Effectiveness of digital modified behavioral activation treatment program for rural older adults with depressive symptoms in Western Hunan: study protocol for a multi-center randomized controlled trial

Rural older adults experience a high burden of depressive symptoms and significant barriers to accessing mental health services. The Modified Behavioral Activation Treatment (MBAT) has been verified to be effective among rural older adults in China. Due to its structured format and skill-based learning, it is well suited for digital-based delivery. However, only a few studies were from developed countries, and the evidence to support its application in rural China still needs to be provided. Thus, based on the fact that digital health technology has the potential to address the shortage of healthcare resources and the constraints of community mental health services in rural China, the effectiveness of the digital MBAT (D-MBAT) program among rural older adults is worth further evaluation. A multi-center randomized controlled trial will be conducted among 216 rural older adults from Huayuan County and Fenghuang County in Western Hunan. The intervention group will receive the D-MBAT program, while the control group will receive routine care. Depressive and anxiety symptoms, social health, quality of life, and satisfaction will be measured at baseline, one-month, and three-month follow-ups to evaluate the digital MBAT program's effectiveness. Existing digital psychological intervention strategies seldom take into account the needs and preferences of the older adults in low-resource rural areas. Thus, this study aims to develop a D-MBAT program based on person-centered and community-engaged approach to maximize the mental health service of rural older adults with depressive symptoms.A successful D-MBAT program would be a feasible and scalable approach to the management of prevalent mental health conditions of rural older adults in resource-limited Western Hunan. Chinese Clinical Trial Registry ChiCTR2400091193. Registered on 23 October 2024.