Managing Multiple Health Conditions in Older Adults (MODS): Benefiting from activities to help your mood and physical wellbeing

INTERVENTION: Participants will be randomly allocated 1:1 to either the behavioural activation intervention group or the usual care group. Active intervention: Behavioural Activation (BA) within a Collaborative Care framework. BA aims to help people maintain or introduce activities which are important to them; such activities may benefit their physical and emotional wellbeing by helping people to stay connected with the world and remain active. The practitioner (MODS support worker) and participant work together to develop a collaborative treatment plan that seeks to reinstate or introduce behaviours that connect people to sources of positive reinforcement (valued activities). The BA intervention has been adapted for older adults with multiple long‐term conditions as part of earlier phases of the MODS research programme. Participants will be offered up to 8 BA sessions over up to a four‐month period, delivered by trained MODS support workers and supported by a self‐help booklet. Sessions will be delivered over the telephone (and/or via video call where feasible and acceptable; with face‐to‐face visits as an option where this would facilitate study inclusion and were feasible for the MODS support worker). As part of the collaborative care framework, MODS support workers will liaise with other professionals relevant to the participant s healthcare needs as appropriate (to include for example medication management). Control intervention: usual care as provided by current NHS and/or third sector providers. The duration of treatment and follow‐up for both groups is 12 months post‐randomisation. CONDITION: Physical health conditions and co‐morbid low mood or depression in older adults. ; Mental and Behavioural Disorders PRIMARY OUTCOME: Self‐reported quality of life and functioning (as measured by the Short Form 12 version 2) at 4 months post‐randomisation. SECONDARY OUTCOME: ; Collected at baseline, 4, 8 and 12 months post‐randomisation (unless otherwise stated):; 1. Quality of life and functioning (SF12v2) at baseline, 8 and 12 months post‐randomisation; 2. Depression status according to DSM‐5 criteria (SCID‐5); 3. Depression severity (PHQ9); 4. Anxiety (GAD7); 5. Physical function (Nottingham Extended Activities of Daily Living Scale); 6. Loneliness (De Jong Gierveld Scale ‐ 11 items); 7. Social Networks and Isolation (Lubben Social Network Scale – 6 items); 8. Health Related Quality of Life (EQ5D‐3L); 9. Chronic pain (Graded chronic pain scale revised – two questions); 10. A bespoke questionnaire will be used to collect health service use data.; INCLUSION CRITERIA: 1. Older adults aged 65 years or over 2. Two or more long‐term physical health conditions 3. Depressive symptoms as indicated by the presence of sub‐threshold depression or major depressive disorder, according to the Structured Clinical Interview for DSM‐5 Axis 1 disorders depression subscale (SCID).