Title: Dunhill Medical Trust Healthy Ageing Research Group (DMT HARG) PhD Studentships
Funder: Dunhill Medical Trust

Abstract: The research themes we have identified for the PhD projects fit Dunhill’s 2020-25 strategic framework specifically in the areas of “Targeting the social determinants of healthy life expectancy”, and “Preventing, delaying or reducing future health and social care requirements, in particular, improving the ability to maintain functional independence for older adults”. We have chosen to focus on these specific priority themes as they align well with our research programme and expertise. Below we outline a series of PhD projects which will be used as the menu of projects for applicants to choose from when applying for studentships under this scheme. These projects are all priority areas in the work of either the Policy Research Unit or the Applied Research Collaboration. They all have considerable opportunity to influence policy and/or practice in ways which will enhance the quality-of-life of older people as well as their healthy life expectancy by preventing or delaying the onset of disability and disease progression. In all projects special attention will be given to the effects of inequalities based on material disadvantage, ethnicity, gender, sexual identity and place of residence. The projects are novel in different ways, either because they are addressing changes in society and the organisation of services, some resulting from the COVID-19 pandemic and others more persistent social trends, or by offering novel solutions to problems such as sedentary behaviour. (1) Technology-assisted implementation of Falls Management Exercise (FaME) falls prevention programme among community-dwelling older adults: • This project will complement ongoing work assessing implementation of the FaME programme in Greater Manchester. FaME is an evidence based programme normally delivered face-to-face. This project will investigate how/if FaME can be delivered digitally alongside more extensive roll out of the programme, and what factors act as barriers/facilitators, based on the lived experience of older people garnered through PPIE. (2) Inequalities and digitalisation of GP services: • There has been a rapid push to digital access of services during the COVID-19 pandemic. It is not clear how this has effected older people’s use of services, health and wellbeing. We do not know enough about the effect of deprivation, ethnicity etc on service access. This studentship will participate in exploration of how routine datasets (big-data) can give us insight into these changes to explore how digitalisation relates to health inequalities. We will use PPIE work to give voice to older people experiencing these changes. (3) Signposting to health: • Frailty Index algorithms can identify people at risk of becoming frail or losing independence. Identification from either GP or shared care records could permit phenotyping and then signposting people to suitable services such as exercise/activity or dietary interventions to reduce risk of frailty progression. This studentship will be linked to our work with the Greater Manchester Frailty Reference Group and PPIE to identify how best to move non-medical but effective interventions up the health policy agenda to facilitate implementation of a signposting to health programme within the emerging landscape of Integrated Care Systems. (4) Addressing the effects of COVID-19 pandemic lockdown deconditioning: • Recently Public Health England highlighted the social determinants related to the “deconditioning epidemic”. Our own work using UKHLS data has also revealed the importance of social determinants of inactivity during lockdowns amongst older people. This project will further explore these social determinants, and using understanding from our reviews of behaviour change, updated MRC framework for developing interventions, and PPIE work to design and feasibility test tailored interventions to help older people from socially deprived backgrounds to become more active. (5) Addressing inactivity amongst older people from UK’s Chinese ethnic minority: (*see note below) • Inactivity has been described as pandemic amongst older Chinese people. Older Chinese people in UK become more inactive with age and have activity levels overall amongst the lowest 3 ethnic groups. This project will explore mechanisms underlying inactivity to develop a culturally appropriate intervention to promote activity levels amongst older UK dwelling Chinese people. PPIE will help co-produce any intervention from inception. (6) Frailty progression and maintaining independence to age in place: • During older old age people can struggle to remain independent and in their own homes, and this is often driven by social determinants of health. This project will use mixed-methods and PPIE to explore social determinants of health, such as caring and housing, and how these support ageing in place. (7) Co-development of a digital activity programme for older South Asian communities: • Exercise has major beneficial health effects. Emerging evidence suggests digital approaches can help motivate older people to participate, but age, ethnicity, poverty, geography are all associated with digital and health inequality. This studentship will explore cultural, environmental, social, economic and physical factors that affect use of digital health solutions in South Asian older adults and take an effective digital intervention (Keep-On-Keep-Up) and adapt it to be accessible and usable for older people from South Asian ethnic groups (8) Developing health promoting activity in the workplace: • Analysis of home working during the pandemic reveals clear deleterious effects of physical inactivity on physical and mental health. Promoting anti-sedentary behaviour to counter these effects in office workers/home workers aged 55+ should be a priority. Following updated MRC framework for development of complex interventions, this project will develop and feasibility test an activity promotion programme in workplace/homeworking settings). *(We specify UK Chinese ethnic minority population. The self-same project could be presented for Asian and Black ethnic minority communities. We will present these options at advertisement and ensure fit of project target population and candidate.)


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.5 RESOURCES AND INFRASTRUCTURE (PREVENTION);7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE