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f1f73a06-b3fc-4e9d-b46d-0ecc2e946c91 PARIEDA - Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance Principal Investigator: Dr Daniel Burns, Senior Research Engineer, University of Southampton, d.burns@soton.ac.uk Team: Professor Michael Boniface, Professorial Fellow of Information Systems, University of Southampton, m.j.boniface@soton.ac.uk Professor Matthew Inada-Kim, National Clinical Director-Infection, AMR & Deterioration-NHS England & Improvement, National Clinical Lead COVID NHS@home Visiting Professor, University of Southampton Chair COVID pathways group, matthew.inada-kim@nhs.net Dr Stephen Kidd, Lead Healthcare Scientist, Hampshire Hospitals Foundation Trust, stephen.kidd@hhft.nhs.uk Starts: 1/4/2023 Ends: 30/9/2024 Aim: We will help community doctors and nurses decide how best to care for patients with serious respiratory illness. The right care depends on how ill a patient is and if they will get worse. Care may include home monitoring or hospital visits. We aim to use computer algorithms to help doctors and nurses make these decisions. We expect patients to avoid unnecessary trips to hospital and to feel more supported. Background: Hospitals have had record number of emergency departments visits. Respiratory infections are almost half of the visits. Many of these patients were not admitted to hospital. This means that some patients could be cared outside of the hospital in the community. COVID-19 is a serious respiratory illness. During the COVID-19 pandemic a new way to care for patients was created. Instead of patients going straight to hospital, they were assessed in the community. Only the most serious cases were then sent to hospital. Community care and assessment is now being considered for other respiratory illnesses. Approach: We will use computer algorithms to help community doctors and nurses decide which patients are at most risk of serious respiratory illness. Risk assessment will be done using machine learning. Machine learning is a way to train a computer to categorise patients into groups using data about patients and services they use. We will use historical hospital data to identify patients in high-risk groups. The patient categories will then be used to inform community decisions before attendance at hospital. Patient and Public Involvement: Patients and public have helped develop the research through evaluation pilots for community assessment hubs. PPI will influence data usage and the use of risk groupings within care pathways. Two public members will participant in a Steering Committee. A PPI Committee will organise three workshops involving ten patients and public in the research. Dissemination: Communication will engage the public and decision makers. We will work with patients and the public to design engaging communication and seek acceptance. Our results will be published and will inform national policy.

78e6cc7b-5ff9-411b-b288-1d82a03f0414 COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase I) Does supermarket placement affect intention to buy healthy and unhealthy foods? Principal Investigator: Janis Baird and Christina Vogel, Professor of Public Health and Epidemiology and Principal Research Fellow in Public Health Nutrition respectively, MRC Lifecourse Epidemiology Centre, University of Southampton Team: Dr Sarah Crozier, Senior Statistician, MRC Lifecourse Epidemiology Centre, University of Southampton Sarah Jenner, Senior Research Assistant at University of Southampton Dr Sarah Muir, Senior Research Fellow, University of Southampton Professor Marcus Munafo and Dr Olivia Maynard, Bristol University Ravita Taheem, Southampton City Council, Sure Start Children’s Centres Megan Brook, Public Contributor Tiana Chadwick, Public Contributo Start date: 1 October 2019 End date: 28 February 2022 Background Poor diet has been recognised as a major contributor to the burden of non- communicable diseases in the UK and costs the NHS approximately £6 Billion annually. Most adults in England consume too much salt, saturated fat and free sugar, and do not eat the recommended five daily portions of fruit and vegetables. Among low-income groups these trends are more extreme. Almost 90% of UK grocery sales occur within supermarkets4 and their subtle use of marketing techniques influences the food choices of an almost captive market. Women of childbearing age are an important target group to study because they remain primarily responsible for domestic food tasks such as shopping and cooking and their nutrition status influences the short and long-term health of their children. Our prior work in Hampshire showed that the diets of women with low educational attainment were more affected by less healthy supermarket environments than women with higher attainment. Shopping at less healthy discount and small supermarkets, with poorer availability, pricing and placement of healthy foods, was associated with poor dietary quality among women who left school aged 16 years but not among those with degree qualifications. UK government policy recognises that more effort is needed to develop interventions to improve health equitably and is introducing legislation on product placement initiatives to support families to make healthier food choices in supermarkets. Research using adequately powered clustered randomised controlled trials in supermarkets is limited, largely due to the complexity and large number of stores required. Evaluating changes in supermarket layout is notoriously challenging due to differing health and business agendas and randomisation at the store level requires commitment that is problematic in this highly competitive, commercial setting. Virtual supermarkets offer a viable alternative to investigate the likely impact of supermarket-based, healthy eating policy options using robust trial designs. Additionally, neuroscience techniques, such as eye-tracking, offer objective evidence that complements self-report behaviours, and facilitate a deeper understanding of the cognitive mechanisms underlying health-related behaviours. Such techniques have been used to examine how product placement facilitates customers’ visual attention, however there is a gap in understanding of how visual attention differs according to the healthfulness of products, particularly while placed in prominent in-store locations and whether visual attention differs according to customer’s socioeconomic position. This study aims to use experimental randomised trials and a virtual supermarket setting to determine differences in visual attention and intended purchase of healthy, unhealthy and non-food products placed in prominent in-store locations such as checkouts. It will also assess effect modification by educational attainment on these relationships to explore potential effects on inequalities. This is the first of two phases of research assessing visual responses to product placement. In this phase, heat mapping technology using Qualtrics software determined whether interest in and intended purchase of products in prominent in-store locations differed if the products were healthy, unhealthy or non-food items. We assessed effect modification by educational attainment to explore potential effects on inequalities. Women with young children (n=230), recruited through Sure Start Children’s Centres, early years setting and other community groups in Hampshire, undertook shopping trips in a virtual supermarket to assess whether their purchasing intentions differ if unhealthy foods, healthy foods or non-food items are placed in prominent positions (store entrances, checkouts and end of aisle). Preliminary findings indicated differences in women’s intention to buy certain types of products according to their educational attainment. Women with no educational qualifications beyond aged 16 years were intent on purchasing fewer healthy products when they were placed in prominent locations whereas those with higher educational attainment were intent on buying significantly more healthy products. A total of 230 women participated in phase I, exceeding our target sample size of 52. The study Women were shown a series of pictures representing six journeys through a supermarket. Pictures focused on the areas in a store where most shoppers usually pass through including the store entrance, end-of-aisles and checkouts. In the first three journeys, women needed to click all items they were interested in. In the last three journeys they needed to click all the items they would intend to buy if this was a real shop. Each set of journeys included a healthy journey, unhealthy journey and a non-food journey. What were the results? 201 women took part in a virtual supermarket survey. Overall, women in the study showed more interest in unhealthy products than healthy or non-food items. At checkouts, however, they did show more interest in non-food items. Women intended to buy more healthy and non-food items than unhealthy food items. On average they wanted to buy 12.9 healthy products per shop compared to 11.5 unhealthy products. What difference will this make? Unhealthy products can be interesting to women who shop at supermarkets but they have higher intentions to buy healthy and non-food items in noticeable places in stores. Supermarkets usually place unhealthy foods in noticeable places to make profits. Replacing these unhealthy foods with healthy or non-food items will just as likely, if not more successfully, lead to purchases. This can help families lead healthier lives. Why is this important for patients, health and care providers and policy makers ? Placing unhealthy foods in noticeable places can lead to impulse purchases of foods that can lead to obesity. Our study shows that women do not intend to buy these foods but may show interest in them. Since 2022, UK policy has banned the placement of some unhealthy foods at noticeable places in supermarkets. This research provides evidence that customers likely support this policy as they would like to buy healthy and non-food items from these locations. What we are going to be doing next? We wanted to further understand how attention to healthy, unhealthy and non-food items differ in noticeable places in supermarkets. We therefore ran eye-tracking experiments with 70 women in Hampshire. Data are being analysed. We plan to report the results of our survey and eye-tracking studies to policymakers (e.g. Department of Health and Social Care and Public Health England) via a policy brief. We also aim to share our results with families via Sure Start Children’s Centres, Facebook and Local Schools. We have plans to share our findings at public health conferences and in an academic journal.

d4e68544-5bd2-44f6-bac8-dd9848c01967 COMPLETED: WADE. Women and Desistence Engagement : An evaluation of a community-based, conditional caution pilot programme for women in the criminal justice system Principle Investigator: Sara Morgan, Fiona Maxwell Start Date: 20th November 2019 End Date: 30th March 2022 Background and study aims Compared to the previous year, in 2018 there was an overall 8% increase in theft in England and Wales and a 6% increase in crimes involving sharp instruments or knives. In order to tackle this increase in crime, many believe that more needs to be done to address the reasons why people commit crime in the first place, as well as the damage it causes to peoples’ lives. This means working together in the community to offer solutions to those affected by crime, including victims and offenders. When we discussed possible solutions with local service providers, it was felt that a tailored approach is needed for women, as their needs are unique. Women in prison are very likely to be both victims and offenders whilst, in the general population, one in four women are also victims of abuse within the home and more than half the women in prison have experienced domestic abuse themselves. In response, three projects are being piloted in Hampshire and Dorset to address the needs of women affected by crime. What does the study involve? To understand how these projects are working, we carried out group interviews with those delivering the pilot intervention projects in the community. These were primarily to understand how the projects are working. We also used information gathered from the project staff about the women using the service to understand whether women go on to seek further assistance in the community, what sort of women engage with the project, and what changes for them as a result of using the service. This study proposal was developed in collaboration with public representatives; including offenders, victims, social care workers, domestic abuse service manager, and police officers. They have all shaped the design of the study; by informing us what types of research questions we should be asking. We continued to involve similar representatives throughout the research study; for example, to co-produce the materials used in the study, such as information sheets, and to gain feedback on the write up of the study. What will we do with the study findings? It is important that the information gained from the study reaches the widest number of people. We therefore considered who to engage, and how to reach them, from the very start of the study. The main findings will be developed into a short summary report, which will be accessible to the general public through our public representatives and collaborators. They might include charitable organisations in the community (e.g. Stop Domestic Abuse, Hampton Trust) or services that work directly with women affected by crime (e.g. NHS, probation services). Impact of the COVID-19 Pandemic The first WaDE cautions were offered from March 2019 and workshops began shortly after. Numbers were initially fewer than expected, and although some variance throughout the year would not have been unusual, there were fewer than the anticipated 10 per month for the first months of the pilot. Unfortunately, from March 2020 the COVID pandemic and stay-at-home regulations had a very significant impact on the operation of the pilot. The pilot was suspended from March as Hampshire Constabulary temporarily ceased offering conditional cautions. From March it was also not possible to deliver the WaDE programme in its intended group format, and a small number of participants who had completed the first workshop as a group completed their second part by telephone on a 1:1 basis with a HT facilitator. As an alternative, a non-mandatory, individual telephone intervention was briefly offered from March 2020 during the first period of restrictions. Overall this had an impact on the planned evaluation, resulting in a reduction in the available quantitative data for analysis (due to fewer numbers coming through the programme). Additionally, there was a planned qualitative element to the evaluation (focus groups) which were cancelled due to the restrictions. Due to the impact of COVID-19 on both the programme operation, and the staff involved in researching, the findings of the final report cover the period of September 2021 – March 2020. Reoffending Due to the suspension of the WaDE programme and the extended period between cohort A completing their workshops and the compilation of this report, reoffending data up to 12m post-intervention is now available. From the initial 27 referrals, 4 women went on to commit further offences. These were: 1 at 35 days (common assault) 1 at 157 days (shoplifting) 1 at 229 days (bladed implement) 1 at 310 days (cannabis) Two of those who reoffended had breached (not attended) any WaDE workshops, and two had completed. A chi-square comparison of the reoffending rate between those who breached and those who attended gives a χ2 value of 2.1, indicating that this difference does not meet the threshold for statistical significance. Exit Questionnaires Hampton Trust routinely ask participants in their programmes to complete an exit questionnaire, which allows for some feedback on the perceived benefits of having attended. It also provides the opportunity for some free text comments. Ten participants answered the following questions: Q1 Since being on the workshops have you identified areas of your life in which you need support? Q2 Since being on the workshop do you have a better understanding of what led you to offend? Q3 Have the workshops helped give you tools/support to make safer more positive life choices? Q4 Since being on the workshops have you accessed other services (e.g. counselling, drugs and alcohol support) or plan to do so in the near future? Q5 Do you intend to attend all or any of the follow-on 12 week programme workshops? Q6 How much have you enjoyed the WaDE workshop? Q7 In your opinion, how well presented were the workshops? Q8 To what extent have the workshops helped you with your problems? Q9 Where 10 is ‘very confident’, how confident are you of not offending in future? On the basis of these responses, the WaDE programme is evidently acceptable to, and valued, by the participants. One respondent was generally negative in her responses and indicated in the free text feedback that she felt she shouldn’t have been having to attend WaDE at all; however even she felt that the course was well presented and enjoyable. Due to the small number of responses and the limited amount of free text feedback, full thematic analysis of the responses is not likely to offer reliable identification of consistent key themes. However, for the majority of respondents the comments reflected overall high levels of satisfaction with the programme, its delivery and its usefulness in terms of helping the participants to understand and address the factors and circumstances leading to their caution. Limitations Overall The WaDE programme delivery, and consequently the size and scope of this evaluation, has been significantly impacted by the COVID-19 pandemic. Greater numbers would have added validity to our findings and allowed for meaningful associations to be explored, while qualitative research would have added a depth of understanding of the true impact of the WaDE programme on its participants. At the time of writing it is hoped that WaDE can now revert to its original model and that a steady throughput in line with original expectations on numbers will be observed. Further research is recommended, including a comparative statistical analysis with a larger cohort. Qualitative research would also be valuable to explore in-depth attitudes, towards reoffending for example, in order to provide better evidence for future decision-making. Conclusions Despite some very challenging times, the team delivering WaDE remains committed to its ongoing operation. Continuing support from the OPCC and a strong working partnership between Hampton Trust and Hampshire Constabulary has enabled the programme to ‘weather the storm’ of the pandemic and emerge ready to re-start. The flexibility and hard work of each individual throughout this time speaks to their belief in WaDE as a worthwhile and much-valued means of supporting female offenders towards a better future.

0962122f-1175-4112-bec9-7327da6e0e5a COMPLETED: Work lives and Wellbeing of Mental Health Nursing Workforce Lead applicant: Prof Jane Ball Co-applicants: Dr Gemma Simons, Prof David Baldwin, Prof Peter Griffiths, Dr Catherine Smith, Dr Emma Wadey Project Summary: Read a long project summary Read a short project summary We have a growing demand for mental health care and nurses are key to meting this demand. Each year roughly 10,000 NHS staff in England leave mental health services. 22% of nursing posts in mental health are vacant. Across the NHS it is recognised that work pressures impact on staff wellbeing, their ability to deliver care well, and likelihood of staff staying in the NHS. Despite being a priority area, most research related to nurses’ work engagement, retention and positive staff outcomes focuses on staff in general acute hospitals. Very little attention has been paid to mental health nurses’ work lives and wellbeing. Where will the research take place and who will it in involve This study focusses on mental health nurses. It will take place in Wessex but also includes desk research to collate workforce data, and a national survey of nurses in a range of mental health settings (community, hospitals, specialist units). The project will be led by the mental health workforce team at Southampton, in collaboration with the Hampshire & Isle of Wight Staff Support Hub, and the national lead for mental health nursing. An advisory group and patient public group will support the research. Aim & Design The aim is to examine the work lives and wellbeing of mental health nurses, in order to improve wellbeing and retention of these staff. This study will map what is known about the mental health nursing workforce, identify modifiable workplace factors that impact on staff experience, wellbeing and outcomes, and work collaboratively to identify solutions. The companion project will identify metrics that we can use to assess the wellbeing of the mental health workforce. Methods Labour market and workforce review - analyse data on the mental health nursing workforce, to create an overview. Survey nurses working in mental health (in Wessex NHS Trusts and a national sample). The questionnaire includes measures of: burnout, job satisfaction, intention to leave, workloads and practice environment. We will include open-ended questions so staff can give their views of work-life challenges, how they impact on their health, and what helps. The RCN Mental Health Forum will be main gateway for the national survey. Interview and focus groups with mental health nurses in Wessex NHS Trusts to explore experiences and views of working in mental health and issues related to wellbeing. These will be both before and after the survey (to help with survey design, and afterwards, to enrich interpretation). Coproduction workshop . Preliminary findings will be shared with a wide range of people with vested interest in, or responsibility for, the mental health workforce (e.g. nurses, managers, workforce leads) at a Wessex based co-production workshop, to identify actions and next steps. How will the findings inform improvements in population health and patient care? Services will run better and care quality will be improved if the workforce is healthy, happy and there are enough staff to provide care to the expected standards. Publications doi:10.12968/bjmh.2023.0037

5a0c9214-8a00-419e-80b5-dd5d80c94fdf ADOPTED PROJECT: Magnet4Europe: Improving mental health and wellbeing in the health care workplace Joint Lead: Professor Peter Griffiths and Professor Jane Ball Partners: University of Southampton, Katholieke Universiteit Leuven (KUL), Belgium Start date – Jan 2020 End date – Dec 2023 Lay Summary The pervasiveness and growing levels with which mental health morbidity is reported by healthcare professionals is a matter of concern. Underlying causes are frequently rooted within the work environment. In the United States, implementing the Magnet© model of organizational work re-design for nurses in hospitals has been associated with improved mental health, reduced burnout and turnover and improved patient outcomes, yet the model has not been implemented at scale in Europe. The aim of the EU-funded Magnet4Europe study is to transfer, modify, scale up, and evaluate the Magnet© model in 60 European hospitals in 6 countries (Belgium, England, Germany, Ireland, Norway, Sweden) between 2020 and 2023. The intervention involves the following: implementing hospital-wide change via a bundle of organizational measures as stipulated in the Magnet© manual, facilitated by one-to-one twinning with 60 Magnet© recognized U.S. hospitals with experience in implementing the Magnet© model, a European learning collaborative for hospital managers, and a critical mass of hospitals promoting innovation to attract public interest and foster replication. Magnet4Europe uses a usual-practice wait-list cluster randomized trial (RCT) to determine the effect and costs of Magnet© hospital organizational redesign on nurse and physician health outcomes and wellbeing, with burnout as the primary outcome, using validated instruments. Secondary outcome variables include staff well-being and turnover. In addition, the implementation of the intervention is evaluated using a nested mixed-methods process evaluation, based on focus groups and individual interviews with a selection of hospitals in the participating countries. Analyses will be based on quantitative (RCT) and qualitative methods (process evaluation) and a triangulation of the findings. Dissemination of the results are planned for different audiences, including clinicians, hospital managers, policymakers and the wider public. NB: The term ‘Physician’ is used for consistency across the EU countries in the study Consortium. In the UK context the staff group referred to equates to Medical Staff -Medics Intervention Hospital Magnet® is a trademark of ANCC registered in the United States of America and other jurisdictions and is being used under license from ANCC. All rights are reserved by ANCC. ANCC’s consent to the use of the Intervention Hospital Magnet® mark shall not be construed as ANCC sponsoring, participating, or endorsing the Magnet4Europe intervention. ©American Nurses Credentialing Center. Reproduced under license from the American Nurses Credentialing Center. All rights reserved. Publications Laying the foundations for implementing Magnet principles in hospitals in Europe: A qualitative analysis - ScienceDirect

2bde6957-3a7b-4fc1-81e9-51f920491c2f Developing a core cohort of community researchers in Wessex: towards a sustainable Wessex Community of Practice for public health research co-production Chief Investigator: Professor Nisreen A Alwan, Professor of Public Health, Centre for Population Health Sciences, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton and University Hospital Southampton NHS Foundation Trust Team: Dr Donna Clutterbuck, Research Fellow, University of Southampton Megan Barlow-Pay, PPIE Lead, NIHR Research Support Service Professor Julie Parkes, Professor of Public Health, University of Southampton, University Hospital Southampton NHS Foundation Trust and Health Education England Wessex Dr Kath Woods-Townsend, Associate Professor (Research) and Lifelab Project Manager, University of Southampton Mirembe Woodrow, Senior Public Health Practitioner, Southampton City Council and PhD student, University of Southampton Partners: Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Bournemouth University, University of Portsmouth, University of Southampton, Southampton City Council, NIHR Research Support Service Specialist Centre for Public Health, LifeLab, University of Southampton / NIHR Southampton Biomedical Research Centre, Health Determinants Research Collaboration, Southampton, Southampton Centre for Research Engagement & Impact (SCREI), Centre for Seldom Heard Voices, Bournemouth University, HDRC Portsmouth Start: 1 October 2024 End: 31 March 2026 Summary Public health research priorities must stem from the needs of the communities served by such research, particularly those most socially and economically disadvantaged, as well as community groups that are seldom heard. Therefore, community members with lived experience of health conditions and the various factors shaping health and wellbeing have a central role in shaping such research. Co-creating research with the public can lead to research findings that are more relevant to population health and wellbeing, leading to a reduction in heath inequalities. The purpose of this project is to develop a core ‘cohort’ of community public health researchers using an approach that considers the multiple social forces that shape people’s identities to inform research design that is meaningful to Wessex local communities. This cohort will form a Community of Practice (CoP) for research co-design that can help us reach those seldom heard groups in our local communities and understand underrepresented perspectives to inform relevant and meaningful health research priorities, questions and methods. People from such communities are more likely to feel comfortable to inform research that is led or co-led with community researchers. This project will be a Partnership between the NIHR Research Support Service (RSS) National Specialist Centre for Public Health (NSCPH) which aims to support the generation of high-quality research evidence aimed to inform decisions about which interventions have the greatest likelihood to improve population health and reduce health inequalities, and the Healthy Communities Theme of the NIHR ARC Wessex. In the first stage of the project, we will engage with stakeholders, including members of the public, voluntary organisations, Local Councils and health services to shape the project protocol and to co-develop its strategy, key milestones and outcomes. In the second phase of the project, we envisage a group of community researchers being recruited and trained in participatory research (or other research methods of their choice) and be provided with opportunities to link in with health researchers. In the third phase of the project, the community researchers will then choose a pathway (or more) that suits their needs from conducting community-based research, linking with other community members to inform further research projects, co-creating research ideas, or informing research proposals developed by researchers within the ARC or through the RSS. In the fourth phase of the project, we will evaluate the above activities and synthesise and disseminate lessons learnt from the project towards sustainability of our CoP framework. The project’s Research Fellows will also work with public contributors to disseminate findings in ways that are meaningful, alongside preparing publication materials for journals and conferences, and producing infographics. The CoP will help us to co-design health research based on local and regional need; provide stakeholder input into public health research proposals in Wessex; contribute to governance and delivery of NSCPH; and support meaningful and equitable research partnerships with community stakeholders and the public.

3a061229-d16f-48eb-aa36-30056ba5bad5 COMPLETED: INVOLVing pEople with cognitive impaiRment in decisions about their hospital nursing care (INVOLVER): a pilot study Principal Investigator: Professor Jackie Bridges Team members: Professor Jackie Bridges (Professor of Older People's Care, School of Health Sciences, University of Southampton), Dr Jo Hope (Lecturer, School of Health Sciences, University of Southampton), Dr Tula Brannely (University of Bournemouth). Professor Katie Featherstone (Univesrity of West London) Start: 1 January 2020 Ended: 31 December 2022 Partners: University of Southampton, Solent NHS Trust, University of Bournemouth, University of West London Collaborations developed through project: Alex Iles (grant co-applicant/film contributor) and the Treat Me Well Group (Southampton Mencap) (grant development and film contributors) The Grow Project, Southampton (film contributors) Different Strokes (Southampton) (film contributors) Mayes Bahrani (Southern Health NHS Foundation Trust Patient Experience Group) (grant co-applicant) Catherine Mead (Portsmouth Hospitals NHS Trust, grant collaborator) Rosalynn Austin (Portsmouth Hospitals NHS Trust, grant collaborator) Francesca Lambert (University of Southampton) (grant co-applicant/film project co-applicant) Sofy Bazzini (Digital Learning Team, University of Southampton) (film project co-applicant) Pippa Collins (University of Southampton) (film project co-applicant) Anthony and Caroline Scott-Gall (film contributors) Lay summary We want to help nurses look after their patients in hospital. We want to help them find out how each patient likes to do things like getting clean, going to the toilet, eating and drinking. Some people have to go into hospital to get better. Sometimes, when they are in hospital, the nurses don’t ask them enough about the way they like to do things. For example, if they like a bath or a shower. Or if they need help going to the toilet. Or if they would like to walk about. Or what food or drink they like. Not being asked about these things is not helpful. It might mean that people end up getting sicker and staying in hospital longer. Or they may go home needing more help from their family. People with dementia, learning disabilities or stroke may not be asked these questions about what they like. Sometimes the nurses don’t know how to do this well. Sometimes they know how to do it but can’t do it. The reasons they can’t do it are not well understood. We are a group of people who want to make this better. Some of us work at a university finding things out. Some of us are nurses. We want to include people with dementia, learning disabilities or stroke in our group. This will help us think about how to make things better. We think we can help nurses by using ideas that have worked in other places. When people like us have an idea about how something can be made better, we try the idea out and see if it works. Summary of findings: We have been looking for good examples of how hospitals have changed what they do to make sure people with dementia, people with learning disabilities and stroke survivors are included in making care decisions in hospitals. We looked at all the research in this area and found only 11 studies that did this! Many more studies said they were making care ‘person-centred’ but did not look at how they could directly include people in decisions about their care. We are currently looking in detail at these studies to see what works well, what can go wrong and which bits work best. We will also check if the people who use or might the service were also involved in the design of the changes and testing them. We will report back soon! Our set of short films, Good Care For Me Is… were co-created with people with learning disabilities, stroke survivors and somebody living with Alzheimer’s. We won funding for this from the University of Southampton’s Public Engagement with Research unit (PERu) PER Development Funding Call 2020/21. These have been used in teaching nursing students at the University of Southampton and we are exploring where else they might be used to teach healthcare staff at the University and other good places. They will also be used in research to help design changes to services with patients and staff. Dr Jo Hope has submitted two funding bids to follow the care of people with learning disabilities in hospitals, to try to understand why care between wards varies so much. They both passed the first round and we are still waiting for the final outcome for the NIHR grant Dr Jo Hope has been developing ideas on how to involve people with profound learning disabilities in research and has published about this with her PhD team. What did we achieve? Good Care For Me Is… films are part of the pre-registration nursing curriculum at the University of Southampton, supporting future nurses to understand how they can improve care for people living with dementia, people with learning disabilities and stroke survivors We have found new collaborators in the health service, and people with lived experience who are co-applicants on our successful Stage 2 NIHR Research for Patient Benefit grant called: Improving the care people with learning disabilities receive in hospital: an ethnographic study examining the experiences of people with learning disabilities and the organisation and delivery of their care. Our papers on the inclusion of people with profound learning disabilities in research are challenging research orthodoxy on who can and cannot be directly involved in research We have shared findings from our previous research in Nursing Times, which explores what makes it difficult for patients to ask for help in hospital and why this is more difficult for people with dementia Publications doi.org/10.1111/1467-9566.13435 doi.org/10.3390/socsci11040159 https://onlinelibrary.wiley.com/doi/10.1111/jan.15637 doi.org/10.3390/socsci13010037 What's next? We will be publishing our systematic review into interventions to engage people living with dementia, people with learning disabilities and stroke survivors in nursing care decisions in hospital settings We will explore how our films about care experiences among people living with dementia, people with learning disabilities and stroke survivors might enable more healthcare students and workers to develop their understanding of supporting these patient groups Dr Jo Hope is developing a research programme to explore how hospital care can be improved for people with learning disabilities We will explore and share practical strategies of how people with more profound communication and understanding difficulties can be involved in research and care decisions

9e2c7f6f-813a-4237-9695-46d21cbe9cea COMPLETED: Development, evaluation and provision of an intervention for primary and community NHS staff to help carers and homecare workers supporting people living at home with dementia with their continence. NIHR Three Schools Dementia Research Programme: NIHR School for Social Care Research, NIHR School for Primary Care Research and NIHR School for Public Health Research Team Lead investigator : Dr Cathy Murphy, Senior Research Fellow, School of Health Sciences, University of Southampton Co-i: Prof Mandy Fader, Professor of Continence Technology, School of Health Sciences, University of Southampton Co-i: Prof Miriam Santer, Professor of Primary Care Research, Faculty of Medicine, University of Southampton, NIHR School for Primary Care Research, Bournemouth based GP Co-i: Dr Leanne Morrison, Lecturer in Health Psychology, School of Psychology & Primary Care Research Centre, University of Southampton, NIHR School for Primary Care Research Co-i (PPI): Jane Ward, Alzheimer’s Society Research Network Member, co-founder of Dementia Friendly Hampshire, Patient Research Ambassador Co-i: Prof Jill Manthorpe, Professor of Social Work, Director of NIHR Policy Research Unit in Health & Social Care Workforce, King’s College London – Associate Director of NIHR School for Social Care Research Start date: 1st June 2022 End date: 28th Feb 2024 We found that Healthcare professionals wanted an easy and quick to use intervention to sign-post carers to continence care guidance. Homecare workers would welcome resources aimed at having difficult continence conversations The findings led us to develop the first evidence-based website to support healthcare professionals to provide continence advice to the carers of people living with dementia. The intervention also provides carers with detailed, practical self-management guidance. The website is www.demcon.org.uk A summary of the work can be found in this article: C Murphy, B Bradbury, M Fader, L Morrison, M Santer, J Ward, H Chester. Supporting continence care for people living at home with dementia. 22 APRIL, 2024. Nursing Times What we did with the new knowledge The findings have led to the first evidence-based intervention to support healthcare professionals to provide continence advice to the carers of people living with dementia. The intervention supports healthcare professionals to initiate conversations and then to sign-post carers to detailed, evidence based self-management guidance. The website can be accessed here: www.demcon.org.uk What are we doing next? The project has provided foundational findings for the next phase of work which includes developing a new intervention to support homecare workers to initiate continence conversations with people living at home with dementia. This work (DemCon2) is being funded by NIHR Three School’s Dementia Research Programme and will start Autumn 2024.

40fed7f8-d8d0-46f4-80c3-660e33675330 PIVOT: Promoting Increased physical actiVity in hospitalised Older adults with Trained volunteers NIHR Advanced Fellowship Award: Dr Stephen Lim, Honorary Consultant Geriatrician University Hospital Southampton NHS Foundation Trust and Principal Clinical Research Fellow, University of Southampton Team : Dr Samantha Meredith Research Fellow, University of Southampton, Professor Beth Stuart Clinical Trials Co-director of the Pragmatic Trials Unit, Queen Mary University of London, Professor Carl Thompson Applied Health Research, University of Leeds Aim(s) of the research To determine whether hospital volunteers can be trained to engage older people in hospital to be more active. We want to know if this intervention will work in different hospitals and explore factors that will support or prevent it from being delivered successfully. Background to the research Between 30 and 60% of older people in hospital are at risk of losing muscle strength and function, known as deconditioning. This reduces their ability to look after themselves independently. Low physical activity level contributes to deconditioning but dedicated physical activity sessions can benefit older inpatients. In most studies, physical activity is led by paid staff. New ideas are needed to ensure additional physical activity sessions are costeffective and sustainable. The Southampton Mobility Volunteer study showed that trained volunteers can safely engage older inpatients to be more active. However, more information is needed on how to make this approach accessible to more people in more hospitals. Design and methods used Hospital inpatients aged 65 years and older will be invited to participate in the study. We will conduct the study in four hospitals. The hospitals will be different in size and from a wider region to include a range of population groups from different settings and context. This is so that different social groups are represented, and the research will be more representative of the wider population. We will use one hospital as a ‘control site’ – where patients will not get volunteer input – to compare our findings against. Volunteers will encourage participants who can walk independently to walk twice daily. Patients who need help with walking will do bedside exercises. They will be encouraged to walk once they can do so independently. We want to know whether trained volunteer delivered exercise sessions are feasible and acceptable to hospitals. We will determine this by collecting data on volunteer recruitment and training, patient recruitment and the walking/ exercises intervention. We will interview patients, staff, and volunteers as the intervention is delivered to establish what worked well and what could be improved. Other outcomes will include physical abilities, muscle strength, length of stay and readmission rates. We will analyse how much money it costs the NHS to deliver the intervention. Patient/service user, carer and public involvement The James Lind Alliance Priority Setting Partnership has highlighted promoting of independence, and physical and emotional well-being as 2 of the top 3 key research priorities for older adults. More specifically, our PPI research with 92 older people showed that 45% of them had experience with hospital volunteers and all spoke highly of their contribution. Most respondents thought volunteers could be trained to help with mobility. My feasibility study (SoMoVe study) confirmed the volunteer-led intervention was acceptable to patients, volunteers, and staff in one hospital. Patients were grateful that the volunteers encouraged them to be more active. Staff members valued the work of the volunteers. This proposal was developed with the support of 2 public researchers, the volunteer services manager and a hospital therapy lead. The study protocol and study documents will be developed with PPI collaboration. 2 public researchers will be invited to join the study steering group. PPI input will be paid at INVOLVE rates. Dissemination Findings from this study will be shared through conferences, academic papers/reports, and media/social media. In collaboration with the Academic Health Science Network, we will share our findings with commissioners, providers of care and voluntary organisations. Study findings will be of interest to voluntary services, healthcare professionals, and directorate managers. A collection of resources will be produced to encourage the adoption of this intervention in other settings.

5241b3d8-a7e9-409f-8d8a-e86421d8cdd5 Evaluating impact of personalised care at service at service and system levels: Learning from the Wessex Academy for Skills in Personalised Care (WASP) programme. Chief Investigators: Professor Mari Carmen Portillo, Professor of Long-Term Conditions. School of Health Sciences. University of Southampton, Dr Louise Johnson, Consultant Therapist and WASP Project Lead, University Hospitals Dorset Team: Dr Beth Clark, WASP Personalised Care Facilitator, University of Southampton Matthew Wood, WASP Digital Lead and current ARC Wessex Statistical Intern Dr Hayden Kirk, Consultant Physiotherapist & Clinical Director Adults Southampton, Solent NHS Trust Janine Ord, Head of Population Health, Dorset Integrated Care Board Fran White, Director of Policy, Innovation and Partnerships, Hampshire and Isle of Wight Integrated Care Board Aisling Flynn, Lecturer in Occupational Therapy and Post-Doctoral Researcher, Bournemouth University Sally Dace, Patient and Public Involvement Representative Luisa Holt, Research Fellow, University of Southampton Partners: Dorset Integrated Care Board, Hampshire and Isle of Wight Integrated Care Board, Dorset County Hospital NHS Foundation Trust, University Hospitals Dorset NHS Foundation Trust, Hampshire and Isle of Wight NHS Foundation Trust, Bournemouth University, University of Southampton. Start: 1 October 2024 End: 31 March 2026 Aim(s) To evaluate if and how the Wessex Academy for Skills in Personalised Care (WASP) programme has led to improvements within healthcare services, and the impacts for patients, services and the wider health system. Background Personalised care focuses on tailoring health services to individuals’ needs and preferences. People who receive personalised care have greater satisfaction, and are more likely to feel in control of their own health and wellbeing. Services that work in a personalised way are likely to use their resource more efficiently - by offering people the right support, in the right way, at the right time. Despite the benefits, widespread adoption of personalised care has been slow. There are many reasons for this – including having healthcare staff who are trained and believe in its importance, and having systems that support its delivery. Since 2018, the Wessex Academy for Skills in Personalised Care (WASP) has been helping NHS services to improve personalised care delivery. This support involves three parts: EVALUATION –understanding current care by collecting the views of service users, frontline clinicians, managers and people who plan services (commissioners) LEARN – training healthcare teams, so they have the knowledge, skills and confidence to change how they work IMPLEMENT – supporting services to identify and deliver improvement projects, with measurable benefits for patients In this research, we will evaluate impact of the programme. This is important to: · know how to improve WASP in the future; · learn how to accelerate the adoption of personalised care within the NHS; · demonstrate impact, so we can spread the benefits more widely. Design We will create a series of case studies from services that have already completed WASP, highlighting learning from the programme, if/how this has been put into practice, and the benefits to service users. We will use interviews and surveys to collect information from healthcare staff, who are working in services that completeWASP in 2024/25. This will allow us to understand peoples experience of the programme, and the impacts this leads to. Interviews will take place at several timepoints, understanding learning development over time. Results will be considered together. Patient, public and community involvement Patient and public feedback has been incorporated into this proposal. Throughout the research, we will work with patient contributors, including a co-applicant, to shape and develop the research programme, ensure we are capturing the most important impacts, and to develop accessible ways to share our findings. Dissemination We will use the findings to create recommendations for how the WASP programme can be improved and spread in the future, reaching more people with long term conditions. We will share results at conferences and in academic journals; and presenting in a range of accessible formats, using the WASP website, social media and in the community.

9651ede0-0793-4179-aed8-009aca83e877 Developing Pathways for older adults who are also drinking at increased-risk levels Older adults Alcohol Pathway (OAP) Chief Investigator: Julia Sinclair , Professor of Addiction Psychiatry, Faculty of Medicine, University of Southampton. Co-Investigators: Stephen Lim, Consultant Geriatrician, NIHR ARC Wessex Ageing and Dementia Theme Lead, university Hospital Southampton Melinda King, Lived Experience Consultant Becky Band, Associate Professor, University of Swansea Partners: Hampshire and Isle of Wight Integrated Care Board, Hampshire and Isle of Wight NHS Foundation Trust, Hampshire Hospitals NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton, Hampshire County Council, Southampton City Council, Wessex Health Partners, Inclusion (community treatment provider of addiction services), CGL, ‘With you’ Community Addiction Services Bournemouth and Poole, NIHR School of Primary care. Start: 1 October 2024 End: 31 March 2026 Summary Alcohol once swallowed is absorbed into every organ of the body as well as affecting the mind. Although approximately 80% of people in Wessex drink alcohol, many people remain unaware of the harm it causes even at relatively low levels. As people age, they are more likely to develop long term health conditions, which alcohol can adversely affect as well as putting them at increased risk of medication interactions, memory problems, and falls. We know that older adults may feel more uncomfortable talking about their alcohol use compared with younger people. This can create barriers to accessing help. Beyond this, very little is known about the reasons why older adults drink alcohol and how this may interact with other aspects of their lives. The aim of this project is to build on our first study which recruited 29 people over 65 years admitted to University Hospital Southampton (UHS) whose alcohol consumption was at increased risk levels (OLA study). To do this we will: Access routinely collected data from all patients (over the age of 65 years) admitted to UHS during the time of our OLA study (1.8.23 -1.8.24). This is over 70,000 admissions to hospital, of whom over 17,000 had a measure of alcohol use (AUDIT -C) taken on admission. From this we wish to examine the impact that increased risk levels of alcohol consumption had on how long people stayed in hospital, their nutritional status (from blood test whilst in hospital), the medications they were prescribed, and their health outcomes. Interview a community sample of patients over the age of 65 years who may have significant levels of distress, long term conditions and who may also use alcohol at increased risk levels, to better understand their diverse needs and optimise outcomes. Bring together an engaged and active stakeholder group of experts by experience and training in this field; including patients, carers, clinicians, social care workers, providers, commissioners and academics to help review and interpret the results of the first OLA study and this new information and to build a network to apply for further funding to take this work forward. We anticipated that these three strands of work will occur in parallel over the next 18 months as part of developing a fully funded application for a programme grant to take the work forward. Our collaborators in Wessex and beyond will enable us both to contribute to the very small evidence base in this area but also to set up and test pathways that may be effective and sustainable.

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