Behavioral Activation for Independence in Older Veterans

Description

As Veterans age, chronic health conditions increase their risk of functional limitations, or difficulty completing day-to-day activities independently. Older adults with functional limitations are more likely to be hospitalized or admitted to long-term care facilities. Maintaining independence at home and in the community is a high priority for many older Veterans. The goal of this study is to support the physical, cognitive, and social functioning of older Veterans by developing a program based on behavioral activation, an evidence-based brief psychosocial intervention that helps individuals increase their engagement in activities aligned with their values (i.e. what matters most to them). The study consists of 3 aims. Aim 1 involves adapting an existing behavioral activation program for older Veterans at risk for functional decline to be delivered by video telehealth and seeking feedback from Veterans and VA staff about the program materials. Aim 2 involves testing the program in a group of 10 Veterans to learn whether it is satisfactory to Veterans; the investigators will make improvements to the program based on the information gathered in this aim. Aim 3 is a randomized controlled trial that will test the behavioral activation program compared to usual care in older adulthood in 48 Veterans. This will help determine whether the program is possible to deliver as planned and acceptable to Veterans, and assess the potential effects of the program on functioning and related health outcomes.

Conditions

Functional Independence

Study Overview

Study Details

Study overview

As Veterans age, chronic health conditions increase their risk of functional limitations, or difficulty completing day-to-day activities independently. Older adults with functional limitations are more likely to be hospitalized or admitted to long-term care facilities. Maintaining independence at home and in the community is a high priority for many older Veterans. The goal of this study is to support the physical, cognitive, and social functioning of older Veterans by developing a program based on behavioral activation, an evidence-based brief psychosocial intervention that helps individuals increase their engagement in activities aligned with their values (i.e. what matters most to them). The study consists of 3 aims. Aim 1 involves adapting an existing behavioral activation program for older Veterans at risk for functional decline to be delivered by video telehealth and seeking feedback from Veterans and VA staff about the program materials. Aim 2 involves testing the program in a group of 10 Veterans to learn whether it is satisfactory to Veterans; the investigators will make improvements to the program based on the information gathered in this aim. Aim 3 is a randomized controlled trial that will test the behavioral activation program compared to usual care in older adulthood in 48 Veterans. This will help determine whether the program is possible to deliver as planned and acceptable to Veterans, and assess the potential effects of the program on functioning and related health outcomes.

Development and Feasibility of a Behavioral Activation Intervention to Support Independence in Older Veterans at Risk for Functional Decline

Behavioral Activation for Independence in Older Veterans

Condition
Functional Independence
Intervention / Treatment

-

Contacts and Locations

Bedford

VA Bedford HealthCare System, Bedford, MA, Bedford, Massachusetts, United States, 01730-1114

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Receiving VA primary care
  • * Community-dwelling (living outside nursing homes)
  • * At risk for functional decline (VES-13 score 3 or higher); (Aim 3 only) For individuals who are age 85 and score 3 on VES based on age alone, we will also require that they have a score of 0.2 on the VA frailty index (mild frailty or greater)
  • * Non-English speaking
  • * Currently receiving physical therapy, occupational therapy, or psychotherapy
  • * Advanced cognitive impairment (MIS-T 3 or lower)
  • * Uncorrectable hearing or visual impairment that would preclude participation
  • * Unstable physical or mental health condition:
  • * ongoing evaluation of new cardiac or respiratory symptoms
  • * receiving hospice or palliative care services
  • * anticipated surgery in the next 3 months
  • * severe depressive symptoms (PHQ-9 14 or higher)
  • * active suicidal ideation
  • * likely substance use disorder (positive TICS)
  • * schizophrenia
  • * psychosis in the past 6 months
  • * (Aim 2 and 3) Currently receiving physical therapy, occupational therapy, or psychotherapy
  • * (Aim 3 only) No access to video-capable device (tablet, smartphone, computer) for VVC visits

Ages Eligible for Study

65 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

VA Office of Research and Development,

Meaghan A Kennedy, MD MPH, PRINCIPAL_INVESTIGATOR, VA Bedford HealthCare System, Bedford, MA

Study Record Dates

2026-10-31