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

Afroditi Stathi, Janet Withall, Diane Crone, Helen Hawley-Hague, Rebecca Playle, Emma Frew, Sally Fenton, Melvyn Hillsdon, Christopher Pugh, Kate Jolly, Chris Todd, Nick Cavill, Max Western, Sarah Roche, Nigel Kirby, Elisabeth Boulton, Janice Thompson, Katie Chatwin, Amy Davies, Zsofia SzekeresColin Greaves

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The Active Connected Engaged [ACE] study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial [RCT] with an internal pilot phase. The ACE study incorporates a multi-level mixed methods process evaluation including a systems mapping approach and an economic evaluation. ACE aims to test the effectiveness and cost-effectiveness of a peer-volunteer led active ageing intervention designed to support older adults at risk of mobility disability to become more physically and socially active within their communities and to reduce or reverse, the progression of functional limitations associated with ageing.

METHODS/DESIGN: Community-dwelling, older adults aged 65 years and older (n = 515), at risk of mobility disability due to reduced lower limb physical functioning (Short Physical Performance Battery (SPPB) score of 4-9 inclusive) will be recruited. Participants will be randomised to receive either a minimal control intervention or ACE, a 6-month programme underpinned by behaviour change theory, whereby peer volunteers are paired with participants and offer them individually tailored support to engage them in local physical and social activities to improve lower limb mobility and increase their physical activity. Outcome data will be collected at baseline, 6, 12 and 18 months. The primary outcome analysis (difference in SPPB score at 18 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals.

DISCUSSION: ACE is the largest, pragmatic, community-based randomised controlled trial in the UK to target this high-risk segment of the older population by mobilising community resources (peer volunteers). A programme that can successfully engage this population in sufficient activity to improve strength, coordination, balance and social connections would have a major impact on sustaining health and independence. ACE is also the first study of its kind to conduct a full economic and comprehensive process evaluation of this type of community-based intervention. If effective and cost-effective, the ACE intervention has strong potential to be implemented widely in the UK and elsewhere.

TRIAL REGISTRATION: ISRCTN, ISRCTN17660493. Registered on 30 September 2021. Trial Sponsor: University of Birmingham, Contact: Dr Birgit Whitman, Head of Research Governance and Integrity; Email: [email protected]. Protocol Version 5 22/07/22.

Original languageEnglish
Article number772
Number of pages13
JournalTrials
Volume24
Issue number1
Early online date29 Nov 2023
DOIs
Publication statusPublished - 31 Dec 2023

Funding

This project is funded by the NIHR Public Health Research programme (130156). KJ is part-funded by NIHR Applied Research Collaboration West Midlands. The Royal Voluntary Society will support the delivery of the ACE intervention. ACE PhDs will be funded by the Universities of Birmingham and Manchester.

FundersFunder number
Universities of Birmingham and Manchester
University College London130156
University College London

    Keywords

    • Community
    • Disability prevention
    • Frailty
    • Mobility
    • Peer-volunteers
    • Physical activity
    • Randomised controlled trial
    • Well-being

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Medicine (miscellaneous)

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