Applying the Theory of Planned Behaviour to investigate mental health help-seeking among older adults in Australia

INTERVENTION: Participants in the intervention group will received a brochure aimed at promoting mental health help‐seeking based on the Theory of Planned Behaviour (TPB). The intervention was developed specifically for this study by the primary researcher, who is a registered psychologist, with support from the research team. During the development phase, a consultative group of key stakeholders were interviewed to inform the design, layout and content of the intervention, including primary health care providers, mental health professionals, health care executives, representatives from community organisations, and consumers. The intervention includes behaviour change messages targeting the three main components of the TPB: attitudes, subjective norms, and perceived behavioural control. Messages designed to promote favourable attitudes towards help‐seeking aim to communicate that help‐seeking is a good and useful thing to do. Examples include ‘speaking about your concerns is the best thing to do’, ‘mental health problems can be prevented and treated’, and ‘it will be useful for you and for others if you speak about your concerns’. Messages to promote favourable subjective norms aim to increase perceived social support and reduce mental health‐related stigma. Examples include ‘we all have fears and concerns from time to time’, ‘when you experience such concerns you are not alone’, and ‘your doctor expects you to talk about your concerns.’ Messages to promote perceived behavioural control aim to strengthen self‐efficacy and reinforce personal choice in help‐seeking. Examples include ‘speaking with a doctor about your concerns helps you to take control of your health,’ and ‘it is important to find a doctor who you can trust, and who will work with you to choose the services a CONDITION: Mental Health ‐ Studies of normal psychology, cognitive function and behaviour Mental health problems; ; Mental health problems Public Health ‐ Health service research PRIMARY OUTCOME: Feasibility; ; The feasibility of the intervention will be assessed by asking participants to respond to 10 items measuring different feasibility criterion. Items are rated on 5‐point Likert scales from strongly disagree to strongly agree. These self‐report items were designed by the research team. ; ; Two open‐ended questions will also be included to gain further feedback on the feasibility of the intervention. Participants will be asked to indicate what they liked about the intervention, and how they think the intervention can be improved.[Three‐weeks post‐intervention] SECONDARY OUTCOME: Attitudes towards help‐seeking ; ; Change in attitudes towards help‐seeking will be measured using one item from the TPB questionnaire. The item asks participants to rate whether speaking with a doctor about their mental health (feeling sad, empty, fearful and/or anxious) would be useless or useful on a Likert scale from 1 ‐7. [Baseline ; Immediately post‐intervention ; Three weeks post‐intervention. ] Help‐seeking behaviour ; ; Help‐seeking behaviour will be measured by asking participants if they had spoken to a doctor about their mental health, and if they had received treatment from a mental health professional. Participants will be asked to respond to each item with yes/no, and if yes, to specify how long ago they spoke to a doctor or received professional treatment, and the number of times. These self‐report items were designed by the research team specifically for this study. [Baseline ; Three weeks post‐intervention] Help‐seeking intention ; ; ; [Baseline ; Immediately post‐intervention ; Three weeks post‐intervention] Perceived behavioural control ; ; Immediately post‐intervention ; Three weeks post‐intervention. ] Retention ; Change in participants intention to seek help for mental health concerns will be measured using one item from a Theory of Planned Behaviour (TPB) questionnaire designed by the research team. The item asks participants to rate their intention to speak with a doctor about their mental health on a 7‐point Likert scale from strongly disagree to strongly agree. ; The TPB questionnaire is a self‐report measure designed to assess TPB constructs of attitudes, subjective norms, perceived behavioural control and intentions within the context of mental health help‐seeking. The questionnaire was pilot tested by the research team with 54 older adults (aged 65 and older) in Perth, Western Australia. Reliability testing demonstrated acceptable internal consistency of the measure (Cronbach’s alpha .69 to .87). ; Change in perceived behavioural control will be measured using two items from the TPB questionnaire. One item will assess changes in controllability, which will be measured by asking participants to rate their level of agreement with the statement ‘Taking the required steps to seek mental health support is under my control’ on a 7‐point Likert scale from strongly disagree to strongly agree. The second item will assess changes in self‐efficacy, which will be measured by asking participants to rate their level of agreement with the statement ‘I am capable of taking the required action(s) to seek mental health support’ on a 7‐point Likert scale from strongly disagree to strongly agree.[Baseline ; ; Retention will be tracked by the researcher, and measured by the number of participants who complete the follow‐up questionnaire compared to the number who gave informed consent to participate. Consent is recorded online before commencement of the initial survey. [Three weeks post‐intervention] Subjective norms ; ; Change in subjective norms will be measured using one item from the TPB questionnaire. The item asks participants to rate their level of agreement with the statement ‘Society expects me to speak with a doctor about my mental health’ on a 7‐point Likert scale from strongly disagree to strongly agree.[Baseline ; Immediately post‐intervention ; Three weeks post‐intervention. ] Time spent reviewing the brochure ; ; The time spent viewing the brochure will be recorded in minutes and seconds by the online survey platform. [At intervention completion ] Utility ; ; The utility, defined as the usefulness of the intervention during pandemics/in times of crises, will be measured by asking participants to respond to 6 items, rated on 5‐point Likert scales from strongly disagree to strongly agree. These self‐report items were designed by the research team specifically for this study. [Three weeks post‐intervention] INCLUSION CRITERIA: Adults aged 65 years and older living in metropolitan areas in Australia.