The ‘Behavioural Activation in Social IsoLation’ Study (BASIL): Modification of a psychosocial intervention for older adults with multiple long-term conditions in response to COVID-19
The problem
Older people (OP) with long-term conditions (LTCs) are at particular risk from COVID-19 infection. In addition, COVID-19 restrictions could impact negatively on the mental health of this vulnerable population in which the risk of depression is already increased by around 2-3 times. The Behavioural Activation in Social IsoLation (BASIL) study aims to prevent or ameliorate depression and loneliness in OP with multiple LTCs by modifying an existing psychosocial intervention (Behavioural Activation within a Collaborative Care framework) for delivery with this group.
- Intervention mode of delivery, supporting materials and support worker (SW) training were adapted to specifically consider social isolation and COVID-19 restrictions, and discussed in a co-design online stakeholder workshop held with OPs, caregivers, health and social care professionals and researchers. The study’s Patient and Public Involvement (PPI) group also met online to discuss intervention materials.
- Intervention modification included diary planning and mood monitoring, with consideration given to finding a functional equivalence for OPs’ most valued activities. An increased focus on anxiety was thought to be needed, with strategies added to manage worry. The method of contacting potential study participants, online and telephone delivery considerations, language around social isolation, planning for social contact, supporting older adults to use IT, as well as supporting access to health care, all required agreement at the co-design meeting. The intervention self-help booklet, which included ‘patient stories’, the SW manual and SW training were also modified.
Why it matters
This work enabled the rapid modification of an existing intervention for use within a new Urgent Public Health trial, focussed on addressing mood and social isolation in older adults with LTCs during COVID-19. Given the importance of maintaining positive mental health during the pandemic, this work would be of interest to health service researchers as well as clinicians and organisations working with older adults.
Funding acknowledgement
This work presents independent research funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme [RP-PG-0217-20006]. The views expressed in this work are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
- Department of Health Services, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD
- Tees, Esk and Wear Valleys NHS FT. Research & Development Office, Flatts Lane Centre
Flatts Lane, Normanby, Middlesbrough, TS6 0SZ
- School of Medicine, Leeds University, Leeds, LS2 9NL
- School of Medicine, Keele University, Staffordshire, ST5 5BG
Presenting author: Claire Sloan1
Co-authors: Dean McMillan1, David Ekers1&2, Della Bailey1, Elizabeth Littlewood1, Samantha Gascoyne1, Lauren Burke1, Suzanne Crosland1, Andrew Henry1&2, Eloise Ryde1&2, Leanne Shearsmith3, Peter Coventry1, Gemma Traviss-Turner3, Rebecca Woodhouse 1, Simon Gilbody1 and Carolyn A. Chew-Graham4, on behalf of the BASIL team