Background: Most studies on interventions using social robots to reduce loneliness have been conducted in facilities in Western nations. Objective: This study evaluated the effectiveness of social robot interventions in reducing loneliness among community-dwelling older Japanese adults using a randomized controlled trial and qualitative analysis. Methods: Individuals aged ≥65 years who lived alone in Tokyo and neighboring areas and experienced loneliness were recruited. Seventy-three eligible participants were randomly assigned to either an intervention or control group. The 4-week intervention involved a humanoid social communication robot (BOCCO emo), which facilitated conversations with human operators and/or family members and reminded participants of daily tasks. The primary outcome was loneliness, with mental health (psychological well-being, depression, and self-rated health), the frequency of laughter in daily life, health competence, and interpersonal relationships (social network and generalized trust) as secondary outcomes. Participants were evaluated at baseline and follow-up. In the follow-up survey, participants in the intervention group provided open-ended responses regarding their experiences using the social robot. Results: In total, 68 participants completed both the baseline and follow-up surveys (34 in each group). The average age was 82.3 years, and 64 (94%) participants were women. A linear mixed-effects model with a random intercept indicated that loneliness decreased more in the intervention group than in the control group (difference-in-difference: -3.1 [-5.9, -0.4]). Psychological well-being also improved in the intervention group (difference-in-difference: 1.9 [0.1, 3.7]). Content analysis identified four categories: “emotional support and psychological connection,” “lifestyle assistance,” “enrichment of social interaction,” and “cognitive and mental stimulation.” Conclusions: Social robots can reduce loneliness among community-dwelling older adults in non-Western societies. Information and communication technology appears to be an effective approach to alleviating loneliness and enhancing well-being among older adults in community settings. Clinical Trial: UMIN Clinical Trials Registry UMIN000050644; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000057702.

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