Institute of Epidemiology & Health Care


HomeHealth Publications

HomeHealth Development through Publications

Frost et al. (2017): How effective are home and community-based health promotion interventions for older people with mild/pre-frailty?

To determine how effective current interventions for older adults with mild frailty living in the community are, we conducted a systematic review and meta-analysis, to summarise the current literature. We found mixed results, highlighting that no recommendatiosn for home based interventions can be made. This identified a gap in clinical practice to meet the unmet need of this popualtion. The full paper has been published here.

Gardner et al. (2017): Which intervention components contribute to intervention effects in home-based health behaviour change interventions for frail older people?

To help with the development of the HomeHealth intervention we conducted an exploratory systematic review of the literature. The aim of this was to identify which content within home-based interventions for older adults with frailty helped them to remain independent and prevent falls in the home. Some components were identified, but the underlying mechanisms were not clear. The protocol and results papers have been published. 

 Drennan et al. (2018): To what extent does policy in England address the needs of older, frail adults to support independence?

The final review of the development phase looked at what the current health and social care policy documents and systems recommended for health promotion in older adults with mild frailty. Despite the specific needs of this population, we found a lack of policy attention for this population of older adults with mild frailty, highlighting a missed opportunity for intervention and prevention to reduce pressures on health and social care services. Again, the full results can be found here

Frost et al. (2017): What are the barriers and facilitators for older adults to engagement with new home-based health promotion services?

Once we had searched the literature and identified these important components, we then conducted interviews with mildly frail older adults, their carers and community health and social care professionals to identify the barriers and facilitators to engaging with home-based health promotion services. The key factors identified were transportation, knowledge of local services, social support, acceptance of limitations, and motivation. Full results can be found in this published paper. 

Together these projects were used to help develop the HomeHealth intervention to help mildly frail older adults maintain their indpendence and improve their wellbeing through information, motivation, and psychological and practical support. 

Walters et al. (2017): What is the feasibility and acceptability of a new home-based health promotion for older people with mild frailty (HomeHealth)?

Following the developement of the HomeHealth intervention, it was pilotted in a feasibility study, to determine the acceptability and potential effectiveness of the intervention. In this pilot study 51 participants were randomised into the control group (treatment as usual) or to receive the HomeHealth intervention. Intervention participants received 3-6 sessions with a support worker to help with goal setting, problem solving, feedback and habit formation. We found that the intervention was acceptable and significant improvement in functioning, grip strength, and psychological distress. The full report of the feasibility study can be accessed here.

Avgerinou et al. (2019): How do mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach?

Within the feasibility study, we conducted some interviews with participants who received the intervention and the staff who delivered it, to understand what people engaged well with and what could be improved. We found three themes, 1) factors affecting choice of goal, 2) factors affecting engagement with behaviour change, and 3) preceptions of goal settins and behaviour change. The results can be found here and helped to refine the intervention before rolling it out in a national clinical trial. 

Frost et al. (2020): How should health promoting interventions for frail older adults be adapted to be delivered remotely during the COVID-19 pandemic?

Following the feasibility study in 2018, we were due to roll out the intervention a national clinical trial in 2020. However, the COVID-19 pandemic put the study on pause. To help us adapt to a changing world and meet the needs of older frailer adults, we conducted another review to identify how we could adapt the intervention to be delivered remotely. We found that whilst effective results can be translated to interventions being delivered remotely, it was important to ensure that those without access to digital technology were not left behind. Full results here. 

Walters et al. (2020): How effective is the HomeHealth intervention on maintaining independence in older people with mild frailty? A Randomised Controlled Trial

We have now completed the data collection for the randomised controlled trial and are due to find out the results in November 2023. Following this, we will be publishing our results, so please check back here for updates, to find out the clinical and cost-effectiveness of the intervention, as well as our plans for rolling out the service nationally.

In the meantime, for more information about the trial please reas the published study protocol.