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