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Guidance for publications As an NIHR researcher you are required to acknowledge NIHR ARC Wessex and inform ARC Wessex when you have submitted a publication. Notification should be sent to arcwessex@soton.ac.uk . When acknowledging the NIHR, please use the relevant statement below ARC Wessex funded projects This study is funded by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. ARC Wessex adopted projects This study is supported by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. Academic Career Development Awards (Name) received(s) support from the NIHR Applied Research Collaboration ARC Wessex and funded through an {insert name of award e.g. NIHR ARC Wessex Internship/PhD fellowship, Post Doctoral Fellowship). The views expressed are those of the authors and not necessarily those of the NIHR, NHS or Department of Health and Social Care. For individuals listed as co-funded ARC investigators and where the research output is linked to the ARC Wessex portfolio please use the following This study is supported by the National Institute for Health and Care Research ARC Wessex. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. Download the Funded by NIHR logo Download

Alignment with Health and Social Care Priorities Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Adoption and Spread Checklist, webinar and resources Quick links: Project Outputs This domain helps you consider how implementation of your project output(s) fit with the changing needs of the health and social care systems and local, regional and national directives and policy. No FAQs yet This category doesn't have any FAQs at the moment. Check back later or explore other categories. What should I consider for my project? Adoption and Spread Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Case study Staff Wellbeing (SWP) project “We knew that senior managers were keen to understand the wellbeing needs and priorities of staff, but we did not know how to address this. By consulting with colleagues from a partner organisation, we were able to understand how they approached this. They informed us that they had conducted an anonymous survey with staff to ascertain key needs and priorities for wellbeing. With their guidance we collaborated with a local research and evaluation partner who helped us design the questions for a survey administered within our organisation. In this way we could make sure any initiatives arising from the project were aligned to staff needs. When we conducted the survey, we realised one key factor impacting on staff wellbeing was influenced by a national policy initiative which had resulted in changes to working practices within our organisation. We reflected that we should have reviewed national policies more closely at an early stage, to ensure that our survey questions considered the potential impact of these. We have since adapted the survey to include questions relating to the impact of these policies. The survey findings have provided important insights into how national policies impacted on staff wellbeing at an organisational level as well as reinforcing the importance of wellbeing initiatives being aligned to local, regional and national priorities.” Take away tips Implementation is more likely to be successful when it aligns with the priorities of all relevant stakeholders Understanding how implementation may align at local, regional, and national levels is key

7fc9e212-9328-4765-add4-7315e187c43b Workforce Evaluation Toolkit project (WET) Outline: This is a commissioned piece of work from the ARC Wessex Workforce & Health Systems (WHS) theme to support them with regular requests from healthcare providers. The project is to iteratively develop a generic toolkit for the evaluation of new workforce roles across healthcare. The aim during the current project is to build a first trial version to prove the toolkit concept and generate buy-in from system partners. The Bakker’s Workforce engagement model Burnout forms the conceptual basis for evaluation toolkit. The deliverable for this project is a minimal viable product, in the shape of a workforce evaluation toolkit. Team: Ruth Barker Programme Manager – Insight Health Innovation Wessex . Cheryl Davies, Senior Programme Manager Innovation Adoption, Health Innovation Wessex. Rachel Bailey Senior Programme Manager - Insight, Health Innovation Wessex. Ends: 30 June 2024 More detailed outline or project and partners Workforce Evaluation Project Work Packages 011223[99] .docx Download DOCX • 390KB

Fit with Health and Social Care Systems Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Adoption and Spread Checklist, webinar and resources Quick links: Project Outputs This domain helps you consider how implementation of your project output(s) fit with the changing needs of the health and social care systems and local, regional and national directives and policy. No FAQs yet This category doesn't have any FAQs at the moment. Check back later or explore other categories. What should I consider for my project? Adoption and Spread Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Case study Parkinson’s disease Charity Community Outreach Project (PCCOP) team "We took time to understand how the aims of our project related to local and national policy and research on improving awareness of Parkinson’s disease in the community. We also spoke to other people within our local networks about their awareness of projects relating to the topic. Because of this, early on we realised there was a project with similar aims being undertaken by another local organisation. Though this was a challenge, as we had taken time to speak to people within our local networks, we had the opportunity to consider whether our project would be able to offer something different. We realised that though the projects had similar aims they were involving different stakeholder groups. We were also able to attend learning events from the other project to understand which steps may be helpful to repeat and avoid in our own project. This was invaluable as it saved both time and resources of those involved. It also ensured that our project fitted with local and national aims and provided something of real benefit and value to our local community.” Take away tips Implementation has a greater chance of success if it fits with the changing needs and priorities of the health and social care systems into which it is being introduced Involvement of stakeholders is key to identifying and understanding fit

be5aaf78-5349-4834-a57a-fcddffbfb962 COMPLETED: GOODNIGHT Covid-19 to care-home-based vulnerable individuals Novel corona virus (COVID-19) is a virus that has spread quickly around the world. Elderly people with other health problems have a high death rate from the infection. There are no treatments for COVID-19 so prevention of infection is very important. COVID-19 is thought to infect people via the nose and mouth. Current best practise to prevent infection focuses on good hand hygiene, the wearing of masks and by limiting social contact. However, elderly people in care homes have to come into contact with staff members who are looking after them. Hypertonic saline nasal irrigation and gargling (HSNIG) has been shown to reduce the viral load of coronaviruses and has potential to reduce Covid-19 transmission in a community setting. The objective of this trial is to assess the feasibility and acceptability of care home staff adopting this technique. This research has now been submitted for publication. If you would like to know more about this study please contact Dr Ryan Buchanan Co-Chief investigators Dr Thomas Daniels, Consultant Respiratory Physician, Honorary Senior Clinical Lecturer, University of Southampton Dr Ryan Buchanan, Academic Clinical Lecturer, Primary Care, Population Science and Medical Education, University of Southampton Partners: University Hospital Southampton NHS Foundation Trust, Southampton CTU & NIHR ARC Wessex Co-applicants Professor Julie Parkes, Professor of Public Health, University of Southampton Professor Helen Roberts, Professor of Medicine for Older People, University of Southampton Emeritus Professor Jeremy Wyatt – University of Southampton Dr Beth Stuart – Medical Statistician, Southampton Clinical Trials Unit Dr Kinda Ibrahim - Senior Research Fellow, Faculty of Medicine, University Hospital Southampton NHS Foundation Trust Dr Andrew Cook – Public Health Consultant, Fellow of Health Technology Assessment, University of Southampton See the training video for Care Home staff: Publications http://dx.doi.org/10.14283/jnhrs.2021.3

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15c54097-9d85-4170-b90f-d0f5767a45d4 COMPLETED: Predicting Patient Deterioration Risks in COMMunities Team: Principle Investigator – Professor Michael Boniface, University of Southampton Co-Investigator - Dr Francis Chmiel and Dr Dan Burns, University of Southampton Clinical Lead – Dr Matt Inada-Kim, Hampshire Hospitals NHS Foundation Trust Completed What did we learn? We found evidence for policies and practices supporting safe COVID-19 integrated care pathways in community settings for early identification of deterioration and timely escalation to hospital. Research validating home oxygen saturations as a marker of clinical deterioration in patients with suspected COVID-19 informed national policies and was critical and rapid evidence necessary to support the COVIDoximetry@home ( https://doi.org/10.1101/2020.11.06.20225938 under peer review at BMJ Open) What difference did it make? £ 500K NHSx RECOxCARE (Remote COVID oximetry care) project for COVID Virtual Wards in collaboration with HHFT, North Hants Primary Care Network, Mid Hants Primary Care Network, South Central Ambulance Service NHS Foundation Trust, WAHSN and University of Southampton IT Innovation Centre. Scaling nationally as the COVID oximetry@home programme, the guidance for people at home to purchase a pulse oximeter published on the BBC News Website https://www.bbc.co.uk/news/health-55733527 and broadcast on BBC News at 10 on Thursday 21st January 2021 (citing the ARC publication) Clinical model was adopted by the World Health Organisation Digital and data analytics approach for remote monitoring of patients in communities was presented by Inada-Kim and Boniface as part of the NHSx@home innovators engagement event 16th Sept 2021. COVID oximetry@home received the overall winner of the prestigious for HSJ Patient Safety Award 2021 Service evaluation demonstrated improved patient outcomes Boniface, M., Burns, D., Duckworth, C., Ahmed, M., Duruiheoma, F., Armitage, H., Ratcliffe, N., Duffy, J., O’Keeffe, C. and Inada-Kim, M., 2022. COVID-19 Oximetry@ home: evaluation of patient outcomes. BMJ Open Quality, 11(1), p.e001584. What impact has it had on patient and the health system? Remote monitoring of patients in communities is important for improved patient outcomes, hospital attendance/admissions avoidance and resource planning. Remote monitoring is a key NHS transformation within the NHS@Home programme Remote monitoring is being extended from COVID to all Acute Respiratory Infections, and is likely to be extended to other conditions in the future What's next? We are working with Hampshire Hospitals and NHS England to transfer the learning from COVID to more general approaches. This research is being conducted in: HDRUK rapid insight project (Jan22-Sep23) called PHILOSARIP “ Predicting Hospital Length of Stay in Acute Respiratory Infections Patients” Wessex ARC PARIEDA project which is tacking “ Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance” Resources Covid Oximetry at Home Toolkit - via AHSN Wessex Publications https://doi.org/10.1101/2020.11.06.20225938 https://doi.org/10.1136/bmjopen-2022-067378 Original Project outline ARC Wessex is supporting research to explore COVID patient risks (deterioration, admission and readmission) in community settings working with Hampshire Hospitals NHS Foundation (HHFT) Trust who are co-leading the development of national pathways linking community, primary and secondary care. According to leading acute care clinicians (Dr. Inada-Kim - HHFT) working at the forefront of UK’s COVID-19 emergency response and policymaking, two of most pronounced COVID-19 Unmet Medical Care Needs (UMCN) include: UMCN-1) Risk prediction tools on triage and admission to emergency care: Evidence shows that early identification of physiological deterioration risks improves patient outcomes through timely and appropriate interventions, including escalations to higher levels of acute care through hospital admissions and intensive care [1] . UMCN-2) Rapid follow up of patients post discharge: There is little evidence to predict the occurrence of COVID19-related complications following discharge, particularly for vulnerable patients with multiple long term conditions at high risk of adverse complication events, and therefore rapid follow up and continuous monitoring of a patients recovery is needed to reduce risk of readmission to hospital. In addition, consideration of population infection risks resulting from contact and transmission from infected individuals has demanded alternative care delivery models. During the initial phase of the pandemic patients freely made their way to GPs and hospitals increasing infection rates within the general population and the healthcare workforce, leading to policies aimed at reducing contact between infected patients and health care workers (HCWs) [2] . This has driven then need to reimagine care pathways that minimise physical interaction using virtual care (video conferencing, mobile symptom reporting/scores, real-time remote sensing, and surveillance) delivered through telemedicine solutions. Virtual care not only protects the population and HCWs during highly infectious periods of a pandemic but importantly offers significant benefits to patients who can now be treated longer in community settings reducing the number of admissions to hospital, the length of stay and mortality. PPDRCOMM proposes to undertake research to develop predictive models for early warning detection arising from a COVID-19 infection, capable of running in residential settings such as care homes. Models will use near-patient observation data (e.g., temperature, respiration rate, and blood oxygen levels), patient demographics, and comorbidities from patients in the community who are in the early stages of a COVID-19 infection. The measurements will be collected with high frequency such that machine-learning algorithms will be able to report real-time risk scores of imminent deteriorations. Overall, this models will allow for real-time detection of deterioration earlier than currently possible with conventional techniques. This will help address the clinical need for pre-emptively stopping the severe deterioration of those with a seemingly mild case of COVID-19. Read the Evaluation Pre-Print evaluation paper

91dc7d16-9cb6-45e1-b40a-33037865948b COMPLETED: Digital support for maintaining physical activity in people with long-term conditions What promotes and prevents health professionals using ‘digital’ technologies to support people with long-term conditions (LTCs) to maintain physical activity and improve their health and wellbeing? Principle Investigator - Professor Mary Barker ( meb@mrc.soton.ac.uk ) Senior Research Assistant – Dr James Gavin ( j.p.gavin@soton.ac.uk ) Team Prof Mary Barker (PI), Prof Maria Stokes (Co-Lead), Prof Suzanne McDonough (Co-Lead at RCSI), Mrs Luisa Holt, Dr Aoife Stephenson (RCSI), Mr Paul Muckelt, Dr Nisreen Alwan, Dr Katherine Bradbury, Dr James Faulkner (University of Winchester), Dr Dorit Kunkel, Dr Euan Sadler, Prof Sandy Jack, Mrs Rachael Eckford, Mr Jem Lawson (PPI) and Mr Ranj Parmar (PPI) Project partners • Royal College of Surgeons in Ireland • University of Winchester What did we find? We interviewed 15 GPs and health professionals to find out their experiences of using digital technologies, such as online consultations, mobile-phone applications (or ‘apps’) and websites, to support people with LTCs to manage their health. We now have a better understanding of the factors preventing and promoting the use of digital technologies by health professionals to support people with LTCs in the NHS. These included: Preventing : one ‘app’ will not suit all LTCs, ‘apps’ must be user-friendly and accurate, clinicians need to dedicate time to the technology, security risks, patients need to have digital literacy, and long-term investment is required (time and finance). Promoting : ‘apps’ being evidence based, peer/social support of GP networks (including positive feedback), charity endorsement, COVID-19 changing people’s attitudes to digital health, ‘apps’ being linked to a hospital’s IT systems, accountability/monitoring of ‘apps’, and digital champions What difference will this make? Better understanding of the factors preventing and promoting the use of digital technologies by NHS healthcare professionals can help researchers develop new assessments and interventions to help people with LTCs to self-manage their conditions. In future, it could inform a regional evaluation of existing self-management programmes and initiatives to support people with LTCs to maintain their health and physical activity, from a digital perspective What are we doing with this? We have published one journal paper in PLOS One ( 2024 ) and co-investigator, Prof O’Donough published one systematic review paper in Digital Health ( 2024 ) In conjunction with the ‘non-digital’ MOTH study, we are in the process of applying for funding for: A PhD studentship, and NIHR Research for Patient Benefit (RfPB) award Maintaining physical activity and social connections for people with multiple LTCs: intervention development. The aim is to produce a plan for how best to proceed with improving partnership working within Wessex. The aim is to produce a plan for how best to proceed with improving partnership working within Wessex. What next? We plan to combine the non-digital and digital findings from the MOTH programme and apply for NIHR RfPB funding to co-design a 12-week follow-on maintenance intervention to sustainphysical activity for people with multiple LTCs following existing PA programmes between healthcare and community settings. The intervention will be developed informed by and aligned to the NHS Neighborhood Health agenda (2025) and current Southampton Integrated Neighborhood Hubs project . A suitable funding call is the NIHR Research for Patient Benefit (RfPB) programme (tier 3), with a stage 1 deadline of February 2026. Digital MOTH summary Non-Digital Moth Summary Publications https://doi.org/10.1177/20552076221089778

0b30aba5-25eb-4a0f-ba09-0cc56d28cb07 PROCED-DST: PROactive, Collaborative and Efficient complex Discharge – Decision Support Tool Chief Investigator: Dr Chris Duckworth, Senior Research Engineer, University of Southampton Email: C.J.Duckworth@soton.ac.uk Team: Professor Michael Boniface, Director of the IT Innovation Centre, University of Southampton, (HEI) Dr Carlos Lamas-Fernandez, Associate Professor, Southampton Business School Dr Dan Burns, Senior Research Engineer, University of Southampton Dr Mark Wright, Patient Flow Lead, University Hospital Southampton NHS Foundation Trust (NHS) Rachel Leyland, Complex Discharge Team Manager, Hospital Southampton NHS Foundation Trust (NHS) Ian Dickerson (PPIE) Partners: Hampshire and Isle of Wight NHS Foundation Trust, Hampshire Hospitals NHS Foundation Trust, Isle of Wight NHS Trust, Portsmouth Hospitals University NHS Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton, Health Innovation Wessex. Start: 1/10/24 End: 31/3/26 Summary As of January 2023, 14,436 patients a day (14% of total capacity) remained in hospital despite being well enough to leave. This is due to delays in arrangements for onward care. Discharge delay occupies beds putting pressure on a wide-range of NHS services. There are currently 7.6 million patients waiting for treatment and an average waiting time of 15 weeks. Leaving hospital at the right time is also better for patients for many reasons. It reduces physical and mental deconditioning and chance of hospital infections. Part of the problem is organising further care required after a hospital stay. For patients in hospitals for seven days or more, 65% are delayed because they are waiting for after-care including care at home, short-term reablement and permanent care or a nursing home. Discharge planning involves lots of people and organisations from patients through to clinical teams in hospitals, community care, and local authorities. Organising care takes time considering the availability of social care services and mediation with patients and their families. It is therefore important that patients are assessed, and needs identified as early as possible within a hospital stay to give time for planning and conversations. An initial discharge assessment is supposed to be made with the first 24 hours of hospital admission. In practice this planning is provided for less than 50% of patients. Staff workload and inability to identify care requirements can delay assessments. Aims: In a previous project called PROCED, we developed a machine learning model to predict onward care needs when someone is admitted to hospital. Machine learning is a computer programme that can learn from information about patients and the services they use to make predictions. We have compared the model against predictions made by clinicians, and the results have shown it works well. In PROCED-DST we aim to investigate how a machine learning prediction can support better discharge planning. By planning care earlier during hospital stays gives more time for patients and families to discuss care needs with care workers. Ultimately we aim to improve the chance that patients can leave hospital on time. Approach: We will consider how a computer algorithm can help clinicians organise onward care by predicting admitted patient’s potential onward care needs. We will organise collaborative sessions with clinicians, patients, and computer programmers to understand how it could be used in the hospital and consider how it may benefit or impact patients. Patient and Public Involvement: Patients and Public will be directly involved in designing, testing and evaluating a decision support tool and help decide how it should be used by care providers to help plan onward care. PPI will influence data usage, patient journey, algorithms and how this should be communicated. The public will participate in a steering committee who will organise a series of workshops to engage patients and public in the research. Dissemination : Communication materials will engage the public and decision makers. We will work with PPIE support networks to develop accessible communication and ensure distribution to diverse communities. Evidence of effectiveness, safety and acceptance will be published. A decision support tool with computer-based decision support will be demonstrated. The outcomes will be championed with institutional, regional, and national implementation teams.

3a7ef7ca-de0e-49f1-be5c-8349df40131c ADOPTED: Community Alternatives to aCute Hospitalisation for Older People who have Fallen (CAtCH-Falls) Principal Investigator: Dr Sara McKelvie, GP & NIHR Clinical Lecturer at the Primary Care Research Centre, University of Southampton. Team members: Lois Woods, Southampton Health Technology Asessments Centre, University of Southampton. Dr Rachel Dewar-Haggart, Primary Care Research Centre, University of Southampton. Professor Peter Griffiths, Health Sciences, University of Southampton Associate Clinical Professor Jacqui Prieto, Health Sciences, University of Southampton Dr Dan Baylis, Chief Medical Officer, NHS Solent Foundation Trust Dr Syed Hasan, Clinical Lead for Virtual Wards, NHS England Dr Elizabeth Angier, PhD student Main funding: NIHR School For Primary Care Research Starts: 1 April 2024 Ends: 31 March 2026 Summary Each year 30% of older people living in the community fall and are often taken to hospital for assessment. National guidelines recommend that after a fall, older people have a thorough check up and help to prevent further falls. We currently don’t know what the best assessment is for older people who fall and are assessed at home. There are several health services which can assess people in the community without a hospital visit. These can be described as “Community Alternatives to aCute Hospitalisation” (CAtCH) services. In different areas in the country these services have different team members, resources and ways of working. Research is needed who and what is needed to work in CAtCH services, particularly to support older people who have fallen. This study plans to look at previous work in this area by looking at published articles, service reports, government documents and internet resources to find out what is essential for these services. We also plan to survey and interview people who work in CAtCH services in the UK to understand what is available for older people who have fallen. The research findings will be used to develop resources for patients, the public and healthcare workers to showcase CAtCH services. The team also plan to produce a report for healthcare commissioners and support policy-makers. It will also allow the team to apply for further research funding in this area including further projects to look at public awareness of CAtCH.

5fde61a4-c4bf-4d47-8ae3-3eed94045497 COMPLETED ADOPTED PROJECT: Evaluating the Operation Encompass Scheme: A Qualitative Scoping Study Principal Investigator: Dr Sara Morgan Project Team: Dr Maddy Greville Harris (Bournemouth University) Start Date: 1st August 2019 End Date: 21st December 2020 Background For young people, experience of domestic violence or abuse (DVA) is associated with an increased likelihood of experiencing mental health problems, poor academic attainment and later criminal or violent behaviour. The importance of early identification and support for children experiencing DVA is therefore paramount. One safeguarding scheme that is implemented in the UK is Operation Encompass (OE). This scheme involves partnership working between police and schools, to ensure that school safeguarding leads are informed of incidents of DVA involving children from their schools by the start of the next school day. Whilst the OE scheme has been implemented nationally, there is no existing published research exploring implementation of the scheme. What we did This qualitative scoping study carried out semi-structured interviews with 13 police workers and 12 school designated safeguarding leads. Thematic analysis explored three main themes: 1) Information sharing: “the beauty of Encompass is that it’s a conversation” , describing, for example, how OE is invaluable, although seen by some as resource-intensive 2) Facilitators and barriers of the OE scheme , such as staff responsiveness, funding, and resources 3) School support and outcomes: “Now they knew about it, they could go on to help” , such as the usefulness of identifying DVA cases, providing family and wellbeing support. While the OE scheme was considered invaluable in identifying and supporting children following OE, further research into the scheme could assist in a better understanding of how to optimise support for children in schools following a notification of an incidence of DVA. What did we find out? We identified three key themes from our interviews with educators and police involved in delivering Operation Encompass (OE). These were 1. Parameters of the scheme: defining DVA; stages to police implementation; extent and scope of information sharing; expanding and tailoring the scheme. 2. Barriers and facilitators: sustainability; attitudes towards the scheme; compliance and engagement; providing useful, timely contact; systemic promotion, and funding and resources. 3. Outcomes of OE and school support making allowances; check-in and monitoring; providing a safe nurture space; family work, and prioritising wellbeing. There was overwhelming support for the OE scheme from police workers and school safeguarding leads, although several potential challenges to implementation were discussed. The parameters of the OE scheme across regions were discussed, with debate around the content of OE notifications, and how best this should be shared. Although making contact with schools was sometimes challenging, schools agreed that timely information sharing via the OE scheme was useful for providing support to children and their families. Schools discussed the types of support they offered following and OE notification, such as checking in with the child and/or family, and providing a nurture space. Several key recommendations were made, such as the potential usefulness of sharing best practice between schools and the importance of promotion and awareness of the OE scheme. What did we do with this new knowledge? • Findings from the evaluation have been cited in a recent impact report from Operation Encompass, which goes out to all areas in England and Wales delivering OE OE-impact-Report-2023.pdf • The findings on the OE scheme have implications on best practice across police, education, social care settings. • The work was presented through the Association for Children and Adolescent Mental Health Supporting children and families experiencing domestic violence: A Devon and Cornwall perspective - Recording - ACAMH • The work was also used to inform a further grant application on children experiencing domestic abuse and led to a funded UKRI ESRC-funded PhD project by Miss Rebecca Harris | University of Southampton What next? Through my work evaluating violence prevention programmes, and how to support those experiencing domestic abuse, including this evaluation of OE, I’m looking to pursue further research work that understands how to prevent the intergenerational cycle of domestic abuse and how to prevent victims being revictimized or becoming perpetrators as adults. This will involve work with the community in non NHS settings, including partnerships with the police, education, social care and the healthcare system.

4f21e11e-3fe7-460c-9bc0-113a56eec7a5 COMPLETED: The ImPACt study - Improving physical activity of older people in the community Club members at Brendoncare joining in group exercise Principal Investigator: Dr Stephen Lim Team members: Dr Stephen Lim (NIHR Clinical Lecturer in Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Professor Helen Roberts (Professor of Medicine for Older People, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Dr Samantha Meredith (Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton) , Dr Kinda Ibrahim (Senior Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Esther Clift (Consultant Practitioner in Frailty, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Lymington New Forest Hospital), Samantha Agnew (Head of Clubs Services, The Brendoncare Foundation , Winchester), Pam Holloway (Patient representative) Start: 1 February 2020 Ended: 31 October 2021 Project Partners: University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Brendoncare. Lay summary Physical activity is important for older people. It has many benefits including maintaining older people’s ability to perform activities of daily living, be independent, and improve their well-being. However, many older adults living in the community do not engage in regular physical activity. Findings We found that we could train volunteers to support older people during the COVID-19 pandemic to stay active by performing exercises that help strengthen their muscles. Trained volunteers from Brendoncare led the online group exercises for older people who attended online community clubs during the COVID-19 pandemic. This was a challenging time when social distancing and lockdown rules were in place, which limited opportunities for older people to stay active. We recruited 19 volunteers, and 15 volunteers completed the training. The volunteers were mainly female (78%), with an average age of 68 years. The exercises were seated exercises and older adults were given exercise bands to increase the exercise intensity. Halfway through the study, lockdown restrictions were lifted, and some groups continued the group exercise in a face-to-face setting. The volunteers led 184 group weekly exercise sessions (127 online and 57 in-person). Thirty older adults participated in the group exercises. We interviewed volunteers, older adults and Brendoncare staff to find out more about what they thought of the online group exercise. The older adults enjoyed the intervention and understood the benefits of exercising. Additionally, they felt that they could exercise in a relaxed way with their peers without fear of being judged. The group exercises helped reduce social isolation and motivated older adults to engage with the exercises. Volunteers were enthusiastic to support the exercise groups. They appreciated the training and opportunity to lead the group exercises. One volunteer reported that the role gave her a sense of purpose by playing an active role the community club. Brendoncare staff members were a great help to the older adults and supported them with any issues, in particular those who were less familiar with the internet. At six months, we found that older adults who participated in the group exercise had an improved physical activity level. The time spent in light physical activity per week improved from an average of 1530 minutes per week to 1620 minutes per week. Only two minor incidents happened during the group exercises. Two participants experienced worsening of old injuries while performing the exercises. The programme trainer ensured the participants were safe and adapted the exercise for them. Overall, we found that volunteers can be trained to lead online group seated exercises. The exercises were safe and older adults enjoyed the exercises as well as the social interaction in the group setting. What we did with the new knowledge We supported Brendoncare in continuing the exercise groups after the study had ended. We presented our study findings to the board of trustees and demonstrated the exercises. Brendoncare has since employed an activity coordinator to continue to role of training volunteers and supporting volunteer-led exercise groups within Brendoncare. We trained the activity coordinator and shared our exercise sheets and other study materials to help Brendoncare develop their own training package. They are now actively recruiting more volunteers to lead group exercises in their community clubs. https://www.brendoncare.org.uk/get-involved/support-us/volunteering/#:~:text=Chair%20Based%20Exercise%20Volunteer,improving%20their%20health%20and%20wellbeing . We have developed a volunteer toolkit which is available to share with other volunteer organisations. The toolkit has recently been shared with Valley Leisure Ltd, a charitable leisure organisation, who have developed their offer of volunteer-based community clubs in Test Valley. Where next? Having explored how we can train volunteers to engage with healthy community-dwelling older adults to stay active through online group exercises, we collaborated with researchers from the Southampton Biomedical Research Centre and Bournemouth University to further develop this volunteer-led online intervention. We successfully secured research funding (£51,000) from University Hospital Southampton NHS FT to conduct a study to explore a multimodal intervention consisting of exercise, nutrition and behaviour change support, to engage with older people living with frailty who have been discharged from hospital, to stay active and eat well. This research has now been completed (10/01/2024) and we showed that it was feasible to translate the programme to support older people living with frailty ( COMPLETED: Wessex Frail2Fit – A feasibility and acceptability study of a virtual multi-modal intervention delivered by volunteers to improve functional outcomes of older adults with COVID-19 discharged from hospital ). What did people say about the work? Volunteer : “We do it because we want to help others…. we enjoy it. I'm gonna go back to belonging again, I feel that I'm benefiting from the group. Because again, I feel like I belong to that group….. I get so much out of it.” Club member: ‘We are not self-conscious when they (volunteers) are around. We have a laugh as well.’ Club member: ‘I’ve really enjoyed it because it keeps you in touch with people, especially during this COVID….. I still feel as if I’m part of a group.’ NEWS: ImPACT volunteers recognised for their wor k ImPACt exercise video IMPACT Exercise with Steve and Esther from NIHR ARC Wessex on Vimeo . Impact Exercise video using Resistance bands - Dr Sam Meredith watch the video on Vimeo Publications doi.org Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: a systematic review - Aging Clinical and Experimental Research Background Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. There is strong evidence to support the benefits of physical activity interventions on the health outcomes of older adults. Nonetheless, innovative approaches are needed to ensure that these interventions are practical and sustainable. Aim This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers describing eight studies (five papers reported different outcomes from the same study) were included in the review. All eight studies included strength and balance exercises and frequency of PA ranged from weekly to three times a week. Volunteer-led exercises led to improvements in functional status measured using the short physical performance battery, timed up and go test, Barthel Index, single leg stand, step touch test, chair stand test, and functional reach. Frailty status identified by grip strength measurement or the use of long-term care insurance improved with volunteer-led exercises. Interventions led to improvement in fear of falls and maintained or improved the quality of life. The impact on PA levels were mixed. Conclusion Limited evidence suggests that volunteer-led PA interventions that include resistance exercise training, can improve outcomes of community-dwelling older adults including functional status, frailty status, and reduction in fear of falls. More high-quality RCTs are needed to investigate the effects of volunteer-led PA interventions among older people. https://doi.org/10.1007/s12603-020-1442-0 https://doi.org/10.7861/clinmed.2022-0283 doi.org Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review - BMC Geriatrics Background Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings. Methods A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis. Results One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status. Conclusions Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients. https://bmjopen.bmj.com/content/13/3/e069533 https://www.sciencedirect.com/science/article/pii/S2260134125000854[SM1] doi.org Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol Introduction Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. Methods A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months. Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. Analysis Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. Ethics and dissemination This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. Trial registration number [NCT04672200][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04672200&atom=%2Fbmjopen%2F12%2F2%2Fe052631.atom · 40 Faces of Brendoncare - Sharon Green · 40 Faces of Brendoncare - Dr Sam Meredith · 2022 Winners | Pride of Andover Awards · https://www.linkedin.com/posts/karen-lewis-6b009665_ahpsday-activity-7385000352397385728-8v1K?utm_source=share&utm_medium=member_android&rcm=ACoAAGAmYqMBCL-wtu3ZnECr4UsylRfjAyKeGFY · https://youtu.be/nMSQR7kp9ec · https://youtu.be/6vxyL4OenmQ?si=RiOBz-yU7tO09fwX