised the issue of how to measure, manage and prevent, if possible, negative outcomes, ranging from anxiety to depression to suicide. 1-3 6-9 Psychological resilience is defined as positive adaptability or the ability to 'bounce back' when confronted with new and especially negative situations involving adversity, stress and trauma.…”