Exploring the Mediating Effects of Comfort with Primary Care and Openness to Social Prescribing on the Relationship Between Social and Emotional Dimensions of Loneliness and Wellbeing Through Factor and Path Analyses

Background Addressing the complex health and wellbeing challenges of older adults is a critical public health priority as populations age. Social Prescribing (SP) represents a promising strategy, connecting patients to non-clinical, community-based resources to enhance physical, mental, and social wellbeing. This study examines comfort with primary care discussions and openness to SP as mediators of the associations between loneliness and wellbeing among Canadians aged 55 and older. Methods Factor analyses identified four factors of comfort with primary care discussions (general, mental, physical, and social wellness) and three factors of openness to SP (effectiveness, meaningfulness, and supportiveness). Path analysis was conducted for each set of mediators separately. Results Path analyses revealed that comfort with primary care discussions about social wellness (β = .08**) is associated with better wellbeing. People who report social loneliness are most comfortable with primary care discussions about general wellness (β = − .17***) and least comfortable with primary care discussions about mental wellness (β = − .24***), whereas people who report emotional loneliness are more likely to have similar levels of comfort to discuss general wellness and mental wellness (β = − .18***; − .18***). In addition, social loneliness is associated with less comfort with primary care discussions about social wellness (β = − .19***) and mental wellness (β = − .19***), whereas association is not found for emotional loneliness. These suggest that addressing the SP needs of people who experience emotional loneliness requires a different strategy. Reporting emotional loneliness is associated with expressing support for SP (β = .14***), which may be key to improving wellbeing (β = .10***) among this population. Overall, social loneliness has total effect sizes, β _total  = − .19, whereas emotional loneliness has β _total  = − .45, more than 2.3 times larger. Conclusions While SP may be acceptable to those who need it, some may experience greater difficulties accessing SP through primary care providers without interventions tailored to their loneliness status that could elicit buy-in and enrolment. Primary care providers may wish to pay closer attention to people with emotional loneliness. Other variables such as trust and motivational interviewing for positive self-beliefs may explain potential changes from loneliness to wellbeing.