Diverse community perspectives on public health guidelines for social connection: a qualitative study in Canada

Loneliness and social isolation harm mental and physical health, yet existing public health strategies often fail to reflect the lived realities of equity-owed communities. To address this gap, our team has been developing potential public health guidelines aimed at fostering social connection in Canada. This study sought to engage five communities facing structural inequities (i.e. 2S/LGBTQ+ individuals, racialized communities, Indigenous peoples, people living with disabilities, and migrants/immigrants/refugees) in reviewing and refining draft public health guidelines. Specifically, we conducted 12 focus groups and 11 one-on-one interviews with 60 participants. During these interviews, we presented our guidelines to the participants, explored their lived experiences of social connection in relation to the guidelines, and elicited direct feedback on how the guidelines could be improved to address unique barriers and facilitators in these communities. Through thematic analysis of these data, we characterized participants' perspectives relating to their (i) identity and belonging, (ii) safety and accessibility, (iii) structural and economic resources, (iv) the role of family, (v) social interactions shaped by discrimination, and (vi) recognized health impacts on social connection. Participants' perspectives highlighted the complex interplay of cultural identity, discrimination, financial constraints, and unmet accessibility needs that limit meaningful social engagement. Their feedback identified specific ways to ensure that newly developed guidelines for social connection address critical equity concerns, including improved cultural relevance, accessibility, and community-level supports. These consultations offer clear guidance on tailoring social connection recommendations to the realities of equity-owed groups, underscoring the importance of structured community engagement in guideline development. Integrating these community-informed insights will help shape public health guidelines that are equitable, inclusive, and responsive to diverse lived experiences.