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Building Blocks for Addressing Social Determinants of Health.

professor of nursing at West Virginia University in Morgantown. In reality, though, loneliness is a psychological construct linked to depression and anxiety, said Theeke, who has developed an intervention called LISTEN, which stands for “Loneliness Intervention using Story Theory to Enhance Nursing-sensitive outcomes.” Theeke and her collaborators recently published the results of a pilot study of LISTEN and are now seeking funding to conduct a larger study. The pilot included 27 cognitively normal adults (only 3 were men) who, to avoid confounding because of the grief reaction, had not lost a spouse in the previous 2 years. They were randomized to the LISTEN intervention or to a control group and met in groups of 3 to 5 with a facilitator for 5 weekly 2-hour sessions. Those in the control group received educational information about aging, while LISTEN participants talked about patterns of thought and behavior that were contributing to their perception of loneliness. “There is a stigma associated with loneliness, and it’s the stigma of social undesirability,” she said. But LISTEN participants learn that “it’s okay to have loneliness and to say it. They like hearing that they’re not the only person who feels this way.” They talked about times in their life when they weren’t lonely, shared ways that they met the challenge of living with loneliness, and identified potential new solutions to their loneliness. To put it simply, Theeke said, “LISTEN is like teaching a person how to fish.” Twelve weeks after the last session, LISTEN participants reported reduced loneliness, enhanced social support, and decreased systolic blood pressure compared with baseline. On the other hand, the control group reported decreased functional ability and reduced quality of life. Several people who completed the LISTEN study made major life changes afterward, Theeke said. For example, an 89-year-old woman realized that the times in her life that she was least lonely were when she lived with or near her daughter. After completing the study, the woman decided to move to her daughter’s town several states away. Although the pilot study was geared toward older adults, Theeke thinks LISTEN would also work with younger people. “We designed LISTEN to help people reconnect with their own individualized need to belong. I think that’s why it works,” said Theeke, adding that she hopes eventually to offer LISTEN online as well as face-to-face.