| Description |
Despite the recognition of social connectedness as a social determinant of health by the World Health Organization, few healthcare systems in the United States screen for and treat loneliness and social isolation. In May 2023, US Surgeon General Vivek Murthy released a general advisory recommending that healthcare organizations use validated screening tools to identify loneliness. Global urgency to combat loneliness and social isolation has risen from research illustrating the harmful effects of social disconnectedness, which include increased risk for premature death, cardiovascular disease, diabetes, depression, and suicidality, among other disease states. Young adults are considered a high-risk group, with close to 80% experiencing loneliness. Problem: Prior to this intervention, the chosen Utah-based university student health center did not use a validated screening tool to measure loneliness in the student population. Successful implementation of the UCLA Three-Item Loneliness Scale could increase the identification and treatment of loneliness in the university student population and address the gap in care at the university student health center. Methods: The IHI Plan Do Study Act model was used to evaluate the success of this intervention. Rapid cycle changes came because of ongoing collaboration with the clinic director. Pre-intervention and post-intervention surveys measured feasibility, usability, satisfaction, and provider attitudes and behavior changes. Completed UCLA Three-Item Loneliness Scales were gathered weekly to assess rates of scale use and treatment administered, providing data on feasibility. Interventions: The clinic selected the UCLA Three-Item Loneliness Scale, a validated loneliness identification tool, due to its length and ease of use. In a pre-intervention meeting, clinicians were educated about loneliness and social isolation and taught how to use the UCLA Three-Item Loneliness Scale. Data collection methods included a pre-intervention and post- intervention survey measuring clinician attitudes toward loneliness screening and provider discussions, which were categorized, organized, and summarized. Data analysis assessed the interventions' effectiveness, feasibility, usability, and changes in provider confidence and attitudes toward loneliness screening. Results: While a majority of clinicians (87.5%) found the scale highly usable, they did not find it feasible at the university student health center, and only 37.5% indicated that they would continue to use it due to time constraints and paperwork fatigue. All clinicians (n=8) reported they would likely suggest the UCLA 3-Item Scale to other clinicians. Clinician confidence in loneliness identification and treatment increased by 50%, and perceived importance of loneliness identification and treatment increased by 12.5% from pre-intervention to post-intervention. Conclusions: This QI project provided the student health center with the tools to identify and treat students struggling with loneliness through essential preventative care. In the future, data on loneliness prevalence should inform campus-wide initiatives that promote social connection. This intervention laid important groundwork for implementing the UCLA Three-Item Loneliness Scale and treating loneliness at universities across Utah. |
