The impact of physical activity interventions on bereaved older people (carers and non-carers) in Pennine Lancashire

Full-time PhD studentships are available, funded by the NIHR Applied Research Collaboration (ARC) North West Coast. The purpose of the NIHR ARC funding is to support applied Health Care, Social Care and/or Public Health research relevant to the needs of the diverse communities served by the NIHR ARC and its local health and care system and be implementable across the local region. The research should be generalisable and have wide applicability across health and care nationally, as well as within the local health and care system where it is conducted.

The studentship will be linked to the existing partnership between Lancaster University and the Together an Active Future (TaAF) programme, a £3 million pilot being delivered in Pennine Lancashire and evaluated by Lancaster University. TaAF’s overarching aim is to improve population physical activity levels, an integral part of Sport England’s investment in tackling physical inactivity (1). Community-based insight activities in Pennine Lancashire suggest that an important focus is bereaved older people. This is one of the more deprived areas of the UK (2), with over 100,000 adults who are physically inactive (3). People aged 55 plus account for over a quarter of the population (4).

Older people are more likely to experience bereavement than any other age group. For those caring for a loved one with a life-limiting illness, high levels of psychological distress are often reported throughout the caregiving phase and during bereavement (5), leading to social isolation (6). However, unexpected loss of a lifetime partner may put widowed older adults at greater risk for depression and reduced physical and psychological resilience than bereavement preceded by chronic disease (7). Reduction in resilience in both groups can lead to an increase in risk of frailty.

Physical activity can slow the onset of frailty (8) and reduce psychological and physical impact of bereavement in older age (9). The research will take such studies further by examining some of the mechanisms by which physical activity interventions may have this impact, focussing on an accumulative deficit model of frailty in which frailty is seen as both preventable and reversible (10) and a psychological model of resilience.

Research
To determine the impact of physical activity interventions on psychological and physical resilience of carers and non-carers aged 55 plus who have experienced a bereavement in the past 6-12 months.

Objectives
(1) In the planning stages of the project, hold an interactive PPI session with members of a bereavement support group for older adults, to discuss the project and ensure its design is informed by their lived experiences of bereavement and physical activity
(2) Explore existing evidence regarding the relationship between ageing, bereavement and physical activity interventions: a mixed-methods systematic literature review using PRISMA guidelines
(3) Explore older carers’ and non-carers’ relationships and transitions with physical activity across the lifespan: a small pilot study using a qualitative life course interview approach (11)
(4) Examine bereaved older adults’ relationships with physical activity at the outset of their participation and explore changes experienced over a six-month duration: a pre and post- intervention qualitative study utilising a life-course interview approach at two time points: within Months 1 and 6 of commencing the physical activity intervention.
(5) Assess impact of the physical activity intervention on: quality of life (12); resilience (13); mental health (14); frailty (15); self-perceived health; perceived age friendliness of the environment (16), and physical activity/mobility (17): A pre- and post-intervention quantitative study using standardised measures. Assessments will be conducted within month’s 1 and 6 of commencing the intervention
(6) Triangulate findings from the mix of methods
(7) Ensure the student’s development is built into the proposed research, e.g. learning from the review or pilot informs the design of subsequent phases.
(8) Examine any impact on health inequalities of the project using the Health Innovation Assessment Tool (HIAT).

To be considered for this opportunity please contact the project supervisor including a covering letter, your CV and a fully completed research proposal (not more than 1000 words excluding references) related to the title you are applying for. Return by email to [Email Address Removed] quoting the studentship reference number LUARC2021.