Awards announcement: interventions targeting the social determinants of healthy older age

In June 2022 we launched our call for research proposals on the theme of interventions targeting the social determinants of healthy older age. Like our previous call focused on suitable living environments and communities for an ageing population, we were looking to support collaborative proposals involving researchers and community partners, which also aligned to our key principles for research.

We received 26 expression of interest applications in total. Following assessment, 15 of these were invited to submit a full application (a success rate of 58% at this stage). You can read our earlier blog post for general feedback on the applications received at this stage.

Full applications were externally peer reviewed, and applicants then had the chance to respond to reviewers’ key points of feedback. The full applications, along with applicants’ responses, were then assessed by a panel of independent experts and suitably qualified members of our Research Grants Committee. The panel members were:

  • Professor Bernard Conway (Chair of the Expert Panel and Dunhill Medical Trust Research Grants Committee)
  • Professor Afroditi Stathi (University of Birmingham)
  • Professor Ala Szczepura (Coventry University)
  • Professor Andrew Clegg (University of Leeds)
  • Professor Carmel Hughes (Queen’s University Belfast)
  • Dr Clarissa Giebel (University of Liverpool)
  • Dr Deborah Fenney (The King’s Fund)
  • Professor Julienne Meyer (City University of London)
  • Professor Karen Lowton (University of Sussex)
  • Professor Ryan Woolrych (Heriot-Watt University)
  • Dr Sophia Amenyah (Bournemouth University)
  • Professor Stuart Gray (University of Glasgow)

Thank you to those who applied to the call – we appreciate the time and effort that goes into making an application. We also appreciate the large amount of work involved in assessing grant applications, which is crucial to good decision-making. We’d therefore like to take this opportunity to extend a huge ‘thank you’ to all those who contributed to the assessment of these proposals.

Of the 15 full applications, three were funded (a success rate of 20% at this stage of the process). We’re delighted to be able to provide details of the funded proposals below.

Please expand any of the project titles below to read more information, including the lay summary:

Lead applicant: Dr Elizabeth Graham (Bradford Teaching Hospitals NHS Foundation Trust)

Community partner: Age UK Leeds

Award amount: £412,252

Duration: 34 months

Award type: Project grant

Summary: Older people are more likely to be ‘digitally excluded’. This refers to them not using the internet, so missing out on things that could be helpful to their well-being and health (e.g. making appointments, banking, connecting with family). Support and training is available to increase digital inclusion but there is no process in place to identify everyone needing help. Support tends to be offered only when people come into contact with health, social care or community services, rather than through actively identifying people who are digitally excluded. This means that some older people who might benefit from support are not offered it, and we don’t know what support is best for them.

AIMS AND OBJECTIVES

  • Develop an inclusive way of identifying older people who are digitally excluded
  • Explore older people’s views of the internet and what might help them get online
  • Adapt available digital support so it addresses a wide range of needs
  • Test this new approach with a group of older people

METHODS

We will send a survey to people aged 65+ on GP registers, and ask about their internet use. Using their responses we will develop a model that predicts who is more likely to not use the internet.

We will talk to older people about their internet use. We will also talk to voluntary organisations that currently provide digital help and support to find out what they do. In workshops with older people and service providers (in a process called co-production) we will explore the needs of those who don’t use the internet. We will review and adapt existing digital support services to make them more accessible to and appropriate for people who are digitally excluded. We will test the adapted service with a group of older people to find out whether it is acceptable.

PATIENT AND PUBLIC INVOLVEMENT

We have spoken to older people who are part of our community study of ageing, Age UK Leeds’ Older People’s Engagement Group, and regional groups serving diverse communities. All those consulted think the proposed work is important, relevant and timely in our increasingly digital world, and are keen to provide support.

DISSEMINATION

The methods we develop to identify digitally excluded older people, and the support services we develop will be widely publicised: we will talk to commissioners of services, policy makers and older people. We will present our findings at community forums and in academic journals.

Study webpage

Lead applicant: Dr Lucy Beishon (University of Leicester)

Community partner: Age UK Leicester Shire and Rutland

Award amount: £112,918

Duration: 24 months

Award type: Proof of concept / seed funding

Summary: Older people commonly experience both physical (e.g. diabetes), and mental health problems (e.g. depression). However, older people with both physical and mental health problems struggle to access the care they need for their health in a joined-up way. This means patients and carers have to seek help for these problems by accessing several different services, rather than together in one place. This particularly disadvantages people on lower incomes who often have poorer physical and mental health.

WHAT ARE THE AIMS OF THIS STUDY?

This study aims to find out the physical health needs of older people who are being cared for by mental health services. Secondly, to find out how best we can design services for patients to meet their physical and mental health needs in a more joined-up way.

WHAT METHODS WILL BE USED IN THIS STUDY?

This study is a partnership with Age UK Leicester Shire and Rutland, and is divided into three main sections. Firstly, we will access anonymised information (information that cannot be traced back to the individual), through an organisation called NHS Digital. This data will include the number and type of medical conditions experienced by older people under mental health services throughout England. We will link this to information to the number of admission to hospital, destination on discharge from hospital (e.g. own home or care home), income level, and number of deaths.

Secondly, we will interview patients, carers, staff (e.g. nurses), hospital managers, and commissioners (people who make decisions about services) to find out their views on the physical health and service needs for older people under mental health services in Leicestershire and Nottinghamshire. Finally, we will combine information from the first two stages to produce a list of recommendations on how services can be improved to provide joined-up physical and mental health care for older people. This list will be reviewed and finalised through consultation with patients and carers.

HOW WILL THIS STUDY BENEFIT PATIENTS AND CARERS?

This study will benefit patients and carers by providing the information needed to develop services to provide more joined-up physical and mental health care. This study will produce a list of recommendations that can be used by NHS hospitals to help address the current inequalities, delivering more holistic, patient-centred care. By reducing admissions between hospitals we have the opportunity to reduce costs to the NHS.

Lead applicant: Dr Kimberley Smith (University of Surrey)

Community partner: UP – The Adult Cerebral Palsy Movement

Award amount: £295,338

Duration: 30 months

Award type: Project grant

Summary: There are 130,000 adults living with cerebral palsy (CP) in the UK. People ageing with CP can experience unequal opportunities throughout their life which become amplified in older age. At the age of 40 someone living with CP can experience many of the health issues that we see in the general population from their late 60’s such as falls, joint replacements and needing to use mobility aids. Alongside this, people aged 40 and older with CP can have complex physical, mental and social health needs that require specialised support. However, at a time when they desperately need specialised support most older people with CP are under the care of their GP who often doesn’t know how to support their complex needs.

One way the government has suggested that we can provide more tailored input to people to support with their physical, mental and social health needs is through the use of social prescribing. Social prescribing is when someone called a link worker works with an individual to understand what issues are impacting them, and what kind of ‘social prescription’ might help to improve their wellbeing. Social prescriptions are things that already exist in a particular area and can include things like exercise, clubs and support groups. Link workers can work with people generally or can be trained to work with groups who have specialised needs. In this project we want to create and test a specialised link worker role to support older adults with CP.

As a first step to creating this role we will talk to people ageing with CP about how ageing has impacted them, how they use resources in their community and what resources they feel could help them age well. We will also look at existing research and government documents to see what support is currently available or suggested to be important for older adults with CP. Once we have this understanding we will work with adults with CP, link workers and healthcare workers to develop training materials on ‘ageing with CP’ for a specialised link worker. These materials will be used to train a link worker to support people with CP in North Central London for 12 months. To see how well this link worker service works we will collect data to see how many people use the service, how the service impacts the wellbeing of people and what feedback people have about the service.

Congratulations to the successful applicants and we very much look forward to working with you. We hope that the unsuccessful applicants found the detailed feedback provided to each of them helpful.

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