Loneliness as a public health challenge: a systematic review and meta-analysis to inform policy and practice

Loneliness is a recognized public health risk factor associated with increased morbidity and mortality. However, the effectiveness of interventions targeting loneliness remains unclear—particularly in relation to baseline severity. This systematic review and metaanalysis assessed intervention effect...

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Detalles Bibliográficos
Autores: Zeas Sigüenza, Ananda, Voldstad, Andreas, Ruisoto Palomera, Pablo, Ganho-Ávila, Ana, Guiomar, Raquel, Cacho Fernández, Raúl, Muntané, Ferràn, Benach, Joan
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/55431
Acceso en línea:https://hdl.handle.net/2454/55431
Access Level:acceso abierto
Palabra clave:Baseline severity
Intervention efficacy
Loneliness
Meta-analysis
Public health
Descripción
Sumario:Loneliness is a recognized public health risk factor associated with increased morbidity and mortality. However, the effectiveness of interventions targeting loneliness remains unclear—particularly in relation to baseline severity. This systematic review and metaanalysis assessed intervention effectiveness and the influence of baseline severity and intervention characteristics. A total of 25 studies were included, of which 16 randomized controlled trials (RCTs; k = 21) were meta-analyzed. Interventions produced a moderate pooled effect at post-intervention (Hedge’s g = 0.65, 95% CI [0.05, 1.26], p = 0.037), though with high heterogeneity. Sensitivity analyses confirmed a moderate effect (g = 0.55, 95% CI [0.22, 0.88], p = 0.003). Higher baseline loneliness predicted greater intervention effects (b = 0.04, 95% CI [0.02, 0.07], Z = 3.36, p < 0.001), with cognitive-behavioral therapy (CBT) showing the largest effect size (g = 0.73). No significant effects were observed at follow-up. These findings underscore the need for dual strategies: targeted psychological interventions (e.g., CBT) for individuals with severe loneliness, and universal, contextbased approaches for the broader population. This aligns with Geoffrey Rose’s distinction between individual-level treatment and population-level prevention and highlights the urgency of embedding loneliness interventions into public health frameworks and policy agendas focused on promoting social connectedness and equity.