Southampton Mobility Volunteer Programme

Study Overview
=================
Brief Summary
-----------------
Physical activity levels of hospitalised older inpatients is low and this results in many adverse health outcomes. Studies have shown that interventions designed to promote increased physical activity of older inpatients using paid staff have shown improvement in physical function of older inpatients, resulting in shorter hospital stay and reduced admissions to nursing home. This study aims to assess the feasibility and acceptability of using trained volunteers to increase physical activity of older people in hospital. Volunteers will be recruited and trained to encourage older inpatients to mobilise or perform chair-based exercises. Patients will be encouraged to walk or exercise with the volunteers twice a day during their hospital stay. Quantitative analysis will be conducted on the outcome measures. Patients, volunteers and staff members will also be interviewed to assess the acceptability of the intervention. This feasibility study will help inform a future controlled trial.

Detailed Description
-----------------
Background: Previous research has shown that low mobility among older people in hospital is associated with poor health outcomes including worsening physical function and increasing dependence in activities of daily living. There is evidence that the implementation by hospital staff of a mobility or exercise programme for older people in the acute care setting is feasible with promising outcomes including improvement in physical function, shorter hospital stay and reduced nursing home admissions. However employing additional therapy or nursing staff is costly and there are well-recognised shortages of suitable applicants to recruit to these posts. Many National Health Service trusts have an established volunteer workforce and in Southampton trained volunteers have successfully assisted older inpatients at mealtimes. Objective: This study aims to assess the feasibility and acceptability of using trained volunteers to increase physical activity levels of older people in hospital. Methods and design: The first part of this feasibility study is the development with the therapy team of a training programme, based on existing literature and best practice, to ensure competency of volunteers in mobilising patients and encouraging physical exercise. The study will be conducted on 2 wards (1 male 1 female) within the Medicine for Older People department. Eligible patients will be encouraged by volunteers to mobilise or perform chair-based exercises, depending on their mobility status, at least twice a day for about 15 minutes each session. The recruitment and retention rates of volunteers will be analysed as will the physical activity interventions they were able to effect. The recruitment of patients, their physical activity and adherence to the intervention will be studied. Qualitative interviews and focus groups will be conducted to explore the views and experiences of the patients, volunteers and health care professionals involved in this study. Participants will be characterised including the measurement of physical activity levels using a StepWatch Activity Monitor and GENEActiv accelerometer. This feasibility study is not powered to show a statistical difference in the outcome measures but data from this study will determine the sample size for future controlled trials. Discussion: Results from this study will provide valuable information regarding the use of trained volunteers to promote physical activity among older inpatients and the practicalities of implementing the intervention throughout the whole department.

Official Title
-----------------
The Southampton Mobility Volunteer Programme to Increase Physical Activity Levels of Older Inpatients: A Feasibility Study

Conditions
-----------------
Physical Activity

Intervention / Treatment
-----------------
* Other: Volunteer-led physical activity session


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: deemed appropriate by the medical team and therapists to receive a physical activity intervention by trained volunteers and able to mobilise with or without a walking aid. Exclusion Criteria: patients normally resident in a nursing home, or who were immobile prior to admission; patients who are in a side room for infection control reasons; palliative care patients; patients deemed inappropriate for the physical activity intervention by the medical or therapy teams.

Ages Eligible for Study
-----------------
Minimum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Volunteer-led physical activity sessions<br>Patient will receive volunteer-led physical activity sessions twice a day during admission. | Other: Volunteer-led physical activity session<br>* Participants will be encouraged by volunteers to walk or perform chair-based exercises during their stay in hospital<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of using trained volunteers to promote increased physical activity among hospitalised older people | Number of volunteers recruited | 2 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability of using trained volunteers to promote increased physical activity among hospitalised older people | Established through interviews and focus groups among patients, volunteers and healthcare staff members. | 2 years | 
| StepWatch Activity Monitor | Mean step count | 2 years | 
| GENEActiv accelerometer | Mean acceleration in milligravity | 2 years | 
| Elderly Mobility Scale |  | 2 years | 
| Barthel Index |  | 2 years | 
| Timed Up and Go test |  | 2 years | 
| Mini-mental state examination |  | 2 years | 
| Geriatric Depression Score |  | 2 years | 
| Gait speed |  | 2 years | 
| Euro-Qol | Measure of quality of life | 2 years | 
| Length of hospital stay |  | 2 years | 
| Discharge destination |  | 2 years | 
| Incidence of thrombotic events |  | 2 years | 
| Incidence of pressure ulcer |  | 2 years | 
| Short Form-36 General Health |  | 2 years | 
| Feasibility assessed by number of volunteers trained |  | 2 years | 
| Feasibility study assessed by number of volunteers retained |  | 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Older people, Physical activity, Hospital