Capturing loneliness across youth: Co-production of a new developmentally sensitive scale

Loneliness is the uncomfortable feelings that arise when a person is not satisfied with the number of social contacts they have or the quality of their social relationships. Loneliness is not the same as social isolation: a person can feel socially disconnected even when they are surrounded by others, conversely, a person can be alone and feel contented. Over the last decade, loneliness has become a public health concern. The COVID-19 pandemic with its various phases of lockdown and social restrictions has only magnified that concern. This is worrying because loneliness can be linked to poorer mental health in the long term, which affects other health outcomes, quality of life, use of health care services, and employment. It is, therefore, crucial to develop ways to help people to manage loneliness before it becomes linked with these poorer outcomes. Past research has looked at the why loneliness occurs and how it can be managed, primarily focussing on older adults, even though loneliness is as common in young people. A key reason for why youth loneliness has been neglected is that our current questionnaires of youth loneliness are limited in capturing the authentic experiences of young people. Existing measures were developed largely without input from young people so they may not include real-life features and characteristics of loneliness. Stigma could also affect reporting on these measures.

We propose to develop and assess a new questionnaire of youth loneliness through a rigorous development process. We will invite young people aged 10-24 years to tell us about their experiences of loneliness. For this and other stages of measure development, we aim to recruit young people who are diverse in gender, ethnicity, sexuality, and family income, and with a range of loneliness experiences. Half of the participants will be from London and the other half, Manchester, to ensure the results are applicable to two distinct UK regions. We will use methods to encourage group discussion using both structured topic guides and different creative art activities that enable us to gain a better picture of what loneliness means to young people. From these discussions, we will create questionnaire items that reflect loneliness as it is experienced across youth from early adolescence to early adulthood. These items will be sent out to academic experts and experts by experience for feedback on their clarify and narrow down the item pool. Next, we will ask a pilot sample of young people to complete ratings of these items, while verbalising their thoughts about each item (e.g., does it reflect loneliness) out loud. This feedback will be used to refine the items before they are distributed as a questionnaire to 1800 young people, twice over a 3-month period. This data will allow us to carry out formal statistical analysis to see if the items fit well together and collectively reflect loneliness.

We are committed to developing this measure with young people. Two of the proposal's applicants are young people. We will offer young people from marginalised backgrounds in London and Manchester the opportunity to be paid and trained co-researchers. Working with the McPin Foundation, we will create a Young Person Advisory Group to give advice and provide oversight of our research and communication strategy. We will also communicate our work beyond academic audiences, organising workshops for those interested in applying our questionnaire to their client groups or to evaluate loneliness interventions and programs within their organisations. With the Campaign to End Loneliness, we will organise roundtable discussions, producing infographics and animations for practitioners and policy-makers. To ensure young people have a voice in communicating findings, we will work with People's Palace Projects to deliver high-profile multi-audience public events, which will also contribute to national conversations about youth loneliness.

Loneliness is a common experience among young people, made more urgent by the pandemic. It is a strategic priority for public health, clinical and educational services, and third-sector bodies. Loneliness can be intense, prolonged, and negatively impact social behaviour and relationships, and incur risks for, or amplify the experiences of, serious mental health problems (e.g., depression, substance abuse). It has an eventual cost on educational and employment opportunities, health, and quality of life. Yet, we know less about loneliness mechanisms and interventions in young people than older adults. This knowledge gap arises from a paucity of developmentally sensitive measures that accurately capture authentic loneliness experiences in young people.

To address this methodological gap, the primary goal of this proposal is to co-produce and evaluate a measure of loneliness suitable for young people aged 10-24 years. In line with best practice in psychometrics, we will develop and evaluate this measure across 3 phases. In Phase 1, we will use focus groups, participatory arts workshops, and systematic searches of the existing literature to generate items. These will be evaluated for content validity through consensus ratings across academic experts and experts by experience. Phase 2 will involve cognitive testing through individual interviews with young people for suitability. This will be followed up by administration to a larger sample (N=1800), which will, in Phase 3, enable psychometric evaluation including reliability and validity assessments. The final items that remain on the scale will be written up and published in a peer-reviewed academic journal. The measure will then be made available for further testing and research on a University-hosted website. We will run workshops that discuss best practice for how to apply this in future loneliness research. Our measure will make a valuable and necessary contribution to knowledge, research, and practice.