Table 2.

Methodological changes to the WELL study.

Changes to inclusion/exclusion criteria	Rationale
•Include those bereaved up to 8 months post death (instead of 6 months)	1.Symptomatology is likely still due to spousal death and not some other event. 2.At 7–8 months participants may now feel ‘ready’ to take on an additional activity
•Include those on a stable dose of antidepressants; if on low dose, will ask PCP not to change dosage during study period.	1.If not in a current episode of MDD, stable medication for the duration of the study is ok.
Changes to intervention protocol
•Everyone chooses a health goal on which to focus during the course of the 12week intervention	1.Will allow participants to feel personally invested in the study
•Provide a nutritional ‘cheat sheet’	1.Information about serving sizes allows participants to better record their nutritional intake
•Provide light encouragement once a month via phone call to the BSM-only arm	1.Reduces patient boredom and increase retention and motivation 2.Allows opportunity to ‘check-in’ with technology
•Provide feedback (Actigraph data) about health behaviors in a ‘report card’ style at the end of the intervention period	1.Feedback about performance is part of the spirit of MI 2.For those in BSM only, feedback may increase motivation to stick with study
•Provide option of a paper diary	1.Increase retention among those with visual problems and/or arthritis who cannot see and/or use tablet
•Provide option of wearing Actigraph on wrist only	1.Decreases participant burden from switching device from waist to wrist. Less likely to lose device around wrist
Changes to assessment schedule
•Add HRSD to post-intervention and follow-up assessments	1.HRSD is a more detailed assessment of depression (compared to PHQ-9) and is clinician administered. It may be able to detect specific change over time
•Monthly ICG assessments (if = 30 at BL)	1.If ICG is greater than 30 may need targeted grief therapy
•Add a questionnaire about end-of-life experiences; circumstances surrounding their loved one's death	1.Information about the circumstances surrounding their spouse's death (good death versus bad death) may impact the quantity of the intervention needed
•Add Social Rhythm Metric at BL	1.Will provide information about bereaved elders' rest/wake cycles
•Add heart rate and blood pressure at BL	1.Physiological data of the bereaved are lacking.