Active, Connected, Engaged (ACE): A multi-centre randomised controlled trial of a peer volunteer led active ageing programme to prevent decline in physical function in older people at risk of mobility disability.

As people get older their physical functioning and mobility decrease. This leads to a vicious circle whereby people become less active and, as a result, even less mobile. This affects health, ability to live independently, quality of life and even how long people live. Active ageing programmes help older people who are at risk of such decline to improve or maintain their mobility through physical activity. As well as improving quality of life for older people, such programmes could reduce health and social care costs, which increase every year as the average age of people in the UK increases. However, at a national level, resources are scarce. The voluntary sector is ideally placed to mobilise older adults as volunteers to deliver active ageing programmes. Unfortunately, little evidence exists for such community-based programmes. The Active, Connected and Engaged (ACE) programme is a low-cost programme, where older volunteers support older people at risk of physical decline to improve their mobility by becoming more active within their communities. This can provide a meaningful experience for the volunteers and it may have a positive impact on their physical and mental well-being, as well as that of the participants. A feasibility study has confirmed that ACE was well-received by both participants and volunteers. The proposed study will evaluate the impact on mobility and value for money of the 6-month ACE programme by delivering it in three diverse areas: West Midlands, Manchester and Wales. First, peer-volunteers will meet with participants twice to build a rapport, find local community-based activities that the participant would like to join, and identify and address any barriers to taking part (weeks 1 and 2). Then, over a 3-month period, the volunteer-participant pair will jointly visit at least three local initiatives chosen by the participant . Telephone support to continue attending local activities independently will be provided over the following three months, with two further joint visits scheduled if needed. We will first conduct a pilot study with 90 participants to confirm that recruitment procedures work well and the programme can be delivered as planned. If we have problems with recruitment or delivering the programme, we will stop the study. Otherwise, it will carry on as a full-scale trial, with 515 participants aged 65 years and older and 150 peer volunteers. Participants will be randomly assigned to either the ACE programme or a comparison group who only receive information about local initiatives. All participants and volunteers will complete measurements at the start of the study and then 6 months and 18 months later. These measurements include tests of mobility (a balance test, a 'sit-to-stand' test and a walking speed test), physical activity and questionnaires to measure mental well-being and quality of life. The delivery of ACE will be supported by the Royal Voluntary Service, a UK-wide volunteering organisation, in collaboration with community-based organisations delivering a range of active ageing initiatives in the three study areas. If successful, Royal Voluntary Service will deliver ACE nationally. The proposed research is important because mobility makes a huge difference to older people's quality of life and ability to live independently. We currently have no peer-volunteering programmes targeting mobility in older people that are known to be effective and provide good value for money.