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  Care-home and Community Residents Engage in Exercise Digitally (CCREED): Exploring and comparing the effectiveness of online physical activity for falls prevention and loneliness for older adults based in care homes versus the community.


   Faculty of Health Sciences and Sport

  ,  Applications accepted all year round  Self-Funded PhD Students Only

About the Project

An exciting opportunity for a full-time PhD period of study is available in the Faculty of Health Sciences and Sport, University of Stirling.

This PhD project will examine the effectiveness of digital physical activity (PA) for preventing falls and loneliness in older adults, comparing care home versus community group delivery. Other outcomes of importance such as objective measures of physical function and psychosocial wellbeing will be determined through co-design with an advisory group. The project will evaluate an existing SME - Burns Gym, who deliver a digital physical activity intervention currently in care homes and will co-design an updated intervention protocol to influence these health markers among older adults. 

Currently the time spent in good health in later life is not keeping pace with life expectancy changes (Whittaker et al., 2018). Ageing can be associated with frailty, declining physical function and effects on the quantity and quality of social interaction and levels of loneliness    (Cox et al., 2014; Doody et al., 2023; House of Lords - Ageing: Science, Technology and Healthy Living - Science and Technology Select Committee, n.d.; Phillips & Vitlic, 2016). However, physical activity can be a potent intervention to reverse frailty and reduce other declines associated with ageing (Theou et al., 2011). In our own research we have shown the positive benefits to physical function and psychosocial wellbeing of physical activity delivered to older adults in residential care homes and explored what works and why (Ofosu et al., 2023; Swales et al., 2022, 2023, 2024).  However, there are several unanswered questions including how best to scale this type of intervention to different settings such as the community. Given demographic change towards a greater proportion of older adults in the population than ever, there is an urgent need to understand the capacity for lifestyle interventions to positively influence mental and physical wellbeing and promote healthy ageing. Now many interventions exist, it is important to determine what works well and how, and whether small changes to interventions can make them more effective.

The PhD project will:

    1) assess the current state of knowledge on the efficacy of digital physical activity interventions for improving physical function and psychosocial health in older adults in residential care homes versus in group settings in the community through a systematic review; 

    2) evaluate an existing digital physical activity intervention and develop a logic model for the intervention and compare it to delivery in a community setting; and  

    3) develop a protocol for an updated digital physical activity intervention with additional elements including e.g., behaviour change techniques aiming to improve both mental and physical wellbeing among older adults in residential care homes.

A mixed-methods approach to evaluating the success and effectiveness of the intervention will be taken incorporating online surveys, in-person physical function assessments, and semi-structured interviews. The logic model will be updated on the basis of the initial evaluation. Whether specific behaviour change techniques might be incorporated into the intervention to maximise effectiveness will also be considered.  

The supervisors Whittaker (Professor of Behavioural Medicine working on interdisciplinary ageing research) and Connelly (Senior Lecturer in Physical Activity and Health) have considerable experience of psychosocial and physiological measurements and multi-disciplinary research into physical activity and health outcomes in ageing. Both are experienced in co-production of research designs for use in real-life settings and intervention evaluation. This interdisciplinary expertise means the student will receive training in psychosocial assessments, physical activity monitoring, physiological function tests, intervention evaluation and development, analysis of multi-disciplinary data, and public participant involvement with older adults, among many other techniques, resulting in creating a PhD graduate with a broad range of interdisciplinary skills applicable for many settings. 

Medicine (26) Nursing & Health (27) Psychology (31) Sport & Exercise Science (33)

Funding Notes

If you have the correct qualifications and access to your own funding, either from your home country or your own finances, your application to work with this supervisor will be considered.

References

Cox, L. S., Mason, P. A., Bagley, M. C., Steinsaltz, D., Stefanovska, A., Bernjak, A., Mc Clintock, P. V. E., Phillips, A. C., Upton, J., Latimer, J. E., & Davis, T. (2014). Understanding ageing: Biological and social perspectives. In The New Science of Ageing.
Doody, P., Lord, J. M., Greig, C. A., & Whittaker, A. C. (2023). Frailty: Pathophysiology, Theoretical and Operational Definition(s), Impact, Prevalence, Management and Prevention, in an Increasingly Economically Developed and Ageing World. Gerontology, 69(8), 927–945. https://doi.org/10.1159/000528561/3876777/000528561.PDF
House of Lords - Ageing: Science, Technology and Healthy Living - Science and Technology Select Committee. (n.d.). Retrieved September 24, 2021, from https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18302.htm
Ofosu, E. F., De Nys, L., Connelly, J., Ryde, G. C., & Whittaker, A. C. (2023). A realist evaluation of the feasibility of a randomised controlled trial of a digital music and movement intervention for older people living in care homes. BMC Geriatrics, 23(1), 1–20. https://doi.org/10.1186/S12877-023-03794-5/TABLES/6
Phillips, A. C., & Vitlic, A. (2016). Stress, coping and resilience in an ageing population. In Handbook of Gerontology Research Methods: Understanding successful aging. https://doi.org/10.4324/9781315771533
Swales, B., Ryde, G. C., Fletcher, I., & Whittaker, A. C. (2023). The reliability and suitability of strength assessments in frail and pre-frail older adults: recommendations for strength testing in older populations. BMC Geriatrics, 23(1), 1–10. https://doi.org/10.1186/S12877-023-04552-3/TABLES/3
Swales, B., Ryde, G. C., & Whittaker, A. C. (2022). A Randomized Controlled Feasibility Trial Evaluating a Resistance Training Intervention With Frail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial. Journal of Aging and Physical Activity, 30(3), 364–388. https://doi.org/10.1123/japa.2021-0130
Swales, B., Ryde, G. C., & Whittaker, A. C. (2024). A Mixed Methods Feasibility Study of Machine-Based Resistance Training With Prefrail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial II. Journal of Aging and Physical Activity, 1(aop), 1–20. https://doi.org/10.1123/JAPA.2022-0170
Theou, O., Stathokostas, L., Roland, K. P., Jakobi, J. M., Patterson, C., Vandervoort, A. A., & Jones, G. R. (2011). The effectiveness of exercise interventions for the management of frailty: A systematic review. In Journal of Aging Research (Vol. 2011). https://doi.org/10.4061/2011/569194
Whittaker, A. C., Delledonne, M., Finni, T., Garagnani, P., Greig, C., Kallen, V., Kokko, K., Lord, J., Maier, A. B., Meskers, C. G. M., Santos, N. C., Sipila, S., Thompson, J. L., & van Riel, N. (2018). Physical Activity and Nutrition INfluences In ageing (PANINI): consortium mission statement. Aging Clinical and Experimental Research, 30(6), 685–692. https://doi.org/10.1007/s40520-017-0823-7

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