Yes / This paper recounts the process of undertaking a randomised controlled trial which was designed to examine the effectiveness of an intervention for socially isolated older people aged 75 years and over. It describes the reasons for early cessation of the study and raises the implications of this outcome for policy, practice and research. The intervention under investigation was designed to alleviate loneliness and foster companionship. It involves participants being linked with a small group of others through a teleconferencing system with each group being facilitated by trained volunteers. There was a requirement to recruit and train a minimum of 30 and a maximum of 60 volunteers over 1 year to facilitate 20 friendship groups to meet the number of older people required to be recruited to the study. Problems with recruiting and retaining the volunteer workforce by the voluntary sector organisation, who were commissioned to do so, led to the study closing even though older people were recruited in sufficient numbers. The paper draws upon analysis of various data sources from the study to identify the potential reasons. The discussion raises considerations regarding the extent of infrastructure required to deliver community services to vulnerable user groups at scale, identifies some of the issues that need to be addressed if such volunteer-initiated services are to be successful and informs future research programmes in this area. / Public Health Research programme (PHR 09/3004/01). Commissioned by NIHR.

Yes / Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Methods: Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. Results: We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, −3 to 16). Conclusions: Recruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For the voluntary sector to recruit sufficient volunteers to match demand for telephone befriending created by trial recruitment would require the study to be run in more than one major population centre, and/or involve dedicated management of volunteers. Trial registration: ISRCTN28645428.

Sveriges integrationspolitik kännetecknas idag av arbetsmarknadsrelaterade integrationsåtgärder såsom utbildning och arbete. Dessa insatser ska stärka individens självständighet och möjliggöra en snabb integrationsprocess, men trots detta ökar segregationen hos invandrare. Tidigare forskning visar att vänskapsrelationer mellan etablerade invånare och invandrare är en viktig förutsättning för invandrares sociala delaktighet. Frivilligorganisationer tar ett stort ansvar i arbetet med invandrares sociala delaktighet och ett återkommande koncept de använder sig av är Befriending programs. Ett liknande koncept har startats av föreningen Vän i Umeå, som genom sina kompismatchningar parar ihop etablerade svenskar med invandrare. Syftet med arbetet är att undersöka hur vänskapsrelationer mellan etablerade svenskar och invandrare kan främja invandrares sociala delaktighet i samhället. Genom kvalitativa semistrukturerade intervjuer har tre kompispar, bestående av tre invandrare och tre etablerade svenskar, berättat om sina upplevelser av kompismatchningen. Resultatet analyserades genom kvalitativ innehållsanalys och symbolisk interaktionism. Det framkom att vänskapsrelationer spelar stor roll för invandrares sociala delaktighet och att de nuvarande statliga insatserna inte räcker till. I vissa relationer hade personerna olika förväntningar vilket skapade svårigheter, och det finns vissa utmaningar kring vänmatchningens utformning. Förhoppningen är att arbetet ska leda till diskussioner kring invandrares sociala delaktighet och kring vilket ansvar civilsamhället respektive staten bör ha.

No / Pregnant asylum-seeking and refugee women are a particularly vulnerable group in society, who may be possibly living alone in poverty in inappropriate accommodation (Dunne, 2007) and experiencing hostile attitudes (Hynes and sale, 2010). They may have poor physical and mental health, placing them at an increased risk of poor pregnancy outcomes (National Institute for Health and Care Excellence (NICE), 2010). Despite this, they are less likely to attend for timely maternity care. This article discusses the evaluation to date of an ongoing befriending project located in Northern england, targeting pregnant asylum-seeking and refugee women and helping to address difficulties that they may face. Volunteer befrienders, who themselves are asylum-seeking and refugee mothers, receive training to provide support and guidance to clients. Preliminary data suggest that befriending has advantages for both client and volunteer: clients appear to develop a trusting relationship with their befriender which facilitates self-confidence and helps overcome social isolation; and the volunteers feel that they are undertaking a worthwhile role and often move onto paid employment. Befriending may be a useful resource for midwives and ultimately improve pregnancy outcomes for asylum-seeking and refugee women.