Abstract
Loneliness is considered a critical global public health issue, with its prevalence rising across regions and populations, adversely affecting quality of life among older adults. This quasi-experimental design aimed to determine the effects of Together We Thrive, a culturally adapted, group-based psychosocial program on loneliness, social connection, depression, cognitive function, and quality of life among older adults in Northern Thailand. Fifty participants were randomly assigned to either the experimental group (n = 25) or the control group (n = 25). The experimental group received the 12-week closed-group Together We Thrive program (fixed membership to foster group dynamics) with culturally relevant activities (arts and crafts, folk dance, writing, and storytelling) in groups of eight or nine older adults with two facilitators. The control group attended a one-day educational program. The intervention was refined based on feedback from older adults experiencing loneliness to ensure contextual relevance and acceptability. The cultural adaptation process was further strengthened by active involvement of these older adults. Outcome measures included the 6-item Revised UCLA Loneliness Scale, the Lubben Social Network Scale, the Geriatric Depression Scale-Short Form, the Cognitive Failures Questionnaire, and the WHOQOL-BREF. Assessments were conducted at 3 time points: baseline, post-intervention (12 weeks), and follow-up (24 weeks). Repeated-measures ANOVA revealed significant interaction effects for loneliness (P = .037, η² = .104), social networks (P = .031, η² = .109), and quality of life (P = .026, η² = .114), favoring the experimental group. No significant changes were observed in depression or cognitive function. Results indicated that the program effectively strengthened social connections, reduced loneliness, and improved quality of life among older adults experiencing loneliness.