Evaluating the feasibility and acceptability of a community-based intervention on nutrition, health, wellbeing and social engagement in older adults – the LEMONADE study protocol. v1

Introduction: Older adults living in socially deprived circumstances experience poor health with adverse effects on their quality of life. Community-based interventions focused on food have been proposed to address some of these challenges. Despite the beneficial effects, a limited number of studies have examined the feasibility and acceptability of these interventions, and there is a paucity of data on objective, measurable outcomes. This study aims to determine the feasibility and acceptability of a co-produced community-based intervention on nutrition, health, wellbeing and social engagement with older adults. Methods and analysis: The LEMONADE (An incLusivE coMmunity fOod model for health wellbeiNg and sociAl connectedness of olDer pEople) will use community-based participatory research and mixed-methods to co-produce and examine the feasibility and acceptability of a community-based intervention to improve the health and wellbeing of older adults aged ≥60 years. A pre-post study design will be used, and the primary outcome is the feasibility and acceptability of implementing the intervention. This will be assessed using participant recruitment and retention rates, the number of sessions delivered and completed by participants and the acceptability of intervention activities and evaluation methods. Secondary outcomes will include health-related quality of life measured using the EuroQol EQ-5D-5L, dietary intake using Myfood24, Physical Activity Scale for the Elderly (PASE) for physical activity, Social Engagement and Activities Questionnaire (SEAQ) for social engagement and the Age-Friendly Cities and Communities Questionnaire (AFCCQ) to measure ageing friendliness of the community. Objective measures will include blood pressure and body composition. Outcomes will be measured at baseline and at 12 weeks. Qualitative data collected using Photovoice will provide insights into participants’ experiences of the intervention. Participants’ characteristics and measures of feasibility will be analysed using descriptive statistics. The effects of the intervention will be analysed using Parametric or non-parametric equivalent for continuous variables and chi-square statistics for categorical variables. Qualitative data will be analysed using both deductive and inductive thematic analysis. Ethics and dissemination: Ethical approval has been obtained in line with the Bournemouth University Research Ethics Committee Code of Practice (Ethics ID: 51979). Informed consent will be obtained from participants prior to enrolment in the intervention. Study findings will be shared with a wide range of stakeholders, including participants, community organisations, policymakers and housing organisations through exhibitions, practice events and conferences. Trial registration number: ISRCTN10147817 (https://doi.org/10.1186/ISRCTN10147817). Strengths and limitations of this study - This is a novel study exploring a co-produced approach to co-creation and implementing a community-based intervention with older adults. - It addresses issues with social isolation, poor quality of life and health in older adults living in an inner-city area. - A mixed-methods approach will be used to document the impact and co-produce a practical toolkit for future implementation. - The exclusion of older adults who lack capacity to consent or to participate limit the generalisability of this study.