Social connection is a basic human need and is important for quality of life and care for residents in long-term care (LTC) homes. Research has established associations between aspects of social connection (e.g., social engagement, social support and loneliness) and mental health outcomes (e.g., depression). Yet, despite living in a congregate setting, those in LTC homes often experience poor social connection. Social connection has unique considerations for LTC homes, including that most residents are living with cognitive impairment or dementia, which requires a customized measurement approach.

The social connection in long-term care home residents (SONNET) study aims to improve measurement of social connection in LTC homes by addressing three specific questions: (1) What existing measures assess social connection in LTC homes and what are their psychometric properties? (2) What do residents, families, staff and clinicians consider to be the important elements of social connection in LTC homes? (3) Can a new measure accurately assess social connection in LTC home residents?

The three study questions will be addressed through: (1) A systematic review of existing measures, where measures will be characterized using content analysis and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methods; (2) Qualitative interviews with residents, families, staff and clinicians to understand important aspects of social connection, and, (3) Development and testing of a new measure of social connection in Canada and the UK.

Previous research will be discussed, including a scoping review summarizing research evidence linking social connection to mental health outcomes as well as strategies to build and maintain social connection during the COVID-19 pandemic. The SONNET study update will include preliminary findings from the systematic review and qualitative interviews, as well as development of a conceptual model and key considerations for a new measure.

Social connection is an important concept in LTC homes. A robust measure of social connection, developed specifically for this setting, will enable researchers and care settings to test the effects of interventions and to report outcomes at the individual-, home- and system-level.

Social connection is important for health, quality of life and care in long-term care (LTC) homes. However, research on how to improve social connection in LTC has been limited by lack of consensus on best approaches to measurement.

We will present a systematic review of measures of social connection developed for use in LTC residents, which aims to identify all existing measures and evaluate their measurement properties including structural validity, internal consistency, reliability and construct validity.

We are following Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic review methods. We searched multiple bibliographic databases from inception to November 2021 for studies that were conducted in LTC resident populations, quantified any aspect(s) of social connection, and reported at least one psychometric property for the measure(s) of social connection. We conducted a second targeted search in April 2022 based on our list of identified measures, supplemented with a list of measures used in previous research in this population. We are currently evaluating the measurement properties reported for each identified measure in accordance with COSMIN guidelines.

We have identified 68 studies reporting on 35 measures used to assess multiple aspects of social connection in LTC homes. The majority (n=25) were measures of quality of life, wellbeing or life satisfaction, which included a social connection subdomain, whilst only 10 measures specifically target social connection. From our pooled evaluation of 20 measures to date, we have found that 20% (n=4) have sufficient evidence of structural validity, 15% (n=3) have sufficient internal consistency, 25% (n=5) have sufficient reliability, and 15% (n=3) have sufficient construct validity.

Many measures have been used to assess social connection in LTC settings, but few are specifically designed for this purpose and they often have insufficient evidence for psychometric properties. This review will provide detailed evidence of the quality of these measures to enable future researchers to prioritise higher quality tools and will inform our development of a new person-centred social connection measurement tool for LTC residents in the Social Connection in Long-Term Care Home Residents (SONNET) study.