# Implementing the Behavioral Activities Intervention (BE-ACTIV) to Reduce Depression among Veterans in Community Living Centers

> **NIH VA I01** · PROVIDENCE VA  MEDICAL CENTER · 2022 · —

## Abstract

Background: Despite widespread recognition of its prevalence and consequences, depression in nursing
homes remains a significant public health issue, affecting 15-25% of community nursing home residents and
contributing to increased morbidity, mortality, care burden, and cost of care. In VA Community Living Centers
(CLCs) the prevalence of depression is nearly 40% and within the first six months of discharge, CLC residents
have a substantially higher risk of suicide compared with other age- and gender-matched VA users. In
accordance with VA’s Strategic Priority to prevent suicide, it is critical to explore approaches to reducing
depression that are specific to the CLC population because depression is a major risk factor for suicidality.
Evidence-based psychosocial treatments are not often used in nursing homes and, when used, little is known
about the quality or effectiveness of the interventions. Behavioral Activities Intervention (BE-ACTIV) is a 10-
week evidence-based psychosocial intervention for depression developed using nursing home staff and
resident input to build in feasibility and acceptability. BE-ACTIV is typically delivered by a mental health
therapist in collaboration with recreational therapy to engage residents in personally meaningful pleasant
activities. This type of approach to improving mental health care is in line with VA’s strategic goals to provide
timely and integrated care that emphasizes Veteran’s well-being and independence.
Objectives: Three gaps must be addressed before BE-ACTIV can be used successfully in CLCs: (1) Adapting
it for the short-stay CLC population, is largely male with higher prevalence of serious mental illness and
substance abuse disorders, (2) Developing a delivery strategy that adapts BE-ACTIV’s current in-person
training and oversight processes for the context of a complex, national system of nursing homes, and (3)
Comparing implementation strategies to facilitate regional or national roll out. We will compare onsite and
remote applications of the LOCK implementation framework, which was developed for use in the CLC context.
The four tenets of the LOCK implementation framework are: 1) Look for the bright spots, 2) Observe, 3)
Collaborate in huddles, and 4) Keep it bite-sized.
Methods: This Hybrid Type 2 Implementation-Effectiveness study will use a mixed methods approach. In Aim
1, at two CLCs, researchers will (a) conduct telephone interviews with CLC staff about adaptation of the BE-
ACTIV training materials and implementation guide and (b) test the adapted BE-ACTIV VA training materials
and implementation guide for user comprehensibility with CLC staff. In Aim 2, 6 sites will implement BE-ACTIV
VA, each over a 6-month period. For this, three sites will have onsite training and check-ins for the
implementation and three will have remote training and check-ins. Aim 3 will be dedicated to finalizing the
training materials and implementation guide based on the input received from staff, our advisor...

## Key facts

- **NIH application ID:** 10524009
- **Project number:** 5I01HX002775-03
- **Recipient organization:** PROVIDENCE VA  MEDICAL CENTER
- **Principal Investigator:** Whitney L Mills
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-03-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10524009

## Citation

> US National Institutes of Health, RePORTER application 10524009, Implementing the Behavioral Activities Intervention (BE-ACTIV) to Reduce Depression among Veterans in Community Living Centers (5I01HX002775-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10524009. Licensed CC0.

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