The Engagement, Life and Meaning Study (ELMS): Effect of behavioural activation on engagement and well being among older adults.

Participants will be randomly allocated to one of conditions: the treatment group, and the active control group. Both conditions will incorporate a 6-session one-on-one intervention administered either via videoconferencing or by telephone. Participants can choose which mode of administration they would prefer. Sessions will occur weekly and will run for between 15 minutes to up to one hour. Participants will be provided with a program manual to guide their progress through the interventions. The treatment condition will be based on a program adapted from the brief behavioural activation treatment for depression, which seeks to identify and promote engagement with reinforcing activities and contexts consistent with each participant’s values. The intervention materials were trialled in the pilot study (ACTRN12620000126910) and have since been adapted based on the results and feedback from pilot participants. Although behavioural activation is a structured approach to therapy, it allows for person-centred delivery and the activities will be determined by the participant, according to their values, interests, and circumstances. As part of this program, participants will learn about the theoretical underpinnings of behavioural activation, track their activities using activity diaries, identify their values and translate those into values-based activities, and schedule and complete those activities. They will also be encouraged to reflect on their enjoyment and meaning for each activity, and reflect on their mood for each day. They will be supported to notice any patterns that may occur between activities, importance and enjoyment ratings and mood. They will also be supported to troubleshoot and overcome barriers to completing these activities. Participants will be encouraged to commit fully to the program and to complete all between-session tasks, but there will not be a minimum requirement of time spent. This program has been designed specifically for this intervention. Further details on the design and content of the intervention manual will be provided in the manuscript based on study no. ACTRN12620000126910. The manual is hoped to be publicly available upon study completion. Facilitators will be trained in program delivery by one of the primary investigators, who is a registered psychologist and has years of clinical experience delivering behavioural activation and positive psychology intervention. Facilitators will be graduates in psychology, with some provisionally registered psychologists. Facilitators will be trained to administer the program by the registered psychologist and will be provided with extensive supporting material to assist. The psychologist, who will also administer some of the sessions, will be on hand to provide supervision when required. For each week, facilitators will refer to running sheets to ensure they cover all the material for that week. They will also make notes on this sheet regarding whether, or how often the participant completed between-session tasks. One data collection is under way, these running sheets may also be used to facilitate formal fidelity checks. Ethics approval was obtained to audio record up to 15% of the sessions for an independent researcher to check facilitator adherence to the program.