Acceptability of an intervention to mitigate the psychological impacts of COVID-19 restrictions in older people with long-term conditions: a qualitative study.

Talk Code: 
Leanne Shearsmith1
Peter Coventry,1 Dean McMillan,1 David Ekers,1&2 Della Bailey,1, Elizabeth Littlewood,1 Leanne Shearsmith,3 Andrew Henry,1&2 Samantha Gascoyne,1, Lauren Burke,1 Suzanne Crosland,1 Eloise Ryde,1&2 Gemma Traviss-Turner,3 Rebecca Woodhouse, 1 Claire Sloan,1 Simon Gilbody1 and Carolyn A. Chew-Graham4, on behalf of the BASIL team
Author institutions: 
1. Department of Health Services, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD 2. Tees, Esk and Wear Valleys NHS FT. Research & Development Office, Flatts Lane Centre Flatts Lane, Normanby, Middlesbrough, TS6 0SZ 3. School of Medicine, Leeds University, Leeds, LS2 9NL 4. School of Medicine, Keele University, Staffordshire, ST5 5BG


Older people with long-term conditions (LTCs) are at increased risk from COVID-19 (C19) infection. In addition, COVID-19 restrictions could impact negatively on their mental health, and the risk of depression is already increased by 2-3 times. The Behavioural Activation in Social IsoLation (BASIL) pilot trial evaluated the feasibility and acceptability of a brief psychosocial intervention (Behavioural Activation within a Collaborative Care framework) to prevent or ameliorate depression and loneliness in older adults with multiple LTCs.


The approach:

Qualitative study, using semi-structured telephone interviews, to explore participants’ and BASIL Support Workers’ views of the intervention. We interviewed participants who had completed the BA intervention (‘completers’), one participant who did not complete the intervention (‘non-completer’) and 9 BSWs who delivered the intervention. An initial thematic analysis was followed by a framework analysis using the TFA (Theoretical Framework of Acceptability).*

Our Patient and Public Involvement (PPI) group contributed, in online meetings, to public-facing materials and topic guides.


Affective attitude towards the BASIL study were positive; attenuated by some participants not experiencing low mood and the limitations on activity-planning due to the C19 context.  The intervention had a low opportunity cost for BSWs and older adults, There was a manageable amount of burden associated with both delivering and participating in the BASIL intervention. Self-efficacy for BSWs appeared to grow with experience of delivering the intervention. For older adults, experience and involvement promoted self-efficacy. In terms of ethicality, both BSWs and older adults discussed participating in the study for altruistic reasons. Older adults discussed valuing positive changes they had made by taking part in the intervention, and BSWs discussed they how valued observing these changes.


The BASIL intervention was acceptable and is now being utilised in a Randomised Controlled Trial, BASIL+.

* Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017 Jan 26;17(1):88. doi: 10.1186/s12913-017-2031-8.


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.