Abstract
Mild frailty is common among older people, but it is potentially reversible with health promotion interventions. Behaviour change may be a key to preventing progression of frailty; however, we know little about what interventions work best and how a behaviour change approach would be perceived by this group. The aim of this study was to explore how mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach. We conducted semi‐structured interviews with 16 older people with mild frailty who received a pilot home‐based behaviour change health promotion service, including a dyad of older person/family carer, and two service providers delivering the service in two diverse areas of South England. Interviews were audio‐recorded, transcribed and thematically analysed. The concept of goal setting was acceptable to most participants, though the process of goal setting needed time and consideration. Goals on maintaining independence, monitoring of progress and receiving feedback were reported to increase motivation. Physical/mental capability and knowledge/perception of own needs were main determinants of the type of goals chosen by participants as well as the approach used by the project workers. Older people with complex needs benefited from care coordination, with a combination of goal setting and elements of social, practical and emotional support in varying proportions. Mildly frail older people responded well to a behaviour change approach to promote health and well‐being. Further consideration is needed of the most effective strategies based on complexity of needs, and how to overcome barriers among people with cognitive impairment.
Highlights
Frailty is an age‐related condition characterised by loss of biological reserves across multiple organ systems, and vulnerability to physiological decompensation after a stressor event (Clegg, Young, Iliffe, Rikkert, & Rockwood, 2013)
This paper reports on a study that explored how health promotion based on behaviour change is perceived by both recipients and providers of a service, to understand how behaviour change techniques (BCTs) are received, which factors affect engagement with behaviour change strategies, and whether adjustments are needed for mildly frail older people
This qualitative study was nested within a feasibility randomised controlled trial of a theory‐ and evidence‐based home‐based health promotion service for older people with mild frailty (HomeHealth) funded by Health Technology Assessment, National Institute for Health Research (Walters et al, 2017)
Summary
Frailty is an age‐related condition characterised by loss of biological reserves across multiple organ systems, and vulnerability to physiological decompensation after a stressor event (Clegg, Young, Iliffe, Rikkert, & Rockwood, 2013). It is associated with an increased risk of hospitalisation, falls, moves to care homes and death (Ensrud et al, 2008; Rockwood et al, 2004). Frailty is potentially reversible (Ng et al, 2015); complex interventions can reduce the risk of moving to care homes, hospital admission and falls in frail older people (Beswick et al, 2008). Interventions targeted at mild frailty can potentially prevent frailty progression, there is insufficient evidence to recommend specific interventions (Frost et al, 2017)
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