Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/9231
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dc.contributor.authorEllard, DR-
dc.contributor.authorThorogood, M-
dc.contributor.authorUnderwood, M-
dc.contributor.authorSeale, C-
dc.contributor.authorTaylor, SJC-
dc.date.accessioned2014-11-25T11:30:01Z-
dc.date.available2014-01-03-
dc.date.available2014-11-25T11:30:01Z-
dc.date.issued2014-
dc.identifier.citationBMC Medicine, 12:1 (3 January 2014)en_US
dc.identifier.issn1741-7015-
dc.identifier.urihttp://bura.brunel.ac.uk/handle/2438/9231-
dc.descriptionThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_US
dc.description.abstractBackground: The 'Older People's Exercise intervention in Residential and nursing Accommodation' (OPERA) cluster randomised trial evaluated the impact of training for care home staff together with twice-weekly, physiotherapist-led exercise classes on depressive symptoms in care home residents, but found no effect. We report a process evaluation exploring potential explanations for the lack of effect.Methods: The OPERA trial included over 1,000 residents in 78 care homes in the UK. We used a mixed methods approach including quantitative data collected from all homes. In eight case study homes, we carried out repeated periods of observation and interviews with residents, care staff and managers. At the end of the intervention, we held focus groups with OPERA research staff. We reported our first findings before the trial outcome was known.Results: Homes showed large variations in activity at baseline and throughout the trial. Overall attendance rate at the group exercise sessions was low (50%). We considered two issues that might explain the negative outcome: whether the intervention changed the culture of the homes, and whether the residents engaged with the intervention. We found low levels of staff training, few home champions for the intervention and a culture that prioritised protecting residents from harm over encouraging activity. The trial team delivered 3,191 exercise groups but only 36% of participants attended at least 1 group per week and depressed residents attended significantly fewer groups than those who were not depressed. Residents were very frail and therefore most groups only included seated exercises.Conclusions: The intervention did not change the culture of the homes and, in the case study homes, activity levels did not change outside the exercise groups. Residents did not engage in the exercise groups at a sufficient level, and this was particularly true for those with depressive symptoms at baseline. The physical and mental frailty of care home residents may make it impossible to deliver a sufficiently intense exercise intervention to impact on depressive symptoms. © 2014 Ellard et al.; licensee BioMed Central Ltd.en_US
dc.description.sponsorshipThe National Institute for Health Research Health Technology Assessment programme (project 06/02/01). This project benefited from facilities funded through Birmingham Science City Translational Medicine Clinical Research and Infrastructure Trials Platform, with support from Advantage West Midlands.en_US
dc.languageeng-
dc.language.isoenen_US
dc.subjectCluster randomised controlled trialen_US
dc.subjectCulture changeen_US
dc.subjectDepressionen_US
dc.subjectElderly residential careen_US
dc.subjectExerciseen_US
dc.subjectProcess evaluationen_US
dc.titleWhole home exercise intervention for depression in older care home residents (the OPERA study): A process evaluationen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1186/1741-7015-12-1-
dc.relation.isPartOfBMC Medicine-
dc.relation.isPartOfBMC Medicine-
pubs.issue1-
pubs.issue1-
pubs.volume12-
pubs.volume12-
pubs.organisational-data/Brunel-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Business, Arts and Social Sciences-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Business, Arts and Social Sciences/Dept of Social Sciences, Media and Communications-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Business, Arts and Social Sciences/Dept of Social Sciences, Media and Communications/Sociology-
pubs.organisational-data/Brunel/Brunel Staff by Institute/Theme-
pubs.organisational-data/Brunel/Brunel Staff by Institute/Theme/Institute of Environmental, Health and Societies-
pubs.organisational-data/Brunel/Brunel Staff by Institute/Theme/Institute of Environmental, Health and Societies/Social Sciences and Health-
Appears in Collections:Sociology
Dept of Social Sciences Media and Communications Research Papers

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