Background: Loneliness is a growing area of concern, attracting attention as a public health concern due to its association with a variety of psychological and physical health problems. However, interventions targeting loneliness are less common than interventions for other mental health problems, such as depression and anxiety, and existing interventions focus primarily on building social skills and increasing opportunities for social interaction despite research suggesting these techniques are not the most effective. Furthermore, although there is an increasing need for scalable and convenient interventions, digital interventions for loneliness are even less common. Objective: Using a qualitative approach, we explore how adults (18-64 years of age) who express wanting to be more connected to others experience loneliness and react to a digital mental health intervention targeting loneliness. Methods: A total of 11 participants were recruited from a pilot randomized controlled trial exploring the impact of a digital mental health intervention, Happify Health, on loneliness among adults aged 18-64 years who indicated wanting to feel more connected to others when signing up for the platform. Participants were invited to participate in a 3-day asynchronous focus group about their experiences with loneliness, with Happify Health, and with social distancing during the COVID-19 pandemic. All 11 participants completed the focus group in May 2020. Results: Participants’ responses were coded using thematic analysis, which led to identifying five themes, each with separate subthemes, that could be applied across the 3-day focus group: loneliness, relationships, social distancing, skill acquisition, and coping. Overall, we observed variability across participants in terms of the source of their loneliness, their perceptions of their social connections, and their motivation to reduce feelings of loneliness; however, participants commonly referred to negative self-perceptions as a cause or consequence of loneliness. Participants also varied in the extent to which they felt social distancing increased or decreased feelings of loneliness. In regard to the intervention, participants showed evidence of adopting skills they used to address their loneliness, particularly mindfulness and gratitude, and then using these skills to shift toward more active coping strategies following the intervention, including during the COVID-19 pandemic. Conclusions: The heterogeneity in participants’ experiences with loneliness described during this focus group emphasizes the subjective and complex nature of loneliness. This highlights the importance of developing loneliness interventions that use a variety of strategies, including both direct and indirect strategies for reducing loneliness. However, based on our data, a key component to loneliness interventions is incorporating strategies for addressing underlying negative self-perceptions that stem from, but also contribute to, loneliness. This data also provides preliminary evidence that digital platforms may be an effective tool for disseminating loneliness interventions while providing the added benefit of offering a productive distraction when feeling lonely.

中文翻译：

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定性焦点小组：在COVID-19期间进行数字干预（幸福）对孤独感的影响

背景：孤独感是一个日益受到关注的领域，由于它与各种心理和身体健康问题相关联，因此引起了公众的关注。但是，针对孤独感的干预措施不如针对其他精神健康问题（如抑郁症和焦虑症）的干预措施普遍，尽管研究表明这些技术并非最有效，但现有的干预措施主要侧重于培养社交技能和增加社交互动机会。此外，尽管对可扩展且方便的干预措施的需求不断增长，但针对孤独感的数字干预措施却很少见。目的：使用定性方法，我们探讨了表示希望与他人建立更多联系的成年人（18-64岁）如何体验孤独感，并对针对孤独感的数字心理健康干预措施做出反应。方法：从一项试点随机对照试验中招募了11名参与者，探讨数字心理健康干预措施Happify Health对18-64岁成年人的孤独感的影响，这些人表示希望在注册时感到与他人的联系更加紧密该平台。邀请参与者参加为期3天的异步焦点小组，讨论他们在COVID-19大流行期间的孤独感，快乐健康和社会疏远经历。所有11位参与者在2020年5月完成了焦点小组讨论。结果：参与者的回答使用主题分析进行编码，从而确定了五个主题，每个主题都有单独的子主题，这些主题可以应用到为期三天的焦点小组中：寂寞，人际关系，社交距离，技能获得和应对。总体而言，我们从参与者的孤独感，对社交关系的感知以及减少孤独感的动机方面观察到了参与者之间的差异。然而，参与者通常将负面的自我感知称为孤独的原因或后果。参与者在不同程度上感到社交疏远会增加或减少孤独感。在干预方面，参与者展示了他们采用的技巧来解决孤独感，尤其是正念和感恩，结论：在这个焦点小组中，参与者对孤独感体验的异质性强调了孤独感的主观性和复杂性。这突出了开发使用各种策略的孤独干预的重要性，包括降低孤独感的直接和间接策略。但是，根据我们的数据，孤独干预的一个关键组成部分是纳入解决潜在的负面自我认知的策略，这些负面自我认知源自但也有助于孤独。这些数据还提供了初步的证据，表明数字平台可能是传播孤独干预的有效工具，同时还提供了在感到孤独时提供有效注意力的额外好处。