Title: How can loneliness and social isolation be reduced among migrant and minority ethnic people? Systematic, participatory review of programme theories, system processes and outcomes
Funder: Department of Health and Social Care

Abstract: This project aims to synthesise available evidence and produce new insight into the range of approaches to addressing social isolation and loneliness in migrant and minority ethnic people, plus the logic, functioning and effects of these interventions. The health risks of loneliness and social isolation are increasingly recognised and various responses have emerged. Earlier evidence reviews have usefully categorised approaches and confirmed that some interventions are effective in reducing social isolation and/or loneliness, particularly group-based and shared interest activities for older people. However, this earlier work has taken a narrow, individually-focused approach, looking exclusively at interventions specifically designed to address loneliness and/or social isolation. It is increasingly recognised that social isolation and loneliness are complex problems, rooted in socio-ecological systems. Determinants operate at individual, family, community and wider societal level and interplay with interventions in complex ways. More holistic research is needed to improve understanding of the causes and solutions in varied settings. This project addresses this need and extends earlier work by: (1) exploring a wide range of interventions (including neighbourhood initiatives and those where isolation/loneliness are secondary outcomes); (2) focusing on migrant and minority ethnic people of all ages (a growing but under-served population with particular risks); and (3) combining effectiveness assessment with detailed examination of intervention logic, system processes and multiple outcomes. We are a multidisciplinary team with population, topic and methodological expertise. We draw on systems thinking and on recent work indicating the value of participatory methods in enhancing reviews of complex, social interventions. We will use an iterative process of desk-based review methods and group modelling workshops with three Consultation Panels (involving lay experts, community workers and beneficiaries in London, Sheffield and Leicester) throughout the 18 month project. We will generate six complementary research products: 1) A typology of interventions (including detailed descriptions of components and resource inputs). 2) An assessment of comparative effectiveness using network meta-analysis, meta-analysis and/or narrative synthesis as appropriate 3) A descriptive synthesis of the costs (and where reported cost effectiveness) of interventions 4) A refined system model (presented visually in causal loop diagrams and in narrative form) 5) A qualitative meta-synthesis of factors supporting/undermining intervention implementation and sustainability 6) A qualitative meta-synthesis of factors that increase/decrease social isolation and loneliness among migrant and minority ethnic people mapped against interventional activity Our study is designed with impact in mind. Close involvement of the Consultation Panels and an Advisory Group means that evidence-users are engaged throughout. We will produce a range of research outputs tailored to varied audiences and use extensive academic, policy-practice and community networks to engage people with the results. Findings will inform future action aiming to tackle social isolation and/or loneliness in ethnically diverse populations. We also anticipate new knowledge on how to identify opportunities within existing public health-related activity to prevent or reduce isolation/loneliness.

Lay abstract: This research project looks at social isolation and loneliness which are common problems for people from minority ethnic and migrant groups. In our research project we will develop new understanding about how these problems have been tackled, and how different approaches have worked out in different places. Feeling lonely or lacking social connections can be bad for people’s health. Bearing this in mind, various initiatives have been developed to tackle loneliness and social isolation. Earlier research has usefully described different approaches and confirmed that some of these work (and some do not). However, this earlier work has taken a narrow focus. Social isolation and loneliness are increasingly recognised as complex problems, rooted in local neighbourhoods and social settings. A range of factors at individual, family, community and wider societal level play a part in people’s isolation and loneliness. There is a need to think more broadly about this issue. We need to improve understanding of the causes and identify the right solutions for different settings. This project addresses this need and goes beyond earlier work in three important ways. We will look at a wide range of approaches including programmes and action at neighbourhood and societal level. We will focus on migrant and minority ethnic people (a growing but under-served population with particular risks). We will assess whether these approaches work and also look closely at how they operate in different places. Our team includes researchers with the necessary expertise in the topic and the methods to be used. We will also work closely with lay experts, community workers and local people through three groups - called Consultation Panels – in London, Sheffield and Leicester. During desk-based work, we will search for relevant research reports and summarise their findings. We will share these findings with the Consultation Panels in two group workshops and invite members to offer their own insights on the causes and potential solutions to isolation and loneliness. We will then draw together the evidence to develop explanations for why isolation and loneliness occur and how particular initiatives might help in particular settings. Six summaries using text and diagrams will describe the: 1) Types of initiatives 2) Effects of different initiatives on isolation and loneliness 3) Costs of various initiatives 4) Ways in which the initiatives work and their interactions with other aspects of the local setting 5) Factors that help or hinder the delivery and sustainability of the various initiatives 6) Factors that increase or decrease social isolation and loneliness and whether these are addressed by current initiatives Our study is designed to guide practical solutions to isolation and loneliness. We will engage potential evidence-users throughout the project through the close involvement of the Consultation Panels and an Advisory Group consisting of researchers, planners, practitioners and community organisations. We will produce a range of published research results tailored to these different audiences. We will use our extensive links to engage people with the results. Findings will guide future action aimed at tackling social isolation and/or loneliness within multi-ethnic populations.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE