Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effective intervention strategy for reducing loneliness, most existing programs aimed at older individuals do not use that method. Further, in terms of mental health service use, older individuals have been found to be an extremely undertreated population. When developing interventions, active involvement of end users in the development process is essential to increase later uptake. The aim of the present study was to develop an internet-based CBT intervention for loneliness in older individuals (i.e., aged ≥65 years) applying a user-centered design. The present report provides an in-depth description of the development process. Two phases of qualitative data collection were conducted in parallel with intervention development using a sample of = 12 participants including both potential end users (i.e., older adults) as well as experts (i.e., psychotherapists). Measures included semi-structured interviews and usability testing. In Phase 1 interviews, participants indicated that they were predominantly positive about the idea of an internet-based program for loneliness targeting older individuals. Individualization and interactivity were named as crucial features. In Phase 2, usability testing of a prototype program provided important insights into technical barriers to intervention use. Further, participants reported that they were missing content on philosophy/theology and the role of descendants/relatives. Valuable insights from Phase 1 and Phase 2 were incorporated into the intervention program resulting in a 7-module internet-based self-help CBT intervention. Findings of this study highlight the significance of including relevant stakeholders in the development process of an intervention. Additionally, results emphasize the high acceptance of internet-based interventions in this population, but also underline the need for considering age-specific aspects when developing treatments.

中文翻译：

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以用户为中心开发基于互联网的 CBT 干预措施，用于治疗老年人的孤独感

孤独是一种普遍现象，与许多负面的健康结果相关。老年人可能是需要有效干预的重要目标群体。然而，尽管有证据表明解决适应不良的社会认知（例如，通过认知行为疗法[CBT]）是减少孤独感的最有效的干预策略，但大多数针对老年人的现有计划并未使用该方法。此外，在心理健康服务的使用方面，老年人被发现是一个极未得到充分治疗的人群。在制定干预措施时，最终用户积极参与制定过程对于提高后续的采用至关重要。本研究的目的是采用以用户为中心的设计，开发一种基于互联网的 CBT 干预措施，针对老年人（即年龄≥65 岁）的孤独感。本报告深入描述了开发进程。定性数据收集的两个阶段与干预措施的开发同时进行，使用了 12 名参与者的样本，其中包括潜在的最终用户（即老年人）和专家（即心理治疗师）。措施包括半结构化访谈和可用性测试。在第一阶段的采访中，参与者表示，他们对针对老年人的基于互联网的孤独项目的想法持积极态度。个性化和交互性被认为是关键特征。在第二阶段，原型程序的可用性测试为干预使用的技术障碍提供了重要的见解。此外，参与者报告说，他们缺少有关哲学/神学以及后代/亲戚的角色的内容。第一阶段和第二阶段的宝贵见解被纳入干预计划，形成了包含 7 个模块的基于互联网的自助 CBT 干预。这项研究的结果强调了让相关利益相关者参与干预措施制定过程的重要性。此外，结果强调了该人群对基于互联网的干预措施的高度接受，但也强调在开发治疗方法时需要考虑特定年龄方面的因素。