Abstract
Care-home residents are among the most sedentary and least active of the population. We aimed to assess the feasibility, acceptability, safety, and preliminary effects of an intervention to reduce sedentary behaviour (SB) co-created with care home residents, staff, family members, and policymakers within a pilot two-armed pragmatic cluster randomized clinical trial (RCT). Four care homes from two European countries participated, and were randomly assigned to control (usual care, CG) or the Get Ready intervention (GR), delivered by a staff champion one-to-one with the care home resident and a family member. A total of thirty-one residents participated (51.6% female, 82.9 (13.6) years old). GR involves six face to face sessions over a 12-week period with goal-oriented prompts for movement throughout. The feasibility and acceptability of the intervention were assessed and adverse events (AEs) were collected. The preliminary effects of the GR on SB, quality of life, fear of falling, and physical function were assessed. Means and standard deviations are presented, with the mean change from baseline to post-intervention calculated along with 95% confidence intervals. The CG smoked more, sat more, and had more functional movement difficulties than the GR at baseline. The GR intervention was feasible and acceptable to residents and staff. No AEs occurred during the intervention. GR participants showed a decrease in daily hours spent sitting/lying (Cohen’s d = 0.36) and an increase in daily hours stepping, and improvements in health-related quality of life, fear of falling, and habitual gait speed compared to usual care, but these effects need confirmation in a definitive RCT. The co-created GR was shown to be feasible and acceptable, with no AEs.
Highlights
Improvements in public health care and advances in medical science have significantly extended life expectancy, and projections show continued increases in longevity
Three care homes were allocated to the intervention group with 22 residents, and one care home was allocated to the CG with nine residents
Our study suggests that a co-created intervention with care home residents, staff, family members, and policymakers is feasible and acceptable to be conducted with care home residents, with the involvement of staff champions and family members
Summary
Improvements in public health care and advances in medical science have significantly extended life expectancy, and projections show continued increases in longevity. Accompanying advancing age, risk of physical and cognitive decline, chronic diseases and comorbidities are more frequent [3]. Risk of institutionalization increases with age, and one in four older adults will spend time in a care home in the United Kingdom [4]. Care-home residents are among the frailest of the population because of their physical dependency [5], cognitive impairment [6], multimorbidity, and polypharmacy [5]. A recent report of the European Commission (EC) concluded that, between 2016 and 2070, public expenditure related to ageing could increase from 1.6% to 26.7% of gross disposable income due to the growth of social and health costs [7]. The recruitment of vulnerable older adults to research has reported low refusal rates, suggesting their willingness to be involved when given the opportunity [10,11]
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