title: Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol.
abstract: BACKGROUND
  Meeting the needs of the growing number of older people is a challenge for health and social care services. Home-based interventions aiming to modify health-related behaviours of frail older people have the potential to improve functioning and well-being. Previous reviews have focused on whether such interventions are effective, rather than what might make them effective. Recent advances in behavioural science make possible the identification of potential 'active ingredients' of effective interventions, such as component behaviour change techniques (BCTs), and intended intervention functions (IFs; e.g. to educate, to impart skills). This paper reports a protocol for a systematic review that seeks to (a) identify health behaviour change interventions for older frail people, (b) describe the content of these interventions, and (c) explore links between intervention content and effectiveness. The protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 guidelines.
  
  
  METHODS
  Studies will be identified through a systematic search of 15 electronic databases, supplemented by citation tracking. Studies will be retained for review where they report randomised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community settings, written in English, and either published from 1980 onwards, or, for registered trials only, unpublished but completed with results obtainable from authors. Interventions will be coded for their content (BCTs, IFs) and for evidence of effectiveness (outcome data relating to behavioural and health outcomes). Analyses will describe characteristics of all interventions. Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence. The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness.
  
  
  CONCLUSIONS
  Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people, and highlight those more associated with positive changes in behaviour and health. Findings from this review will provide a useful basis for understanding, developing, and implementing behaviour change interventions in this field.
  
  
  BACKGROUND
  PROSPERO CRD42014010370.
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. ajovicic91@googlemail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Jovicic
authors.affiliation: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK. benjamin.gardner@kcl.ac.uk.|UCL Centre for Behaviour Change, University College London, London, UK. benjamin.gardner@kcl.ac.uk.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gardner
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. c.belk@ucl.ac.uk.
authors.forename: Celia
authors.initials: C
authors.lastname: Belk
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. k.kharicha@ucl.ac.uk.
authors.forename: Kalpa
authors.initials: K
authors.lastname: Kharicha
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. s.iliffe@ucl.ac.uk.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Social Care Workforce Research Unit, King's College London, London, UK. jill.manthorpe@kcl.ac.uk.
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.affiliation: Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK. c.goodman@herts.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Goodman
authors.affiliation: Centre for Health and Social Care Research, St George's, University of London, London, UK. v.drennan@sgul.kingston.ac.uk.
authors.forename: Vari
authors.initials: V
authors.lastname: Drennan
authors.affiliation: Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. k.walters@ucl.ac.uk.
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
mesh_terms: D000368:Aged; D016330:Frail Elderly; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D012107:Research Design; D000078202:Systematic Reviews as Topic