An Evaluation of a Low-Intensity Cognitive Behavioral Therapy mHealth-Supported Intervention to Reduce Loneliness in Older People

• Published in: International journal of environmental research and public health Vol. 16; no. 7; p. 1305
• Main Authors: Jarvis, Mary Ann, Padmanabhanunni, Anita, Chipps, Jennifer
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 11-04-2019; MDPI
• Subjects: Aged; Aged, 80 and over; Behavior modification; Cognition; Cognition & reasoning; Cognitive Behavioral Therapy - methods; Cognitive Behavioral Therapy - standards; Communication; Female; Human behavior; Humans; Instant messaging; Intervention; Loneliness; Loneliness - psychology; Male; Middle Aged; NGOs; Nongovernmental organizations; Older people; Questionnaires; Residence Characteristics; Smartphones; Social Behavior; Social Environment; Social networks; Social organization; South Africa; Studies; Telemedicine; South Africa; mHealth; older people; smartphone; loneliness; low-intensity CBT; WhatsApp
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph16071305

There is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can affect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which targeted maladaptive cognitions in older people (≥60 years) experiencing loneliness. The three-month intervention using WhatsApp was implemented with older people in four inner-city residential care facilities. The intervention included three components: technology acceptance, psycho-education, and individualized positively worded messages addressing maladaptive cognitions. The intervention was evaluated using a randomized control design. Key outcomes were measured pre-, post-, and one month after the intervention. There were significant changes in social cognition (YSQ-SF T₀-T₁-T₂,
² = 9.69,
0.008) and loneliness levels (total loneliness T₀-T₁-T₂,
² = 14.62,
= 0.001), and an increase in WhatsApp usage (T₀ = 26% vs. T₁ = 60%,
²=15.22,
= 0.019). At 1-month follow-up, even with a significant reduction in WhatsApp usage, a significant reduction in loneliness was maintained. LI-CBT delivered via instant messaging may be effective in reducing loneliness experienced by older people.