Background: Addressing loneliness, which is associated with poor mental and physical health, implicates the need for connectivity to a broad set of situated relationships and activities in the contexts of people's everyday lives. Social engagement has been identified as a relevant psychosocial mechanism mediating health and wellness and is central to addressing loneliness. The aim here is to explore the way in which people identified as lonely conceptualise their experiences of loneliness and social engagement for the purposes of incorporating these into the design and workings of an intervention that allows people to map their social networks and connect them to community-based valued activities.

Methods: Semi-structured qualitative interviews were undertaken with 20 participants, aged 21-82 years old (mean age 59.7) nested within a pragmatic, community-based randomised controlled trial in the north and south of England. Participants had wide-ranging social network sizes (from 1 to 10 individuals) and reported variable impact of loneliness on their lives.

Results: Loneliness consisted as an absence of intimacy in the face of being surrounded by others, a sense of entrapment and boredom, lacking access to meaningful activities and difficulties in relating to others. The analysis highlighted the role that important relationships have in mediating loneliness. Individual readiness, skills and confidence in forming new connections and engaging with new activities are important barriers that exist in overcoming loneliness. For many, wider socio-political factors, such as transport provision, availability of resources and costs associated with social engagement are also important barriers which are difficult to overcome.

Implications: Exploring the link between feelings, experiences and meaning of loneliness and the way in which a network intervention can be incorporated offers a focus for mediating the richness and opportunities that arise from locality-based connections and collective activities in the broader social environment. However, any intervention seeking to address loneliness requires a further focus on both individual and relational factors which might contribute to addressing loneliness and increasing a sense of wellness.

Patient or public contribution: The study team worked closely with community partner organisations in all aspects of this research, including, the submission of the funding proposal, development of the study protocol and procedures, recruitment, intervention deployment and assessment of implementation. PPI representatives provided advice on participant materials and interview schedules, and project management throughout and contributed to management and steering committee meetings.