Social Isolation Predicts Frequent Attendance in Primary Care

TY - JOUR

T1 - Social Isolation Predicts Frequent Attendance in Primary Care

AU - Cruwys, Tegan

AU - Wakefield, Juliet R. H.

AU - Sani, Fabio

AU - Dingle, Genevieve A.

AU - Jetten, Jolanda

N1 - This research was made possible by funding from the Australian Research Council (DE160100592) and the Economic and Social Research Council (ES/I038349/1).

PY - 2018/10

Y1 - 2018/10

N2 - Background: Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their healthcare. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks). Methods: Study 1 (N=1752) was a large cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N=46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance. Results: All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness. Conclusions: Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services.

AB - Background: Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their healthcare. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks). Methods: Study 1 (N=1752) was a large cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N=46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance. Results: All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness. Conclusions: Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services.

KW - family practice

KW - mental health

KW - somatization

KW - social identity

KW - frequent attenders

KW - health services research

KW - multiple group membership

U2 - 10.1093/abm/kax054

DO - 10.1093/abm/kax054

M3 - Article

C2 - 30212847

SN - 0883-6612

VL - 52

SP - 817

EP - 829

JO - Annals of Behavioral Medicine

JF - Annals of Behavioral Medicine

IS - 10

ER -