Jiang Da, Kwok Jojo Yan Yan, Yeung Dannii Yuen-Lan, Tang Vivien Foong Yee, Choi Namkee G, Ho Rainbow Tin Hung, Warner Lisa M, Chou Kee-Lee
Department of Special Education and Counselling, The Education University of Hong Kong, Lok Ping, Hong Kong, China.
School of Nursing, University of Hong Kong - School of Nursing, Hong Kong, China.
Age Ageing. 2025 Aug 1;54(8). doi: 10.1093/ageing/afaf209.
BACKGROUND: Loneliness among older adults during the COVID-19 pandemic constituted a global public health crisis. This study aimed to determine whether layperson- and telephone-delivered behavioural activation (Tele-BA) and mindfulness (Tele-MF) interventions, compared to telephone befriending/support calls (Tele-BF; attention control), could reduce loneliness among older adults who were living alone, socioeconomically deprived and digitally excluded. METHODS: As part of the 'Helping Alleviate Loneliness in Hong Kong Older Adults' dual randomised controlled trial (RCT), 1151 older adults (Mage = 76.6, SD = 7.8) were randomly assigned to Tele-BA, Tele-MF or Tele-BF. Assessments were conducted at baseline (T0), 4-week (T1), 3-month (T2) and 6-month post-intervention (T3). All interventions (eight 30-minute telephone sessions over four weeks) were delivered by 185 trained lay counsellors who were 50-70 years old and reported feeling lonely. OUTCOMES: The primary outcome was loneliness (assessed with the UCLA Loneliness Scale [UCLA-LS] and De Jong Gierveld Loneliness Scale [DJGL]). Secondary outcomes were perceived social support, social network size, perceived stress, life satisfaction, psychological well-being, sleep quality and depressive and anxiety symptoms. The UCLA-LS scores were significantly reduced in Tele-BA at T2 and T3 and in Tele-MF at T2, compared to Tele-BF. No significant difference was observed between Tele-BA and Tele-BF from T1 through T3 in DJGL. The Tele-MF group showed significantly higher DJGL scores at T1 and T3 than the Tele-BF group. Significant positive effects of Tele-BA, compared to Tele-BF, were found in perceived social support, perceived stress, psychological well-being, depression and anxiety. Tele-MF did not significantly differ from Tele-BF on these secondary outcomes. INTERPRETATION: The trial demonstrates the effectiveness of telephone-based psychosocial interventions delivered by laypersons in reducing loneliness. It also underscores the potential for training peer lay counsellors to telephone-deliver scalable psychosocial interventions for older adults experiencing loneliness.
背景：在新冠疫情期间，老年人的孤独感构成了一场全球公共卫生危机。本研究旨在确定，与电话交友/支持热线（Tele-BF；注意力控制组）相比，由非专业人员通过电话提供的行为激活干预（Tele-BA）和正念干预（Tele-MF），是否能够减少独居、社会经济条件差且被数字技术排斥的老年人的孤独感。 方法：作为“帮助减轻香港老年人孤独感”双盲随机对照试验（RCT）的一部分，1151名老年人（年龄中位数 = 76.6，标准差 = 7.8）被随机分配至Tele-BA组、Tele-MF组或Tele-BF组。在基线期（T0）、干预后4周（T1）、3个月（T2）和6个月（T3）进行评估。所有干预措施（四周内进行八次30分钟的电话咨询）均由185名经过培训的非专业咨询师提供，他们年龄在50至70岁之间，且表示自己有孤独感。 结果：主要结局指标为孤独感（采用加利福尼亚大学洛杉矶分校孤独量表[UCLA-LS]和德容·吉尔维尔德孤独量表[DJGL]进行评估）。次要结局指标包括感知到的社会支持、社交网络规模、感知到的压力、生活满意度、心理健康、睡眠质量以及抑郁和焦虑症状。与Tele-BF组相比，Tele-BA组在T2和T3时UCLA-LS得分显著降低，Tele-MF组在T2时UCLA-LS得分显著降低。在DJGL方面，从T1到T3，Tele-BA组和Tele-BF组之间未观察到显著差异。Tele-MF组在T1和T3时的DJGL得分显著高于Tele-BF组。与Tele-BF组相比，Tele-BA组在感知到的社会支持、感知到的压力、心理健康、抑郁和焦虑方面有显著的积极效果。在这些次要结局指标上，Tele-MF组与Tele-BF组没有显著差异。 解读：该试验证明了由非专业人员通过电话提供的心理社会干预措施在减少孤独感方面的有效性。它还强调了培训同伴非专业咨询师通过电话为孤独的老年人提供可扩展心理社会干预措施的潜力。
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