Dataset Information

Optimising older adults' home spaces to enhance their physical activity level: an exploratory qualitative study protocol.

ABSTRACT:

Introduction

Housing is a major contributing factor to health, and better housing condition has been linked to improved general and psychological health. There has also been strong evidence that the physical environment within the home setting substantially impacts sedentary behaviour and physical activity in children. However, there is a lack of research that has investigated the physical environment within the home setting in the context of older adults' physical activity levels and sedentary behaviour. Given that with increasing age, older adults spend large proportions of their time in their homes it is important to optimise older adults' home settings to support healthy ageing. Therefore, this study aims to explore older adults' perceptions around optimising their physical environment within their home space to support physical activity and subsequently facilitate healthy ageing.

Methods and analysis

In this formative research, a qualitative exploratory research design using in-depth interviews (IDIs) and a purposive sampling approach will be employed. IDIs will be conducted to collect data from study participants. Older adults from diverse community organisations in Swansea, Bridgend and Neath Port Talbot will formally request approval to recruit via its contacts for this formative research. The study data will be analysed thematically using NVivo V.12 Plus software.

Ethics and dissemination

Ethical approval for this study has been obtained from the College of Engineering Research Ethics Committee (NM_31-03-22), Swansea University. The findings of the study will be disseminated to the scientific community and to the study participants. The results will enable us to explore the perceptions and attitudes of older adults towards physical activity within their home environment.

SUBMITTER: Meghani NAA

PROVIDER: S-EPMC9936290 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Optimising older adults' home spaces to enhance their physical activity level: an exploratory qualitative study protocol.

Meghani Naureen Akber Ali NAA Hudson Joanne J Stratton Gareth G Mullins Jane J

BMJ open 20230216 2

<h4>Introduction</h4>Housing is a major contributing factor to health, and better housing condition has been linked to improved general and psychological health. There has also been strong evidence that the physical environment within the home setting substantially impacts sedentary behaviour and physical activity in children. However, there is a lack of research that has investigated the physical environment within the home setting in the context of older adults' physical activity levels and se ...[more]

PMID: 36797016

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Project description:BackgroundIn the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those at risk may help to reduce malnutrition risk, reduce the resulting need for healthcare use and improve quality of life. Interventions are needed to raise older adults' risk awareness, offer relevant and meaningful strategies to address risk and support general practices to deliver treatment and support.MethodsUsing the Person-based Approach and input from Patient and Public Involvement representatives, we developed the 'Eat well, feel well, stay well' intervention. The intervention was optimised using qualitative data from think aloud and semi-structured process evaluation interviews with 23 and 18 older adults respectively. Positive and negative comments were extracted to inform rapid iterative modifications to support engagement with the intervention. Data were then analysed thematically and final adjustments made, to optimise the meaningfulness of the intervention for the target population.ResultsParticipants' comments were generally positive. This paper focuses predominantly on participants' negative reactions, to illustrate the changes needed to ensure that intervention materials were optimally relevant and meaningful to older adults. Key factors that undermined engagement included: resistance to the recommended nutritional intake among those with reduced appetite or eating difficulties, particularly frequent eating and high energy options; reluctance to gain weight; and a perception that advice did not align with participants' specific personal preferences and eating difficulties. We addressed these issues by adjusting the communication of eating goals to be more closely aligned with older adults' beliefs about good nutrition, and acceptable and feasible eating patterns. We also adjusted the suggested tips and strategies to fit better with older adults' everyday activities, values and beliefs.ConclusionsUsing iterative qualitative methods facilitated the identification of key behavioural and contextual elements that supported engagement, and issues that undermined older adults' engagement with intervention content. This informed crucial revisions to the intervention content that enabled us to maximise the meaningfulness, relevance and feasibility of the key messages and suggested strategies to address malnutrition risk, and therefore optimise engagement with the intervention and the behavioural advice it provided.

Project description:IntroductionOptimal medication management is one of the basic conditions necessary for home-dwelling older adults living with multiple chronic conditions (OAMCC) to be able to remain at home and preserve their quality of life. Currently, the reasons for such high numbers of emergency department visits and the very significant rate of hospitalisations for OAMCC, due to medication-related problems (MRPs), is poorly explored. This study aims to reveal the current state of the medication management practices of polymedicated, home-dwelling OAMCC and to make proposals for improving clinical and medication pathways through an innovative and integrated model for supporting medication management and preventing adverse health outcomes.Methods and analysisA mixed-methods study will address the medication management of polymedicated, home-dwelling OAMCC. Its explanatory sequential design will involve two major phases conducted sequentially over time. The quantitative phase will consist of retrospectively exploiting the last 5 years of electronic patient records from a local hospital (N ≈ 50 000) in order to identify the different profiles-made up of patient-related, medication-related and environment-related factors-of the polymedicated, home-dwelling OAMCC at risk of hospitalisation, emergency department visits, hospital readmission (notably for MRPs), institutionalisation or early death. The qualitative study will involve: (a) obtaining and understanding the medication management practices and experiences of the identified profiles extracted from the hospital data of OAMCC who will be interviewed at home (N ≈ 30); (b) collecting and analysing the perspectives of the formal and informal caregivers involved in medication management at home in order to cross-reference perspectives about this important dimension of care at home. Finally, the mixed-methods findings will enable the development of an innovative, integrated model of medication management based on the Agency for Clinical Innovation framework and Bodenheimer and Sinsky's quadruple aim.Ethics and disseminationEthical approval has been obtained from the Human Research Ethics Committee of the Canton Vaud (2018-02196). Findings will be disseminated in peer-reviewed journals, professional conferences and other knowledge transfer activities with primary healthcare providers, hospital care units, informal caregivers' and patients' associations.

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Project description:BackgroundMultimorbidity, the coexistence of multiple chronic conditions in an individual, is a growing public health challenge. Amidst the COVID-19 pandemic, physical distancing remains an indispensable measure to limit the spread of the virus. This pertains especially to those belonging to high-risk groups, namely older adults with multimorbidity. In-person visits are discouraged for this cohort; hence, there is a need for an alternative form of consultation such as video consultations to continue the provision of care.ObjectiveThe potential of video consultations has been explored in several studies. However, the emergence of COVID-19 presents us with an unprecedented opportunity to explore the use of this technological innovation in a time when physical distancing is imperative. This study will evaluate the sustainability of video consultations on a micro-, meso-, and macro-level by assessing the views of patients, physicians, and organizational and national policymakers, respectively.MethodsThe NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was designed as a guide for the development of health care technologies. In this study, the implementation of and experiences related to video consultations will be studied using the NASSS framework. Individual in-depth interviews or focus group discussions will be conducted with participants using the Zoom platform. Data will be analyzed by at least two investigators trained in qualitative methodology, organized thematically, and coded in two phases-an initial phase and a focused selective phase. All disagreements will be resolved by consulting the larger research team until consensus is reached.ResultsThis study was approved for funding from the Geriatric Education and Research Institute. Ethics approval was obtained from the National Healthcare Group Domain Specific Review Board (reference #2020/00760). Study recruitment commenced in July 2020. The results of the data analysis are expected to be available by the end of the year.ConclusionsThis study aims to evaluate the adoption and sustainability of video consultations for older adults with multimorbidity during the pandemic as well as post COVID-19. The study will yield knowledge that will challenge the current paradigm on how care is being delivered for community-dwelling older adults with multimorbidity. Findings will be shared with administrators in the health care sector in order to enhance the safety and quality of these video consultations to improve patient care for this group of population.International registered report identifier (irrid)DERR1-10.2196/22679.

Dataset Information

Optimising older adults' home spaces to enhance their physical activity level: an exploratory qualitative study protocol.

Introduction

Methods and analysis

Ethics and dissemination

Publications

Optimising older adults' home spaces to enhance their physical activity level: an exploratory qualitative study protocol.

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