Aim. The overall aim of the thesis was to explore the relationship between loneliness, social connections, and health among older adults, alongside the interpersonal interactions and experiences of older adults participating in a community-based activity programme aimed at reducing loneliness.

Methods. The first study investigated loneliness in relation to social factors and self-reported health among older adults, using a cross-sectional design in which data from the Swedish National Study on Aging and Care-Blekinge were analysed. The sample consisted of 394 participants aged 66 years or older who participated in the 18-year follow-up survey conducted between February 2019 and April 2021. All participants included in the analysis had responded to the question, Do you ever feel lonely? The data were analysed using descriptive, inferential, and multivariate statistics. The second study described the significance of social connections and health in relation to loneliness as experienced among older adults living at home. A qualitative method was employed, using semi-structured interviews conducted with 16 participants from the Swedish National Study on Aging and Care-Blekinge aged 68 years and older, all of whom answered the question, Do you ever feel lonely?, with yes, often or yes, sometimes. The transcribed interviews were analysed using inductive content analysis, following the approach described by Elo and Kyngäs (2008). The third study aimed to describe interpersonal interactions in a community-based activity programme targeting loneliness among older adults. An ethnographic method was used, consisting of observations in Team Senior, a community-based activity programme developed in collaboration with the Elderly Services Department. The sample consisted of ten participants aged 66 years and older. Field and reflective notes were made during the observations, focusing on when, where, and how the participants interacted with each other. The analysis followed the ethnographic approach as described by Hammersley and Atkinson (2007). The fourth study followed a qualitative method with the aim of exploring older adults’ experiences of a community-based activity programme designed to reduce loneliness. Semi-structured focus group interviews were conducted twice with nine participants aged 66 years or older, divided into two groups, who had all attended Team Senior. The focus group interviews took place 3–4 weeks and 9– 10 weeks after the activity programme had ended, and were analysed using reflexive thematic analysis, following the approach described by Braun and Clark (2006, 2019, 2023).

Findings. The results from the first study revealed that n = 125 (31.7%) stated loneliness sometimes or often, and n = 269 (68.3%) stated loneliness never or rarely. Among those who reported feeling lonely, only 10% had more than seven people they knew well and could talk to, whereas this proportion was higher (29.4%) among those who did not report loneliness. Despite reported loneliness, most (89.0%) reported a strong emotional bond with their family, compared with those who did not report loneliness (85.6%). Limited contact with grandchildren was also associated with loneliness (70.6% saw them monthly or less), compared to those who had not reported loneliness, 53% met them monthly or less. Additionally, prescribed medication use was higher among those reporting loneliness (94.2%) in comparison to those not stating loneliness (85.6%). The findings from the second study illustrated different strategies for preventing loneliness, as captured within the main category, preventing loneliness. The first aligning generic category, the silver lining of connecting with oneself, portrayed loneliness as self-chosen and time-limited, offering space to learn, enjoy nature, and pursue activities. The second generic category, being surrounded by meaningful connections, involved sharing thoughts, engaging in joint activities, and establishing social connections. While feelings of loneliness were absent when in the company of others, challenges were noted in coping with lost relationships and in forming new ones. The last generic category, striving to maintain an active and healthy life, was perceived as a necessity for preventing loneliness, although physical and cognitive limitations could make it difficult to remain as active as before. The findings from the third study showed, promoting support through communication as one of the two general categories. The support was reflected in the two category subtypes. The first, creating togetherness in the activities by encouraging each other, highlighted a sense of caring, equality and helpfulness. The second, exchanging knowledge and information, reflected how the participants, through sharing, supported one another and created future possibilities for activities. The second general category, connecting by embracing openness, illustrated the two subtypes of categories. The first, willingness and courage in sharing life experiences, highlighted sharing aspects of one’s life, both sensitive subjects and new knowledge. The second, bringing memories into the conversations, described recalling memories triggered by the activity or the environment, which facilitated reflection and discussion among participants. The findings from the fourth study were explored and reflected in the overarching theme of bridging loneliness through meaningful participation, with fulfilling social needs as the first subtheme. This subtheme illustrated participants' opportunities to interact and form new social connections through the activity programme. The second subtheme, discovering inner and outer resources, reflected that the activity programme increased participants' self-confidence and reflected one's own initiative to do something for oneself. The third subtheme, being able to contribute and influence, reflected participants' willingness to contribute and influence. The last subtheme, sparking future engagement, highlighted the experience of the activity programme as a way of initiating and planning future activities beyond Team Senior.

Conclusion. Meaningful social connections are important for preventing loneliness and thus for promoting healthy ageing (I, II). An extensive social network may also be related to reduced loneliness (I). There is a need to feel needed, especially in the context of a reduced network resulting from adverse life events (II). At the same time, it is essential to recognise that time spent alone can be treasured and associated with well-being (II). Engaging in activities is important for preventing loneliness (II–IV), and meeting social needs through community-based initiatives can support older adults who experience loneliness, thereby increasing social capital (III–IV). Personally tailored social activities that are adapted to the person's needs can be a step in the right direction (II). There should be opportunities to offer a variety of joint activities that cater to personal needs (IV). It is also important to emphasise the value of designing initiatives alongside older adults and viewing them as active contributors (IV). At the same time, community-based activity programmes aimed at reducing loneliness may require a longer duration for interactions to increase over time (III).