title: Active Residents in Care Homes (ARCH): study protocol to investigate the implementation and outcomes of a whole-systems activity programme in residential care homes for older people.
abstract: OBJECTIVE
  To evaluate the effectiveness, acceptability and costs of Active Residents in Care Homes, ARCH - a programme aiming to increase opportunities for activity in older care home residents.
  
  
  METHODS
  Feasibility study.
  
  
  METHODS
  Residential care homes for older people.
  
  
  METHODS
  10-15 residents, staff and family members will be recruited in each of the three participating care homes.
  
  
  METHODS
  ARCH is a 12-month 'whole-systems' programme implemented by occupational therapists and physiotherapists. They will conduct a comprehensive assessment of each care home, considering the physical environment, working practices and organisation structure as well as residents' individual needs, and recommend ways to address barriers and increase residents' activity levels. The therapists will then work with staff to improve understanding of the issues, instigate training, environmental, organisational and working practice changes as necessary.
  
  
  METHODS
  Residents' activity levels, health and quality of life will be tested using several measures to see which are practicable and appropriate for this population in this context. This includes: Assessment of Physical Activity in Frail Older People; Pool Activity Level Checklist; Dementia Care Mapping observations; and EQ-5D-5L. Residents will be assessed prior to programme implementation then 4- and 12-months post-implementation. Semi-structured interviews will explore the experiences of residents, staff, family members and therapists.
  
  
  CONCLUSIONS
  Providing evidence of effectiveness and acceptability of ARCH, and documenting factors that impede/facilitate implementation will help us identify ways to enhance the care and quality of life of older people in residential care, and our understanding of how to implement them.
  
  
  BACKGROUND
  ISRCTN24000891.
authors.affiliation: Faculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, UK. Electronic address: Sian.Koskela@sgul.kingston.ac.uk.
authors.forename: Sian A
authors.initials: SA
authors.lastname: Koskela
authors.affiliation: Faculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Jones
authors.affiliation: Faculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, UK.
authors.forename: Natasha
authors.initials: N
authors.lastname: Clarke
authors.affiliation: Integrated Falls and Bone Health Service, St George's Healthcare NHS Trust, London, UK.
authors.forename: Liezl
authors.initials: L
authors.lastname: Anderson
authors.affiliation: Integrated Falls and Bone Health Service, St George's Healthcare NHS Trust, London, UK.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kennedy
authors.affiliation: Faculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Grant
authors.affiliation: School of Economics, University of Surrey, Guildford, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Gage
authors.affiliation: Faculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, UK.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Hurley
mesh_terms: D000368:Aged; D004777:Environment; D015444:Exercise; D006293:Health Promotion / Q000458:organization & administration*; D006304:Health Status; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration*; D009788:Occupational Therapy / Q000458:organization & administration*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012107:Research Design; D006113:United Kingdom
keywords: Activity; Older people; Quality of life; Residential care homes; Whole-systems programme