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This qualitative narrative correspondence study investigates older adults' experiences of physical activity (PA) during the 2020 COVID-19 pandemic lockdowns in Aotearoa, New Zealand. This paper presents a reflexive thematic analysis of 501 letters received from 568 participants that discussed PA. Participants described PA as bringing joy and rhythm to daily life under stay-at-home measures. The most frequently discussed forms of PA included exercising, gardening, and housework. Four interconnected conceptual themes identified were as follows: (a) renegotiating environmental relationships, (b) social connection, (c) pleasure and PA, and (d) navigating active aging discourses. This paper emphasizes the important environmental and social motivations for becoming and remaining physically active despite restrictions on movement. Older adults' understandings and performance of PA were heavily shaped by active aging discourses. As such, we suggest that initiatives seeking to promote PA should foreground older adults' feelings of connection, productivity, and pleasure and recognize their diversity. This is contrary to current recommendations focused on duration or intensity of older adults' PA. [ABSTRACT FROM AUTHOR]

High rates of cardiometabolic disease and poor physical health outcomes contribute to significant premature mortality in people living with severe mental illness (PLWSMI). Lifestyle interventions such as exercise are known to improve both physical and mental health outcomes, however the best way to deliver exercise programs for PLWSMI remains a challenge. This paper uses a pragmatic program evaluation of a co-delivered low-cost community-based exercise program implemented over a 6-month period. Of 46 referrals in the first half of 2023 to the SLHD Gym and Swim program, 13 gave consent to participate in standardised measures and qualitative interviews. Findings revealed an increase in average hours of sport/exercise, improvements in confidence to exercise independently and within group settings, as well as achievement of individualised goals. The success of the program was in part due to the co-facilitation between peer support workers and exercise physiologists, community connection and the established partnership between the public health service and the local government council. Results offer evidence to adopt and implement accessible and low-cost exercise opportunities in the community external to health services to address barriers of attendance for PLWSMI. [ABSTRACT FROM AUTHOR]

Purpose: Social connections are essential for the development of life skills for youth. Youth with disabilities have long faced barriers to meaningful social connections. The onset of COVID-19 increased barriers to social connections for all youth, and also led to enhanced use of virtual platforms in paediatric rehabilitation programming. Harnessing this opportunity, service providers created a suite of online programs to foster social connections and friendships. The current study explores participant and service provider experiences of such programs. Methods: This qualitative descriptive study used interviews and focus groups to explore how youth with disabilities (n = 8), their parents (n = 7), and service providers (n = 13) involved in program development and delivery experienced the programs, the accessibility of the virtual platforms, and their social connections in relation to program participation. Results: Participants were satisfied with the programs' content, accessibility and ability to meet their social needs. Qualitative themes included facilitating social connections, accessibility of virtual spaces, and recommendations for future virtual programming. Discussion: For youth with disabilities who have been historically marginalized in social spheres, the newly ubiquitous infrastructure regarding virtual programming must be supported and enhanced. A hybrid approach involving virtual/in-person options in future programming is recommended. IMPLICATIONS FOR REHABILITATION: Youth with disabilities can benefit from social connections on virtual platforms in terms of physical access to social spaces and opportunities to communicate in alternative ways For some youth with disabilities, virtual social connections can be the only feasible and readily available option for reducing social isolation due to physical barriers to access When offering virtual program options, service providers should consider the various benefits of connecting with the physical, communication-based, interaction-based, access-based and other barriers to virtual connection [ABSTRACT FROM AUTHOR]

Objective: Self-neglect (SN) is the most common report to Adult Protective Services (APS) and is associated with significant morbidity and mortality risks for older adults. Lack of instrumental support is a well-evidenced etiologic factor in the development and continuation of SN, but little is known about other modifiable social connection characteristics. The social connection framework provides evidence-based characteristics across structure, function, and quality missing from SN studies that could be identified if explored. These factors could provide prevention and intervention targets related to poor health. Methods: A narrative case study is presented using quantitative and qualitative data to explore social connection across structure, function, and quality in the context of SN. Results: The findings highlight the complexity of social connection that may be observed in SN cases reported to APS. Strategic utilization of direct and indirect social interventions to support social connection in this case are presented. Conclusion: The results from this case give rise to considerations that may be generalizable to other SN cases. Recommendations for future research on social connection in this population are provided. [ABSTRACT FROM AUTHOR]

Background and Objectives Social isolation is commonly experienced by older people and is associated with adverse health outcomes. Little is known about the influence of social isolation on the risk of acute care utilization among people living with mild cognitive impairment (MCI) or dementia. Our objective was to investigate the impact of social isolation on the risk of death, hospitalization, and emergency department (ED) use among people living with MCI or dementia who are followed in our Community Internal Medicine practice at Mayo Clinic, Rochester, Minnesota. Research Design and Methods We included people living with MCI or dementia, 55 years and older, who had a clinic visit between June 1, 2019, and June 30, 2021, and who had completed questions about social connections. The risk of death, hospitalization, and ED use was examined by levels of social connection (socially isolated, moderately isolated, moderately integrated, or socially integrated). Results Of 2,320 people included (1,010 with MCI and 1,310 with dementia), 455 (19.6%) were classified as socially isolated and 591 (25.5%) were moderately isolated. Compared with those who were socially integrated, people who were socially isolated were at higher risk of death, hospitalization, and ED visits (p  < .001). Discussion and Implications Social isolation is associated with an increased risk of acute health care utilization and death in people living with MCI or dementia. Interventions to address social isolation in this population are needed. [ABSTRACT FROM AUTHOR]

Background/Objectives: Volunteering has been widely recognized as beneficial to the well-being of older adults, providing health benefits, increased social engagement, and a sense of purpose. This study aimed to explore the associations between volunteering and physical and mental health measures among older adults in Japan. Methods: Using an online survey conducted during the COVID-19 pandemic, 500 participants aged 65 and older were divided into volunteer and non-volunteer groups. Demographic, lifestyle, and health characteristics were comprehensively assessed using a series of reliable and validated instruments. Logistic regression analysis was used to explore the associations between volunteering and health outcomes. Results: The findings revealed that while there were no significant differences in physical health indicators and undertreatment of most diseases (with the exception of cataracts), volunteers reported significantly lower levels of depression and loneliness compared to non-volunteers. The volunteer group also showed greater engagement in social activities and hobbies, which may have contributed to their improved mental health outcomes. Conclusions: The results of this study add to the growing body of evidence suggesting that volunteering may be an effective, low-cost intervention for promoting mental health and social engagement among older adults. [ABSTRACT FROM AUTHOR]

Background. Social connections not only contribute to psychological and emotional well-being but also positively impact physical health, with social isolation and loneliness linked to early mortality and detrimental health outcomes. Objectives. This study aims to evaluate an online Awareness, Courage, and Love (ACL) group intervention designed to enhance social connectedness and subjective well-being while reducing loneliness, depression, and anxiety among older adults. Methods. This randomised controlled trial (RCT) will involve an intervention group receiving a 2 h ACL session via videoconferencing. Eligible participants selected after screening will be assigned randomly to either a treatment or waitlist-control group. Participants in both conditions will complete the assessments at three time points, including baseline, post-intervention, and one-month follow-up. Tools for assessing the concerned variables include the Inclusion of Other in the Self Scale, de Jong Gierveld Loneliness Scale, Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder 2-item (GAD-2) Scale, and World Health Organisation—Five Well-Being Index (WHO-5). Conclusions. This study will offer a robust framework for investigating the impact of the online ACL intervention on loneliness and social connectedness among Chinese older adults. The result of this study will reach theoretical, empirical, practical, and teaching significance on mental health care strategies for Chinese older adults. [ABSTRACT FROM AUTHOR]

Background: Social connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents. Methods: We used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada. Results: Themes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. 'Becoming familiar with life in the LTC home to support social connection' described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. 'Physical and virtual access beyond the LTC home as strategies to maintain contact' related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. 'Getting to know residents to deepen relationships' related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. 'Person-centred approaches to build social connection' included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs. Conclusions: This study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes. Clinical trial number: clinicaltrials.gov ID NCT05315960. [ABSTRACT FROM AUTHOR]

Background It is unclear whether social isolation and loneliness may precede frailty status or whether frailty may precipitate social isolation and loneliness. We investigated the reciprocal and temporal sequence of social isolation, loneliness, and frailty among older adults across 21 years. Methods We used seven waves of the Longitudinal Aging Study Amsterdam from 2302 Dutch older adults (M = 72.6 years, SD = 8.6, 52.1% female) ages 55 or older. Using random intercept cross-lagged panel models, we investigated between- and within-person associations of social isolation and loneliness with frailty. Frailty was measured using the Frailty Index. Loneliness was measured using the 11-item De Jong Gierveld Loneliness Scale. Social isolation was measured using a multi-domain 6-item scale. Results Social isolation and loneliness were weakly correlated across waves. At the between-person level, individuals with higher levels of frailty tended to have higher levels of social isolation but not loneliness. At the within-person level, the cross-lagged paths indicated that earlier frailty status predicted future social isolation and loneliness over time. However, prior social isolation was not associated with subsequent frailty except at time point 5 (T5). Loneliness at specific time points (T1, T4 and T6) predicted greater frailty at later time points (T2, T5 and T7). The results also supported reciprocal and contemporaneous relations between social isolation, loneliness and frailty. Conclusions Social isolation and loneliness are potential outcomes of frailty. Public health policies and health practitioners should prioritise interventions targeting social connection among older adults with pre-frailty or frailty. [ABSTRACT FROM AUTHOR]

This study identified research trends, intellectual connections, and social connections in the field of museum visitor experiences. It also outlines future research to understand existing scientific research and shed light on key areas of research. The study reviewed 407 articles published in peer-reviewed journal articles, which were generated from the Scopus database. Bibliometric analysis software VOSviewer and Harzing POP were used. Citation analysis, co-authorship analysis, bibliometric coupling, and co-occurrence analysis have been employed. Findings highlight the need for increased representation from scholars in the Global South to ensure a more inclusive and comprehensive understanding of museum visitors' experiences worldwide. Nine key research areas for future studies were identified: sustainability, mixed reality, social media, accessibility, emotion, co-creation, interpretation, exhibition, and museum visitors' experience and engagement. The results benefit stakeholders and researchers by allowing them to stay informed about the latest developments and breakthroughs in the global academic landscape and visitors' experiences in museums. [ABSTRACT FROM AUTHOR]

The arts have enriched human experiences across time and culture. Beyond their intrinsic value, a growing body of evidence suggests that engaging with the arts has numerous benefits for health and well-being. Increasingly, research on older adults suggests that arts-based interventions and engagement with arts-based leisure activities enhance states of well-being (e.g. life satisfaction, positive emotions, belonging) and reduce states of ill-being (e.g. depression, anxiety, loneliness) In this paper, we focus on the potential for the arts to contribute to women thriving in their 80s and 90s. In particular, we aim to bring awareness to the ways in which the arts can play a vital role in cultivating positive states of social well-being (e.g. social connections, social networks, social support, and belonging) and mitigating negative states of social ill-being (e.g. loneliness, social isolation). We first lay the groundwork for the relationship between the arts and health and discuss social well-being as an important facet of overall well-being. We then review research findings from four artistic domains (music, visual art, art and craft, and performing arts) and their associations with social well-being in older adulthood. Finally, we discuss potential applications of art-based interventions to support the social well-being of women in later life. [ABSTRACT FROM AUTHOR]

Little is known about how perfectionistic adolescents experience social connection in online spaces. The current qualitative study addressed this gap by examining themes related to social (dis)connection in online and in-person settings from semistructured interviews with 43 adolescents (Mage = 15.16, SD = 2.43; 62.8% female; 58.1% white; 54.4% self-identified perfectionists). Results demonstrated that perfectionists expressed feeling less connected online than nonperfectionists, likely driven by heightened levels of interpersonal sensitivity. However, a subgroup of perfectionists sought out meaningful online relationships, often in response to a fear or experience of rejection by in-person peers. The results highlight the role of interpersonal sensitivity in fueling feelings of disconnection among adolescent perfectionists in both online and in-person settings, as well as the importance of self-monitoring in the social experiences of perfectionistic youth. Public Significance Statement: This study examined teen perfectionists' sense of connection with others on social media, by comparing their responses in semistructured interviews to those of nonperfectionists. For most perfectionists, connecting with others via social media was challenging due to the lack of social cues online that they seem to rely heavily on in-person to soothe their social anxieties. However, for a small group of perfectionists who felt they did not fit in with their face-to-face peers, online platforms gave them a safe space where they could connect with others with whom they shared common interests and values. [ABSTRACT FROM AUTHOR]

Objective: To examine social connection as a protective factor against exam stress. Participants: 55 undergraduate students at two universities. Methods: Students were evaluated on an exam day for their hardest class and at baseline, a day in a week where they had no exams. Social connection, salivary cortisol, perceived stress, and cognitive control (measured with the Stroop test) were assessed. Exam scores were later reported. Results: Higher social connection was associated with lower perceived stress on exam day. At a small liberal arts school, higher levels of social connection were associated with higher Stroop scores. This correlation with cognitive control was not significant at a large public university. Conclusions: These findings indicate that social connection may be a protective factor in mitigating perceived stress and cognitive control capabilities may help facilitate reduced exam stress in some school environments. [ABSTRACT FROM AUTHOR]

This study explores the academic and social experience of international students in colleges in the United States of America. Specifically, the study focuses on colleges with a high percentage of international students as they represent diverse cultural backgrounds and contribute significantly to the campus environment. Data were collected from 30 participants (undergraduate students) across five focus group interviews and a thematic analysis was performed. For academic experience, four sub-themes emerged: relationship with professors, academic resources, liberal arts requirements; and class participation weightage. For social experience, four sub-themes emerged: role of student clubs and societies; inter-college collaborations; intercultural sensitivity; and religious/cultural events. Findings provide valuable implications on how colleges with a high population of international students can improve the academic and social experience of these students. [ABSTRACT FROM AUTHOR]

Background: People in late adulthood die by suicide at the highest rate worldwide. However, there are still no tools to help predict the risk of death from suicide in old age. Here, we leveraged the Survey of Health, Ageing, and Retirement in Europe (SHARE) prospective dataset to train and test a machine learning model to identify predictors for suicide in late life. Methods: Of more than 16,000 deaths recorded, 74 were suicides. We matched 73 individuals who died by suicide with people who died by accident, according to sex (28.8% female in the total sample), age at death (67 ± 16.4 years), suicidal ideation (measured with the EURO-D scale), and the number of chronic illnesses. A random forest algorithm was trained on demographic data, physical health, depression, and cognitive functioning to extract essential variables for predicting death from suicide and then tested on the test set. Results: The random forest algorithm had an accuracy of 79% (95% CI 0.60-0.92, p = 0.002), a sensitivity of.80, and a specificity of.78. Among the variables contributing to the model performance, the three most important factors were how long the participant was ill before death, the frequency of contact with the next of kin and the number of offspring still alive. Conclusions: Prospective clinical and social information can predict death from suicide with good accuracy in late adulthood. Most of the variables that surfaced as risk factors can be attributed to the construct of social connectedness, which has been shown to play a decisive role in suicide in late life. [ABSTRACT FROM AUTHOR]

Young people with long-term conditions (LTCs) often experience prolonged school absences. School absenteeism can adversely affect home or hospital-bound (HHB) young people's wellbeing and subsequent re-entry to school. Social connectedness through technology, especially for young people, is a burgeoning area of international research. However, connectedness through technology for HHB young people only recently gained traction. Using an integrative literature synthesis methodology, we examine the literature on connectedness through technological initiatives for HHB young people with LTCs. Results indicate potential for virtual-inclusion initiatives to enable academic and social connections but highlight the invisibility of HHB young people with LTCs in inclusive education policies. We argue that support for virtual initiatives and increased visibility of HHB young people with LTCs in inclusive education policies will enhance classroom belonging and disrupt experiences of isolation resulting in social and academic benefits. [ABSTRACT FROM AUTHOR]

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups. [ABSTRACT FROM AUTHOR]

Abstract Background Social connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents. Methods We used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada. Results Themes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. ‘Becoming familiar with life in the LTC home to support social connection’ described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. ‘Physical and virtual access beyond the LTC home as strategies to maintain contact’ related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. ‘Getting to know residents to deepen relationships’ related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. ‘Person-centred approaches to build social connection’ included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs. Conclusions This study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes. Clinical trial number clinicaltrials.gov ID NCT05315960.

This study identified research trends, intellectual connections, and social connections in the field of museum visitor experiences. It also outlines future research to understand existing scientific research and shed light on key areas of research. The study reviewed 407 articles published in peer-reviewed journal articles, which were generated from the Scopus database. Bibliometric analysis software VOSviewer and Harzing POP were used. Citation analysis, co-authorship analysis, bibliometric coupling, and co-occurrence analysis have been employed. Findings highlight the need for increased representation from scholars in the Global South to ensure a more inclusive and comprehensive understanding of museum visitors’ experiences worldwide. Nine key research areas for future studies were identified: sustainability, mixed reality, social media, accessibility, emotion, co-creation, interpretation, exhibition, and museum visitors’ experience and engagement. The results benefit stakeholders and researchers by allowing them to stay informed about the latest developments and breakthroughs in the global academic landscape and visitors’ experiences in museums.

The current study uses socioemotional selectivity theory (SST; Carstensen in Psychology and Aging. 7(3):331–338,1992,10.1037/0882-7974.7.3.331) as a framework to examine the experiences of older adults during COVID-19 in Aotearoa/New Zealand. SST posits that when time horizons are perceived as limited—such as with increasing age, or during times of medical uncertainty—people selectively focus on spending time with emotionally close others and in personally fulfilling activities. This may be the case particularly when uncertainty is experienced by older people. Aotearoa/New Zealand instigated an elimination strategy early in the pandemic (prior to widespread vaccine availability), employing a series of lockdowns that further challenged older adults' perceptions of future horizons, their ability to maintain social connections with loved ones, and engagement in pleasurable activities. This study used thematic analysis to analyze existing qualitative COVID-19-related data drawn from the experiences of 510 older adults who participated in the 2021 Health, Work, and Retirement study (HWR). Participants ranged in age from 56 to 87 (Mage = 69.73); 15.9% identified as Māori, and 76.2% identified as female. Two broad themes were revealed: Social Connection and Anticipating the Future. Although most participants expressed comparatively more positive than negative experiences, some also expressed frustration and anxiety about health directive-related divisions in relationships, and the inability to share in important life events (such as weddings, births, and funerals). Findings highlight the complex impact of COVID-19 on older adults' perceptions of time horizons, and the opportunities presented by the pandemic for reassessment of social relationships and activities. [ABSTRACT FROM AUTHOR]

Mobile telepresence robots can help reduce loneliness by facilitating people to visit each other and have more social presence than visiting via video or audio calls. However, using new technology can be challenging for many older adults. In this article, we examine how older adults use and want to use mobile telepresence robots, how these robots affect their social connection, and how they can be improved for older adults' use. We placed a mobile telepresence robot in the home of older adult primary participants (N = 7; age 60 \(+\)) for 7 months and facilitated monthly activities between them and a secondary participant (N = 8; age 18 \(+\)) of their choice. Participants used the robots as they liked between monthly activities. We collected diary entries and monthly interviews from primary participants and a final interview from secondary participants. Results indicate that older adults found many creative uses for the robots, including conversations, board games, and hide "n" seek. Several participants felt more socially connected with others and a few had improved their comfort with technology because of their use of the robot. They also suggested design recommendations and updates for the robots related to size, mobility, and more, which can help practitioners improve robots for older adults' use. [ABSTRACT FROM AUTHOR]

Humans are motivated to connect, be autonomous, and exercise competence. When the social distancing compelled by COVID-19 compromised people’s abilities to connect, did certain autonomy- and competence-fulfilling behaviors and psychological resources compensate for reductions in social connection? To address this question, the present study assessed changes in social connection, changes in life satisfaction, and the potential buffering effects of positive shifts in competence- and autonomy-related behaviors and resources before to after the onset of the pandemic in 2020. An online panel completed surveys in January/February 2020 (NT1 = 396), April 2020 (NT2 = 336), and May 2020 (NT3 = 299). Sharper decreases in connectedness and sharper increases in loneliness from January/February 2020 to May 2020 predicted sharper decreases in life satisfaction. However, these effects were buffered among those who reported sharper-than-average growth in learning, sense of meaning/purpose, and use of skills. [ABSTRACT FROM AUTHOR]

In recent years, there has been growing recognition of the threats to health posed by loneliness. One of the main strategies that has been recommended to address this is social prescribing (SP). This typically involves general practitioners (GPs) and other health practitioners directing clients who are experiencing loneliness and related conditions to take part in social activities—typically in recreational and community contexts. However, evidence for the effectiveness of SP is mixed—leading some to suggest that enthusiasm for it might be misplaced. In this review, we argue that a core problem with most existing approaches to SP is that they lack a strong theoretical base. This has been a barrier to (a) understanding when SP will work and why, (b) designing optimally effective SP programmes, and (c) developing practitioner skills and appropriate infrastructure to support them. As a corrective to this state of affairs, this review outlines a three-tier social identity framework for SP and five associated hypotheses. These hypotheses predict that SP will be more effective when (a) clients join groups and (b) these groups are ones with which they identify, and when SP is supported by (c) social-identity-enhancing social infrastructure, (d) a social-identity-based therapeutic alliance, and (e) identity leadership that builds and shapes this alliance as well as clients' identification with prescribed groups. This framework is supported by a range of evidence and provides an agenda for much-needed future research and practice. [ABSTRACT FROM AUTHOR]

Background: Chronic conditions may limit older peoples' social engagement and wellbeing. Reduced social connections can result in loneliness and social isolation. This study aimed to explore the experience of social connection in older people living with chronic conditions, and the factors influencing their social participation. Methods: A purposive sample of 19 community-dwelling older Australians (mean age 75.5 years) with one or more chronic conditions participated in a qualitative descriptive study. Semi-structured interviews explored participants' perceptions of their social connections and the potential impact of their chronic conditions. Views about the role of general practice in supporting older persons' wellbeing were discussed. Data were analysed inductively using thematic analysis. Results: Five themes were identified: (1) the experience of loneliness, (2) managing diminishing social contacts, (3) living with chronic conditions, (4) barriers to social connection, and (5) facilitators of social connection. Participants felt that ageing with chronic conditions contributed to loss of function and independence, which limited social connections, and increased loneliness and social isolation. Barriers to social connections included issues with mobility, transport and forming new networks. Families were a primary support, with continued community engagement and general practice support crucial to staying well and socially connected. Conclusions: Understanding older peoples' experiences, and the barriers and facilitators of social connections can guide clinicians' interventions. General practice is a promising intervention point because of its high use by those with chronic conditions to stay well. General practice nurses are well-placed to collaboratively address the barriers older people face in maintaining social connections. Chronic conditions may limit older peoples' social engagement, with diminished social connections leading to loneliness, social isolation and other serious health consequences. This study explored the experience of social connection in older people living with chronic conditions and factors influencing their social participation. Older people identified the importance of family, community engagement and staying well through primary care support. Understanding the barriers and facilitators of social connections for older people can guide the general practice team in developing appropriate interventions. [ABSTRACT FROM AUTHOR]

Through an analysis of the Chinese labor-force dynamics survey (CLDS) data, our study investigates the relationship between broadband infrastructure and happiness among rural households. By leveraging the “Rural BROADBAND” project as an exogenous shock for broadband infrastructure and employing a difference-in-differences (DID) framework, we find that households benefiting from this project experience higher levels of overall happiness after controlling for observables. We put forth two plausible explanations for this noteworthy finding. First, broadband infrastructure facilitates social connections among households by enabling the use of internet-based communication applications. Second, it enhances convenience in daily life by expanding internet accessibility. Furthermore, our research reveals that the positive impact of the broadband construction project on the overall happiness of rural households increases with household income. [ABSTRACT FROM AUTHOR]

Many social ties end when one side rejects the other, but rejection does not need to happen directly. Ghosting—the act of ending a relationship by ignoring another person's attempts to connect—is a common way of ending social ties. The present experiments first establish the key characteristics of ghosting and distinguish it from other rejection behaviors (Pilot Studies 1a–1c). The experiments then proceed to explore the relational and motivational implications of this behavior, finding that ghosters (those who ghost) care about the well-being of ghostees (those who are ghosted) more than ghostees realize. This result occurs in recalled instances of ghosting (Experiment 1), when ghosting in real time (Experiment 2), and when refraining from ghosting is monetarily costly (Experiment 3). We find that this occurs partly because ghostees underestimate the other-oriented motives involved in ghosting, misunderstanding that ghosters ghost partly as a way to end a tie while avoiding hurting ghostees' feelings (Experiments 4–6). Indeed, greater other-oriented motives lead to a higher likelihood of ghosting others (Experiment 7). A final experiment finds relational consequences whereby ghostees miss out on opportunities for future help exchange due to their underestimation of the extent to which ghosters care about them (Experiment 8). Ghosting is social rejection without explanation or feedback, but not without care. This study highlights how prosocial motives can drive rejection behaviors and the role of interpersonal accuracy in mitigating the negative effects of social rejection. Public Significance Statement: Ghosting—the act of ending a relationship by ignoring another person's attempts to connect—is a common way of ending social ties. The present research establishes the key characteristics of ghosting and distinguishes it from other rejection behaviors. The present research also finds a systematic gap between how ghosters (those who ghost) and ghostees (those who are ghosted) experience ghosting. Specifically, ghostees underestimate the extent to which ghosters care about their well-being, a judgment that occurs because ghostees misunderstand ghosters' prosocial motives and leads ghostees to miss out on opportunities for future help from ghosters. [ABSTRACT FROM AUTHOR]

Mediatization and digitalization are trends that are increasingly affecting religious communities and their communicative practices. While many aspects of these developments have been described theoretically and empirically, little is known about the dynamic interplay between digital media use, an individual's religious meaning system, and the relationships within a religious community. Building on the theory of the mediatization of religion, the functionalist perspective of religion, media selection, and co-orientation research, we propose a dynamic model of digital media use in religious communities. Hereby, the religious functions of meaning-making and social connection are considered important drivers for how individuals engage with others. Additionally, theories on media selection help our understanding of the acceptance and domestication of new technologies, as well as selective exposure to specific content. In combination, the model links the individuals with the social context of their religious communities and vice versa. Furthermore, the theoretical model helps to combine and systematize empirical research from different disciplines that are relevant to understanding today's digital religious media use. We therefore conclude with a discussion of the benefits of the model for future theoretical developments and empirical research in the field of digital religion and beyond. [ABSTRACT FROM AUTHOR]

Although there has been notable progress in educational inclusion for students with intellectual and developmental disabilities (I/DD), they generally receive inadequate sexual health education. This paper outlines the historical factors for this gap, current practices in sexual health education, and related outcomes for this group of students. [ABSTRACT FROM AUTHOR]

Social connection is important for long‐term care (LTC) residents' quality of life and care. However, there is a lack of consensus on how to measure it and this limits ability to find what improves and impairs social connection in LTC homes. We therefore aimed to systematically review and evaluate the measurement properties of existing measures of social connection for LTC residents, to identify which, if any, measures can be recommended. We searched eight electronic databases from inception to April 2022 for studies which reported on psychometric properties of a measure of any aspect(s) of social connection (including social networks, interaction, engagement, support, isolation, connectedness, and loneliness) for LTC residents. We used COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) guidelines to evaluate the measurement properties reported for each identified measure and make recommendations. We identified 62 studies reporting on 38 measures; 21 measured quality of life, well‐being or life satisfaction and included a social connection subscale or standalone items and 17 measures specifically targeted social connection. We found there was little high‐quality evidence on psychometric properties such as sufficient content validity (n = 0), structural validity (n = 3), internal consistency (n = 3), reliability (n = 1), measurement error (n = 0), construct validity (n = 4), criterion validity (n = 0) and responsiveness (n = 0). No measures demonstrated satisfactory psychometric properties on all these aspects, so none could be recommended for use. Thirty‐four measures have the potential to be recommended but require further research to assess their quality and the remaining four are not recommended for use. Our review therefore found that no existing measures have sufficient evidence to be recommended for assessment of social connection in residents of LTC homes. Further validation and reliability studies of existing instruments or the development of new measures are needed to enable accurate measurement of social connection in LTC residents for future observational and interventional studies. Highlights: Social connection is fundamental to person‐centered care in long‐term care homes.There is insufficient evidence for the reliability and validity of existing measures.No current measures can be recommended for use based on existing evidence.A reliable and valid measure of social connection is needed for future research. [ABSTRACT FROM AUTHOR]

Research increasingly highlights the importance of social disconnectedness for the development of psychosis. However, the perspective of individuals with psychosis remains largely underexplored. At present, there is also no comprehensive view of the role of social processes throughout different phases of psychosis development. The current study aims to investigate 1) how individuals with a psychotic disorder experience social disconnection and 2) the role of social disconnection We conducted two focus groups, with individuals diagnosed with a psychotic disorder (N = 8). The data were analyzed using interpretative phenomenological analysis. We structured the data according to three phases: pre-psychotic early life, development of psychotic symptoms and recovery. The first phase included following themes: “developing distrustful views of others through childhood interpersonal adversity” and “growing up socially isolated”. The second phase had three themes: “increasing separation between common and individual reality perception”, “struggling to share psychotic experiences due to stigma” and “losing relationships due to feeling misunderstood and decreased social functioning”. The final phase encompassed: “accepting psychosis diagnosis through social support”, “grounding influence of others” and “finding purpose through social integration”. In general, individuals with psychosis viewed social disconnectedness as a highly important factor for understanding and treating psychosis. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionLoneliness is associated with maladaptive cognitions, yet little is known about the association between loneliness and intrusive thinking during older adulthood. Links between loneliness and intrusive thoughts may be particularly strong among individuals with mild cognitive impairment (MCI), who may have greater difficulty regulating emotion and intrusive thoughts. In contrast, having close relationships (e.g. being married) may serve as a protective factor as marital status is associated with better overall well-being.Participants were 316 older adults (recruited from the Bronx, NY, as part of a larger study) without dementia at study intake (40% Black; 13% Hispanic, Mage = 77.45 years, 67% women) who completed ecological momentary assessments five times daily for 14 consecutive days (13,957 EMAs total). Multilevel modeling was used to examine the association between momentary loneliness and intrusive thoughts and whether MCI and marital status interacted to moderate this association.There was a significant three-way interaction (β = −0.17, p < 0.05), such that lagged momentary loneliness was positively associated with intrusive thoughts (3–4 h later) for those with MCI who were not married.Findings suggest that among older adults with MCI, being married may be a protective factor and being unmarried may be a risk factor for experiencing loneliness and subsequent intrusive thoughts. [ABSTRACT FROM AUTHOR]

Loneliness arises when there is a discrepancy between one's desired and actual social connection with others. Studies examining the effects of loneliness in romantic relationships show that people who are lonely are less satisfied and committed to their romantic relationships. The present study explored the association between loneliness and romantic relationship well-being. Using a cross-sectional design, loneliness was correlated with relationship commitment, trust, and conflict. Relationship awareness, but not relationship distraction, statistically mediated the association between loneliness, relationship conflict, and relationship trust. The indirect effect of loneliness on relationship well-being was only present in people reporting low and medium levels of psychological inflexibility. Implications are discussed for acceptance- and mindfulness-based interventions for persons in romantic relationships. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic (2020–2021) resulted in isolation due to social distancing rules and lockdowns, during which technology was used to enable families and friends to maintain contact. Despite loneliness being high in parents, little is known about which parents are more likely to experience loneliness and strategies to support them. Method: This mixed‐methods study examines which parents were lonely during the pandemic and how digital technologies were used to reduce loneliness and social isolation. Data were collected during the first UK lockdown from May to July 2020 via an online survey (N = 145) and follow‐up interviews (n = 13). Results: Loneliness reported during lockdown was greater than retrospective reporting of loneliness for all respondents, but it was higher in single parents, those caring for children with specific needs, and those with lower household incomes before and during lockdown. Parents rapidly adapted to and experimented with using technology for social connection during the lockdown, which helped to reduce feelings of isolation and loneliness. Video calling was found to be useful for making connections and enhancing social presence, but parents also experienced anxieties and difficulties with its use. There were mixed views about technology use; some were keen to continue using technology for socializing after the lockdown ended, but for others, it was only a temporary measure. Conclusion: Although technology was invaluable during the pandemic, it was not a panacea, and the way parents used it was influenced by their approach to technology and existing social behaviors and networks. [ABSTRACT FROM AUTHOR]

Introduction: With Australiaʼs ageing population, especially in rural regions, promoting physical activity among older adults is crucial. Objective: To identify factors influencing participation of older adults (60 years or over) from a rural community in a modified sport program and assess satisfaction with a pilot modified sport program informed by these findings. Design: Insights and ideas from two focus groups exploring community perspectives on a modified sport program informed the development of a six‐week pilot modified sport program delivered with the local fitness centre. Post‐program surveys assessed participant satisfaction, willingness to continue, and likelihood of recommending the program to others. Findings: Nine participants attended the focus groups, highlighting increased social connection, health management, and healthy ageing as key motivators. Joint and health concerns, cost, and time constraints emerged as main barriers. Preferences for the program included weekly sessions, alternating sports, indoor venues, and supporting modifications, but maintaining traditional rules. Thirteen participants participated in the pilot modified sport program. There was strong program attendance (86%). All participants (13/13) rated their satisfaction as very satisfied. They were highly likely to recommend the program to others (8.5/10) and were interested in continuing modified sport after the pilot (7.7/10). Discussion: This study demonstrates for the first time that modified sport is of interest to older people in the rural setting, and that delivering such a program is feasible in a small community. Rural communities implementing modified sport should consider the availability of suitable facilities and equipment, access to an engaging facilitator and participant cost. Conclusion: Through a strong connection between the health service and community fitness centre, a modified sport program was developed and implemented, well‐attended and enjoyed by participants in a rural community. [ABSTRACT FROM AUTHOR]

Background and Objectives Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020–December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. Research Design and Methods This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. Results The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. Discussion and Implications HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations. [ABSTRACT FROM AUTHOR]

Social support is a well-established determinant of mental wellbeing. Community initiatives, which combine a purposeful activity with social connection, may be appropriate to promote the mental wellbeing of middle-aged men in Ireland—a group at risk of poor mental wellbeing due to social isolation. parkrun offers free, weekly, 5km run or walk events in 22 countries. This study aims to explore the social experience of parkrun participation for middle-aged men in Ireland and considers how social connections made at parkrun relate to mental wellbeing. Online semi-structured interviews were conducted in 2022/23 with 39 men aged 45–64 years, who run, walk or volunteer at parkrun in Ireland, recruited purposively in rural and urban communities. Men with a range of parkrun experience gave interviews lasting a mean of 32 minutes. Interviews were recorded and transcribed verbatim. Reflexive thematic analysis resulted in three themes and ten subthemes. The men described parkrun as offering a welcoming and supportive environment (Theme 1). Men at parkrun could choose the level of social connections, building strong or weak social ties to provide social support and improve mental wellbeing (Theme 2). Social engagement with parkrun evolved following repeated participation (Theme 3). The results suggest that parkrun is a suitable community initiative for middle-aged men at risk of poor mental wellbeing due to social isolation. Social connections were developed after repeated participation in parkrun and these connections improved subjective mental wellbeing. The findings from this study could be used to design new initiatives for mental health promotion. [ABSTRACT FROM AUTHOR]

Background: A gap exists in measures available to assess levels of motivation, desire, and value associated with connecting with others. Moreover, few social connection scales have been developed with a goal of including autistic individuals in the sample to create a measure that has utility across neurodiverse populations. This study aims to develop a measure to assess different facets of social connection that is valid among both autistic and non-autistic adults. Methods: The sample consisted of 200 participants recruited online. Participants completed an initial set of 35 items. Exploratory factor analyses and confirmatory factor analyses were performed. Four-factor models were produced by the EFAs. Results: Item reduction resulted in the development of two 8-item scales: the Connections with Others Scale (CWOS) intended for the general population and the CWOS–Autistic Version (CWOS-AV) intended for autistic populations (CWOS-AV). Autistic participants had significantly greater motivation/desire to connect with others compared to non-autistic participants (t(195) = 3.39; p < 0.001). Conclusions: These measures will allow for greater ability to assess the motivation to connect with others, resulting in improved ability to produce research that clarifies theories and describes psychological phenomena. [ABSTRACT FROM AUTHOR]

Loneliness is detrimental to well-being and is often accompanied by self-reported feelings of not being understood by other people. What contributes to such feelings in lonely people? We used functional MRI of 66 first-year university students to unobtrusively measure the relative alignment of peoples mental processing of naturalistic stimuli and tested whether lonely people actually process the world in idiosyncratic ways. We found evidence for such idiosyncrasy: Lonely individuals neural responses were dissimilar to those of their peers, particularly in regions of the default-mode network in which similar responses have been associated with shared perspectives and subjective understanding. These relationships persisted when we controlled for demographic similarities, objective social isolation, and individuals friendships with each other. Our findings raise the possibility that being surrounded by people who see the world differently from oneself, even if one is friends with them, may be a risk factor for loneliness.

Students with Long-Term Conditions (LTCs) experience prolonged absences that can impact their school connectedness and belonging. Inclusive education policies in New Zealand advocate for equitable learning opportunities for students with disabilities. Students with LTCs are included under this purview, but responses to their unique learning and connectedness needs are not well articulated. Literature suggests the potential of technology to enable virtual connections to keep these students’ continued presence and engagement in class (i.e., sustainable connections). Studies internationally and in New Zealand, argue that virtual connections with schools can enhance educational opportunities and a sense of belonging for students with LTCs. However, limited research is available on developing and nurturing such ongoing connections with schools. This article reports on a qualitative study investigating New Zealand stakeholder perspectives on the facilitators of virtual connection with schools for students with LTCs. Findings from a thematic analysis of 18 individual interviews with stakeholders highlighted six facilitators for virtually connecting these students with schools, indicating the need for a flexible approach tailored to students’ needs, strong support systems and purposeful, safe and inclusive connection opportunities. The stakeholders indicated these facilitators as essential for the virtual school connections to be sustainable and enhance students with LTCs’ presence, belonging and social connection in schools.

BackgroundPeople in late adulthood die by suicide at the highest rate worldwide. However, there are still no tools to help predict the risk of death from suicide in old age. Here, we leveraged the Survey of Health, Ageing, and Retirement in Europe (SHARE) prospective dataset to train and test a machine learning model to identify predictors for suicide in late life.MethodsOf more than 16,000 deaths recorded, 74 were suicides. We matched 73 individuals who died by suicide with people who died by accident, according to sex (28.8% female in the total sample), age at death (67 ± 16.4 years), suicidal ideation (measured with the EURO-D scale), and the number of chronic illnesses. A random forest algorithm was trained on demographic data, physical health, depression, and cognitive functioning to extract essential variables for predicting death from suicide and then tested on the test set.ResultsThe random forest algorithm had an accuracy of 79% (95% CI 0.60-0.92, p = 0.002), a sensitivity of.80, and a specificity of.78. Among the variables contributing to the model performance, the three most important factors were how long the participant was ill before death, the frequency of contact with the next of kin and the number of offspring still alive.ConclusionsProspective clinical and social information can predict death from suicide with good accuracy in late adulthood. Most of the variables that surfaced as risk factors can be attributed to the construct of social connectedness, which has been shown to play a decisive role in suicide in late life.

IntroductionLoneliness and social isolation are public health concerns. This study aimed to examine levels and trends in loneliness and social isolation among older adults (77+ years) in Sweden, assess subgroup variations, and determine associations between loneliness and social isolation.MethodsThe 1992, 2002, 2004, 2011, 2014 and 2021 waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were analysed through ordered logistic and linear regressions.ResultsOn average, 12.5 percent of the participants experienced loneliness often/nearly always, while 6 percent were categorised as severely isolated. Loneliness and social isolation were more common in women, those aged 85+, and persons with basic education, in psychological distress or with mobility limitations. Loneliness was also associated with living alone. No increases in loneliness or isolation were identified; instead, loneliness tended to decrease in groups already experiencing lower levels of loneliness. Loneliness and social isolation were moderately associated each survey year.DiscussionThis study challenges perceptions of high and increasing levels of loneliness and social isolation. Given the impact on health and wellbeing and the ageing of populations, policy and practice should still address these issues and target vulnerable groups. Subgroup analyses in trends are scarce and should be explored further in future research.

Experiments prompting people to engage in more prosocial behavior (e.g., acts of kindness) or simple social interactions (e.g., acting extraverted) have both shown promise in boosting well-being. However, little is known about how much the impact on well-being depends on the type of interpersonal interaction (i.e., social vs. prosocial) or on other proximal features (e.g., whether the interaction takes place online vs. in-person, the closeness of the relationship, or amount of social connection associated with a given interaction). We randomly assigned a sample of full-time employees recruited via a special employed mTurk sample (N = 754) to perform weekly acts of kindness online versus in-person, to engage in weekly social interactions online versus in-person, or to list their daily activities (control) over the course of 4 weeks. First, on average, all conditions reported improvements in well-being (i.e., increases in positive affect and life satisfaction, decreases in negative affect) across the 4-week intervention period. Second, relative to controls, the four experimental groups reported increases in general social connectedness over time. Finally, according to auxiliary analyses collapsed across the experimental condition, closer relationship with target and non-digital medium of delivery predicted episode-level social connection, which, in turn, was associated with general social connectedness and positive affect. We conclude that the "who" and the "how" of a behavior (i.e., its target, its delivery method, and the feelings of social connection generated) are important for well-being, but not the "what" (i.e., whether the behavior is social or prosocial). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known prepandemic as well as contemporary research conducted during the pandemic. This focuses on the negative impact of the pandemic on psychosocial health and how this in turn has likely consequences for critically relevant viral and vaccination outcomes. We end by looking forward, highlighting the potential of psychosocial interventions that could be leveraged to support all people in navigating a postpandemic world and how a biopsychosocial approach to health could be incorporated into public health responses to future pandemics.

Previous research has identified a robust connection between prosociality and happiness, suggesting that kindness has both hedonic and eudaimonic benefits-in the short term and in the long term. By contrast, our experiment aimed to examine people's momentary eudaimonic feelings while engaging in kind acts for others. To that end, we randomly assigned participants to one of four positively valenced conditions that varied in their inclusion of potential "active ingredients" of prosocial behavior. Namely, engaging in kind acts for others was compared to engaging in kind acts for oneself (social element removed), extraverted behavior (kindness element removed), and open-minded behavior (both social and kindness elements removed). Participants were assessed five times over 2 weeks, each time reporting on how they felt during their assigned activities. Multilevel models revealed that relative to all other conditions, participants assigned to do kind acts for others reported a greater sense of competence, self-confidence, and meaning while engaging in those acts across the intervention period. Engaging in acts of kindness for others also led to stronger feelings of connection relative to engaging in open-minded behavior or acts of kindness for oneself but did not differ from engaging in extraverted behavior. These results illuminate the experience of positive eudaimonic feelings while one commits kind acts for others and highlight the unique benefits of prosociality compared to other positive behaviors.Supplementary informationThe online version contains supplementary material available at 10.1007/s42761-022-00143-4.

Abstract Background Asset-based approaches (ABAs) tackle health inequalities by empowering people in more disadvantaged communities, or targeted populations, to better utilise pre-existing local community-based resources. Using existing resources supports individuals to better manage their own health and its determinants, potentially at low cost. Targeting individuals disengaged with traditional service delivery methods offers further potential for meaningful cost-savings, since these people often require costly care. Thus, improving prevention, and management, of ill-health in these groups may have considerable cost implications. Aim To systematically review the extent of current cost and economic evidence on ABAs, and methods used to develop it. Methods Search strategy terms encompassed: i) costing; ii) intervention detail; and iii) locality. Databases searched: Medline, CENTRAL and Wed of Science. Researchers screened 9,116 articles. Risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) tool. Narrative synthesis summarised findings. Results Twelve papers met inclusion criteria, representing eleven different ABAs. Within studies, methods varied widely, not only in design and comparators, but also in terms of included costs and outcome measures. Studies suggested economic efficiency, but lack of suitable comparators made more definitive conclusions difficult. Conclusion Economic evidence around ABAs is limited. ABAs may be a promising way to engage underserved or minority groups, that may have lower net costs compared to alternative health and wellbeing improvement approaches. ABAs, an example of embedded services, suffer in the context of economic evaluation, which typically consider services as mutually exclusive alternatives. Economics of the surrounding services, mechanisms of information sharing, and collaboration underpin the success of assets and ABAs. The economic evidence, and evaluations in general, would benefit from increased context and detail to help ensure more nuanced and sophisticated understanding of the economics of ABAs. Further evidence is needed to reach conclusions about cost-effectiveness of ABAs.

This study aimed to understand how COVID-19 affected social connection, barriers to connection, and generated ideas for creating pro-connection activities and spaces. The approach was guided by design principles and included generative interviews and a group workshop with young people aged 16–24 years. COVID-19 allowed young people to recognize the importance of face-to-face and incidental social contacts and appreciate deeper connections to friends, family, and community. Young people identified barriers and enablers to forming quality social connection as confidence, the time and effort taken to build meaningful friendships, mental health, and cultural identity. Programmes that overtly tackle social connection were considered unappealing and usually reach only those who are already engaged. Instead, social connection is a by-product of other activities that take a ‘mild structure, low pressure’ approach and focus on strengths and interests. Activities and spaces must be free and easy to access and involve multiple engagements over time.