Why am I obsessed with viewing mukbang ASMR? The roles of mediated voyeurism and intertemporal choice.

This study investigates the determinants of the obsessive view of mukbang autonomous sensory meridian response (Mukbang ASMR) and examines the moderation role of intertemporal choice and the mediating effect of mediated voyeurism among university students in Malaysia. A quantitative survey was conducted with 408 university students in Malaysia who viewed mukbang channel(s) often on social media. PLS-SEM is adopted to examine the associated paths and effects. The results demonstrate the significant impact of alienation and novelty, vicarious satisfaction, companionship and loneliness on mukbang ASMR obsession. Mediated voyeurism intervenes the effects of alienation and novelty on mukbang ASMR and intertemporal choice positively moderates the relationship between companionship and loneliness and mukbang ASMR. This study constructs a model to estimate Mukbang ASMR obsession by identifying specific motives and relationships among key factors, highlighting loneliness as the most effective determinant of mukbang ASMR among Malaysian younger generation. Research results provide an extended understanding of the mukbang ASMR, offering valuable insights in the areas of lifestyle, social well-being, and social media consumption.

Psycho-social problems among older people residing in community of Chitwan, Nepal-A cross-sectional study.

BACKGROUND: Older people are vulnerable to various psycho-social problems such as depression, anxiety, insomnia, dementia, and loneliness that have profound impact on overall health and their quality of life and higher use of health services. Prevention and treatment of psychological problems in this risk group is critical for improving their quality of life. OBJECTIVE: This study aimed to find out the psycho-social problems among older people residing in community. METHODS: The study was a cross-sectional study design and 388 older people aged 65 years and above residing in different wards of Bharatpur Metropolitan city were selected using probability simple random sampling technique. Data were collected using interview schedule containing geriatric depression scale-15; Geriatric anxiety scale-10, University of California Loss Angels Loneliness Scale (UCLA-20), Anthens Insomnia Scale and Mini-Cog Test. Obtained data were analyzed in SPSS version 20 for windows. Chi-square test was applied to measure the association between psychosocial problems and selected variables. RESULT: Findings of the study revealed that the mean age (± SD) of respondents was 72.92 (±7.12) years. Almost all (93.6%) older people had full functioning of activity of daily living and two third (66.5%) had other co-morbid conditions. More than two third (67.0%) of older adults had depression, 60.3% had anxiety, 53.6% had moderate to high level loneliness, 47.2% had insomnia, and 33.3% had dementia. Age, functional dependency, sex, co-morbidity, financial dependence, education and occupation were significantly associated with the psychosocial problems among older people. CONCLUSION AND RECOMMENDATION: Psychosocial problems are common among older people residing in community of Chitwan. Hence, there is need to develop and implement health care strategy by local health care planner to prevent, treat and manage the psychosocial problems among this risk groups. Further, health care providers working in geriatric problems or psychosocial health need to conduct regular screening programs for the early diagnosis and treatment of these problems.

The impact of social relationships on the risk of stroke and post-stroke mortality: a systematic review and meta-analysis.

BACKGROUND: The association between poor social relationships and post-stroke mortality remains uncertain, and the evidence regarding the relationship between poor social relationships and the risk of stroke is inconsistent. In this meta-analysis, we aim to elucidate the evidence concerning the risk of stroke and post-stroke mortality among individuals experiencing a poor social relationships, including social isolation, limited social networks, lack of social support, and loneliness. METHODS: A thorough search of PubMed, Embase, and the Cochrane Library databases to systematically identify pertinent studies. Data extraction was independently performed by two researchers. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either a random-effects or fixed-effects model. Sensitivity analyses were conducted to evaluate the reliability of the results. Random-effects meta-regression was performed to explore the sources of heterogeneity in stroke risk estimates between studies. Assessment for potential publication bias was carried out using Egger's and Begg's tests. RESULTS: Nineteen studies were included, originating from 4 continents and 12 countries worldwide. A total of 1,675,707 participants contributed to this meta-analysis. Pooled analyses under the random effect model revealed a significant association between poor social relationships and the risk of stroke (OR = 1.30; 95%CI: 1.17-1.44), as well as increased risks for post-stroke mortality (OR = 1.36; 95%CI: 1.07-1.73). Subgroup analyses demonstrated associations between limited social network (OR = 1.52; 95%CI = 1.04-2.21), loneliness (OR = 1.31; 95%CI = 1.13-1.51), and lack of social support (OR = 1.66; 95%CI = 1.04-2.63) with stroke risk. The meta-regression explained 75.21% of the differences in reported stroke risk between studies. Random-effect meta-regression results indicate that the heterogeneity in the estimated risk of stroke may originate from the continent and publication year of the included studies. CONCLUSION: Social isolation, limited social networks, lack of social support, and feelings of loneliness have emerged as distinct risk factors contributing to both the onset and subsequent mortality following a stroke. It is imperative for public health policies to prioritize the multifaceted influence of social relationships and loneliness in stroke prevention and post-stroke care. TRIAL REGISTRATION: The protocol was registered on May 1, 2024, on the Prospero International Prospective System with registration number CRD42024531036.

Strategies to overcome mental health stigma: Insights and recommendations from young people with major depressive disorder (MDD).

BACKGROUND: Young people with depression are met with stigma related to their mental health, which exacerbates loneliness, social isolation, and depression symptoms. While disclosing depression could improve one's mental health, stigma can also make social interactions more challenging and reduce the likelihood of receiving treatment. This research explored young people's experiences with stigma and recommendations for addressing it. METHODS: Semi-structured interviews conducted with N = 35 young people aged 18-25 years (Mage = 20.09) were analyzed with thematic analysis. Participants met the criteria for clinical depression using the Mood and Feelings Questionnaire (score >27) or had recently obtained a medical diagnosis (N = 18) of depression by a medical professional. RESULTS: Participants faced stigma when deciding to disclose their depression, which fed into a vicious cycle influencing feelings of loneliness, social isolation, and withdrawal. Their recommendations for others to avoid this cycle can be summarized under three main themes: (1) Social affirmation: identify allies and build meaningful connections; (2) Self-affirmation: build a constructive relationship with the self; and (3) Societal affirmation: structural changes are needed. CONCLUSIONS: The current research indicates that social, self-, and societal affirmation are considered important for reducing the detrimental impacts of stigma. Policies and programs are needed that provide mental health support to young people, and public awareness campaigns that guide young people to appropriate resources (i.e., support and intervention) via governmental public health bodies.

Social Isolation and Population Density: Racial and Ethnic Differences Among Older Adults.

This study uses secondary data analysis to assess the relationship between social isolation (SI) and population density in the US, as well as any moderating influence that race/ethnicity may have on that relationship. A recent consensus on the measure of SI is that it focuses on the objective absence of social connections, whereas loneliness refers to subjective assessments of one's social connections. Therefore, while the original study measured both objective and subjective SI may be innovative, it may also be overly ambitious. SI puts older people at risk for health problems, including an increased chance of dying. The AARP Foundation gathered the initial convenience sample, which included 8149 senior citizens. The study determined population density using self-reported zip codes, measured as persons per square mile, and divided the results into tertiles. Linear mixed models were used to investigate the moderating role of race/ethnicity between population density and SI. The findings revealed that greater population density was associated with less SI for individuals residing in zip codes with a higher percentage of the same race/ethnicity, but more SI for those in zip codes with a lower percentage of the same race/ethnicity. These results suggest that race/ethnicity should be considered in future studies or when developing policies and interventions to address SI among older adults in high-population-density areas. For example, when policymakers aim to address SI in a community, they may want to collect data based on zip codes and create targeted interventions for specific racial/ethnic groups within those zip code areas.

Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis.

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (ß = .68, P < .001) and perceived stress (ß = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (ß = .65) * (ß = .40); and social support (ß = -.21) * (ß = -.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.

Digital music and movement intervention to improve health and wellbeing in older adults in care homes: a pilot mixed methods study.

BACKGROUND: Low physical activity among older adults is related to adverse health outcomes such as depression and loneliness, poor physical function and increased risk of falls. This study was designed to increase physical activity through a digital, group-based, physical activity and music intervention and to examine its effectiveness on social, mental and physical health outcomes. METHODS: Participants were 34 older adults (65 years +) recruited across four care homes in Scotland to a pilot study. Surveys were administered at baseline and post-intervention, comprising measures of fear of falling, depression and anxiety, loneliness, sleep satisfaction and quality of life. A battery of physical function tests and saliva sampling for cortisol and dehydroepiandrosterone hormone analysis were also conducted at each time point. Additionally, process evaluation measures (recruitment, intervention fidelity, attendance, retention rates and safety) were monitored. The intervention comprised 12 weeks of three prescribed digital sessions per week: movement and music (n = 2) and music-only (n = 1), delivered by an activity coordinator in the care home. Post-intervention interviews with staff and participants were conducted to gain qualitative data on the acceptability of the intervention. RESULTS: An average of 88% of prescribed sessions were delivered. Pre- to post-intervention intention-to-treat analysis across all participants revealed significant improvements in anxiety, salivary DHEA, fear of falling and loneliness. There were no significant improvements in health-related quality of life, perceived stress, sleep satisfaction or physical function tests, including handgrip strength. Qualitative analysis highlighted benefits of and barriers to the programme. CONCLUSIONS: The digital movement and music intervention was deemed acceptable and delivered with moderate fidelity, justifying progression to a full-scale trial. Although a proper control group would have yielded more confident causal relationships, preliminary psychosocial and biological effects were evident from this trial. To show significant improvements in physical function, it is likely that a bigger sample size providing sufficient power to detect significant changes, greater adherence, longer intervention and/or higher exercise volume may be necessary. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov, number NCT05601102 on 01/11/2022.

Social disconnection correlates of a "Wish to Die" among a large community-dwelling cohort of older adults.

Introduction: Social disconnection and deaths by suicide among older adults are both important public health concerns, particularly in the context of ageing populations. The association between death ideation and behaviours, and social disconnection is well established and both functional and structural social relationships have been identified as predictive of suicide-related thoughts and behaviours. The "Wish to Die" (WTD) involves thoughts of or wishes for one's own death or that one would be better off dead is a commonly used indicator to capture death ideation. It has been shown to be as predictive as active ideation of future suicide attempt. Methods: Data were from a large cohort of community-dwelling older adults aged 50+, The Irish Longitudinal Study on Ageing (TILDA). Cross-sectional analyses of the association between numerous markers of social disconnection (loneliness, social isolation, living alone, marital status, social participation, volunteering, and attending religious service) and WTD were conducted. Results: Multiple markers of social disconnection were associated with a "wish to die". However, loneliness was the strongest risk factor while attendance of religious services was an important protective behaviour. Discussion: There is a strong association between social disconnection and a WTD among older adults. There is also a strong association between depression and a WTD, while attending religious services or similarly prosocial settings may protect older adults from experiencing negative thoughts about dying.

Understanding the Effect of Loneliness on Quality of Life in Older Adults from Longitudinal Approaches.

Aim: To study the longitudinal relationship between loneliness and quality of life (QoL) in adults to identify key mechanisms to better design future psychosocial interventions. Method: 13,222 participants from three consecutive waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE), aged 65 or older, 56.3% women. They were analyzed using cross-lagged panel model (CLPM), random intercept cross-lagged panel model (RI-CLPM), and multi-group models disaggregated by gender. Results: The RI-CLPM provided a better fit than the CLPM. Both models showed the stability of QoL and loneliness. All autoregressive paths were significant, and a negative association between concurrent QoL and loneliness was observed across all waves. The CLPM supported a reciprocal relationship, while the RI-CLPM only confirmed the effects of loneliness on QoL. Women reported higher levels of loneliness and poorer QoL, but no gender differences were identified in the longitudinal association. Conclusions: Addressing loneliness in early stages could be a better preventive measure to promote quality of life in both genders.

Childhood conditions and mental health among youth and young adults in Greenland: a latent class analysis.

Poor mental health among youth in Greenland is a major challenge, childhood conditions are critical for mental health later in life. The study aimed to examine the clustering of childhood conditions by considering risk and protective factors for mental health among youth and young adults in Greenland and to explore the relationship between these clusters and mental health outcomes in youth. The study included 565 participants aged 15-34 living in Greenland. Seven indicators including childhood adversities (ACEs), childhood residence, language, and cultural indicators (protective factors) were used to define clusters via latent class analysis (LCA). The associations between clusters and mental health outcomes (satisfaction with life (Cantrill's ladder), self-esteem, self-efficacy, loneliness, psychological distress (General Health Questionnaire) and mental illness (Kessler 6)) were assessed by logistic regression. Four clusters were identified through LCA. While most participants reported positive childhoods, 40% (in two clusters) experienced ACEs. The two clusters differed as more participants in one cluster had experienced protective factors than the other. ACEs were associated with increased odds of negative aspects of mental health in youth. However, participants who faced high levels of adversity and few protective factors also had reduced odds of positive aspects of mental health in youth.

Social isolation and loneliness among people living with experience of homelessness: a scoping review.

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.

Animal companionship and psycho-social well-being: Findings from a national study of community-dwelling aging Canadians.

A growing body of evidence has provided support for the beneficial impact of human-animal interactions on a range of biological, social, and psychological outcomes for humans; however, less is conclusively known about the association between animal companionship and psycho-social health specifically among aging populations. In this study, we assessed the association between animal companionship and psycho-social well-being in a large sample (N = 30,865) of community dwelling Canadians aged 45 and older. Using cross-sectional data from the Canadian Community Health Survey-Healthy Aging, we conducted hierarchical multiple regression to assess the relationship between animal companionship and four domains of psycho-social well-being (satisfaction with life, loneliness, depression, and levels of social support) after controlling for socio-demographic factors and psycho-social measures. Results indicate that those with animal companionship report significantly higher levels of social support than aging Canadians without animal companionship; however, animal companionship was also associated with significantly lower levels of life satisfaction and higher levels of both loneliness and depression. These findings complicate the existing literature on human-animal interactions by suggesting the benefits associated with animal companionship may vary across distinct domains of psycho-social health. As such, results from this study highlight the need for more nuanced model specifications when assessing the relationship between animal companionship and psycho-social well-being. Implications of these findings for the provision of social services to older adults with pets are provided.

The association between mental status, personality traits, and discrepancy in social isolation and perceived loneliness among community dwellers.

BACKGROUND: Social isolation and loneliness can co-occur; however, they are distinct concepts. There is discrepancy as some people feel lonely in social isolation, while others do not. This study sought to enhance our understanding of this discrepancy between social isolation and loneliness by investigating its related factors, with a specific focus on mental status and personality traits. METHODS: This study adopted a cross-sectional study design and utilized data from the 2016 and 2018 waves of the University of Michigan Health and Retirement Study. The participants were community dwellers aged 50 years and older. The outcome measurement was defined as the discrepancy between social isolation, based on six criteria, and loneliness, assessed using the three-item version of the Revised UCLA Loneliness Scale. Multinomial logistic regression models were conducted to examine the factors associated with the discrepancy. RESULTS: Participants with fewer depressive symptoms and higher extraversion were associated with the only social isolation group and the only loneliness group rather than the group consisting of those who felt lonely with social isolation. In addition, lower neuroticism was associated with the only social isolation group. Participants with fewer depressive symptoms, lower neuroticism, and higher extraversion were more likely not to feel lonely even with social isolation, compared to feeling lonely even in the absence of isolation. CONCLUSIONS: Mental status and personality traits may be closely related to the discrepancy between social isolation and loneliness. This study suggests that incorporating social, mental, and psychological factors may be essential for interventions in social isolation and loneliness.

From childhood emotional abuse to adolescent loneliness: The roles of self-compassion and rejection sensitivity.

BACKGROUND: Emotional abuse is one of the important risk factors for adolescent loneliness. However, there is a shortage of information regarding protective factors and potential mediating mechanisms between emotional abuse and adolescent loneliness, which require further investigation. OBJECTIVES: The present study explored the chain mediating role of self-compassion and rejection sensitivity on the pathway from childhood emotional abuse to adolescent loneliness, based on attachment theory and a stress process model. PARTICIPANTS AND SETTING: Five hundred sixty-seven Chinese adolescents aged 12 to 17 years participated in this study. METHODS: An online questionnaire was utilized to assess a variety of variables including childhood emotional abuse, physical abuse, sexual abuse, self-compassion, rejection sensitivity, and loneliness. To increase the validity of the results, physical and sexual abuse were included as covariates since emotional abuse may co-occur with these types of abuse. RESULTS: Emotional abuse in childhood is significantly positively correlated with adolescent loneliness. Emotional abuse in childhood can affect adolescent loneliness not only directly, but also indirectly through self-compassion (including its components of self-warmth and self-coldness) and rejection sensitivity. CONCLUSIONS: This study sheds further light on the chain mediating role of self-compassion and rejection sensitivity in the relationship between emotional abuse in childhood and loneliness in adolescence, suggesting that intervention programs targeting increased self-compassion and decreased rejection sensitivity may be effective to reduce loneliness in adolescents.

"Maintaining symbiosis in conflict": the quality of life of disabled elderly individuals in Chinese elderly care institutions - a grounded theory study.

BACKGROUND AND OBJECTIVES: Exploring the quality of life of disabled elderly individuals in eldercare facilities holds significant importance in the improvement of service quality, the allocation of eldercare resources, and the enhancement of the well-being of the elderly. This study, grounded in the subjective perspective of disabled elderly individuals, aims to investigate their quality of life within eldercare institutions. RESEARCH DESIGN AND METHODS: A grounded theory approach was employed, involving semi-structured interviews with 35 participants. RESULTS: Data analysis revealed that the quality of life of disabled elderly individuals in Chinese elderly care institutions is characterized by "maintaining symbiosis in conflict" and encompasses four dimensions: complex adaptation process, complexities in social interactions, physical pain and the lonely soul. DISCUSSION AND IMPLICATIONS: Spending late years in elderly care institutions poses a trial and challenge for disabled elderly individuals, especially within a cultural environment that traditionally revolves around the "family" unit. In these institutions, disabled elderly individuals not only endure physical pain but also grapple with feelings of loneliness. They maintain the facade of family dignity by concealing true emotions, ensuring the harmonious and stable operation of the elderly care institution.Enhancing the quality of life for disabled elderly individuals requires not only an improvement in the service capabilities of elderly care institution staff but also collaborative efforts from policymakers and family members.

Loneliness and Social Isolation Factors Under the Prolonged COVID-19 Pandemic in Japan: 2-Year Longitudinal Study.

BACKGROUND: Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them. OBJECTIVE: In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population. METHODS: The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19-positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase. RESULTS: While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3. CONCLUSIONS: This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases.

Digital Interventions for Reducing Loneliness and Depression in Korean College Students: Mixed Methods Evaluation.

BACKGROUND: The COVID-19 pandemic has exacerbated the prevalence of loneliness and depression among college students. Digital interventions, such as Woebot (Woebot Health, Inc) and Happify (Twill Inc), have shown promise in alleviating these symptoms. OBJECTIVE: This study aims to investigate the effectiveness and acceptability of Woebot and Happify in reducing loneliness and depression among college students after the COVID-19 pandemic. METHODS: A mixed methods approach was used over 4 months. A total of 63 participants aged 18 to 27 years from Sungkyunkwan University in Seoul, South Korea, were initially recruited, with an inclusion criterion of University of California, Los Angeles (UCLA) Loneliness Scale score ≥34. The final sample consisted of 27 participants due to attrition. Participants were randomly assigned to Woebot (15/27, 55%); Happify (9/27, 33%); or a control group using Bondee (Metadream), a metaverse social network messenger app (3/27, 11%). Quantitative measures (UCLA Loneliness Scale and Patient Health Questionnaire-9) and qualitative assessments (user feedback and focused interviews) were used. RESULTS: Although mean decreases in loneliness and depression were observed in the control and intervention groups after the intervention, the differences between the control and intervention groups were not statistically significant (UCLA Loneliness: P=.67; Patient Health Questionnaire-9: P=.35). Qualitative data indicated user satisfaction, with suggestions for improved app effectiveness and personalization. CONCLUSIONS: Despite limitations, this study highlights the potential of well-designed digital interventions in alleviating college students' loneliness and depression. The findings contribute to the growing body of research on accessible digital mental health tools and underscore the importance of comprehensive support systems. Further research with larger and more diverse samples is needed to better understand the effectiveness and optimization of such interventions. TRIAL REGISTRATION: Clinical Research Information Service KCT0009449; https://bit.ly/4d2e4Bu.

Understanding and using experiences of social care to guide service improvements: translating a co-design approach from health to social care.

Background: Local authorities need to find new ways of collecting and using data on social care users' experiences to improve service design and quality. Here we draw on and adapt an approach used in the healthcare improvement field, accelerated experience-based co-design, to see if it can be translated to social care. We use loneliness support as our exemplar. Objectives: To understand how loneliness is understood and experienced by members of the public and characterised by social care and voluntary sector staff; to identify service improvements around loneliness support; to explore whether accelerated experience-based co-design is effective in social care; and to produce new resources for publication on Socialcaretalk.org. Design and methods: Discovery phase: in-depth interviews with a diverse sample of people in terms of demographic characteristics with experience of loneliness, and 20 social care and voluntary staff who provided loneliness support. Production of a catalyst film from the public interview data set. Co-design phase: exploring whether the accelerated experience-based co-design approach is effective in one local authority area via a series of three workshops to agree shared priorities for improving loneliness support (one workshop for staff, another for people with experience of local loneliness support, and a third, joint workshop), followed by 7-monthly meetings by two co-design groups to work on priority improvements. A process evaluation of the co-design phase was conducted using interviews, ethnographic observation, questionnaires and other written material. Results: Accelerated experience-based co-design demonstrated strong potential for use in social care. Diverse experiences of participants and fuzzy boundaries around social care compared to health care widened the scope of what could be considered a service improvement priority. Co-design groups focused on supporting people to return to pre-pandemic activities and developing a vulnerable passenger 'gold standard' award for taxi drivers. This work generated short-term 'wins' and longer-term legacies. Participants felt empowered by the process and prospect of change, and local lead organisations committed to take the work forward. Conclusions: Using an exemplar, loneliness support, that does not correspond to a single pathway allowed us to comprehensively explore the use of accelerated experience-based co-design, and we found it can be adapted for use in social care. We produced recommendations for the future use of the approach in social care which include identifying people or organisations who could have responsibility for implementing improvements, and allowing time for coalition-building, developing trusted relationships and understanding different perspectives. Limitations: COVID-19 temporarily affected the capacity of the local authority Project Lead to set up the intervention. Pandemic work pressures led to smaller numbers of participating staff and had a knock-on effect on recruitment. Staff turnover within Doncaster Council created further challenges. Future work: Exploring the approach using a single pathway, such as assessing eligibility for care and support, could add additional insights into its transferability to social care. Trial registration: This trial is registered as Current Controlled Trials ISRCTN98646409. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128616) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 27. See the NIHR Funding and Awards website for further award information.

Local councils need to find new ways of using people's experiences of social care to improve services. We explored whether a way of improving health services can improve social care services. 'Experience-based co-design' is a complicated name. It means working with people who use health or social care services to improve that service, and interviewing people as part of this process. Accelerated experience-based co-design uses existing interviews instead of new interviews. To see if the approach works in social care, we chose the topic of loneliness because many of us experience loneliness. We worked with Doncaster City Council because it has been focusing on loneliness. We interviewed 37 people across England and recorded what they said about loneliness. We made a film about their experiences that showed examples of good or poor care. We call these touch points. We held three workshops in Doncaster. Workshop 1 was with people who work in social care as paid workers or volunteers, and workshop 2 was with people who use social care services. In both workshops, people made a list of types of support that needed improvement. Both groups attended workshop 3, watched the film and decided what to focus on from the two lists. Two groups were set up to work on improving support for loneliness in Doncaster. Each group met seven times. One focused on taxi services, and the other group focused on supporting people to do activities they did before the pandemic. A researcher attended these meetings and talked with everyone involved to see how this approach worked. At the end, there was a celebration event. We found that loneliness is complicated. We found the approach to improving support does work in social care, but it needs some changes because social care is not like health care. We suggest ways the approach can be done differently.

Comparing cognitive behavioral therapy and social prescribing in patients with loneliness on long-term opioid therapy to reduce opioid misuse: protocol for a randomized controlled trial.

BACKGROUND: Patients with chronic pain on opioids frequently experience loneliness, which is associated with poorer health outcomes and higher risk for opioid misuse and opioid use disorder. Given that almost half of opioids are prescribed in primary care, a critical need exists for the development and testing of interventions to reduce loneliness in primary care patients at risk for opioid misuse. Cognitive behavioral therapy and social prescribing have been shown to be efficacious in reducing loneliness and improving outcomes in other populations but have not been tested in patients at risk for substance use disorder. The overall objective of our study is to reduce opioid misuse and opioid use disorder by addressing loneliness in patients on long-term opioid therapy in real-world primary care settings. METHODS: We will conduct a 3-arm pragmatic, randomized controlled trial to compare the effectiveness of two group-based, telehealth-delivered interventions with treatment as usual: (1) cognitive behavioral therapy to address maladaptive thought patterns and behaviors around social connection and (2) a social prescribing intervention to connect participants with social opportunities and develop supportive social networks. Our primary outcome is loneliness as measured by the UCLA Loneliness Scale and our dependent secondary outcome is opioid misuse as measured by the Common Opioid Misuse Measure. We will recruit 102 patients on long-term opioid therapy who screen positive for loneliness from 2 health care systems in Washington State. Implementation outcomes will be assessed using the RE-AIM framework. DISCUSSION: Our study is innovative because we are targeting loneliness, an under-addressed but critical social risk factor that may prevent opioid misuse and use disorder in the setting where most patients are receiving their opioid prescriptions for chronic pain. If successful, the project will have a positive impact in reducing loneliness, reducing opioid misuse, improving function and preventing substance use disorder. TRIAL REGISTRATION: NCT06285032, issue date: February 28, 2024, original.

Older persons making a life closure: experiences of loneliness in an academic nursing home - a phenomenological qualitative interview study.

BACKGROUND: Loneliness is a public health concern and more than half of the residents in nursing homes experience lonliness. Risk factors are age and loss of close relatives. PURPOSE: This study aimed to describe experiences of loneliness among older people living in an academic nursing home. METHODS: Qualitative semi-structured interviews were conducted with ten older people and data analysed with systematic text condensation inspired by a phenomenological approach. RESULTS: Three themes were identified: "Relatives and health care professionals matter"; "Acceptance and meaningful existence alleviate loneliness"; and "Challenges affecting the experience of loneliness". The older persons described themselves as lonely, but their experience of loneliness differed. They managed loneliness by adapting to it or getting used to it; some also chose to be alone. To add meaningfulness to their daily life, talking about memories and their past were appriciated. Personality traits and variations in functional ability were identified as barriers to social interactions. CONCLUSIONS: Health care professionals can reduce negative experiences of loneliness by listening to nursing home residents, creating a meaningful daily life with individualized activities, and by encouraging contacts with close relatives. This can be a way of maintaining older persons' dignity and coping with the longing for what has been.