Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK; Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK.
Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
J Adolesc. 2021 Dec;93:53-79. doi: 10.1016/j.adolescence.2021.09.007. Epub 2021 Oct 15.
Loneliness is prevalent and associated with negative health outcomes in young people. Our understanding of how it can be best addressed is limited. This systematic review aims to assess the acceptability and effectiveness of interventions to reduce and prevent loneliness and social isolation in young people.
Six bibliographic databases were searched; references of included studies were screened for relevant literature. A pre-defined framework was used for data extraction. Quality appraisal was performed using the Mixed Method Appraisal Tool. Data were synthesised narratively.
9,358 unique references were identified; 28 publications from 16 interventions met the inclusion criteria. The majority of interventions were high intensity, individual or small group interventions, often targeted at specific 'at risk' populations. While 14 interventions were associated with a statistically significant reduction in loneliness or social isolation, the heterogeneous measures of loneliness, small sample sizes, short periods of follow-up and high attrition rates limit evidence on effectiveness. Interventions implemented in more general populations of young people appeared more acceptable than those in specific 'at risk' populations.
High intensity interventions are unlikely to be feasible at a population level. Further work is required to develop and evaluate theoretically-informed loneliness interventions for young people that reach wider audiences.
孤独在年轻人中普遍存在，并与负面健康结果相关。我们对如何最好地解决这一问题的理解有限。本系统评价旨在评估减少和预防年轻人孤独和社会隔离的干预措施的可接受性和有效性。
检索了六个文献数据库；对纳入研究的参考文献进行了筛选，以寻找相关文献。使用预定义的框架进行数据提取。使用混合方法评估工具进行质量评估。数据以叙述方式进行综合。
确定了 9358 个独特的参考文献；16 项干预措施中的 28 项出版物符合纳入标准。大多数干预措施是高强度、个体或小组干预措施，通常针对特定的“高危”人群。虽然有 14 项干预措施与孤独感或社会隔离的统计学显著降低相关，但孤独感的衡量标准不同、样本量小、随访时间短和高流失率限制了有效性的证据。在更广泛的年轻人人群中实施的干预措施似乎比在特定的“高危”人群中实施的干预措施更具可接受性。
高强度干预措施在人群层面上不太可行。需要进一步开发和评估针对年轻人的、具有理论依据的孤独感干预措施，以覆盖更广泛的受众。
