Background/Objectives: This cross-national study focuses on adolescents who provide care and support to family members or significant others. Current evidence regarding their mental health and solutions to strengthen it is limited and mostly available in a few countries. The aim of this study is to evaluate the results of a primary prevention intervention for improving the mental health and well-being of adolescent young carers (AYCs) aged 15-17 years in six European countries. The intervention was based on a psychoeducational program and tools adapted from the Discoverer, Noticer, Advisor, and Values (DNA-V) model. Methods: We designed a randomized controlled trial with 217 AYCs participating in the study, either in the intervention or control group. Quantitative and qualitative data were collected via questionnaires at baseline, post-intervention, and a 3-month follow up. Results: The results were mixed, as positive improvements in primary (i.e., psychological well-being and skills) and secondary (school/training/work functioning) outcomes were shown by the experimental group but, in most cases, they were not statistically significant. The qualitative data supported positive claims about the intervention and its appropriateness for AYCs. Conclusions: The study implementation during the peak of the COVID-19 pandemic forced the consortium to adapt the design and may have influenced the results. More long-term studies are needed to assess similar mental health programs with this hard-to-reach target group.

Young carers provide a substantial amount of care to family members and support to friends, yet their situation has not been actively addressed in research and policy in many European countries or indeed globally. Awareness of their situation by professionals and among children and young carers themselves remains low overall. Thus, young carers remain a largely hidden group within society. This study reports and analyses the recruitment process in a multi-centre intervention study offering psychosocial support to adolescent young carers (AYCs) aged 15–17 years. A cluster-randomised controlled trial was designed, with recruitment taking place in Italy, the Netherlands, Slovenia, Sweden, Switzerland and the United Kingdom exploiting various channels, including partnerships with schools, health and social services and carers organisations. In total, 478 AYCs were recruited and, after screening failures, withdrawals and initial dropouts, 217 were enrolled and started the intervention. Challenges encountered in reaching, recruiting and retaining AYCs included low levels of awareness among AYCs, a low willingness to participate in study activities, uncertainty about the prevalence of AYCs, a limited school capacity to support the recruitment; COVID-19 spreading in 2020–2021 and related restrictions. Based on this experience, recommendations are put forward for how to better engage AYCs in research.

Young carers are children and adolescents who provide care to other family members or friends, taking over responsibilities that are usually associated with adulthood. There is emerging but still scarce knowledge worldwide about the phenomenon of young carers and the impact of a caring role on their health, social and personal development spheres. This paper provides an overview of the main results from the ME-WE project, which is the first European research and innovation project dedicated to adolescent young carers (AYCs) (15–17 years). The project methods relied on three main activities: (1) a systematization of knowledge (by means of a survey to AYCs, country case studies, Delphi study, literature review); (2) the co-design, implementation and evaluation of a primary prevention intervention addressing AYCs’ mental health (by means of Blended Learning Networks and a clinical trial in six European countries); (3) the implementation of knowledge translation actions for dissemination, awareness, advocacy and lobbying (by means of national and international stakeholder networks, as well as traditional and new media). Project results substantially contributed to a better understanding of AYCs’ conditions, needs and preferences, defined tailored support intervention (resilient to COVID-19 related restrictions), and significant improvements in national and European policies for AYCs.

Samenvatting In de loop der jaren is een breed aanbod aan eenzaamheidsinterventies voor ouderen ontwikkeld. Het merendeel van de interventies blijkt weinig effectief in het verminderen van eenzaamheid. Om meer inzicht te krijgen in waarom veel interventies niet het gewenste doel bereiken, gaan we in op de werkzame elementen die in interventies worden ingezet om eenzaamheid te reduceren, of waarmee subdoelen bereikt kunnen worden: een sociaal netwerk hebben, erbij horen, intimiteit ervaren, betekenis hebben. Om tot een indeling in werkzame elementen te komen is een kwalitatieve analyse uitgevoerd van 119 eenzaamheidsinterventies, beschreven in 22 reviews van interventies. Het resultaat is een indeling in zeven werkzame elementen: ‘bezigheden’, ‘ontmoeten’, praktisch ondersteunen’, ‘betekenisvol contact’, ‘sociale vaardigheden’, ‘realistische verwachtingen’ en ‘betekenisvolle rol’. De meeste interventies combineren verschillende werkzame elementen. Sommige combinaties van werkzame elementen komen vaak voor. Door afzonderlijke onderdelen van interventies in kaart te brengen, kan de werkzaamheid van elk element geëvalueerd worden. Het inzetten van een combinatie van werkzame elementen, en van algemene werkzame elementen zoals een goede uitvoering, kan de effectiviteit van interventies vergroten. Abstract Over the years, a wide range of loneliness interventions for older adults have been developed. The majority of these interventions are not effective in reducing loneliness. In order to gain more insight into why many interventions do not achieve the desired goal, we examine active elements that are used in interventions into reduce loneliness. In order to achieve this goal, intermediate goals are needed: to have a social network, a sense of belonging, to experience intimacy, to experience meaning. In order to arrive at a division into active elements, a qualitative analysis was carried out of 119 loneliness interventions, described in 22 reviews of interventions. The result is a division into seven active elements: ‘activities’, ‘meeting others’, practical support’, ‘meaningful contact’, ‘interpersonal skills’, ‘realistic expectations’ and ‘meaningful role’. Most interventions combine several active elements. Some combinations of active elements are common. By mapping out the individual components of interventions, the effectiveness of each element can be evaluated. The use of a combination of active elements, and of general active elements such as good execution, may increase the effectiveness of interventions.

Over the years, a wide range of loneliness interventions for older adults have been developed. The majority of these interventions are not effective in reducing loneliness. In order to gain more insight into why many interventions do not achieve the desired goal, we examine active elements that are used in interventions into reduce loneliness. In order to achieve this goal, intermediate goals are needed: to have a social network, a sense of belonging, to experience intimacy, to experience meaning. In order to arrive at a division into active elements, a qualitative analysis was carried out of 119 loneliness interventions, described in 22 reviews of interventions. The result is a division into seven active elements: 'activities', 'meeting others', practical support', 'meaningful contact', 'interpersonal skills', 'realistic expectations' and 'meaningful role'. Most interventions combine several active elements. Some combinations of active elements are common. By mapping out the individual components of interventions, the effectiveness of each element can be evaluated. The use of a combination of active elements, and of general active elements such as good execution, may increase the effectiveness of interventions.

Background Online interventions can be as effective as in-person interventions. However, attrition in online intervention is high and potentially biases the results. More importantly, high attrition rates might reduce the effectiveness of online interventions. Therefore, it is important to discover the extent to which factors affect adherence to online interventions. The setting for this study is the online Friendship Enrichment Program, a loneliness intervention for adults aged 50 years and older. Objective This study examined the contribution of severity of loneliness, coping preference, activating content, and engagement in attrition within an online intervention. Methods Data were collected from 352 participants in an online loneliness intervention for Dutch people aged 50 years and older. Attrition was defined as not completing all 10 intervention lessons. The number of completed lessons was assessed through the management system of the intervention. We tested 4 hypotheses on attrition by applying survival analysis (Cox regression). Results Of the 352 participants who subscribed to the intervention, 46 never started the introduction. The remaining 306 participants were divided into 2 categories: 73 participants who did not start the lessons of the intervention and 233 who started the lessons of the intervention. Results of the survival analysis (n=233) showed that active coping preference (hazard ratio [HR]=0.73), activating content (HR=0.71), and 2 indicators of engagement (HR=0.94 and HR=0.79) lowered attrition. Severity of loneliness was not related to attrition. Conclusions To reduce attrition, developers of online (loneliness) interventions may focus on stimulating active behavior within the intervention.

Loneliness stems from a mismatch between the social relationships one has and those one desires. Loneliness often has severe consequences for individuals and society. Recently, an online adaptation of the friendship enrichment program (FEP) was developed and tested to gain insight in its contribution to the alleviation of loneliness. Three loneliness coping strategies are introduced during the program: network development, adapting relationship standards, and reducing the importance of the discrepancy between actual and desired relationships. Data were collected among 239 participants aged 50–86. Loneliness was measured four times using a multi-item scale, and on various days with a single, direct question. Loneliness assessed with the scale declined during and after the program. Scores on loneliness assessed for a specific day, however, are more ambiguous. Despite the immediate positive effect of conducting assignments, we did not observe a decline in the single loneliness item score over the course of the program. The online FEP seems to reduce loneliness in general, but these effects are not visible on today’s loneliness. Nevertheless, the online intervention to reduce loneliness is a valuable new contribution to the collection of loneliness interventions.

De online Vriendschapscursus 50+ is een interventie die de eenzaamheid van haar deelnemers vermindert. De cursus bouwt voort op een succesvolle groepscursus. In twee series van vijf lessen worden de deelnemers met informatie en opdrachten aangezet tot actie om hun vriendschappen uit te breiden en te verbeteren.