Division of Psychiatry, Faculty of Brain Sciences, University College London, 149 Tottenham Court Road, London, W1W 7NF, UK.
School of Informatics, University of Edinburgh, Crichton St, Newington, Edinburgh, UK.
BMC Psychiatry. 2022 May 12;22(1):331. doi: 10.1186/s12888-022-03889-0.
Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design.
We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi: https://doi.org/10.17605/OSF.IO/CNX8A ).
Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions.
Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field.
社会隔离包含主观和客观概念。两者都与负面健康后果相关联，并且在心理健康问题患者中比在普通人群中更为普遍。为了缓解社会隔离，数字干预措施作为面对面干预措施的可及替代或辅助手段具有潜力。本范围综述旨在描述评估数字干预措施缓解心理健康问题患者社会隔离的可行性、可接受性和有效性的类型，并概述产生的定量证据，以为未来干预设计提供信息。
我们在五个电子数据库中搜索了 2000 年 1 月至 2020 年 7 月发表的定量和混合方法研究。如果研究评估了针对心理健康状况个体的数字干预措施，并且将主观和/或客观社会隔离作为主要结局，或者如果没有指定主要结局，则将其作为次要结局之一，则将其纳入研究。如果可行性研究是主要结局，并且社会隔离是次要结局之一，则将其纳入研究。我们采用叙述性综合法来呈现研究结果。该方案在开放科学框架上进行了注册（doi：https://doi.org/10.17605/OSF.IO/CNX8A）。
我们的综述纳入了 32 项研究：16 项可行性研究、7 项单组研究和 9 项有效性试验。干预措施、研究设计和样本人群差异很大。干预措施包括基于网络的方案、基于电话的方案、混合干预措施、社交辅助机器人和虚拟现实干预措施。其中许多是可行性研究，或者否则没有足够的能力来检测如果存在效果，则无法得出明确的临床效果结论。令人满意的可行性结果表明，未来的试验有潜力评估这些干预措施。
我们的范围综述确定了一系列用于缓解心理健康障碍患者社会隔离的数字方法。由于方法的可变性和缺乏大规模随机对照试验，因此无法得出关于临床有效性的结论。为了对数字社会隔离干预措施提出明确建议，未来的研究需要基于严格的方法和更大的样本。未来的研究还应侧重于利用理论驱动的方法和改进现有的方法来推动该领域的发展。
