Depressed nursing home residents' activity participation and affect as a function of staff engagement.

Behavioral interventions for depression target activity engagement and increased positive reinforcement, particularly from social interaction. Nursing homes provide limited opportunity for meaningful social engagement, and have a high prevalence of depression. Often residents obtain most of their social contacts from staff members. We present intra-individual correlations among positive staff engagement, resident affect, and resident activity participation from behavior stream observations of residents who were participants in an ongoing trial of an intervention for depression. Sixteen residents were observed 6 times weekly for 8 to 45 weeks, 5 minutes per observation. Positive staff engagement during the observations was significantly correlated with resident interest and pleasure. Positive staff engagement was related to resident participation in organized group activity; however, residents tended to be more engaged and show more pleasure when in informal group activities, especially those residents receiving the behavioral treatment. Positive staff engagement was not related to time in activities of daily living. Results have implications for understanding mechanisms and potential targets of interventions for depression.