PMEN-D-24-00283

Process Evaluation of the BASIL+ trial: a Behavioural Activation approach to addressing low mood and depression among older people with long-term conditions

PLOS Mental Health

Dear Dr. Newbronner,

Thank you for submitting your manuscript to PLOS Mental Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Mental Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Oct 09 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at mentalhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pmen/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Dr Gareth Hagger-Johnson

Academic Editor

PLOS Mental Health

Journal Requirements:

1. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

The intervention is a complex intervention with at least three active ingredients / mechanisms.

Refer to the framework for complex intervention evaluation more explictly throughout.

https://www.bmj.com/content/374/bmj.n2061

in particular complex interventions as events in systems. Make more of the interaction between the intervention and its delivery context. e.g. does your evaluation have any implications for theory modification?

L130 Is purposive the right word?

L140 Completers vs non-completers should be a bullet here (and an entry in Table 1) with numbers

L195 Brief explain what deductive and induction means to readers unfamiliar with qualitative research

L230 Reference needed for existing quantitative research on pre-pandemic social isolation (e.g. introduction here https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.02201/full)

L232 Please avoid 'speak to' which sounds fluffy and informal

L240 Should be non-completers not none-completers

L541 Please add references to quantitative findings, even if in press / recently accepted

L600 Not clear when you say BASIL+ qualitative study if you mean this paper or another qualitative paper?

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Mental Health’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS Mental Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I have very few comments on this paper. It is a rigorous evaluation of the process of the BASIL+ trial. However:

I would have liked something more about the 'adaptation' of the (L67) for the setting of COVID in this paper to frame the findings, and comment on whether any further adaptation was found to be necessary, or not.

(L102) some explanation of why the collaboration care intervention was considered to be 'light touch' would be helpful to readers unfamiliar with collaborative care.

(L229) the section on context of the findings is interesting, but some data to support the statement in the line sentence beginning 'Analysis suggested...' would be helpful.

(L337) were there any examples of the reality of lockdown impeding chosen social activities or how these were modified to suit the circumstances given that the potential need to do this was recognised in the protocol?

(L507) missing word

Finally were there any particular issues that arose in supervision of the BSWs given the potential difficulties arising in such a study during COVID? Supervisors were not interviewed and may have provided some useful insights.

Reviewer #2: Overall, this is a very clear and well written paper reporting a qualitative process evaluation. The introduction describes the background well, the methods provide a detailed description of the study process. The themes developed in the results section are interesting, succinct and clearly described. The discussion is appropriate and offers further contextualisation of the insights offered in the results. Consequently, I have little to suggest by way of improvements.

One area to consider perhaps is that, as written, it is a very positive report of the intervention, its use and its impact. Which left me wondering if there was more to be said regarding any participants who did not get on well with the intervention? We are told that in most cases the intervention had a positive impact. What happened where it did not? Were these the participant who had taken part primarily for altruistic reasons rather than low mood (we also find this in our research), the non-completers? Were there any completers who didn’t like it? I understand if not, but it would be useful just to cover this a little more.

One other minor aspect to expand on is in the analysis section. It says a deductive and inductive approach was adopted. Could the authors expand? In what way was the approach to analysis deductive, that wasn’t clear to me.

As it stands, this process analysis represents an important and useful contribution to this area, complementing the trial publications. Expanding on the above issues may further strengthen the paper.

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Reviewer #1: No

Reviewer #2: Yes: Adam Geraghty

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Process Evaluation of the BASIL+ trial: a Behavioural Activation approach to addressing low mood and depression among older people with long-term conditions

PMEN-D-24-00283R1

Dear Dr Newbronner,

We are pleased to inform you that your manuscript 'Process Evaluation of the BASIL+ trial: a Behavioural Activation approach to addressing low mood and depression among older people with long-term conditions' has been provisionally accepted for publication in PLOS Mental Health. Both reviewers were happy with the changes made, and I am happy to accept this on a provisional basis.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

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Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Mental Health.

Best regards,

Dr Gareth Hagger-Johnson

Academic Editor

PLOS Mental Health