Abstract

Background

An essential consideration in health research is to conduct research with members of the public rather than for them. Public and patient involvement (PPI) of older people in research can improve enrolment, relevance and impact. However, few studies with PPI in frailty research have been identified. PPI has fallen during the Covid-19 pandemic.

Objective

We aimed to involve older people in co-designing a randomised control trial (RCT) intervention to reverse frailty and build resilience. We also wished to encourage wider use of PPI with older people by outlining our approach.

Methods

Involvement of older people was undertaken in three stages. Eighteen over 65-year-olds helped co-design an exercise intervention in two group discussions using the Socratic education method. Ninety-four contributed intervention feedback in one-on-one telephone interviews over nine months. Ten contributors helped optimise the intervention in three online workshops. Multidisciplinary team input and systematic review supported co-design.

Results

Eleven home-based resistance exercises were co-designed by group discussion contributors (mean age 75, 61% female). Frailty intervention format, gender balance and GP follow-up were shaped in telephone interviews (mean age 77, 63% female). Dietary guidance and patient communication were co-designed in workshops (mean age 71, 60% females). Technology proved no barrier to PPI. The co-designed frailty intervention is being evaluated in a definitive RCT.

Conclusions

We enabled meaningful the involvement of 112 older people in the co-design of an intervention to reverse frailty and build resilience in diverse ways. Inclusive involvement can be achieved during a pandemic. Feedback enhanced intervention feasibility for real-world primary-care.

中文翻译：

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让老年人参与共同设计一项干预措施，以扭转虚弱并建立复原力

摘要

背景

健康研究的一个基本考虑是与公众而不是为他们进行研究。老年人参与研究的公众和患者参与 (PPI) 可以提高参与度、相关性和影响力。然而，很少有关于 PPI 在脆弱性研究中的研究被确定。在 Covid-19 大流行期间，PPI 有所下降。

客观的

我们的目标是让老年人参与共同设计一项随机对照试验 (RCT) 干预，以逆转虚弱并建立复原力。我们还希望通过概述我们的方法来鼓励老年人更广泛地使用 PPI。

方法

老年人的参与分三个阶段进行。18 名 65 岁以上的人使用苏格拉底式教育方法在两个小组讨论中帮助共同设计了一项运动干预。在九个月的一对一电话采访中，有 94 人提供了干预反馈。十位贡献者帮助优化了三个在线研讨会的干预。多学科团队输入和系统审查支持协同设计。

结果

小组讨论的参与者（平均年龄 75 岁，61% 为女性）共同设计了 11 项家庭阻力练习。通过电话访谈（平均年龄 77 岁，63% 为女性）确定了虚弱干预形式、性别平衡和 GP 随访。饮食指导和患者交流是在研讨会上共同设计的（平均年龄 71 岁，60% 为女性）。技术证明对 PPI 没有障碍。共同设计的衰弱干预措施正在一项明确的 RCT 中进行评估。

结论

我们让 112 名老年人有意义地参与了一项干预措施的共同设计，以扭转虚弱并以多种方式建立复原力。在大流行期间可以实现包容性参与。反馈增强了现实世界初级保健的干预可行性。