This meta-analysis aimed to assess the impact of identity-building interventions on recovery identity and patient-reported health outcomes in chronic disease patients. We identified 15 relevant empirical studies (comprising 2261 patients) from 989 records through extensive keyword searches and manual screening conducted between March 2nd and March 13th, 2023. Utilizing the Cochrane tool, meta-regression, and the GRADE approach, we evaluated these studies for their characteristics, findings, and quality. The analysis revealed that identity-building interventions, encompassing recovery-oriented group, interest group, and linguistic approaches, positively influenced identity synthesis and had varying effects on health outcomes. Notably, multiple regression analysis demonstrated that identity synthesis significantly predicted health outcomes. However, the study identified mild heterogeneity, a high attrition bias risk, and insufficient data on selection and detection bias as limitations. Overall, identity-building interventions proved influential in enhancing recovery identity, a vital predictor of patient-reported health outcomes in chronic disease patients.
BellizziKMBlankTO (2007) Cancer-related identity and positive affect in survivors of prostate cancer. Journal of Cancer Survivorship: Research and Practice1: 44–48.
2.
BossyDKnutsenIRRogersA, et al. (2017) Group affiliation in self-management: Support or threat to identity?Health Expectations20(1): 159–170.
3.
BurkePJStetsJE (2022) Identity Theory: Revised and Expanded. New York, NY: Oxford University Press.
4.
CalandriEGrazianoFBorghiM, et al. (2017) Improving the quality of life and psychological well-being of recently diagnosed multiple sclerosis patients: Preliminary evaluation of a group-based cognitive-behavioral intervention. Disability and Rehabilitation39(15): 1474–1481.
5.
CameronJE (2004) A three-factor model of social identity. Self and Identity3(3): 239–262.
6.
CameronJEVothJJaglalSB, et al. (2018) “In this together”: Social identification predicts health outcomes (via self-efficacy) in a chronic disease self-management program. Social Science & Medicine208: 172–179.
7.
CorstenSSchimpfEJKonradiJ, et al. (2015) The participants’ perspective: How biographic-narrative intervention influences identity negotiation and quality of life in aphasia. International Journal of Language & Communication Disorders50(6): 788–800.
8.
CruwysTStewartBBuckleyL, et al. (2020) The recovery model in chronic mental health: A community-based investigation of social identity processes. Psychiatry Research293: 113241.
9.
DingleGAStarkCCruwysT, et al. (2014) Breaking good: Breaking ties with social groups may be good for recovery from substance misuse. British Journal of Social Psychology54(2): 236–254.
10.
DoosjeBEllemersNSpearsR (1995) Perceived intragroup variability as a function of group status and identification. Journal of Experimental Social Psychology31: 410–436.
11.
FaullKHillsMDCochraneG, et al. (2004) Investigation of health perspectives of those with physical disabilities: The role of spirituality as a determinant of health. Disability and Rehabilitation26(3): 129–144.
12.
FigueirasMJMarquesA (2018) Coping with chronic illness: The role of illness perceptions. Psychology, Health & Medicine23(7): 779–785.
13.
FosterCCBlackwellCKKanK, et al. (2023) Parental self-efficacy managing a child’s medications and treatments: Adaptation of a PROMIS measure. Journal of Patient-Reported Outcomes7(1): 10.
14.
GardinerCGeldenhuysGGottM (2018) Interventions to reduce social isolation and loneliness among older people: An integrative review. Health and Social Care in the Community26(2): 147–157.
15.
GignacMAMBackmanCLDavisAM, et al. (2013) Social role participation and the life course in healthy adults and individuals with osteoarthritis: Are we overlooking the impact on the middle-aged?Social Science & Medicine81: 87–93.
16.
GrazianiFTsakosG (2020) Patient-based outcomes and quality of life. Periodontology83(1): 277–294.
17.
GreenawayKHHaslamSACruwysT, et al. (2015) From “we” to “me”: Group identification enhances perceived personal control with consequences for health and well-being. Journal of Personality and Social Psychology109: 53–74.
18.
GreenawayKHLouisWRHornseyMJ (2013) Belief in precognition increases perceived control and loss of control increases belief in precognition. Plos One8(8): 1–6.
19.
HaslamCHolmeAHaslamSA, et al. (2008) Maintaining group memberships: Social identity continuity predicts well-being after stroke. Neuropsychological Rehabilitation18(5–6): 671–691.
20.
HaslamCBertschyKCruwysT, et al. (2023) The group mechanism in treatment: Group identification and cohesion contributes to reducing chronic lower back pain by increasing personal control. Disability and Rehabilitation45(8): 1332–1342.
21.
HaslamCCruwysTChangMX, et al. (2019) GROUPS 4 HEALTH reduces loneliness and social anxiety in adults with psychological distress: Findings from a randomized controlled trial. Journal of Consulting and Clinical Psychology87(9): 787–801.
22.
HinkleSTaylorLAFox-CardamoneDL, et al. (1989) Intragroup identification and intergroup differentiation: A multicomponent approach. British Journal of Social Psychology28(4): 305–317.
23.
JettenJBranscombeNRSchmittMT, et al. (2001) Rebels with a cause: Group identification as a response to perceived discrimination from the mainstream. Personality and Social Psychology Bulletin27(9): 1204–1213.
24.
JettenJPachanaNA (2012) Not wanting to grow old: A Social Identity Model of Identity Change (SIMIC) analysis of driving cessation among older adults. In: JettenJHaslamCHaslamAS (eds) The Social Cure: Identity, Health and Well-Being. London: Psychology Press, pp.97–113.
25.
JettenJReicherSDHaslamSA, et al. (2020) Together Apart: The Psychology of Covid-19. London: Sage Publications Limited.
26.
JunkerNMDickRAvanziL, et al. (2019) Exploring the mechanisms underlying the social identity–ill-health link: Longitudinal and experimental evidence. British Journal of Social Psychology58(4): 991–1007.
27.
KelleziBBainesDLCouplandC, et al. (2016) The impact of injuries on health service resource use and costs in primary and secondary care in the English NHS. Journal of Public Health38(4): e464–e471.
28.
KelleziBWakefieldJRHStevensonC, et al. (2019) The social cure of social prescribing: A mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision. BMJ Open9(11): e033137.
29.
KellyJFAbryAWMilliganCM, et al. (2018) On being “in recovery”: A national study of prevalence and correlates of adopting or not adopting a recovery identity among individuals resolving drug and alcohol problems. Psychology of Addictive Behaviors32(6): 595–604.
30.
KerfootBPGagnonDRMcMahonGT, et al. (2017) A team-based online game improves blood glucose control in veterans with type 2 diabetes: A randomized controlled trial. Diabetes Care40(9): 1218–1225.
31.
KingodNClealBWahlbergA, et al. (2017) Online peer-to-peer communities in the daily lives of people with chronic illness: A qualitative systematic review. Qualitative Health Research27(1): 89–99.
32.
LehardyENFowersBJ (2020) Ultimate (evolutionary) explanations for the attraction and benefits of chronic illness support groups: Attachment, belonging, and collective identity. Current Psychology39: 1405–1415.
33.
LorenzLS (2010) Discovering a new identity after brain injury. Sociology of Health & Illness32(6): 862–879.
LuyckxKSeiffge-KrenkeISchwartzSJ, et al. (2008) Identity development, coping, and adjustment in emerging adults with a chronic illness: The sample case of type 1 diabetes. Journal of Adolescent Health43(5): 451–458.
36.
MartinABHartmanMLassmanD, et al. (2020) National health care spending in 2019: Steady growth for the fourth consecutive year. Health Affairs (Millwood)40(1): 1–11.
37.
Martin-SaezMMJamesN (2019) The experience of occupational identity disruption post-stroke: A systematic review and meta-ethnography. Disability and Rehabilitation41(14): 1684–1695.
38.
MatthiasM SKuklaMMcGuireAB, et al. (2016) Facilitators and barriers to participation in a peer support intervention for veterans with chronic pain. The Clinical Journal of Pain32(6): 534–540.
39.
MeuretAEChmielewskiMSteeleAM, et al. (2016) The desire to belong: Social identification as a predictor of treatment outcome in social anxiety disorder. Behaviour Research and Therapy81: 21–34.
40.
MorrisBAChambersSKCampbellM, et al. (2011) Motorcycles and breast cancer: The influence of peer support and challenge on distress and posttraumatic growth. Supportive Care in Cancer20(8): 1849–1858.
41.
MorrisBALeporeSJWilsonB, et al. (2014) Adopting a survivor identity after cancer in a peer support context. Journal of Cancer Survivorship8(3): 427–436.
42.
MuldoonOTHaslamSAHaslamC, et al. (2019) The social psychology of responses to trauma: Social identity pathways associated with divergent traumatic responses. European Review of Social Psychology30(1): 311–348.
43.
OrisLLuyckxKRassartJ, et al. (2018) Illness identity in adults with a chronic illness. Journal of Clinical Psychology in Medical Settings25(4): 429–440.
44.
PryceHMoutelaTBunkerC, et al. (2019) Tinnitus groups: A model of social support and social connectedness from peer interaction. British Journal of Health Psychology24(1): 1–20.
45.
RassartJVan WanseeleCDebrunL, et al. (2023) Illness identity in inflammatory bowel disease. International Journal of Behavioral Medicine30(1): 77–88.
46.
RonaldsonAMolloyGJWikmanA, et al. (2015) Optimism and recovery after acute coronary syndrome: A clinical cohort study. Psychosomatic Medicine77(3): 311–318.
47.
SchmittMTBranscombeNRKobrynowiczD, et al. (2002) Perceiving discrimination against one’s gender group has different implications for well-being in women and men. Personality and Social Psychology Bulletin28: 197–210.
48.
SteffensNKLaRueCJHaslamC, et al. (2019) Social identification-building interventions to improve health: A systematic review and meta-analysis. Health Psychology Review15(1): 85–112.
49.
SteinKFCorteCChenDG, et al. (2013) A randomized clinical trial of an identity intervention program for women with eating disorders. European Eating Disorders Review21(2): 130–142.
50.
StuartAKatzDStevensonC, et al. (2022) Loneliness in older people and COVID-19: Applying the social identity approach to digital intervention design. Computational Human Behavior Reports6: 100179.
51.
SuJDugasMGuoX, et al. (2022) Building social identity-based groups to enhance online peer support for patients with chronic disease: A pilot study using mixed-methods evaluation. Translational Behavioral Medicine12(5): 702–712.
52.
TajfelH (1978) Differentiation Between Social Groups: Studies in the Social Psychology of Intergroup Relations. London: Academic Press.
53.
TajfelHTurnerJC (1979) An integrative theory of intergroup conflict. In: AustinWGWorchelS (eds) The Social Psychology of Intergroup Relations. Monterey, CA: Brooks/Cole, pp.33–47.
54.
TaylorSE (2011) Social support: A review. The Oxford Handbook of Health Psychology1: 189–214.
55.
TarrantMLamontRACarterM, et al. (2021) Measurement of shared social identity in singing groups for people with aphasia. Frontiers in Psychology12: 669899.
Van BulckLGoossensELuyckxK, et al. (2018) Illness identity: A novel predictor for healthcare use in adults with congenital heart disease. Journal of the American Heart Association7(11): e008723.
58.
Van DickRWagnerUPetzelT, et al. (1999) Occupational stress and social support: First results of a study among schoolteachers. Psychologie in Erziehung und Unterricht46: 55–64.
59.
VedstedPChristensenMB (2005) Frequent attenders in general practice care: A literature review with special reference to methodological considerations. Public Health119(2): 118–137.
60.
VillaDCauserHRileyGA (2021) Experiences that challenge self-identity following traumatic brain injury: A meta-synthesis of qualitative research. Disability and Rehabilitation43(23): 3298–3314.
61.
VosTBarberRMBellB, et al. (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet386(9995): 743–800.
62.
WilliamsEDingleGJettenJ, et al. (2018) Identification with arts-based groups improves mental wellbeing in adults with chronic mental health conditions. Journal of Applied Social Psychology49(1): 15–26.
63.
ZhengKNewmanMWVeinotTC, et al. (2010) Using online peer-mentoring to empower young adults with end-stage renal disease: A feasibility study. Proceedings of the AMIA Annual Symposium2010: 942–946.
64.
ZwarNHarrisMGriffithsR, et al. (2006) A systematic review of chronic disease management.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
