Design of a Digital Intervention to Improve Connectivity and Reduce Loneliness in Older Adults (Preprint)

BACKGROUND The COVID-19 pandemic impacted older adults' social connections and increased loneliness, but also led to increased technology adoption, providing new opportunities to develop technology interventions to meet their social needs. Existing off the shelf social connection platforms do not contain facilities designed to break the cognitive cycle of loneliness, and loneliness interventions implemented without due process could cause detriments to wellbeing. There is also lack of digital technology designed with older adults. OBJECTIVE We set out to iteratively design a user-centred smartphone app that could address older adult needs for social connection. The research questions were: how could our prototype smartphone app be used in mitigating loneliness and increasing a sense of social connectedness? What were emergent concerns resulting from use? In what ways could it be improved to better meet user needs? METHODS We used technology probes to elicit older adults' reflection on the concept of using the app in two studies: Concept focus groups (N=33) and Concept interviews (N=10), and then conducted a prototype trial with one week of use and follow up interviews (N=12). RESULTS A thematic analysis was conducted to explore the experience and emergent challenges of our app through the design process. This led to the development of four themes occurring in all three qualitative datasets: 1) Reflection on a digital social map is reassuring, 2) App features encourage socialising, 3) Risk of compounding loneliness, and 4) Feeling more control with mutual, socially beneficial activities. CONCLUSIONS Smartphone apps have the potential to increase older people’s awareness of the richness of their social connections, which may support loneliness reduction. Our qualitative approach to app design enabled the inclusion of older adults' experiences in the technology design. With that, we conclude that our older adults most desired functionalities that can support mutual activities and maintaining or finding new connections, rather than sharing of emotional state. They were wary of the app being used to replace preferred in-person social interactions, and they raised concerns about making the user aware of a lack of connections or support in their social network, unless they are offered specific means of addressing their needs. Further user-centred design work is needed to enhance the app to support mutual activities and socialising. Our study illustrates the continued importance of user-centred design work to ensure that digital interventions are designed for populations like older adults.