# Adapting the "Do More, Feel Better" intervention for older people living with HIV

> **NIH MH R34** · UNIVERSITY OF WASHINGTON · 2026 · $699,750

## Abstract

More than half of people living with HIV (PWH) in the United States (US) are 50 years of age or older.
Compared with those without HIV, older PWH have 2.3-fold increased risk of depression. The impact of
unmitigated mental health symptoms and related conditions among this growing population is significant and
includes social isolation, loss of independence, and poor engagement with healthcare, undermining progress
towards ending the HIV epidemic. Due to a shortage behavioral health providers, there is growing interest in
innovative interventions using community-based, peer-led approaches to improve access to effective mental
health services. Behavioral activation is an evidence-based intervention that has shown promise for reducing
depressive symptoms among older adults. Our team has developed a streamlined lay-delivered behavioral
activation intervention called “Do More, Feel Better” (DMFB) that has been shown to decrease depressive
symptoms among depressed (PHQ-9 ≥10) older adults obtaining services in community senior centers.
Delivery of an adapted version of the DMFB intervention for older PWH with poor access to professional
counseling could be relatively straightforward within the existing Ryan White HIV/AIDS program, supported by
organizations that provide essential services such as non-medical case management to low-income PWH.
Because the intervention is tailored to individual preferences and needs, it promises to be acceptable,
especially after careful adaptation using input from community members and stakeholders. Our aims for the
proposed work are therefore: (1) to understand the impact of mental health issues on HIV care, functioning,
and quality of life and identify multi-level barriers and facilitators that could influence participation in and
delivery of an adapted DMFB intervention; (2) to adapt and enhance the DMFB intervention for delivery by
case management program staff or volunteers to older PWH, following the ADAPT-ITT model in collaboration


## Key facts

- **NIH application ID:** 11327157
- **Project number:** 1R34MH143573-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Susan Marie Graham
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** MH
- **Fiscal year:** 2026
- **Award amount:** $699,750
- **Award type:** 1
- **Project period:** 2026-05-07T00:00:00 → 2029-05-06T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11327157

## Citation

> US National Institutes of Health, RePORTER application 11327157, Adapting the "Do More, Feel Better" intervention for older people living with HIV (1R34MH143573-01). Retrieved via AI Analytics 2026-07-09 from https://api.ai-analytics.org/grant/nih/11327157. Licensed CC0.

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