A synthesis of evidence for policy from behavioural science during COVID-19.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Connecting to Community: A Social Identity Approach to Neighborhood Mental Health.

ACADEMIC ABSTRACT: Integrative theorizing is needed to advance our understanding of the relationship between where a person lives and their mental health. To this end, we introduce a social identity model that provides an integrated explanation of the ways in which social-psychological processes mediate and moderate the links between neighborhood and mental health. In developing this model, we first review existing models that are derived primarily from a resource-availability perspective informed by research in social epidemiology, health geography, and urban sociology. Building on these, the social identity model implicates neighborhood identification in four key pathways between residents' local environment and their mental health. We review a wealth of recent research that supports this model and which speaks to its capacity to integrate and extend insights from established models. We also explore the implications of the social identity approach for policy and intervention. PUBLIC ABSTRACT: We need to understand the connection between where people live and their mental health better than we do. This article helps us do this by presenting an integrated model of the way that social and psychological factors affect the relationship between someone's neighborhood and their mental health. This model builds on insights from social epidemiology, health geography, and urban sociology. Its distinct and novel contribution is to point to the importance of four pathways through which neighborhood identification shapes residents' mental health. A large body of recent research supports this model and highlights its potential to integrate and expand upon existing theories. We also discuss how our model can inform policies and interventions that seek to improve mental health outcomes in communities.

Therapists who foster social identification build stronger therapeutic working alliance and have better client outcomes.

BACKGROUND: For decades we have known that therapeutic working alliance is a key contributor to client engagement and positive outcomes in therapy. However, we have made little progress in narrowing down its determinants, which is critical in supporting trainees to optimize such alliance. We make a case for the value of incorporating social psychological frameworks into models of alliance and explore the role of social identity processes in the development of therapeutic alliance. METHOD: Across two studies, over 500 psychotherapy clients completed validated measures of alliance, social identification with their therapist, positive therapy outcomes, and a range of client and therapist characteristics. FINDINGS: Social identification strongly predicted alliance in both samples, whereas client and therapist characteristics showed few such associations. Alliance mediated the relationship between social identification and positive therapy outcomes. In addition, we found evidence that (a) personal control is a key psychological resource in therapy that arises from social identification, and (b) therapists who engage in identity leadership (i.e., who represent and build a social identity that they share with clients) are more likely to foster social identification and its downstream benefits. INTERPRETATION: These data show that social identity processes are key to the emergence of working alliance. We conclude with a discussion of how recent social identity and identity leadership interventions might be adapted to train therapists in relevant identity-building skills.

Why a group-level analysis is essential for effective public policy: The case for a g-frame.

Societal problems are not solved by individualistic interventions, but nor are systemic approaches optimal given their neglect of the social psychology underpinning group dynamics. This impasse can be addressed through a group-level analysis (a "g-frame") that social identity theorizing affords. Using a g-frame can make policy interventions more adaptive, inclusive, and engaging.

Misery loves company: Predictors of treatment response to a loneliness intervention.

OBJECTIVE: The last 10 years have seen a surge of interest in loneliness and interventions to reduce it. However, there is little evidence regarding differential treatment effectiveness and predictors of treatment outcome. This paper aimed to investigate possible predictors of treatment response. METHODS: We analysed data from two clinical trials of an evidence-based loneliness intervention: Groups 4 Health (G4H). Study 1 had 163 observations across two timepoints, n = 94; Study 2 had 297 observations across four timepoints; n = 84. Theorised predictors-symptom severity at baseline, program engagement, and demographic characteristics-were assessed for their effect on the primary outcome: loneliness. RESULTS: Across both trials, participants with more severe baseline loneliness or social anxiety, or who attended more sessions, experienced greater improvement in loneliness. In Study 2, those with diagnosed mental illness or more severe baseline depression also tended to have better outcomes. There was no evidence that age, gender, or ethnicity predicted program efficacy. CONCLUSION: Overall, those with greater need-reflected in either severity of loneliness or psychological distress-tended to show greater improvement over time. This was due, in part, to greater engagement with the program among those who were lonelier. We discuss how loneliness interventions can be deployed most effectively to combat this profound public health challenge.

Groups 4 Health versus cognitive-behavioural therapy for depression and loneliness in young people: randomised phase 3 non-inferiority trial with 12-month follow-up.

BACKGROUND: Depression treatments are typically less effective for young people than for adults. However, treatments rarely target loneliness, which is a key risk factor in the onset, maintenance and development of depression. AIMS: This study evaluated the efficacy of a novel loneliness intervention, Groups 4 Health (G4H), relative to the best-practice treatment of cognitive-behavioural therapy (CBT) in reducing loneliness and depression over a 12-month period (Australian New Zealand Clinical Trial Registry: ACTRN12618000440224). METHOD: The study was a phase 3 randomised non-inferiority trial comparing G4H with dose-controlled group CBT. Participants were 174 people aged 15-25 years experiencing loneliness and clinically significant symptoms of depression, who were not in receipt of adjunct treatment. Participants were recruited from mental health services in Southeast Queensland, Australia. Randomisation was conducted using computer software. Follow-up assessments and statistical analyses were masked to allocation. Both interventions consisted of five 75 min group-based psychotherapy sessions. The primary outcomes were depression and loneliness, with a non-inferiority margin of 2.20 for depression. RESULTS: The trial enrolled 174 participants between 24 April 2018 and 25 May 2019, with 84 in the G4H condition and 90 in the CBT condition. All randomised participants were included in the intention-to-treat analyses (n = 174). The pre-post effect sizes for depression were dG4H = -0.71 and dCBT = -0.91. For loneliness, they were dG4H = -1.07 and dCBT = -0.89. At 12-month follow-up, the absolute difference between groups on depression was 1.176 (95% CI -1.94 to 4.29) and on loneliness it was -0.679 (95% CI -1.43 to 0.07). No adverse effects were observed. CONCLUSIONS: G4H was non-inferior to CBT for depression and showed a slight advantage over CBT for loneliness that emerged after treatment completion.

Life Change, Social Identity, and Health.

Life change affects health. Research aimed at understanding the consequences of life change has primarily focused on the important roles played by stress, social support, individual differences, and broader socioeconomic factors in shaping health outcomes, most notably mental health decline. In this review we extend these accounts by exploring social identity-based determinants of adjustment to life change. We do so by drawing on social identity theorizing and, in particular, the Social Identity Model of Identity Change (SIMIC). This points to the importance of multiple, maintained, new, and compatible group memberships as determinants of people's responses and adjustment to life change. We apply this model to understand the health consequences of adjustment to life change in four diverse areas: pursuit of higher education, migration, trauma and resilience, and recovery from illness and injury. Finally, we provide direction for future research on SIMIC and the health consequences of life change.

A controlled evaluation of the effect of social prescribing programs on loneliness for adults in Queensland, Australia (protocol).

BACKGROUND: In social prescribing, link workers support individuals whose persistent health problems are exacerbated by loneliness by connecting them to community-based social activities. This approach is well established in the UK and is gaining attention in Australia. However, a major limitation of research to date has been a lack of theoretically informed and rigorous evaluations of social prescribing. We will address these points in this study, applying a social identity framework to examine the effects of group-based social prescribing (SP) activity compared to primary care treatment as usual (TAU). METHODS: Ninety participants experiencing loneliness recruited from primary care services and community centres across five sites in Southeast Queensland will be assigned to one of two conditions (SP, TAU) and assessed at two timepoints (baseline, + 8 weeks). Individuals will be aged 18 years and over, have sufficient English language skills to provide consent, and at the time of recruitment they will not be experiencing acute symptoms or social issues that require urgent intervention. Primary outcomes are loneliness, mental well-being, and health service use (total number of GP, hospital, and allied health visits in the past 3 months). Secondary outcomes will assess social group processes, including number of important social groups, new group identification, multiple identity compatibility, and group-based support and emotion regulation. DISCUSSION: This study will provide comprehensive data about the extent to which, and how, social prescribing to community-based group activities may help people to feel less lonely, more socially integrated, and healthy over the first 8 weeks. If effective, this social identity-informed model of social prescribing can be disseminated in communities across Australia. TRIAL REGISTRATION: ANZCTR, Registered 8 June 2022 - Retrospectively registered, https://www.anzctr.org.au/ACTRN12622000801718.aspx.

Exploring links between social identity, emotion regulation, and loneliness in those with and without a history of mental illness.

OBJECTIVE: Emotion regulation and social identity theorizing provide two influential perspectives on loneliness. From an emotion regulation perspective, loneliness is understood as a negative emotional state that can be managed using emotion regulation strategies. A social identity perspective views loneliness as resulting from a loss or lack of important social groups and related identities. This study aimed to explore the relationships between key constructs drawn from both perspectives, with a view to understanding loneliness in adults with and without a history of mental illness. DESIGN AND METHODS: Participants (N = 875) with a mental illness history (MH Hx, n = 217; Mage = 45 years, 59% female) and without a mental illness history (No MH Hx, n = 658; Mage = 47 years, 48% female) completed a survey comprising measures of group membership and connectedness, emotion regulation strategies, and loneliness. RESULTS: The MH Hx group reported higher internal affect worsening strategy use and loneliness than those No MH Hx. Hierarchical regressions indicated that the unique contributions of emotion regulation strategies and social identity factors to loneliness were equivalent between the groups. Together, social identity and emotion regulation explained 37% of the variance in loneliness in the No MH Hx subsample and 35% in the MH Hx subsample. CONCLUSION: These findings suggest that both emotion regulation and social identity had significant unique contributions to the reported loneliness of people when controlling for demographics and each other in those with and without a history of mental illness. Integration of the two frameworks may provide novel avenues for the prevention and management of loneliness. PRACTITIONER POINTS: Individuals with a history of mental illness report more use of internal emotion worsening regulation strategies and greater loneliness than those with no such history, but there were no differences in social identity factors. Internal emotion worsening strategies and social support received from others explained the variance in reported loneliness for both those with and without a history of mental illness. Internal emotion improving strategies were significant for those with a history of mental illness, while social support given was significant for those without a history of mental illness. Screening clients for emotion regulation difficulties, social disconnectedness, and loneliness may provide clinicians with an indication of risk for developing psychological distress/disorders.

Unlocking the power of 'us': Longitudinal evidence that identity leadership predicts team functioning and athlete well-being.

The social identity approach has become an important framework for understanding effective leadership. The present study is the first to longitudinally examine the relative impact of coaches' and athlete leaders' identity leadership on athletes' identification with their team, as well as the subsequent relationships with key team and individual outcomes. To investigate these research questions, 18 sport teams (N = 279) completed a questionnaire early and late in their season competition. To analyse these data, we conducted structural equation modelling and controlled both for baseline values and the nested structure of our data. Results revealed that it was mainly the identity leadership of athlete leaders (and not of the coach) early in the season that predicted athletes' team identification later in the season. This increased team identification in turn fed into both team outcomes (i.e., task climate, team resilience, team performance) and individual outcomes (i.e., well-being, burnout, and individual performance). The mediating role of team identification suggests that by building a shared sense of 'we', athlete leaders can improve the team's effectiveness and enhance athletes' well-being. Accordingly, we conclude that empowering athlete leaders and strengthening their identity leadership skills is an important way to unlock sport teams' full potential.

Group? What group? A computational model of the group needs a psychology of "us" (not "them").

Groups are only real, and only serve as a basis for collective action, when their members perceive them to be real. For a computational model to have analytic fidelity and predictive validity it, therefore, needs to engage with the psychological reality of groups, their internal structure, and their structuring by (and of) the social context in which they function.

Experiments make a good breakfast, but a poor supper.

Cesario's analysis has three key flaws. First, the focus on whether an effect is "real" (an "effects flaw") overlooks the importance of theory testing. Second, obsession with effects (a "fetishization flaw") sidelines theoretically informed questions about when and why an effect may arise. Third, failure to take stock of cultural and historical context (a "decontextualization flaw") strips findings of meaning.

More than just another bib: group dynamics in an elite Nordic ski team.

The social environment within individual sport teams can have a significant influence on the success, development, and well-being of athletes. We explored elite individual sport athletes' group experiences through the lens of social identity theorising. Participants were six members (4 male, 2 female, Mage = 21.5 years) of a National Development Nordic Ski team. At two time points in the competitive season, we used Social Identity Mapping (Bentley et al., 2020) in combination with semi-structured interviews to explore athletes' experiences as a member of the ski team. Social Identity Mapping provided a visual representation of each participant's social identities and was used to facilitate athletes' views of their group experiences in the semi-structured interviews. Interview data were thematically analysed to explicate participants' perceptions of social identity and cohesion, and their perceived relevance to success and development in elite individual sport. Major themes included social group memberships and identities, the presence of subgroups, the ebb and flow of cohesion and conflict, and teammate and coach influence on the group. On this basis, we argue that social identity mapping can be a valuable resource for athletes and coaches seeking to create a positive and cohesive team environment within an elite individual sport team.

Standing out from the crowd: Identifying the traits and behaviors that characterize high-quality athlete leaders.

OBJECTIVES: An emerging body of evidence indicates that, in addition to the coach, athlete leaders within a team are vital for a sports team's success. Sports teams are therefore keen to know which attributes are distinctly characteristic of high-quality leaders on and off the field. The present study aims to shed more light on this question. METHOD: A wide variety of traits and leadership behaviors was assessed in a sample of 776 athletes, stratified across gender, competitive level, and four sports. The leadership quality of each of the athletes (ie, as task, motivational, social, and external leader) was determined on the basis of the perceptions of teammates using social network analysis. RESULTS: Findings revealed that leadership behaviors outweighed personality traits in distinguishing high-quality leaders from others on and off the field. Providing identity leadership that creates, embodies, advances, and embeds a collective sense of "us" in their teams was found to be a particularly important leadership behavior that characterized high-quality leaders both on and off the field. CONCLUSION: The fact that leadership behaviors were important predictors of high-quality athlete leadership (and more important predictors than traits) suggests that leaders are not just born, but can also be made. Our findings therefore highlight the clear need for leadership development programs to target the behaviors that we identified as important predictors of leadership.

Predictors of social identification in group therapy.

Background: Group therapy is a popular and effective format for psychological intervention, and both anecdotal and empirical data consistently point to group dynamics as a primary driver of its benefits. However, to date there has been no systematic investigation of what facilitates an engaged, cohesive group environment. We argue that this is social identification and explore the features of groups that help to build this. Method: We present two longitudinal studies of group therapy and examine the predictors of social identification. Study 1 was a sample of psychiatric outpatients (N = 103) who completed group cognitive behavior therapy. Study 2 was a sample of young women with body shape or weight concerns (N = 112) who completed an eating disorder prevention program. Results: Multilevel analyses indicated that social identification was best predicted by participant fit with the therapy group, specifically the degree to which (1) participants were and perceived themselves to be similar to other group members, and (2) participants met the group therapy eligibility criteria at baseline. Conclusions: These results show that attending to issues of client fit in group therapy can improve social identification, with implications for reducing client attrition and improving client outcomes.

Friendships that money can buy: financial security protects health in retirement by enabling social connectedness.

BACKGROUND: Research on the health and wellbeing of retirees has tended to focus on financial security and financial planning. However, we suggest that one reason why financial security is important for retirees is that it enables social connectedness, which is critical for healthy ageing. METHODS: This paper tests this hypothesis cross-sectionally (N = 3109) and longitudinally (N = 404) using a population-weighted mixed effects mediation model in two nationally representative samples of Australian retirees. RESULTS: Analyses provide robust support for our model. Subjective financial security predicted retiree health cross-sectionally and longitudinally. Social connectedness also consistently predicted mental health and physical health, on average four times more strongly than financial security. Furthermore, social connectedness partially accounted for the protective effect of subjective financial security. CONCLUSIONS: We discuss the implications of these findings for public health, with a particular emphasis on how social connectedness can be better supported for people transitioning to retirement.

Leaders promote attendance in sport and exercise sessions by fostering social identity.

Sport and exercise participation exert a positive effect on numerous aspects of individuals' health. Although sport and exercise leaders have generally been observed to play a key role in shaping group members' behavior, our understanding of their impact on group members' attendance in sport and exercise sessions is limited. To address this, and building on promising findings in other domains, we examined the associations between perceptions of sport and exercise leaders' engagement in social identity leadership, group identification, and attendance. A sample of 583 participants from sports teams (n = 307) and exercise groups (n = 276) completed questionnaires measuring identity leadership, group identification, and attendance. Analyses demonstrated that perceptions of leader engagement in social identity leadership were positively associated with members' group identification, and that this in turn was positively associated with their attendance in either a sports group or an exercise group. Moreover, there was a significant indirect effect for perceptions of leader engagement in identity leadership on group members' attendance through their greater identification with these groups. Findings highlight the importance of considering the impact sport and exercise leaders have on group members' attendance and suggest that leaders who represent, advance, create, and embed a shared sense of identity (ie, a shared sense of "us") among attendees can promote participation in sport and exercise.

A Meta-Analytic Review of Social Identification and Health in Organizational Contexts.

We provide a meta-analytical review examining two decades of work on the relationship between individuals' social identifications and health in organizations (102 effect sizes, k = 58, N = 19,799). Results reveal a mean-weighted positive association between organizational identification and health ( r = .21, T = .14). Analysis identified a positive relationship for both workgroup ( r = .21) and organizational identification ( r = .21), and in studies using longitudinal/experimental ( r = .13) and cross-sectional designs ( r = .22). The relationship is stronger (a) for indicators of the presence of well-being ( r = .27) than absence of stress ( r = .18), (b) for psychological ( r = .23) than physical health ( r = .16), (c) to the extent that identification is shared among group members, and (d) as the proportion of female participants in a sample decreases. Overall, results indicate that social identifications in organizations are positively associated with health but that there is also substantial variation in effect size strength. We discuss implications for theory and practice and outline a roadmap for future research.

Loss of group memberships predicts depression in postpartum mothers.

PURPOSE: The postpartum period presents the highest risk for women's mental health throughout the lifespan. We aimed to examine the Social Identity Model of Identity Change in this context. More specifically, we investigated changes in social identity during this life transition and their consequences for women's postpartum mental health. METHODS: Women who had given birth within the last 12 months (N = 387) reported on measures of depression, social group memberships, and motherhood identification. RESULTS: Analyses indicated that a decrease in group memberships after having a baby, controlling for group memberships prior to birth, was associated with an increase in depressive symptomology. However, maintaining pre-existing group memberships was predictive of better mental health. New group memberships were not associated with depressive symptomology. Identification as a mother was a strong positive predictor of mental health in the postpartum period. CONCLUSIONS: The social identity model of identity change provides a useful framework for understanding postpartum depression. Interventions to prevent and treat postpartum depression might aim to support women in maintaining important social group networks throughout pregnancy and the postpartum period.