Design Requirements for mHealth Solutions to Mitigate Loneliness in Older Adults: A Mixed-Methods Study

Loneliness in later life is common and harmful, yet interventions show modest, heterogeneous effects, partly because services are designed without explicit user requirements. We conducted a cross-sectional mixed-methods study to derive design requirements for mHealth-based loneliness support. Twenty-seven smartphone-using older adults in Hong Kong (aged 60–78) who screened positive for elevated loneliness completed standardized measures and semi-structured interviews. Participants reported high loneliness (UCLA Loneliness Scale version 3: mean 51.3, SD 9.3) and constrained social networks (63.0% below the LSNS-6 cutpoint of 12). Their accounts distinguished solitude, emotional loneliness even in company, and fear that no one could help in time; engagement was shaped by self-reliance, channel fit, and scam-related distrust. We derived six design requirements: recognizable, verifiable contact; hybrid delivery; human-in-the-loop support; low-burden, Cantonese-first usability; privacy as a baseline; and engagement fit. These requirements inform the design of mHealth-based loneliness support, including conversational interfaces.