title: INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness.
abstract: BACKGROUND
  For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT).
  
  
  METHODS
  The INSPIRE study will be conducted within the Medical Research Council (MRC) Framework for the Evaluation of Complex Interventions (Phases 0-2) and includes an exploratory two-arm delayed intervention randomised controlled trial. Eighty patients and/or their carers will be randomly allocated to one of two groups: (I) Intervention: GNP in addition to standard care or (II) Control: Standard Care. Recipients of the GNP will be asked for their views on participating in both the study and the intervention. Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before, during and after the intervention. The primary outcome is the effect of the intervention on social and practical need. Secondary outcomes are quality of life, loneliness, social support, social capital, unscheduled health service utilisation, caregiver burden, adverse impacts, and satisfaction with intervention. Volunteers engaged in the GNP will also be assessed in terms of their death anxiety, death self efficacy, self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers.
  
  
  CONCLUSIONS
  The INSPIRE study addresses an important knowledge gap, providing evidence on the efficacy, utility and acceptability of a unique model of social and practical support for people living at home, with advanced life-limiting illness. The findings will be important in informing the development (and evaluation) of similar service models and policy elsewhere both nationally and internationally.
  
  
  BACKGROUND
  ISRCTN18400594 18(th) February 2015.
authors.affiliation: Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland. kathleen.mcloughlin@nuim.ie.|Milford Care Centre, Limerick, Ireland. kathleen.mcloughlin@nuim.ie.
authors.forename: Kathleen
authors.initials: K
authors.lastname: McLoughlin
authors.affiliation: Milford Care Centre, Limerick, Ireland. j.rhatigan@milfordcarecentre.ie.
authors.forename: Jim
authors.initials: J
authors.lastname: Rhatigan
authors.affiliation: Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland. sinead.mcgilloway@nuim.ie.
authors.forename: Sinead
authors.initials: S
authors.lastname: McGilloway
authors.affiliation: Faculty of Health Studies, University of Bradford, Bradford, UK. a.kellehear@bradford.ac.uk.
authors.forename: Allan
authors.initials: A
authors.lastname: Kellehear
authors.affiliation: Milford Care Centre, Limerick, Ireland. m.lucey@milfordcarecentre.ie.
authors.forename: Michael
authors.initials: M
authors.lastname: Lucey
authors.affiliation: Milford Care Centre, Limerick, Ireland. f.twomey@milfordcarecentre.ie.
authors.forename: Feargal
authors.initials: F
authors.lastname: Twomey
authors.affiliation: Milford Care Centre, Limerick, Ireland. m.conroy@milfordcarecentre.ie.
authors.forename: Marian
authors.initials: M
authors.lastname: Conroy
authors.affiliation: Newhealth Foundation, Sevilla, Spain. emilio.herrera@newhealthfoundation.org.
authors.forename: Emillio
authors.initials: E
authors.lastname: Herrera-Molina
authors.affiliation: Institute of Palliative Medicine, Kozhikode, Kerala, India. drsuresh.kumar@gmail.com.
authors.forename: Suresh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland. mairead.furlong@nuim.ie.
authors.forename: Mairead
authors.initials: M
authors.lastname: Furlong
authors.affiliation: Milford Care Centre, Limerick, Ireland. j.callinan@milfordcarecentre.ie.
authors.forename: Joanne
authors.initials: J
authors.lastname: Callinan
authors.affiliation: Queens University Belfast and Northern Ireland Hospice, Belfast, UK. alimaxuk@yahoo.com.
authors.forename: Max
authors.initials: M
authors.lastname: Watson
authors.affiliation: Flinders University, Adelaide, Australia. david.currow@flinders.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Currow
authors.affiliation: University of Southampton, Southampton, UK. C.D.Bailey@soton.ac.uk.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bailey
mesh_terms: D000328:Adult; D017028:Caregivers; D019058:Community Networks / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D012107:Research Design; D012111:Residence Characteristics; D012944:Social Support; D011795:Surveys and Questionnaires