PT  - JOURNAL ARTICLE
AU  - Michael McGrath
AU  - Fiona Duncan
AU  - Kate Dotsikas
AU  - Cleo Baskin
AU  - Liam Crosby
AU  - Shamini Gnani
AU  - Rachael Maree Hunter
AU  - Eileen Kaner
AU  - James Bowes Kirkbride
AU  - Louise Lafortune
AU  - Caroline Lee
AU  - Emily Oliver
AU  - David P Osborn
AU  - Kate R Walters
AU  - Jennifer Dykxhoorn
ED  - ,
TI  - Effectiveness of community interventions for protecting and promoting the mental health of working-age adults experiencing financial uncertainty: a systematic review
AID  - 10.1136/jech-2020-215574
DP  - 2021 Jul 01
TA  - Journal of Epidemiology and Community Health
PG  - 665--673
VI  - 75
IP  - 7
4099  - http://jech.bmj.com/content/75/7/665.short
4100  - http://jech.bmj.com/content/75/7/665.full
SO  - J Epidemiol Community Health2021 Jul 01; 75
AB  - Background The COVID-19 pandemic has created a period of global economic uncertainty. Financial strain, personal debt, recent job loss and housing insecurity are important risk factors for the mental health of working-age adults. Community interventions have the potential to attenuate the mental health impact of these stressors. We examined the effectiveness of community interventions for protecting and promoting the mental health of working-age adults in high-income countries during periods of financial insecurity.Methods Eight electronic databases were systematically screened for experimental and observational studies published since 2000 measuring the effectiveness of community interventions on mental health outcomes. We included any non-clinical intervention that aimed to address the financial, employment, food or housing insecurity of participants. A review protocol was registered on the PROSPERO database (CRD42019156364) and results are reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results From 2326 studies screened, 15 met our inclusion criteria. Five categories of community intervention were identified: advice services colocated in healthcare settings; link worker social prescribing; telephone debt advice; food insecurity interventions; and active labour market programmes. In general, the evidence for effective and cost-effective community interventions delivered to individuals experiencing financial insecurity was lacking. From the small number of studies without a high risk of bias, there was some evidence that financial insecurity and associated mental health problems were amenable to change and differences by subpopulations were observed.Conclusion There is a need for well-controlled studies and trials to better understand effective ingredients and to identify those interventions warranting wider implementation.