Abstract
Across many regions of the world, more people are not having children. Non-parents are viewed more negatively than parents, particularly those who deliberately choose to forego parenthood. This systematic review synthesises existing literature on social networks and support among parents and non-parents, attempting to distinguish between different groups of non-parents, namely not-yet-parents, childless, and childfree individuals. Eighty studies were included, sourced from systematic searches of six scientific databases, supplemented by a systematic search of ProQuest Dissertations and Theses, hand searches of Google Scholar, websites of relevant organisations, reference lists from prior reviews and included studies, and contacting authors. Findings are presented using narrative synthesis, supplemented by average effect size estimates for group differences for selected aspects. Parents have larger, more stable, family-centred networks, reliant on children and relatives for support. In contrast, non-parents have smaller, more diverse networks, with closer relationships with friends and siblings, but often rely on formal (i.e. paid) sources of support. The available evidence on differences and distinctions between groups of non-parents is investigated, emphasising a need for appropriate operationalisation of reproductive status groups in future research. Implications of life course-related changes in social networks for those with and without children are discussed.
Introduction
Across many regions of the world and for different reasons, more and more people are not having children, resulting in a growing demographic of non-parents. This review synthesises literature on social networks and support to examine differences between parents and non-parents, as well as among distinct non-parent groups. In light of both a widespread decline in the number of children being born and persistent stigma towards those without children, it is increasingly important to understand the social dynamics influencing these individuals’ wellbeing.
Terminology surrounding non-parenthood varies, potentially concealing meaningful distinctions and hindering knowledge accumulation. Following Watling Neal and Neal (2021), this review differentiates among not-yet-parents (those planning to have children), childless individuals (those who want children but cannot), and childfree individuals (those who neither have nor want children). These distinctions, based on desire rather than the ability to have children, clarify the experiences of different non-parent groups. In this review, the term ‘non-parent’ is used in its broadest sense to refer to individuals who do not have children, where appropriate. ‘Parental status’ is used to differentiate between parents and non-parents, while ‘reproductive status’ refers to more specific groups among the non-parent category.
Declining fertility rates
Fertility rates have been declining, with fewer people becoming parents and more people choosing not to have children. Over the last 70 years, fertility rates have decreased by 50%, with an average of 5 children per family in 1952, compared to 2.4 in 2020 (World Economic Forum, 2022) 1 . This decline is attributed to multiple factors, including economic instability (Sobotka et al., 2011), increasing costs of parenting (McDonald, 2002), increased educational attainment, family planning and access to contraception for women (Liu & Raftery, 2020) and shifting views on parenthood and motivations (Kearney et al., 2022; Mitchell & Gray, 2007). Reasons for foregoing parenthood include–but are not limited to–internal motivations such as disinterest in children (Park, 2005), opportunities for freedom and independence (Höglund & Hildingsson, 2023), maintaining close relationships (Gillespie, 2003), and broader concerns regarding overconsumption, overpopulation and climate change (Helm et al., 2021; Nakkerud, 2024) (see also Agrillo & Nelini, 2008).
Demographic trends also demonstrate an increase in the number of individuals not expecting or intending to have children (e.g., Berrington, 2017), and a trend of delaying parenthood, with women increasingly having children in their thirties rather than their twenties (ONS, 2024). Therefore, understanding the social dynamics of non-parenthood has become an increasingly relevant area of research. Yet, in empirical work, non-parents are often treated as a single, undifferentiated group, which risks obscuring the heterogeneity within this population (Dykstra & Hagestad, 2007). To improve our knowledge of this population and choices around parenthood, it is important to more fully differentiate among non-parents. The current review thus aims to characterize potential differences in social networks and support systems between parents and non-parents, including distinct non-parent groups.
Stigma of foregoing parenthood
Across many cultural contexts, including contemporary Western societies (McCutcheon, 2020), parenthood is still conceived of as natural and fixed, and pronatalist views prevail. Compared to parents, non-parents are often perceived more negatively: they are viewed as less warm, less fulfilled, and having less positive marital relationships (Ashburn-Nardo, 2017; Bays, 2017; Çopur & Koropeckyj-Cox, 2010; Ekelund & Ask, 2021). Similar negative perceptions and social exclusion have been found in other regions of the world, such as India (Babu, 2024), Indonesia (Rismarini & Adira, 2024) and Japan (Tanaka & Lowry, 2018). Non-parents are aware of these negative views and feel targeted for not having children (Doyle et al., 2013; Park, 2002; Turnbull et al., 2016).
Importantly, not all non-parents are perceived equally. Childfree individuals–those who choose not to have children–face moral outrage (Ashburn-Nardo, 2017) and are perceived as deviant (Blackstone & Stewart, 2012). Childfree individuals tend to be evaluated more negatively than those who are childless or delaying parenthood and can be viewed as an outgroup by those who (want to) have children (Iverson et al., 2020; Koropeckyj-Cox et al., 2007, 2018; Watling Neal & Neal, 2021). Thus, the desire or intention to have children may act as a buffer against becoming the target of others’ negative attitudes. Childbearing intentions can be shifted by perceived social pressure (Albertini & Brini, 2021), which may be stronger in some regions, such as Central and Eastern Europe, where parenthood is often regarded as even more of an ideal, a societal obligation, and an important component of personal fulfilment (Miettinen & Szalma, 2014; Sobotka & Testa, 2008).
Social network and support system theories
Social support can help manage the impact of stigma. Defined as “the provision of assistance or comfort to others, typically to help them cope with biological, psychological, and social stressors” (American Psychological Association, 2018), social support is intrinsically connected to the relationships people have with others, i.e. their social network. Theories of social networks and support systems highlight the central role of children in providing support, suggesting that their absence may shape both the structure and function of non-parents’ support systems in distinct ways. In this review, we apply the Hierarchical Compensatory Model and Task-Specific Support Theory to help interpret how individuals without children may rely on alternative sources of support.
The Hierarchical Compensatory Model suggests a well-ordered hierarchical preference for support, with spouses and children typically being the primary providers (Penning, 1990). When the primary or preferred support providers are unavailable (e.g. no spouse or children), relationships lower in the support hierarchy, such as extended family, friends, and neighbours, are called upon (Dykstra, 2015); components of support networks are interchangeable (Penning, 1990). For parents, adult children are suggested to serve as key support providers. In contrast, non-parents may rely more on relationships lower in the support hierarchy, such as friends. These relationships, however, may be less stable, as peer-based support is often more susceptible to deterioration than parent-child ties in unbalanced exchanges of support (Dykstra, 2015). Complementarily, Task-Specific Support Theory proposes that relationships tend to be specialized in their support provisions (Dykstra, 2015), shaped by network characteristics such as proximity, role, and shared experience (Penning, 1990). Family members, including children, often provide instrumental help (e.g. transportation, shopping) and foster a sense of belonging, while friends are better suited to emotional support (e.g. providing comfort) and tasks based on similarities of interests or experience (e.g. giving advice; Dykstra, 2015; Penning, 1990; Teerawichitchainan et al., 2024). Therefore, non-parents may develop more diverse networks and rely on other family members, such as siblings, to fulfill instrumental support needs, reflecting structural and functional differences in the social networks of parents and non-parents.
While parenthood is presumed to integrate individuals into social networks and provide a sense of purpose in life (Hansen et al., 2009), empirical evidence for its psychosocial advantages is limited (but see Hudde & Jacob, 2025, on parents across Europe reporting higher meaning in life). Many individuals choose to be childfree for the advantages it provides, including better relationships with others (Gillespie, 2003; Magennis, 2024). It has been suggested that research casts a one-sided negative view of non-parents as isolated and outright lacking in support (Klaus & Schnettler, 2016), overlooking compensatory ties, including the increasing number of online communities that provide advice and support (mutually supporting reference groups; Basten, 2009).
Rationale for the current review
It is widely established that support can have a significant impact on wellbeing, and this may be especially true for adults without children. Children are often seen as an important source of support, particularly for parents later in life, referred to as “old age insurance” (Johnson & Catalano, 1981). Not all parents will receive care from their children due to factors such as geographical distance or family dynamics (e.g. Patterson et al., 2022; Quashie & Zimmer, 2013; Shuey & Hardy, 2003), but for those without children, it remains less clear how and from whom support is received.
A lack or loss of close social contacts, dissatisfaction with social support, low emotional support, and social isolation have all been found to be risk factors for depression in older adults (Djernes, 2006) while larger networks can help older adults receive more opportune support during illness (Choi & Wodarski, 1996). As Holt-Lunstad and Steptoe (2022) note, weak social foundations, characterised by few relationships or little contact with others, limit individuals’ capacity to meet physical, emotional, and cognitive needs. Therefore, understanding the structure and function of social networks among those without children is essential for assessing their wellbeing. With this in mind, what do we already know about social networks and social support for individuals without children, and childfree people in particular, and how may this look different at different life stages?
Method
Review aims and objectives
In line with the aims of this review, the following research question was formulated: (1) What is known about social networks and social support of non-parents, including not-yet parents, childless, and childfree individuals?
More specific questions informed the focus of the review, including: (1a) How are social networks and social support for non-parents different from parents? (1b) Are there differences in social networks and social support between different groups of non-parents, namely not-yet-parents, childless and childfree individuals?
Accordingly, the key objectives of this review were: (1) Identify social network characteristics (e.g. network size) for non-parents and the amount and forms of support they receive, (2) Summarise how social networks and social support for non-parents may be different to parents, (3) Summarise the evidence on social networks and social support for non-parents, distinguishing between different groups, namely not-yet-parents, childless and childfree individuals, and (4) Identify and summarise the current gaps in the literature, specifically relating to how social life differs between groups of non-parents.
Method
This review followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (PRISMA; Page et al., 2021). Further details regarding the method can be found in the pre-registered protocol with the Open Science Framework (https://doi.org/10.17605/OSF.IO/SFUE6).
Information sources and search strategy
The primary source of literature was a structured electronic search using the following databases: Medline, APA PsycINFO, Web of Science Collection, International Bibliography of the Social Sciences, Sociological Abstracts, and Scopus. Grey literature included the first 1000 articles on Google Scholar, due to viewing limitations (Haddaway et al., 2015), ProQuest Dissertations and Theses and searches of websites of relevant organisations, supplemented by hand searches of the reference lists from prior reviews and included studies. Search terms and strategy were developed in collaboration with a subject librarian with specialist knowledge (see Table S1-7) and in accordance with the Peer Review of Electronic Search Strategies (PRESS) checklist (McGowan et al., 2016). Table S8 shows how the Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) tool was applied to the research question and eligibility criteria.
Inclusion and exclusion criteria
No limitation related to the years of publication was applied. The inclusion and exclusion criteria were identified a priori. Studies must have included a direct comparison of social network characteristics and/or social support between either parents versus non-parents or different groups of non-parents. Social network characteristics broadly included structural and quality aspects of individuals’ relationships, such as network size, composition, frequency of contact, closeness, reciprocity. Social support involved any measure assessing perceived or received support or assistance, including emotional, informational, and instrumental forms. Full inclusion and exclusion criteria can be found in the pre-registered protocol and document listing amendments. Any studies not meeting all the relevant inclusion criteria were excluded.
Study selection
Study selection involved three stages. Studies were first screened for relevance by title and abstract, followed by full-text review against the inclusion and exclusion criteria. Then, lead authors of all included studies were contacted to identify any additional relevant studies meeting the inclusion criteria, and the reference lists of each included study were searched. At all stages except regarding grey literature, the second author and third author screened 50% of articles (25% each). There was high agreement regarding inclusion/exclusion amongst the reviewers, with only 17 conflicts recorded out of 339 articles assessed at full text screening (94.99% agreement).
Quality appraisal and risk of bias
The quality of each study and risk of bias were assessed by the first author using the Joanna Briggs Institute (JBI) Appraisal Tools checklists (e.g. Checklist for Analytical Cross-Sectional Studies; JBI, 2020; available online). These tools evaluate methodological rigor across several domains, such as clearly defined inclusion criteria, appropriate measurement of outcomes, and adequate control of confounding factors. However, they do not give extra consideration to sample representativeness or to the robust sampling designs common in large-scale national surveys. Each question was answered “Yes,” “No,” “Not applicable,” or “Unclear,” in line with JBI guidance and the overall score reflected the proportion of criteria met. Scores were interpreted as high (≥70%), moderate (50–69%), or low (<50%) quality, guided by recent systematic reviews (Alfeo et al., 2024; Kachabian et al., 2024; Kundu et al., 2024) and an overview by George et al. (2014). Of note, low scores often reflected gaps in reporting or lack of detailed information on key variables (e.g. descriptions of parent/non-parent status in some studies) rather than weaknesses in study design. Studies were not excluded based on scores/overall appraisal from the JBI checklists–all eligible studies were included.
Data management and extraction
Rayyan was used to manage all levels of screening and to record the reasons for excluding articles at each level. Relevant quantitative data for the findings section was extracted by reviewing each study’s reported descriptives, such as the mean, standard deviation, and sample sizes. A summary of findings from included studies can be found in Table S9 and quantitative data for three aspects of the review in Tables S10, 11 and 12.
Analysis
Narrative synthesis is utilised in this review using the guidance by Popay et al. (2006). Findings from included studies are synthesised into themes, and together with the patterns found across the whole dataset (e.g. similarities and differences) form the narrative synthesis, allowing for interpretation beyond the primary findings of individual papers. Additionally, where deemed appropriate, descriptives provided for parent and non-parent groups from the included studies were used to calculate inverse-variance weighted average effect sizes for three key aspects: network size, received social support, and satisfaction with network/support.
Results
Eighty quantitative articles were included in the final synthesis. Initially, 585 articles were identified from databases after duplicates were removed. After title and abstract screening, 296 papers were excluded. Of the remaining 289 articles solely from databases, 44 full texts could not be retrieved, and 186 were excluded after full-text screening, as shown in Figure 1 (PRISMA flowchart). This left 59 articles from databases in addition to 21 from grey literature and hand searches. Table S9 summarises the characteristics and main findings of included studies. In the reference list, included studies are indicated by an asterisk (*). PRISMA flow diagram of searches of databases and other sources. Note. ‘Sn’ refers to social network and ‘Ss’ refers to social support.
Quality
The majority of articles had detailed information regarding inclusion criteria, study subjects and setting, and measurement of outcomes. Lack of detail in the reporting was most often a result of using secondary data. Some studies lacked detailed analysis (e.g. significance testing) or reporting of findings for data that was directly comparable (e.g. means for parents and non-parents) as these results were largely used for descriptive purposes rather than the main analysis. JBI appraisal scores ranged from 25% to 100%, with a mean score of 67.42%, indicating a medium quality (see Table S9).
Study characteristics
Purpose
The studies varied in their aims. Some explored the social implications of not having children and its effect on social networks and support, while others explored the impact of parenthood on mental health, marital adjustment, and loneliness. Many studies quantified network size and composition, with some delving into more detailed network characteristics, such as contact frequency and proximity. Much of the social support research focused on identifying sources of support, with a few differentiating between types of support.
Sample characteristics
Sample sizes differed significantly, ranging from 40 (Chatterjee, 2016) to 75,452 (Pesando, 2019), with a median of 510 respondents. Some studies focused on specific groups, including university students (5 articles), LGBTQ+ participants (4 articles), widow(er)s (3 articles), and participants with health conditions (2 articles). Nineteen articles had exclusively female samples, and the majority of other studies had a larger proportion of women than men. Regarding age, the majority of studies focused on midlife or older adults. One study used centenarian participants (99–103 years old; Boerner et al., 2016). Thirty-five articles used primary data, while 45 used secondary data. Non-parents were categorised based on the available information (i.e. reproductive status or intentions; see Table S9). Two studies had no sample of parents, and 9 studies distinguished between two or more types of non-parents, making up only 11.25% of all included studies. In 87.5% of studies, the non-parent sample could not be further specified (e.g., childless).
Publication of studies spanned 5 decades, from 1974 to 2024, 36% (29) of which were published from 2014 onwards. Studies were carried out in the U.S (35), Germany (17), Canada (9), Sweden (9), Australia (8), France (7), Italy (7), The Netherlands (7), Spain (7), Austria (6), Denmark (6), Switzerland (6), Belgium (5), Czech Republic (5), Greece (4), Poland (4), UK (4), China (4), Portugal (4), Croatia (2), Hungary (2), Slovenia (2), Estonia (2), Israel (2), Finland (2), Japan (2), India (1), New Zealand (1), Norway (1), Luxembourg (1), Bulgaria (1), Georgia (1), Romania (1), and Russia (1). Approximately half of the studies drew on data from larger-scale, national or cross-national surveys, while the remainder relied on smaller, often purposive or convenience samples.
Demographic differences between parents and non-parents
There were some notable demographic differences between parents and non-parents. Non-parents were much more likely to live alone (Edgar, 1989; Hill et al., 2009; Kivett & Learner, 1980; Vicente & Guadalupe, 2024) or live without a partner/spouse (Albertini & Kohli, 2009; Graham, 2018) compared to parents. Non-parents were also more likely to live with siblings, friends, or in a care facility or nursing home (Boerner et al., 2016; Kivett & Learner, 1980). Fewer non-parents were in a relationship or married compared to parents (Balbo & Mills, 2011; Graham, 2018; Hsieh & Zhang, 2021; Langlois, 2003; McNamee & James, 2012; Vicente & Guadalupe, 2024) and had shorter current relationship durations (Chatterjee, 2016; DeMino, 2004). There were no clear differences in education, employment or wealth, and limited comparisons between different groups of non-parents.
Network characteristics
Network size
Across 11 studies (13.75%) from the late 1990s through to the early 2020s, it was found that parents generally have larger and more stable social networks compared to non-parents. Among adults aged 40 and above, non-parents had smaller networks than parents, regardless of how far parents lived from their children (Klaus & Schnettler, 2016; Schnettler & Wöhler, 2016). This is similar to findings a few years earlier by Lang et al. (2013) who compared non-parents in young adulthood and early midlife (age range 25–45 years, mean age = 37.4 years) and older adults (age range 60–86, mean age = 72.7 years).
While older parents and non-parents had larger networks than their younger counterparts, non-parents in both age groups had significantly smaller social networks than biological and blended family parents (Lang et al., 2013). Additionally, Lois and Arranz Becker (2014) found that couples who became parents had larger networks than those without children, and noted that younger couples with women aged 18–25 had larger networks compared to those aged 26–43. This suggests a potential U-shaped relationship where network size may peak in younger and older age groups but decline during midlife. Kisber (2000) reported that Jewish women who identified as LBTQ+ had larger social networks if they were parents, followed by prospective parents, with the smallest networks for non-parents. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH), Cwikel et al. (2006) found a significant difference in network size among women aged 70 and older. Women who were previously married with children had the largest social networks, followed by previously married without children, never married without children, married with children, and lastly married without children. Thus, it appears that previously married individuals, regardless of parental status, had larger networks than currently married individuals. Similarly, in an earlier study, Wellman et al. (1997) found non-parents had fewer ties in their network than parents (23 vs 53 respectively), but also over a decade those without children had less stable networks, retaining less intimate relationships than those who became or already were parents.
Although the studies span almost 30 years, research has found that parents tend to have larger social networks than non-parents, with some studies providing insights into how this may vary by age and marital status. For 7 of the 11 studies, descriptive data was available allowing us to determine the effect size of the network size differences between parents and non-parents (Table S10). We mostly found small to medium effect sizes, ranging from 0.05 to 0.43 and amounting to an inversely variance-weighted average Hedges g of 0.24. Thus, while parents tend to have larger networks than non-parents, the difference is likely small.
Network composition
Network composition refers to specific characteristics of the people who make up an individual’s social network, such as their relationship to the individual (e.g. family, friends, neighbours) and demographic attributes (e.g. whether they have children or not). Twelve studies (15%) allowed for comparisons regarding the composition of social networks for parents and non-parents. Early research focused on family relationships. Rubin-Terrado (1994) found mothers have significantly more (three times as many) immediate kin (spouse, children, siblings) in their social networks than women without children. Similarly, another study from the 1990s (McMullin & Marshall, 1996) found older parents were significantly more likely to have a close family member in their network than non-parents and a greater number of close family ties. More recent findings align with earlier studies. Lois and Arranz Becker (2014) found couples who became parents tended to have a larger proportion of relatives in their networks while non-parents had larger proportions of friends. Vicente and Guadalupe (2024) extended this further finding that older non-parents had a significantly smaller proportion of family members in their networks compared to parents (48.38% vs 79.61%) but a significantly greater proportion of friends (24.82% vs 11.23%) and neighbours (18.02% vs 6.49%). Although, there may be some exceptions for siblings, who play a more significant role in the confidant networks of non-parents compared to parents, especially when siblings live nearby (Campbell et al., 1999).
Non-parents have a greater number of friends and extended kin in their personal networks, and fewer partners/spouses, compared to those of parents (Mair, 2019; Schnettler & Wöhler, 2016). Mair (2019), using data from 17 European countries, found that in countries where more people value friendships highly, older adults, particularly those without children, report more friends in their networks. The author also highlights a link between economic development and less traditional cultural values (more normative/acceptable to not have children), and an association between higher GDP and having more friends. This suggests that older non-parents residing in countries with fewer economic resources and a weaker emphasis on friends (e.g. Southern and Eastern Europe in this study) may have fewer sources of social connection and support.
Furthermore, Lois and Arranz Becker (2014) found that couples who became parents had networks that were more child-compatible (network also had children) relative to couples who did not start a family. This resembles findings by a study 40 years earlier by Bram (1974) who found women without children were significantly more likely to have friends who are also non-parents, while parents make up at least half of the friends of parent women, a trend that is somewhat less pronounced among men.
In general, findings over the past five decades show that non-parents networks tend to be composed of more friends and extended kin, while parents have more immediate family in their networks. Yet, both parents and non-parents tend to have more people of the same parental status in their network.
Contact
Eleven studies (13.75%) provided insight regarding differences in frequency of contact with others between parents and non-parents. Early studies from the 1990s demonstrate that non-parents are more likely to maintain regular contact with siblings compared to parents. Johnson and Troll (1992) determined that less than a third (30%) of unmarried non-parents have frequent weekly contact with family (other than spouse or children) compared to 89% of unmarried parents but have more frequent weekly contact with siblings (21% vs 15%). Similarly, Burholt and Wenger (1998) found that over 16 years, non-parents had a significant and larger increase in frequency of sibling contact, accompanied by an increase in emotional closeness for non-parents but a significant decrease for parents. This is also reflected by more recent findings that non-parents were significantly more likely to see a sibling regularly than parents (Hill et al., 2009). This trend was consistent across 18 countries, but only statistically significant in Hungary, New Zealand, and Denmark.
Moreover, Wenger et al. (2000) found significant differences regarding contact with relatives. Parents were nearly twice as likely to see a relative daily as those without children (47% vs 26% respectively) and 70% of parents saw a relative more often than once a week, compared with 40% of non-parents. Country-specific marital status differences exist. Among non-parents, in Australia and Finland married individuals are least likely to have weekly contact with relatives, whereas married men in Japan and married women in the UK are most likely to have weekly contact with relatives (Wenger et al., 2007).
Social interactions with friends also vary significantly by parental status. An early study found that non-parents, especially younger adults, had more frequent and longer interactions with friends compared to those in the parenthood phase (Carbery, 1993). This is supported by Wenger et al. (2000) who found that non-parents were significantly more likely to have contact with friends than parents, although women were more likely to see friends than men. However, Larsson and Silverstein (2004) found that older parents (81+) had significantly more contact with friends than their non-parent counterparts. Additionally, Mikus (1981) found no significant variation in contact with neighbours by parental status, a finding corroborated by a study 30 years later (Vikstrom et al., 2011).
Overall, non-parents may compensate for the absence of children through closer relationships with siblings and friends, while parents maintain closer contact with relatives. This may be due to the demands of raising children and managing family obligations.
Proximity to network
Four studies (5%) examined proximity to network members. Non-parents tend to have higher levels of contact with siblings, likely due to their closer proximity. Burholt and Wenger (1998) found over a 16-year period, both parents and non-parents aged 65 years and older experienced an increase in physical distance from their siblings, with parents showing a more significant increase, possibly due to family obligations or career-related moves. Building on these findings, Wenger et al. (2000) found non-parents were significantly more likely to live very close (within a mile) to a sibling (30% single non-parents, 17% married non-parents and 11% parents). However, nearly half (47%) of parents lived within a mile of a relative, compared to 32% of non-parents. Later studies support the finding that parents tend to reside closer to certain family members than non-parents. For instance, Koller (2008) found parents, compared to non-parents, lived significantly closer to their mothers and fathers. Vikstrom et al. (2011) found that significantly more parents reported having relatives close by compared to non-parents (86.4% vs 62.5% respectively).
Overall, parents and non-parents may differ in which relatives they live closest to. Non-parents likely live closer to siblings while parents live closer to other family, potentially affecting the relationship between parental status and contact and reflecting distinct social support patterns.
Social connectedness and reciprocity
While earlier research emphasised structural aspects, recent studies have begun to explore more distinctive relational characteristics of social networks. Two studies (2.5%) provided data on social connectedness and reciprocity. Mair (2019) found that middle-aged and older non-parents experienced lower levels of social connectedness (proximity, contact and closeness) than parents, highlighting the importance of having children in maintaining social ties in later life. More recently, Vicente and Guadalupe (2024) observed that older non-parents had significantly lower network reciprocity compared to parents.
Network types
Network types are typically uncovered by examining multiple characteristics of networks (such as network composition, availability of support, frequency of contact, proximity) in parallel. Rather than examining single characteristics of networks separately, specific methodologies, for example, latent class analysis, are used to cluster individuals’ networks that exhibit similar patterns. Four studies (5%) used such an approach to elucidate differences in types of networks between parents and non-parents.
An early study by Burholt and Wenger (1998) found that, among adults aged 65 and over, close knit relationships with siblings, characterised by close proximity, frequent contact, feeling emotionally close and receiving help, were significantly more common for non-parents (65%) than parents (31.7%). Shortly after, Wenger et al. (2000) identified that 79% of parents aged 65 and over had large locally integrated networks (i.e., large in size with involvement with neighbours, friends, local family and community groups) or family-dependent networks (i.e., small in size with primary reliance on local family and little involvement with friends, neighbours or community groups), while non-parents were more likely to have private restricted (28%; i.e., typically no local family and no source of local informal support outside the household; highly dependent on household carer), or local self-contained networks (20%; i.e., smaller in size than average; household-focused with primary reliance on neighbours), often relying on formal care or neighbours. Men, particularly married men without children (40%), were more likely to have private restricted networks and to be isolated from family. Later Wenger et al. (2007) examined cross-country differences indicating that in the Netherlands and the US, parenthood was key to network types, while in Spain and Israel, marital status was a more significant influence. In Spain, married individuals (both parents and non-parents) had locally integrated networks. In Israel, those who never married often had private restricted networks. In Australia and Finland, both parenthood and marriage were crucial: In Finland, women without children often had restricted networks, whereas in Australia, community-focused networks were common for both parents and non-parents, with local self-contained networks prevalent among those not married (Wenger et al., 2007). More recently, Lois (2016) examined younger adults finding that among respondents aged 20–42 years old, a slightly larger proportion of those starting a family had family-centred networks compared to non-parents (48.1% and 43.9% respectively). Thus, distinctions in network type may begin to emerge earlier in the life course than previously studied.
Overall, non-parents are more likely to have smaller networks with little local family or informal support relying more heavily on carers or neighbours, while parents have more family-centred networks, although cross-country variations may also be present.
Received social support
Almost half (37; 46.25%) of all included studies included a general measure of perceived or received support, sources of support and proportion of informal or formal/paid help. Here we provide a brief overview.
Earlier studies demonstrated that non-parents often rely more on a broader range of non-familial relationships, including friends, neighbours, and siblings, for support, especially in emergencies (Hogan & Eggebeen, 1995; Johnson & Catalano, 1981). The likelihood of receiving support from outside the household for parents varies with age and life stages, such as childrearing and health deterioration, while it remains relatively stable for non-parents, with an increase in later life for non-parent women (Albertini & Mencarini, 2014).
In more recent research, parents were shown to perceive and receive greater social support than non-parents, with larger support networks. For instance, Klaus and Schnettler (2016) found that non-parents perceive a significantly smaller number of potential supporters than parents, and receive significantly less actual support. Harwood-Gross et al. (2023) also found that parents reported significantly greater perceived social support than non-parents.
More recent studies have placed greater emphasis on the distinction between informal and formal support. Older non-parents are more likely to receive formal support, such as professional care, compared to parents who receive more informal support, predominantly from adult children (Albertini & Kohli, 2009; Deindl & Brandt, 2017). Across 12 European countries, Deindl and Brandt (2017) found that older non-parents more often relied on either formal care alone or a combination of formal and informal care. In countries with greater social service availability, such as those in Northern Europe, particularly Scandinavia, the use of formal and combined support within households was more likely compared to Southern and Eastern European countries, where public support for those in need is less comprehensive. Consequently, older non-parents in lower-service countries may face a higher risk of formal care shortages.
In general, parents typically receive more social support through larger informal networks, while non-parents rely more on formal support and non-familial relationships, with more recent work incorporating cross-country comparisons. For 19 out of 37 studies, descriptive data on social support in parent and non-parents groups was available (Table S11). Again, we mostly found small to medium effect sizes, ranging from −0.009 to 0.84 and amounting to an inversely variance-weighted average Hedges g of 0.25, suggesting a rather small effect with non-parents perceiving less support than parents.
Instrumental support
Eleven studies (13.75%) specifically examined more practical help, i.e. instrumental support. Earlier research, such as Kivett and Learner (1980) and O'Bryant (1985), observed older non-parents receiving regular financial assistance from relatives (5%), slightly higher than parents (3.8%), and were significantly more likely to receive transportation assistance from neighbours. Additionally, Campbell et al. (1999) found that siblings made up a larger proportion of non-parents instrumental support network compared to parents, with greater differences when the nearest sibling lived within a 1 hour drive. Similarly, Burholt and Wenger (1998) found that a larger percentage of non-parents received instrumental support from siblings compared to parents, although this trend decreased over time.
In a later study, Albertini and Kohli (2009) found that individuals aged 50 and older without children were less likely to receive financial transfers than parents (4.7% and 5.5% respectively) and the amount received was generally lower. Similarly, Guo (2014) noted that older non-parents received less instrumental support than parents of one child and multiple children (42%, 50.70% and 54.76% respectively) although these differences were not statistically significant. Albertini and Kohli (2009) also highlighted that for non-parents, more than one-third of the financial support they received came from non-relatives (34%), while descendants (members of the younger family generations) were the primary financial providers for parents (52%). Koller (2008) further showed that non-parents were significantly more likely to receive instrumental help from friends than parents, whereas parents received significantly more practical help (not including childcare) from family than non-parents.
More recently, Zhou et al. (2019) reported that among adults aged 45 and older, those without children were significantly less likely to receive economic support compared to parents of both sons and daughters, especially for those with a spouse/partner (12%) compared to those without (19%). Non-parents without a spouse/partner had 76.4% lower odds of receiving economic support than parents with a spouse/partner. Yet, Boerner et al. (2016) found that centenarian non-parents were significantly more likely to report receiving assistance with doctor visits, shopping (17% vs 1%) and housework (13% v 1%) from friends and neighbours compared to parents.
The findings across the studies show that parents receive more financial and instrumental support from their descendants, particularly children, while non-parents are more likely to rely on support from siblings, friends, and neighbours.
Emotional support, companionship and confidants
Fourteen studies (17.5%) explored emotional support, companionship and the presence of confidants (people you can trust and confide in).
Early research showed that non-parents tend to receive less emotional support than parents. Rubin-Terrado (1994) found that 41% of older women without children reported having nobody as a confidant, compared to 28% of mothers. Similarly, Gironda et al. (1999) determined that older adults, aged 65 and over, without children had significantly less availability of a confidant compared to parents with no proximal children (no children living within a half hour drive), and parents with one or two proximal children. This is supported by more recent findings by Schnettler and Wöhler (2016) who found that non-parents had significantly fewer potential emotional supporters than both remote parents (whose children live over 2 hours away) and regional parents (whose children live closer).
Early studies also began to identify differences in sources of emotional support. In another study from the 1990s, Johnson and Troll (1992) reported a significant difference in received expressive help (positive sociability, shared activities, and emotional rewards) between non-parents and parents aged 85 years old and over. Specifically, 74% of married parents received support from more than one relative, compared to 57% unmarried parents and 7% of unmarried non-parents. Campbell et al. (1999) noted that siblings made up a larger proportion of non-parents’ network of confidants compared to parents, particularly when the sibling lived close by. Sources of support were further explored in more recent studies. Koller (2008) found that non-parents received significantly less emotional support from family than parents but received significantly more emotional support from friends than parents while Boerner et al. (2016) found that centenarian parents were significantly less likely to report receiving help with socialising and companionship from relatives, excluding their children and grandchildren, compared to non-parents (7% vs 33%). Thus, children may be the key providers of family-based emotional support for parents while siblings may play a more important role for non-parents.
Marital status may also play a role. Penning and Wu (2014) noted that among adults aged 60 and older, never-married individuals with children were the most likely to receive emotional support from others living outside the household, followed by never-married non-parents, married/cohabiting parents and lastly married/cohabiting individuals without children (54%, 42%, 35%, 33% respectively). While those who had never been married were more likely to receive emotional support, parents were still more likely to receive support compared to their non-parent counterparts.
In sum, findings across these studies show that non-parents often rely more on friends and siblings for social and emotional support, developing stronger support relationships outside of the family. In contrast, parents, especially those with children living closer by, have more family-based support.
Support provision
Seven studies (8.75%) examined the support parents and non-parents provide to others. The earliest study by Wagner et al. (1999) found that parents aged 70 and over provided more help to their network than non-parents, though the difference was not statistically significant. More recent research, using large cross-national datasets like the Survey of Health, Ageing and Retirement in Europe (SHARE), provides clearer insights. Albertini and Kohli (2009) found among adults aged 50 and older, parents were significantly more likely to give financial support to others compared to non-parents (28.8% vs 15.5%), the majority of which (89%) was given to descendants, while non-parents were more inclined to support non-relatives (33%). A similar pattern was observed in later work by Albertini and Kohli (2017) who observed that generally, non-parents were less likely to give economic support compared to parents (17.2% vs 32.9%) although they gave similar amounts as parents who had minimal or no contact with their children (17.2%). There were less clear differences between parents and non-parents regarding the provision of social support, except that non-parent women spent significantly less time providing social support to others than parent women. Furthermore, Albertini and Mencarini (2014) observed that non-parents were slightly less likely to support others outside the household. The largest differences were observed among men, with this support declining earlier with age for non-parents. Conversely, Hurd (2009) noted that individuals without children, especially those with higher income, were more likely to provide financial assistance to parents, in-laws, friends, or relatives. While differences between non-parents and parents tended to be smaller for couples than for single individuals, in some income/wealth quartiles, the propensity among non-parents to provide financial support was twice as high as parents.
Regarding emotional and practical (e.g., household chores, transportation) support, Koller (2008) reported that parents provided significantly more practical help to family, not including childcare, than non-parents and significantly more emotional support. Comparatively, non-parents provided significantly more practical help to friends than parents and significantly more emotional support. Pesando (2019) found that non-parents in several countries were more likely to offer emotional and practical support to their elderly parents (upward support), with significant differences in Bulgaria, Georgia, Poland and France. In general, upward support was notably low in the Netherlands and Sweden, representing Northern European countries in the study characterised by publicly funded, universal welfare programmes. No substantial differences were observed in the overall likelihood of providing upward support between Eastern and Western European countries. Using logistic regression, the authors further conclude that across all 11 countries, non-parents were significantly more likely to provide support to their elderly parents compared to parents. Non-parent men were estimated to be 30–40% more likely to provide upward support compared to their parent counterparts.
Overall, parents tend to provide more support compared to non-parents. However, non-parents often give more support to non-relatives and their own parents or parents-in-law (upward transfer) while parents may provide the majority of familial support to their children (downward transfer). The nature and extent of support may also vary based on factors such as age, gender, and income.
Satisfaction with network and support
Seven studies (8.75%) provided insights into how the presence of children relates to satisfaction with social networks and support, finding mostly small differences. Becker et al. (2019) examined 16 European countries and observed slightly higher network satisfaction among parents aged 50 or older with three or more children compared to non-parents. The positive correlation between children and network satisfaction was attributed to children who have left home as opposed to resident children. When country-specific analysis was conducted, the overall findings remained largely unchanged. However, some variation was apparent, with some countries showing no significant effects (e.g. Poland, Portugal, Germany, Denmark) while others were consistent with the overall positive association (e.g., Austria, Estonia, Hungary). Similarly, Pushkar et al. (2014) reported marginally higher social support satisfaction among parents, regardless of the gender of their children compared to non-parents. However, two studies (Graham, 2018; McNamee & James, 2012) found that women with children reported slightly lower satisfaction with their support networks compared to women without children, though differences were not statistically significant. Rempel (1985) noted little difference in friendship satisfaction among older individuals (M age = 72.3 years), whereby parents were slightly more satisfied than non-parents. Thus, due to the non-significant difference and relatively high means the authors suggest that the elderly as a whole were satisfied with friendships.
Marital status and gender also play a role. Cwikel et al. (2006) found a significant difference in the proportion of women satisfied with social support, which was greatest among previously married women with children (71.6%), followed by married women with children (67.5%), previously married women with no children (61.5%), married women with no children (58.7%) and lastly never-married women without children (57.2%). Whilst more parents, regardless of marital status, were satisfied with support compared to non-parents, a larger proportion of previously married women were satisfied with support than their married counterparts. Cobb (2002) observed that parenting can impact satisfaction differently based on gender. Parent husbands in the early stages of parenthood (6 months after the birth of first child) reported lower satisfaction and fewer available supports than non-parent husbands while parent wives reported higher and more available supports than non-parent wives. This finding may suggest that fathers are less satisfied as they experience more difficulty sourcing support compared to mothers.
Overall, satisfaction can vary depending on marital status, gender, and the number of children; however the majority of these studies found minimal or non-significant differences. For 4 out of 7 studies, descriptive data on satisfaction with social networks or support in parent and non-parents groups was available (Table S12). Small to medium effect sizes were found, ranging from −0.15 to 0.24 and amounting to an inversely variance-weighted average Hedges g of 0.23, indicating that parents tend to be more satisfied than non-parents but the difference is small.
Differences between non-parents
Nine studies (11.25%) included two or more different groups of non-parents, with many of these studies being conducted in the last decade and the majority focusing on social support. Štambuk et al. (2019) observed significant differences for LGBTIQ not-yet-parents, childfree, and undecided individuals in perceived social support from family, friends, and significant others. Specifically, those who wanted children perceived significantly more support from friends, significant others, and family compared to those who did not want children, with no significant difference compared to those who were undecided. Using data from the Australian Longitudinal Study on Women’s Health, Jin et al. (2023) found a significant difference in social support, noting that among women aged 40–45, childfree women had lower social support than childless women and mothers. A few years earlier, Turnbull et al. (2016) found among women aged 25–44 also based in Australia, circumstantially childless women (those who wanted children but cannot due to reasons other than infertility e.g. absence of a partner, or a lack of resources or opportunity) reported significantly lower social support compared to involuntarily childless women, women who were undecided, childfree women, and women planning to have children in the future. However, Turnbull et al. (2016) recruited a younger sample than Jin et al. (2023), thus, social support may decrease for childfree individuals as they age and are perceived as having less opportunity to change their minds. Adding to the recent research, Ribeiro et al. (2024) found that 72.3% of involuntary definitive childless women (had tried to conceive for at least 2 years but did not achieve pregnancy and were not a fertility treatment patient or an adoption candidate) reported that they received low social support compared to 48.7% of women with infertility who were actively trying to conceive and 49.2% of fertile women planning to have children (not-yet-parents), though the difference was not significant.
Regarding social network characteristics, an early study from 1974 found a significant difference among groups of women in sources of primary friendships. Voluntarily childless (childfree) women primarily formed their closest friendships at work, with 60% identifying work as their main source of primary friends (Bram, 1974). The same study showed women who delay childbearing (not-yet-parents) to have an equal split between friendships formed through work and their neighbourhood, with some also forming friendships through their spouses. Parents, however, were more likely to form their closest friendships in their neighbourhoods, with 54.2% of women and 31.8% of men doing so (Bram, 1974). Jeffries and Konnert (2002) found no significant differences in positive relations with others between mothers, childfree, and childless women.
Overall, some differences between different groups of non-parents were found. Early research suggests not-yet-parents are more likely to form close relationships through neighbourhoods, similar to parents, while childfree women may tend to form close friendships at work. More recent research indicates not-yet-parents perceive and receive more support than childless and childfree individuals, although research is conflicting concerning support differences between childless or childfree individuals.
Discussion
Differences between parents and non-parents
Overall, there appear to be differences in the size, type, and composition of social networks, as well as sources of support, according to parental status. Our findings suggest parents tend to have larger, more robust family-centred networks, more frequent contact with relatives, and more informal support, predominantly from adult children. This aligns with the Hierarchical Compensatory Model, which positions children as primary sources of support when available and the Task-Specific Support Theory, which highlights family as key providers of instrumental support. While the Task-Specific Support Theory proposes that emotional support is more typically provided by friends, we found that many parents also receive emotional support from family members. This may reflect the overlap between support types, where emotional and instrumental support are often intertwined, potentially facilitated by closer geographic proximity and more frequent contact with relatives.
Conversely, non-parents are often reported as having smaller and more restricted networks but also more diverse social ties outside the immediate family, typically with more friends and extended kin, with the exception of markedly closer relationships with siblings. According to the Hierarchical Compensatory Model, non-parents tend to rely more on secondary and tertiary support providers, receiving more formal sources of support and assistance from non-relatives, when primary providers like children are absent. Similarly, the Task-Specific Support Theory suggests that non-parents supplement their smaller networks with task-specific support providers (e.g., care professionals) or by nurturing broader social ties outside of immediate familial ties, including “families of creation”. However, while friends often provide emotional support, they may be less equipped or expected to offer consistent instrumental help. Accordingly, we found that non-parents tend to receive less instrumental support overall. Additionally, reliance on these less stable secondary and formal supports may be linked to more changeable networks over time, vulnerable to life transitions such as moving house, shifts in social circles, or health-related changes (e.g. Doherty, 2021; Finchum, 2003; Köhler et al., 2021).
It is important to note that we cannot infer a causal relationship between parental status and social networks and support. For instance, Lois and Arranz Becker (2014) found that couples who became parents had networks that were more highly child-compatible compared to couples who did not start a family. However, in further longitudinal path model analyses, the authors determined that child-compatibility was related to fertility intentions: the more child-compatible a couple perceived their network to be, the more intentions they had to start a family. Therefore, parental status may drive some changes in social networks, but importantly, social network characteristics may also influence the decision to have children (see also Keim et al., 2009).
Some studies suggest that social networks and support vary with both age and parental status. Parents generally have larger networks, with network size peaking in early adulthood (and older age) and potentially decreasing or stabilising during midlife for both parents and non-parents (Lang et al., 2013; Lois & Arranz Becker, 2014), aligning with established research on age-related social network changes (Wrzus et al., 2013). Across the lifespan, non-parents may maintain more stable networks (Albertini & Mencarini, 2014), potentially engaging in relationships that are based more on closeness, companionship or connections, rather than reciprocal exchanges of support (Burholt & Wenger, 1998; Vicente & Guadalupe, 2024). However, more research is needed to better understand how age interacts with parental status to influence social support patterns.
Differences between groups of non-parents
This review aimed to explore differences in social networks and support between different groups of non-parents, such as not-yet parents, childless, and childfree individuals. However, only 9 out of 80 studies included in this review allowed comparison between two or more groups of non-parents. Evidence on social network structure is limited. One early study (Bram, 1974) found that childfree women tended to rely on work environments for social connections. However, given the increased proportion of mothers remaining in or returning to the workforce (ONS, 2022), this raises questions about the continued relevance of career-focused stereotypes of childfree individuals (Magennis, 2024) and how work and personal lives intertwine for those without children more generally.
Additionally, despite the mixed findings regarding whether childfree or childless individuals receive less support, it is clear that individuals without children, whether because they choose to or not, perceive less support compared to those intending to become parents in the future. This potentially reflects the societal pressures and negative attitudes towards those who deviate from traditional family structures. Within the childless group, circumstantially childless women received less support than involuntarily childless women, highlighting variation within this group (Turnbull et al., 2016). Our findings also suggest that not-yet parents may have a social life that resembles that of parents, forming friendships through neighbourhoods, similarly to parents (Bram, 1974) and receiving more support than other non-parent groups.
Notably, compared to studies that treat non-parents as a single group, those that distinguish types of non-parents focused on younger adults. This may be the result of both–a shrinking number of non-parents between (late) young adulthood and midlife (i.e. most people, especially former not-yet-parents, following the “normative” life course by having had children before turning 50) and researchers’ assumptions that reproductive distinctions among non-parents (such as whether not having children was intended or not) matter less as people age. While we can only offer speculations here, we encourage researchers to include such finer-grained distinctions in their studies on individuals beyond the typical reproductive years and older adults, as it could help clarify how social networks and support change across the lifespan and whether these experiences differ across non-parent groups. Ultimately, the limited number of studies comparing non-parent groups restricts our theoretical understanding of how these groups compensate for the absence of children.
Limitations and directions for future research
The lack of qualitative studies and inclusion of lower quality studies are sources of potential bias in the review. Of note, lower quality ratings often resulted from lack of detail in reporting in the articles rather than weaknesses in study design; JBI quality appraisals are provided to detail these issues (see Table S9). While methodological quality may affect the robustness of the conclusions drawn, only 15% of studies were rated as low quality. Readers are encouraged to consider the appraisal scores alongside the broader context of each study when interpreting the findings of this review.
Definitions and measures of social networks and support varied considerably. For instance, few studies included relationships beyond family and close friends. While social support was often measured via established scales, subtypes of social support were measured heterogeneously. This diversity limits formal meta-analysis and effect sizes could only be calculated for outcomes deemed sufficiently comparable.
Included studies were primarily conducted in Europe and the US, limiting our findings beyond Western and industrialised contexts (Henrich et al., 2010). Reproductive status may have more profound effects in regions with tighter norms around family formation and more traditional or pronatalist values (Dyer, 2007, see also Nauck & Klaus, 2007). Some studies suggested differences in social networks and support may be influenced by country-specific factors like culture, economic development, and welfare systems. Moreover, the findings from studies included in this review span 50 years, further limiting the ability for direct comparison due to changing historical and cultural contexts. Age-related variations may also be overlooked, as most studies in this review focused on individuals aged 50 and older and few examined changes over the lifespan. Longitudinal studies are needed to assess whether observed differences persist at different life stages.
Further research is needed to understand how demographic differences intersect with social networks and support (e.g., Kersten et al., 2024). For example, non-parents are more likely to be single and live alone; observed network and support differences between parents and non-parents may partly reflect characteristics like these rather than parental status itself. Health conditions, socioeconomic status, gender, and a range of other factors may impact both social networks and parental/reproductive status. Therefore, differences in social networks and support should be interpreted in the context of broader demographic and life circumstances.
This review highlights a significant gap in the literature regarding distinctions among non-parents. 87.5% (70/80) of studies included a non-specified non-parent sample (i.e. no details of whether participants were childless, childfree, etc.) and only 11.25% (9/80) included two or more different groups of non-parents. Clear and consistent operationalisation of non-parent status is vital in establishing a cumulative science on how social networks and support may differ for different non-parent groups as well as the correlates and consequences of reproductive status and childbearing decisions.
Conclusion
This review highlights notable differences in social networks between parents and non-parents. Parents usually have larger, family-focused networks while non-parents tend to have smaller, more diverse networks relying more on formal support. Distinguishing between different groups of non-parents is important to better understand their specific needs, reduce stigma, and increase wellbeing. Future studies should explore how demographic factors and culture interact with reproductive status to affect social support.
Supplemental material
Supplemental Material - The social life of non-parents: A systematic review of social networks and social support among adults without children
Supplemental Material for The social life of non-parents: A systematic review of social networks and social support among adults without children by Olivia Crawford, Phoebe E. McKenna-Plumley, Rosalyn Millar, Tanja M. Gerlach in Journal of Social and Personal Relationships.
Supplemental material
Supplemental Material - The social life of non-parents: A systematic review of social networks and social support among adults without children
Supplemental Material for The social life of non-parents: A systematic review of social networks and social support among adults without children by Olivia Crawford, Phoebe E. McKenna-Plumley, Rosalyn Millar, Tanja M. Gerlach in Journal of Social and Personal Relationships.
Footnotes
Acknowledgements
The authors would like to acknowledge and thank Ms Carol Dunlop, subject librarian at Queen’s University Belfast, for their advice and assistance in the conduct of this review.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Department for the Economy (DfE) Research PhD studentship.
Open research statement
As part of IARR’s encouragement of open research practices, the author(s) have provided the following information: The research was pre-registered. The aspects of the research that were pre-registered were review methods, search strategy, screening, extraction, synthesis and quality assessment. The registration was submitted to Open Science Framework. The data used in the research are available. The data can be obtained by emailing:
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Ethical considerations
Ethical approval was not required.
Data Availability Statement
Pre-registration of the protocol for this review is available at OSF https://doi.org/10.17605/OSF.IO/SFUE6 (Van den Akker et al., 2023).
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