Peer-led digital skill training reduces social isolation and enhances digital health literacy among nursing home residents: a randomised controlled trial

BACKGROUND: Nursing home residents are at high risk of social isolation. Despite the digital era, effective interventions to promote digital inclusion in this population remain limited. OBJECTIVES: This study aimed to evaluate the effectiveness of a peer-led digital skill training (PLDST) intervention in reducing social isolation and improving digital health literacy among nursing home residents. DESIGN: A two-arm, assessor- and analyst-blinded, parallel-group randomised controlled trial. SETTING AND PARTICIPANTS: Eligible older adults were recruited from two nursing homes in Fujian Province, China, between August 2024 and March 2025. METHODS: The intervention group additionally participated in a 6-week Digital Skill Training comprising 12 sessions delivered by trained peer mentors. RESULTS: A total of 120 participants were randomly assigned to the intervention or control group. Compared with controls, the intervention group showed signifcant and sustained improvements in social isolation, digital health literacy, perceived social support and technology anxiety over the 3-month follow-up period (all P < .05). Additionally, the intervention group demonstrated short-term benefits, including enhanced social networks and improved subjective well-being, though these effects diminished during follow-up. No significant between-group differences were observed for internet addiction at follow-up. CONCLUSIONS: This study demonstrates that a PLDST intervention provides sustained benefits for nursing home residents, significantly enhancing digital health literacy and perceived social support while reducing technology anxiety and social isolation over a 3-month follow-up, alongside short-term improvements in social networks and subjective well-being, all without elevating internet addiction risks. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2400086689).