Alleviating Loneliness in Older Adults Living in Poverty: A Multi-level Intervention

NCT ID: NCT07123064

Last Updated: 2025-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1344 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-15

Study Completion Date

2029-05-31

Brief Summary

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The study aims to reduce loneliness among Hong Kong Chinese older adults living in poverty with a multi-level intervention involving components at the individual, interpersonal, and community levels.

Detailed Description

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Loneliness is widespread, with negative impacts on both individuals and society and associated direct and indirect healthcare and long-term care costs. Thus, it is imperative to alleviate loneliness in old age by implementing effective, accessible, affordable, and scalable interventions. Loneliness is often erroneously considered an individual problem due to personal failure. Still, growing evidence indicates that loneliness is caused by factors at multiple levels, including the individual, interpersonal, and community levels. Hence, a multi-level approach is recommended to alleviate loneliness.

However, multi-level interventions for reducing loneliness are in their infancy, and there is yet to be evidence to suggest that they are more effective than single-level interventions. The investigators will conduct an innovative and impactful study to fill this important research gap. This study is a single-blinded cluster, four-arm randomized controlled trial (RCT) designed to test the effect and cost-effectiveness of a multi-level intervention to alleviate loneliness among Hong Kong Chinese older adults living in poverty. The investigators will also adopt the modified biopsychosocial (BPS) model, called the BPS-Pathways model, as the theoretical framework to guide our selection of interventions, mediators, secondary outcomes, long-term outcomes, and impact.

Conditions

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Loneliness Poverty

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single Blinded, 4-arm cluster randomized controlled trial
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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First Arm

Individual-level

Group Type EXPERIMENTAL

Individual Level

Intervention Type BEHAVIORAL

A 8-weekly, 1hour telephone-delivered sessions using mindfulness and SOLUS-D program. Key contents include: introduction to mindfulness - Body awareness and present moment experiences, emotional awareness and mind-body labeling, relaxation techniques and sensory discrimination, deepening awareness and accepting feelings, personal values, interconnection between thought patterns and emotions, identifying and analyzing of thought traps, and challenging thoughts and future planning. Maintenance sessions which focus on embedding mindfulness practices and SOLUS-D program among older adults as a persistent habit will be conducted.

Second Arm

Individual- and Interpersonal-level

Group Type EXPERIMENTAL

Individual Level

Intervention Type BEHAVIORAL

A 8-weekly, 1hour telephone-delivered sessions using mindfulness and SOLUS-D program. Key contents include: introduction to mindfulness - Body awareness and present moment experiences, emotional awareness and mind-body labeling, relaxation techniques and sensory discrimination, deepening awareness and accepting feelings, personal values, interconnection between thought patterns and emotions, identifying and analyzing of thought traps, and challenging thoughts and future planning. Maintenance sessions which focus on embedding mindfulness practices and SOLUS-D program among older adults as a persistent habit will be conducted.

Interpersonal Level

Intervention Type BEHAVIORAL

A 8 weekly, 1hr sessions through telephone or Zoom using the Group 4 Health. Key contents include: understanding the benefits of social connections, exploring self and community, community and action, support and breakthrough, summary and moving forward. Maintenance sessions which focus on continuous practice of support and community will be conducted.

Third Arm

Individual-, Interpersonal-, and Community-level

Group Type EXPERIMENTAL

Individual Level

Intervention Type BEHAVIORAL

A 8-weekly, 1hour telephone-delivered sessions using mindfulness and SOLUS-D program. Key contents include: introduction to mindfulness - Body awareness and present moment experiences, emotional awareness and mind-body labeling, relaxation techniques and sensory discrimination, deepening awareness and accepting feelings, personal values, interconnection between thought patterns and emotions, identifying and analyzing of thought traps, and challenging thoughts and future planning. Maintenance sessions which focus on embedding mindfulness practices and SOLUS-D program among older adults as a persistent habit will be conducted.

Interpersonal Level

Intervention Type BEHAVIORAL

A 8 weekly, 1hr sessions through telephone or Zoom using the Group 4 Health. Key contents include: understanding the benefits of social connections, exploring self and community, community and action, support and breakthrough, summary and moving forward. Maintenance sessions which focus on continuous practice of support and community will be conducted.

Community Level

Intervention Type BEHAVIORAL

A 4 weekly, 2hour in-person sessions through (1) strengthening collective efficacy via neighbor identification with the community. Key contents include: building neighbourhood connections, getting to know each other, health aging, neighbourhood care, vibrant exploration, thriving community, connecting the dots.

Forth Arm

Education Control Group

Group Type ACTIVE_COMPARATOR

Education Control

Intervention Type OTHER

Monthly monthly messages via text, graphics or voice recordings will be sent over a period of 6 months. Key content includes: healthy diet tips, recognizing warning signs of health, understanding dementia, fall prevention tips, health message, and anti-fraud tips.

Interventions

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Individual Level

A 8-weekly, 1hour telephone-delivered sessions using mindfulness and SOLUS-D program. Key contents include: introduction to mindfulness - Body awareness and present moment experiences, emotional awareness and mind-body labeling, relaxation techniques and sensory discrimination, deepening awareness and accepting feelings, personal values, interconnection between thought patterns and emotions, identifying and analyzing of thought traps, and challenging thoughts and future planning. Maintenance sessions which focus on embedding mindfulness practices and SOLUS-D program among older adults as a persistent habit will be conducted.

Intervention Type BEHAVIORAL

Interpersonal Level

A 8 weekly, 1hr sessions through telephone or Zoom using the Group 4 Health. Key contents include: understanding the benefits of social connections, exploring self and community, community and action, support and breakthrough, summary and moving forward. Maintenance sessions which focus on continuous practice of support and community will be conducted.

Intervention Type BEHAVIORAL

Community Level

A 4 weekly, 2hour in-person sessions through (1) strengthening collective efficacy via neighbor identification with the community. Key contents include: building neighbourhood connections, getting to know each other, health aging, neighbourhood care, vibrant exploration, thriving community, connecting the dots.

Intervention Type BEHAVIORAL

Education Control

Monthly monthly messages via text, graphics or voice recordings will be sent over a period of 6 months. Key content includes: healthy diet tips, recognizing warning signs of health, understanding dementia, fall prevention tips, health message, and anti-fraud tips.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* aged 65 years or older
* living in poverty (defined: inability to afford at least 5 items on the material deprivation index)
* proficiency in spoken Cantonese
* experiencing loneliness (defined: score of ≥ 6 on the 3-item UCLA Loneliness Scale)

Exclusion Criteria

* cognitive impairments, psychiatric disorders, learning disabilities, or active suicidal ideation
* actively participating in other psychotherapy or psychosocial interventions in the past 1 year


\-
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University College, London

OTHER

Sponsor Role collaborator

The Hong Kong Polytechnic University

OTHER

Sponsor Role collaborator

University of Texas at Austin

OTHER

Sponsor Role collaborator

Australian National University

OTHER

Sponsor Role collaborator

The University of Hong Kong

OTHER

Sponsor Role collaborator

Medical School Berlin

OTHER

Sponsor Role collaborator

Chinese University of Hong Kong

OTHER

Sponsor Role collaborator

University of Bern

OTHER

Sponsor Role collaborator

Linkoeping University

OTHER_GOV

Sponsor Role collaborator

Education University of Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Chou Kee Lee

Chair Professor of Social Policy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kee Lee Chou, PhD

Role: PRINCIPAL_INVESTIGATOR

The Education University of Hong Kong

Locations

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The Education University of Hong Kong

Hong Kong, , Hong Kong

Site Status

Countries

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Hong Kong

Facility Contacts

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Kee Lee Chou, PhD

Role: primary

+85229487473

Vivien Tang, MSc

Role: backup

References

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Other Identifiers

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R8002-24

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2023-2024-0624

Identifier Type: -

Identifier Source: org_study_id

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