Table 4.

Summary of key recommendations for technology interventions.

Category	Key recommendations	Certainty of evidence
General ICTa	Simple technology interventions can be more successful than complex ones. Usability is a potentially important outcome. ICT is not recommended for increasing either the quantity or quality of communications or helping to establish new relationships. It is recommended for maintaining and enhancing existing relationships and access to services (such as health-related services).	Moderate
SNSb	SNS is not recommended as an intervention for loneliness and isolation as SNS use has often been shown to worsen loneliness. SNS is useful in knowledge and support acquisition scenarios, which can themselves reduce loneliness. Research shows that SNSs are generally more successful in these scenarios than in making new connections. Privacy is an important concern among older adults and needs to be considered when designing an intervention. Usability is potentially a very important theme and needs to be factored into the study design.	Low
Videoconferencing	Videoconferencing reduces loneliness by providing social support and improving the existing conditions in health care–type situations. Financial investment (eg, cost of computer hardware) needs to be considered when planning a videoconferencing intervention.	Moderate low
MIMc	MIM is recommended for rapid deployment as it is easy to use, and applications such as WhatsApp additionally allow the sharing of pictures, which can improve social connectedness. MIM can replace email, but designers must be wary because any lack of responses can increase the perception of loneliness.	Very low
Computer and internet training	Longer training periods are recommended with shorter-duration studies (as highlighted above) as they have been the most effective. For reducing loneliness, group-based training is more effective than one-to-one training. The study design should reflect whether the training or use of the intervention causes reduction in loneliness. RCTsd are particularly important in the study design as they determine precise effect sizes.	Low
Telecare	Frequency of contact combined with telecare solution influences the success of an intervention. Interventions designed for regular frequent contact are more successful than interventions delivered on-demand; for example, when a resident needs clinical attention. Videoconferencing groups such as group counseling can help to reduce feelings of anxiety, isolation, and loneliness and provide emotional and social support; however, designers must understand that some participants do not immediately feel at ease with others, especially in a group setting.	Very low
Robotics	Pet robots can provide the same advantages as animal-assisted therapy in reducing loneliness and social isolation; study designs can mimic previous studies in this area. Conversational agents provide companionship through social interaction, enabling older adults to connect with family members and friends (social presence). These agents can be effective and are recommended for intervention studies. RCTs are recommended in the study design of robotic interactions, especially as this area is understudied.	Moderate low
Gaming	Video gaming devices such as Wii, which capture natural physical activities, are recommended as they reduce loneliness and provide better social interactions than typical video games.	Very low
3D and augmented reality	Too few of the existing studies provide robust recommendations, and further longitudinal and cross-sectional RCT studies are needed in this area.	Very low

^aICT: information and communications technology.

^bSNS: social networking site.

^cMIM: mobile instant messaging.

^dRCT: randomized controlled trial.