Older adults are not only at a significantly greater risk of mortality and a more difficult recovery following infection with COVID-19, but they also face additional vulnerabilities, such as social isolation because of a range of non-pharmaceutical public health social distancing measures. 

Social isolation is likely to lead to loneliness and our study has shown that approximately 45% of Hong Kong Chinese older adults sometimes or always felt lonely. It is well-established that loneliness is associated with numerous detrimental consequences on psychological, physical, and cognitive health. Against this backdrop, it is of the utmost importance to develop an effective intervention to reduce loneliness among Hong Kong’s older adults, especially during times like the COVID-19 pandemic. Accordingly, we will examine the effectiveness of two different psychosocial interventions (i.e. a layperson-delivered, empathy-focused program of telephone calls and wisdom-enhancing narrative-therapy intervention) by comparing them with a telephone-delivered befriending intervention in a three-arm randomized controlled trial (RCT) of a random sample of 282 community-dwelling older adults who feel lonely. 

To meet the huge demand for such interventions during possible future pandemics – or this ongoing one – we plan to recruit and train retirees as volunteers to implement the promising interventions. The primary outcomes including loneliness and the secondary outcomes are sleep quality, depressive symptoms, cognitive functioning, social network and social support. We will also examine the potential mediators (wisdom and empathy received) underlying the effect of the intervention, and investigate whether the proposed tailoring factors (gender, age, poor financial situation, self-rated health, baseline assessment of wisdom and empathy received) moderate their impact of the intervention on loneliness. Data collection will be done at baseline, four weeks, six months and 12 months after the beginning of the intervention. Our selection of interventions and secondary outcomes are based on the Biopsychosocial (BPS)-Pathways model of loneliness and the findings will provide evidences to understand and refine the model.