TOPLINE:

Behavioral activation and mindfulness interventions, which aimed to reduce inactivity and avoidance and to improve awareness and acceptance, showed reductions in loneliness over 12 months.

METHODOLOGY:

• Researchers conducted a three-arm, dual randomized clinical trial in Hong Kong from 2021 to 2024 to evaluate the effect of telephone-based interventions on reducing loneliness among older adults.
• They included 1151 older adults (mean age, 76.6 years; 73.2% female) who reported being lonely, financially disadvantaged, and living alone.
• Participants were assigned to receive one of three interventions via telephone: a behavioral intervention focused on reducing inactivity and avoidance (n = 335), a mindfulness intervention aimed at improving awareness and acceptance (n = 460), or a befriending intervention offering emotional and informational support that served as a control (n = 356).
• Interventions consisted of eight 30-minute sessions over 4 weeks, delivered by 148 trained lay counselors who were older retiree volunteers aged 50-70 years.
• The primary outcome was loneliness, measured using two scales; assessments were conducted at five timepoints over 12 months.

TAKEAWAY:

• At 12 months, significant reductions in loneliness were observed in the behavioral activation and mindfulness intervention groups compared with the befriending intervention group on the UCLA Loneliness Scale (mean difference, -0.73; 95% CI, -1.29 to -0.16 and mean difference, -0.72; 95% CI, -1.24 to -0.20, respectively).
• Significant reductions in loneliness on the De Jong Gierveld Loneliness Scale were observed only in the behavioral activation group.
• Participants in the behavioral activation and mindfulness intervention groups reported lower levels of social isolation at 6 months than those in the befriending intervention group, which correlated with reduced loneliness levels at 12 months. The indirect effect of social isolation accounted for 13.5% and 18% of the total effects for behavioral activation and mindfulness, respectively.
• Secondary outcomes such as psychological well-being and life satisfaction also showed significant overall between-group differences (P < .001).

IN PRACTICE:

“The involvement of older adult peers as lay counselors underscored the potential of these interventions to offer accessible, scalable solutions for promoting well-being in resource-limited contexts,” the study authors wrote.

SOURCE:

The study was led by Vivien Foong Yee Tang, MSc, Department of Social Sciences and Policy Studies, The Education University of Hong Kong, Hong Kong, China. It was published online on February 4, 2026, in JAMA Network Open.

LIMITATIONS:

The study’s results may not apply to larger groups owing to its focus on Cantonese-speaking older adults with limited resources. Differences in the skills of the counselors could also affect the results.

DISCLOSURES:

The study was supported by grants from the One-off Collaborative Research Fund COVID-19 and the Research Grants Council of the Government of the Hong Kong Special Administrative Region. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.