PhD Fellowship 11

In this project, the candidate will be part of both the EU-MSCA-funded Innovative Training Network’s research project “Health CASCADE”, and Fundació Blanquerna’s Sport, Physical Activity and Health research group under the experienced coordination of Dr. Maria Giné-Garriga.

The supervisory team consists of Dr. Maria Giné-Garriga and Dr. José Morales at Fundació Blanquerna, and Prof. Dawn Skelton and Dr. Philippa Dall at the School of Health and Life Sciences from Glasgow Caledonian University, where the applicant will do a three-month research stay. Prof. Skelton is also the founder of Later Life Training. Fundació Blanquerna is well-known for its experience in top quality-ranked higher education, research, and a standing out individualized teaching methodology. It is a large faculty, with more than 3,000 students, 250 lecturers and researchers with different areas of expertise and 1,400 training agreements with many companies and relevant institutions. The Health, Physical Activity and Sport Research Group has researchers from several disciplines with an excellent national and international track record in high-quality research on movement behaviour and health, functional performance, design and evaluation of health-related interventions for different age groups, including co-creation and participatory research.

The main aim of the Engage4Change project is to conduct a co-creation process to co-design a behaviour change intervention adapted to the specific needs of institutionalized older adults from care/nursing homes of all ages. We anticipate the outcome being reducing sedentary behaviour and loneliness, even though other health concerns may arise along the participatory way. The co-creation process will include older adults at different stages of life: work-to-retirement transition older adults (60-70 years old); community-dwelling older adults (65+ years old); and institutionalized older adults, healthcare staff members, family members and relatives, caregivers, policy makers, and researchers. Including older adults at the edge of retirement and still in the workforce, as well as community-dwelling older adults should be an important strategy to tackle some common effects of retirement and anticipating the health effects yet to come, through the understanding of their thoughts, fears and preferences on how to become more active and more socially engaged before it becomes more difficult to achieve such behavioural changes.

We will (a) explore the best-fitted enabling technologies to facilitate the co-creation process, enhance sustainability and improve adherence; (b) assess the intervention’s feasibility, (c) assess the acceptability within the context [1], and (d) conduct a pilot study of a two armed pragmatic randomized clinical (RCT) to assess the crucial components of the main RCT (e.g. to predict an appropriate sample size for the full-scale RCT, to assess the acceptance and accomplishment of the intervention manual, and the resources and time for the outcomes assessment). The full-scale RCT won’t be tested with the present project. Our complex intervention co-designed with end-users and relevant stakeholders will be compared to usual care (e.g. existing PA interventions if available).

The candidate along with the supervisory team will:

1. Organize the co-creation technique and methodology. We will follow the PRODUCES framework [2] and will discuss the most appropriate co-creation technique, along with ESRs and their supervisory teams of WP1.
2. Explore enabling technologies to facilitate the co-creation process, enhance sustainability and improve adherence along with WP2 ESR and supervisory team.
3. Identify placements and recruit participants at each placement.
4. Conduction of co-creation. The first discussion group with the intergenerational older population will be aimed to collect information regarding their main health-related concerns in old age. We will design the contents of several workshops for older adults and one workshop for the relevant stakeholders (e.g. workplace/ healthcare/ care home staff members, family/ relatives/ caregivers, policy makers). The workshops will aim to answer the following general research questions: (a) what are the interests and worries in relation to movement, decreasing SB and enhancing socialization in institutionalized older adults?; (b) currently, what makes you satisfied/happy regarding your physical, mental, emotional and social health?; (c) how are SB and movement in institutionalized older adults perceived and experienced among end-users, healthcare/ care home staff members, relatives and policy makers?; and (d) how can we work together to decrease SB and increase movement and social connections in older adults?
5. Thematic analysis of the workshops. All workshops will be transcribed verbatim and an inductive thematic analysis will be conducted, following the six steps described by Braun and Clarke [3].

Once the workshops are analysed we will design a draft of an intervention for each placement. We will then present the intervention to all the participants of the workshops to ensure their agreement and to collect their feedback. We will then write the intervention manual to be presented to the Health Cascade consortium. We will recruit three care home professional “champions” in at least one care home that will participate in the feasibility and acceptability study. All champions will be trained with the intervention manual.

The supervisory team conducted a previous study aimed to co-create an intervention to increase physical activity with care home residents [4], thus will be able to anticipate and mitigate some risks that may appear along the way.