Key Points Question Can a program of empathetic conversations delivered by laypeople via telephone reduce loneliness, depression, and anxiety in at-risk older adults? Findings In this randomized clinical trial of 240 older adults receiving services through a Meals on Wheels organization, a 4-week empathy-oriented telephone program delivered by rapidly trained lay callers during the coronavirus disease 2019 pandemic improved loneliness, depression, anxiety, and general mental health. Meaning In this study, loneliness, depression, and anxiety were rapidly reduced through layperson-delivered calls that focused on empathetic listening, suggesting a scalable approach to persistent mental health challenges of older adults.

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